injury to lower back – help

[romymuz]

#1983

Hi Gabrielle,

initially i had this posted in the lower back forum, but it might be better here, with some extra developments since my last post.

I have done Bikram yoga for about 4 months now and truly love it. I’m naturally quite flexible (hypermobile joints my physio days), fit and strong, could do pretty much all the postures straight from the start. Good core strengths too, in any case i can see my abs in the mirror if that counts for anything.

However, about two weeks ago i started noticing pain in my lower back/ sacrum area during savasana, and a ‘weird’ feeling during half moon. During the last few classes I felt so instable in the side and back bends that I frequently fell out of them – very odd, as I always had pretty good balance. Also in standing bow, i noticed ever increasing tightness in my lower back, and fell out more and more often. I should have listened to those warning signs, but didn’t…

Instead I pushed through it mostly, and separated my feet during savasana to alleviate the pain a bit. In the last class half moon was extremely uncomfortable, and in triangle i heard a loud pop in my left sacrum area (no pain), after which i could bring my hip way further forward and felt like a big break-through in the posture. The rest of the class i felt very unstable and kinda wobbly inside but finished and didn’t think much of it. The next day i could hardly get out of bed because of intense shooting pain in my lower back whenever i moved. even resting, there was still a deep ache strong enough to keep my from sleeping the next night. Went to the chiropractor the next day, and after adjustment the shooting pain has become gradually less intense, but still very achy and impossible to lie flat on my back with legs straight out front. Still a lot of pain when coughing or sneezing. When i sit in an armchair it helps to have my knees splayed out with feet touching in front, otherwise not much relief.

Now (5 days after injury), the achiness has subsided quite a lot, but I’m still very uncomfortable. And there is one spot on my spine (pretty much behind my navel)that, if touched with even light pressure, with give me an electric shock down the side of my leg into the outside of my knee, with phenomenal pain exploding into my back, that actually makes me see white bursting fireworks for a second. I’ve never had this sort of thing happen before and am a bit worried…

Would love to know what it could be and what i can do to make it better. My chiro advised to avoid yoga for at least 3-4 weeks argh!!

Thanks heaps
Romy

[Gabrielle (The Hot Yoga Doctor)]

#7935

Hi Romy

Thanks for the update on your other post. If your problem is being exacerbated by less than optimal technique then the rest will help but then when you go back to yoga it’s possible that you’ll create the same problems again.

In Half Moon: When you say you feel weird, what further distinctions can you offer? Would that be a feeling on one side of your spine only? Is it close into the spine or nearer the hip? If it’s sore on one side of your spine for the first side of the pose, does it reverse for the second side? More info please.

In Backbend: sometimes the anticipation of pain or discomfort can cause you to be overly cautious. That’s one thing to consider. However if it’s related to your issue then for a while, until we work this out, set up, drop your head, keep your legs strong and just take your arms back a little. In effect just do a tiny backbend.

In Standing Bow: Is this tightness one sided on the back (same sort of questions as for Half Moon).

I would like you to go and check out the video Opening Up Your Hamstrings With Hot Yoga. Come back and tell me whether you think you’ve been rounding your back in an effort to have your legs straight. And if you have, try the technique I suggest.

Your new information about the nervous issue (electric shocks or lancinating pain) certainly should worry you and definitely means to me that you can modify your approach to help you.

Try the above and come back. See whether it feels better in your body. If you’ve got hypermobile joints then it can be hard to build strength and go against your natural inclination to take the poses as far as you probably already do.

Be careful and mindful and enjoy your practice while you’re at it. Don’t be concerned about depth and please stop if something’s not right. Reassess, report to me and then we’ll find a way.

Namaste
Gabrielle 🙂

[romymuz]

#7941

Hi Gabrielle,

Thanks for your quick reply! I think you’re right, it must be bad technique that has led to my problem. I’m so grateful that you’re here answering everybody’s questions – it’s tricky to find out by oneself what’s going wrong without knowing what to look for.

Ok, Half Moon: when I started out, I made a big mistake by going into a backbend first (following the first part of the dialogue “hips forward, upper body back” and, although getting confused about the second part “in a straight line”, still sticking with it and trying to bend sideways out of a bent back! silly), until my husband told me that that first part of the dialogue may only be for those people in class who are hunched over to begin with.
Making this modification helped and I became more comfortable in the pose. But then I went overseas and therefore had a six week break from yoga, and afterwards it all went downhill.
The “weird” feeling I referred to wasn’t pain as such, but more a general feeling that something “wasn’t right” and ever increasing stiffness in my hips. I kept falling out sideways from not being able to push my hips left/right to counterbalance. More and more frequently, my feet would creep apart in the pose, too.
When I tried to bring the bottom shoulder and the outside hip forward more, I did get some pain on one side of my spine (pretty close to it, just below waist height), and this did reverse on the other side. I wasn’t too concerned, though, as it seemed more achy than sharp.

In Backbend: again, the problem wasn’t there from the start. I have always been able to breathe ok in the backbend and never had pain in it. I don’t think I’m overly cautious either – I could go back pretty far, looking halfway down the back wall, though the teacher did tell me to move my arms further back once, which caused some mild pain when I did it. Come to think of it, this was in the first class after my holiday, which is when all the trouble seemed to start. But it could be a coincidence. Anyhow, since then I also started falling out backwards in backbend.

In Standing Bow: the tightness seems to go across my whole lower back, but lower down in the sacrum area. Another thing just occurred to me, which may or may not be important. From the outset, I have always had trouble with the left side: even just standing, holding my foot in a slight backbend would give me sharp pain in the outside of my left knee, and I couldn’t kick my heel away from my butt without causing stabs so intense I’d get a bit nauseous. I always thought it was my ITB (used to be a runner until ITB syndrome put an end to that), but now I’m thinking maybe it was the sciatic nerve. My ITB was bung on the right side, whereas the pain during class was only on the left side (also in floor bow, but not as bad as in standing)…
Thinking about it now, the location and quality of the shooting pain in bow was remarkably similar to the pain I got in my left knee from the “electric shock” brought on by touching my spine.

General technique: I always make a point of stretching up before bending in all the side and the back bends because it feels right, even if the dialogue seems to have this recommendation only in some instances. Can keep my arms locked and palms together most of the time, unless I’ve got a bad day. That being said, I feel that in the backbends my chest tends to collapse a bit into my lower back and I can’t always keep up the initial stretch upwards.

Thanks for the link to Opening Up Your Hamstrings With Hot Yoga. It was like a revelation! I have never been able to grab my heels (only the feet) in standing intense stretching pose, and now I see that my step has been MUCH too wide. I have probably been rounding my back after going down in order to reach the feet in the first place: had no idea I was allowed to bend the legs for that! Wow. That’ll make this pose so much easier. In my studio the teachers always say in this pose to “lock the knees, go down with a straight back looking forward, keep the knees locked to protect the hamstrings.” There is actually a lot of emphasis on keeping the knees locked. Is this part of the original dialogue or just my studio?

Anyhow, I will definitely try the technique you suggest when I go back – it makes a lot more sense to me. Are there any other modifications you would suggest for me to prevent re-injury?

Yes, I think the main thing I’ve learned from this is to listen to my body more and be mindful, rather than giving in to my inclination towards extremes and “pushing beyond the pain.”

Thank you so so much for your help!
Romy

[Gabrielle (The Hot Yoga Doctor)]

#7961

Hi Romy

It’s been a week. What have you got to report? I know you’re finding Paschimottanasana pose better and probably Hands to Feet because of the techniques I offered you.

What about Half Moon and Backbend and Standing Bow? Rather than launch into any different techniques an update would be better to make sure we’re moving in the right direction!

Namaste
Gabrielle 🙂

[romymuz]

#7969

Ooops, a little miscommunication here! Sorry, I should have been a bit clearer: when I said your techniques were a revelation, I meant that in a – so far – purely intellectual way. 😛 Everything you wrote makes total of sense to me, and I can’t wait to try it out. However, I haven’t actually been back to the studio, since for now I am still “forbidden” to do any yoga, or anything other than walking in fact. I’m feeling a lot better, but my chiropractor suggested strongly that I give my body at least 3-4 weeks to heal in order to avoid re-injury.

So I have only been doing some very careful cobras, but no forward bends yet.

I’ll definitely let you know how I go with my first class after the break! Are there any poses you would say I should avoid completely in the beginning (i.e. the straight legged sit-ups and spine twisting seem like candidates), until my back feels 100% again, or do you think I should be fine as long as i go really easy and heed your advice on correct technique?

Thanks for checking up on me though, that’s much appreciated! 🙂

Romy

[Gabrielle (The Hot Yoga Doctor)]

#7972

Hi Romy

I don’t mind the miscommunication. If your body says it would work for you then I am happy with that! 😉

Cobras are great for your issue. I would avoid sit-ups for the moment. My manual gives you in depth instructions how to transform sit-ups from risky to helpful and strengthening. You will find some details on the forum if you don’t have my book.

I would be working on core activation. I would, while walking be working on best posture and technique too. Did you look at my free videos? There’s one on each of those subjects! Go here for Free Yoga Videos!

It’s up to you if you need to avoid the deep spinal twist. You could do a mild one instead. If you think that would work for you then let me know and I can give you some instructions.

Namaste
Gabrielle 🙂

[romymuz]

#8233

Hi Gabrielle,

finally time for an update! My injury took much longer to heal than the 3-4 weeks my chiropractor had initially guessed, and I’ve only just started going back to yoga. It’s still not 100%, and may not be for a while, but all in all I consider myself lucky – after reading how debilitating herniated disks can be for many people. You mentioned in your emails last year that you had planned one on the subject of how to do yoga with a back injury and I’m happy to wait for it, but just thought I’d share my experience so far.

I was extremely surprised to find that my yoga classes have now become easier and more enjoyable than before! And that’s even though I went back the first time quite worried, if not scared, about re-injuring myself, being singled out for modifying postures, or not being able to do it at all. But lo and behold, I breezed through the whole thing (well almost: I skipped the rabbit and the intense stretching) with a smile on my face! :cheese: I attribute that purely to your advice Gabrielle. It has helped me immensely to know that I don’t have to follow the dialogue word by word, instead paying attention to what my body tells me. Also, thanks to you, I have now lost the attitude of trying to push myself beyond my flexibility, and I don’t accept pain anymore. Somehow, this simple mental shift has allowed me to relax into the postures, with the result that I can now focus on form rather than depth and I’m sooooo much more comfortable! It’s hard to explain, but I feel a real shift in my practise. Hurrah.

As I said, I’m sitting out Rabbit at the moment. I’m also extremely careful with any forward bends, and don’t do the straight-legged sit-up (instead bending my knees and coming up with a straight back and the help of my hands) on the advice of my chiropractor. As per your recommendation, I work on my core strength using the leg raises with the basketball, and that also seems to help. I’m looking forward to any other tips in your upcoming email on yoga with a bung back! 😉

The one posture where I still seem to be stuck with pain is standing bow – perhaps you have some thoughts on that: the right side is easy-peasy now (it’s amazing how much better my balance is now that I have stopped berating myself in my head for not getting it perfect! haha), but on the left (injured) side I’m not getting anywhere. As soon as I grab my foot and position my knee next to the other, I get pain shooting down my leg into my knee and an ache at the site of the injury. It’s bearable, so I try and do at least this first part of the posture. Do you think that’s a good idea? Or is there a modification I could do to avoid that pain? It hasn’t got any better at all so far. I can’t kick back and up without significant, stabbing pain, so I have completely given up on that for now.

I get a similar ache (though much less intense) in floor bow, cobra, and spine twisting, but this seems to get little bit better each time.

As you guessed, my worries about being singled out were unfounded. I did tell the instructor before my first class back that I had injured my back and may have to do some modifications. The answer was no surprise: “Don’t modify anything! Bikram yoga is perfect!” but I think they could tell by my expression that I would do it anyhow and left me alone.

I’m still thinking about whether I should talk to them about the whole subject of pain, but I’m not sure if it would just be a waste of energy. But every time now, when I hear them talk about “good” pain, I cringe and I worry for my fellow yogis in the class. Apparently good pain is “the kind you get during the posture, but which goes away afterward” – is this really part of the dialogue? I think most people can’t tell the difference between good pain and bad pain, and there’s no way of telling during the posture whether the pain will go away afterward or not. Humph.

Anyhoo, thanks a ton for your advice and inspiration Gabrielle, you’ve made a huge difference!

Cheers
Romy

[Gabrielle (The Hot Yoga Doctor)]

#8306

Hi Romy

Thanks, I am in appreciation of your update post and your kind words. I am happy I could help you. So grateful that my work has made your life a little easier!!! Struggle is optional!

For standing bow, just hold your foot and press your knee back and avoid that excruciating pain. If that’s hard with the regular grip, grab the foot from the outside, thumb forward. This does make a difference.

If all that is too difficult on that side, why don’t you simply keep your left (kicking) leg foot on the ground and step forward on your right foot and lunge (back straight, hands on hips) and bring your left knee to the ground. You will be able to modify the depth of the stretch through that leg and hip etc when you’re down there.

Then periodically try the bow to see where you’re at.

Let me know if that makes sense, works or not, so we can try something else.

As for talking with your teachers. I leave that up to you. I’m on a crusade! 😆 It’s not easy just talking. But there are tons of people like you for whom my ideas make a difference; who flick the switch and suddenly find that their yoga is hard but enjoyable DURING class too but without that struggle (and even pain)! It’s an energetic thing. I know you know what I am talking about. It just makes it more satisfying. Thanks so much.

Namaste
Gabrielle 🙂

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