Yoga for Back Pain
Yoga for Back Pain: How Gentle Yoga and Hanna Somatics Work to Relieve Back Pain and Stress
A Note from Julia…
I’ve been teaching classes in Yoga for Back Pain since 2013 when I trained with Alison Trewhela who founded Yoga for Healthy Lower Backs. I found her programme to be highly effective in helping students relieve their back pain. This effectiveness increased once I incorporated the Somatic work of Thomas Hanna (learned from Tanya Fitzpatrick in 2015). Since then, I’ve developed my own style of teaching yoga for back pain which draws on various yoga and movement disciplines, including the study of chronic pain with the Minded Institute. This article outlines the rationale behind the way I teach yoga to people with back pain. But it in no way covers the whole issue as back pain is very complex and quite unique to each individual. There is however, so much that you can do to relieve back pain with gentle yoga. The solution is not just in corrective exercise but in working with the nervous system as I explain in the article below.
The video above and right, is me on ITV’s Tonight programme teaching a Yoga for Healthy Lower Backs class and being interviewed by Dr. Oscar Duke about yoga for back pain.
Hanna Somatics, Yoga & Back Pain: How to Relieve Stress and Pain
We all know that poor posture in sitting, standing, moving and lifting, puts uncomfortable stress on the back. However, in addition to physical stressors, modern science is beginning to understand that emotional and mental stressors also contribute to the development of back pain. To fully understand your back pain, it is very helpful to learn a little about your nervous system. This will help you why yoga and somatic practices work so well to relieve back pain.
Back Pain and the Nervous System
The sensory-motor nervous system (S-MNS) governs the activation of the muscles that move our skeleton. Whereas the the autonomic nervous system (ANS) activates body processes according to external events and internal emotions. Looking at how these two parts of the nervous system work together is helpful in understanding how to identify and remove the mental and emotional stress held in the muscles, particularly muscles that flex or extend the spine.
Posture and Emotional States
If our mood is low, we tend to take on a more slumped posture (rounded shoulders and lower back). Conversely, if we feel under threat we tend to tense up and take on a more arched and upright posture. These two responses are known as red light reflex (slump) and green light reflex (arched) in Hanna Somatics. When the reflexes are repeatedly activated they become embedded in our posture. Osteopaths, Bodyworkers and Physiotherapists see these postures frequently. They call them “upper cross syndrome” (red light) and “lower cross syndrome” (green light).
Power Posing – Posture and Resilience
Research in the field of psychology has shown that if we consciously change how we hold our posture (this research focussed on consciously coming out of the red light or upper cross syndrome posture) we can help to lift and improve our mood. Here is the latest research paper on the subject. However, you’ll probably find it more inspiring and interesting to listen to the lead researcher, Amy Cuddy’s inspiring TED talk here.
What is a Reflex?
A reflex is a medical term, it can be described as “ any particular automatic response mediated by the nervous system. A reflex is built into the nervous system and does not need the intervention of conscious thought to take effect.”(1) (my italics). The red light reflex is connected to a developmental reflex known medically as the Moro Reflex. The green light reflex is connected to a developmental reflex known as the Landau reflex. The medical profession considers these reflexes as relevent only when considering baby and child development, such as learning and motor skills. Thomas Hanna puts forward that activation of these reflexes in adults contributes to postural problems, muscular inbalances and pain.
Source (1) : [https://medical-dictionary.thefreedictionary.com/reflex]
Red Light Reflex (Hanna Somatics)
Our bodies respond to the experiences of illness, pain, grief, defeat or terror by curling up and protecting the vulnerable organs at the front. We might also withdraw, go quiet, feel shut down or blank. We may, or may not, be aware that we are responding in this way. This reflex was useful at an earlier stage of our evolution. It enabled humans to curl up and freeze or play dead when hiding from predators. The (ANS) response associated with this reflex is called shutdown (or dorsal vagal activation, in Steven Porges’ Polyvagal Theory). This mode of the autonomic nervous system preserves the vial organs and limits blood supply to muscles. This helped to conserve bodily resources when ancient humans or their loved ones were in grave danger (severe injury, famine or sickness).
Slumping and Back Pain (Red Light)
When the red light reflex is unconsciously triggered we then tend to slump, the spine becomes more rounded (kyphosis). Slumping in our standing, seated or moving posture compresses the intervertebral discs and also the organs within our body. It also adversely affects our breathing and mood. Slumping creates problems for the pelvic floor, deep abdominal, multifidus and neck muscles. In the yoga for back pain classes we’ll work to strengthen the back and pelvic floor muscles so that it becomes easier not to slump.
Green Light Reflex (Hanna Somatics)
Our body responds to feeling threatened, judged or attacked by inflating the chest to get more air into the body to feed the muscles with oxygen. We lift our head to scan for threats and increase muscle tone to prepare to defend ourselves. Again, we might not be aware of the event, thought or emotion that has triggered this reflex, it can be bubbling just under the surface of our consciousness. This reflex is associated with the sympathetic nervous system which galvanises the body’s resources to fight or flight. Again we can see the benefit of this reflex when we lived in the wild and were not at the top of the predator chain.
Tightness in the Lower Back (Green Light)
When green light reflex is triggered we overtighten the lower back muscles, over time this can cause a lordosis (over-arched lower back). It might seem, to the untrained eye, that we are in a fairly good posture, as we can appear more upright. However, when we are holding too much tension, the body signals pain. Chronic activation of this reflex leads to the deep hip flexor muscles (called the psoas) becoming too short and tight. These muscles are well-known amongst bodyworkers for storing the stress of past or recent shock, fright or trauma. There are a few excellent ways of working with the psoas muscles in a gentle yet powerful way, that we explore in the yoga for back pain courses.
Ancient Reflexes – Modern Times
Although the reflexes are beneficial for humans with hunter-gather lifestyles, they are poorly suited to modern humans. Our nervous systems have not caught up with these fast-paced, information-dense times. These days when we are bombarded with ideas, stories and events that are often not actually happening to us in the moment, these reflexes can be problematic. The reflexes are still triggered each time we sense or even imagine threat or grave danger (emotionally, physically, socially, financially, environmentally or vicariously through our tv screens).
How Stress Gets Stored as Muscular Tension
An imagined event (an anxious thought, a disturbing scene in a film, an upsetting social media post) is almost as impactful on our nervous system as if it was really happening to us. Therefore, the reflexes are triggered much more frequently in modern times than they would have been in the past, when we were exposed to much less information. Most of the time these bodily responses go unnoticed, but the effect of them builds up over time. This is how stress gets stored as muscular tension. This tension has a knock-on effect on the muscles and joints of the spine and leads to back pain. Regular practice of somatics and yoga for back pain leads to an understanding of where we are holding tension and the ability to release it.
Making the Unconscious Conscious
We can gain more control over our stress responses (red light and green light reflexes) if we learn to become more conscious of how we are feeling moment to moment. The fifth limb of the Patanjali’s Eight Limb’s of Yoga is pratyahara translated as withdrawal of the senses inwards). The modern term for this is interoception, it is similar to the practice of mindfulness in the Buddhist tradition. As we turn the mind inwards we start to notice what is going on in our muscles and tissues, more clearly. As we get used to engaging this internal kinaesthetic awareness we have a chance to become more aware of the reflexes that are being activated under the surface of our consciousness. In yoga for back pain classes we learn to cultivate pratyahara in breathing, relaxation, yoga and somatic practices.The practices we do on our mat in the yoga for back pain classes enable us to have more awareness of our body’s responses and reflexes in our everyday lives.
Unwind Tension in the Back with Deep Rest
In addition to yoga and somatic movement practice, creating time to consciously rest, (using the techniques of yoga nidra, deep relaxation or body scan) helps us to find a more neutral baseline for our nervous system. In yoga for back pain classes we engage in the process of finding the middle way between collapse/shutdown and fight/flight. This sweet spot (known as the ventral vagal state) is where we feel calm and relaxed whilst enjoying social engagement. True peace is actually an active state of connection, community, warmth and loving-kindness. If we practice deep rest, we’ll find our way to being more comfortable and relaxed in any situation. Try it right now by clicking on the video link here ->
Developing Awareness Through Rest
Resting is a key component of yoga for back pain. Skipping this practice of rest is often the reason that people don’t get the results they’d like out of the back care courses. If there was one practice to recommend for back care it would be diaphragmatic breathing in an appopripriate resting position. When we have an established practice of rest, we become more aware when we move out of this more neutral state and into stress. We become more sensitive to our reflexes and responses to stress. We become more conscious of them. Do we tense at the sound of a doorbell ringing? Do we subtly slump (red light) at the sight of another huge pile of laundry? Or tense (green light) as we listen to the news? It is impossible to notice these responses if we don’t have a regular practice of finding our baseline of safety and calm. Noticing these responses is a sign of becoming more consciously aware.
Is Stress Your “New Normal”?
If we reside constantly in a state of stress, this is our baseline, our normal state. In this stressed state is harder to discern the action of the reflexes, unless they are more extreme and cannot be ignored. We might not even realise that we need to take action until the stress starts to manifest as pain or exhaustion, insomnia, anxiety or another stress-related illness. Being in a state of stress is hard work. Holding tension in the muscles of the body is exhausting. One of the many benefits people find from practice yoga for back pain, is the increase in energy levels, the tension release allow precious energy of the body to be used in other ways. It’s not just the muscles that take the strain of stress. Constantly being in “fight or flight mode” can eventually take a toll on the digestive, immune, circulatory and respiratory systems. We ignore the body’s call for deep rest at our peril.Taking at least 15 minutes rest once or twice a day is enormously beneficial for one’s over all health as well as providing relief for back pain sufferers.
Sensory Motor Amnesia, Muscle Tension and Stress
Once the stress builds up in the body it locks us into the posture of red light or green light. The muscles around the spine hold the tension, guarding against the subconscious real or imagined threats. This tension is thought to restrict oxygen flow to the muscles, which is signaled as a dull aching sensation. The muscles don’t “know” that the threat was never real. Similarly, if the threat was not brought fully to consciousness, the muscles don’t “know” that the threat has passed. Hence the muscles don’t know when to switch off the tension. So they keep holding on. This causes a condition Thomas Hanna called sensory-motor amnesia. The muscles get stuck in their tense place and the brain no longer communicates with them as well through the sensory-motor nervous system. This is how most of us get stuck in an uncomfortable posture of red light or green light (or sometimes a combination of the two).
Creating Safety – Relief for Back Pain
If we don’t consciously create a situation in which the nervous system can feel safe, the muscles will continue to hold on, creating layers of tension and pain. By creating a comfortable calm state of mind and putting our full attention on the tight muscles, we can create the conditions for them to release. Thomas Hanna discovered a technique called pandiculation, that enables us to identify and release sensory-motor amnesia. This technique enables the muscles to come back “online”, as the sensory-motor nerve pathways from the brain to muscle fibres become clearer and stronger.
By tensing a muscle and then slowly releasing it (similar to a cat stretching after a nap) we can clear the held tension in the muscles’ fibres and reset their resting tension. Sometimes the fibres are held too short struggle to release; sometimes they are too long and struggle to engage. In both instances, there is a disconnect between brain and muscle fibre through the sensory nerves (that tell the brain what the muscles are feeling and doing) and the motor nerves (that instigate movement in the muscles).
Benefits of Hanna Somatics Practice
By really focussing on the engagement and release of the muscle fibres we can bring back fine motor control. This enables us to release the unconsciously held tension in the lower back muscles and therefore they no longer have to signal pain. The short-term effect of this is a reduction of discomfort, more mobility an increase in energy, an uplift in mood. After continued practice, we can experience a sense of mastery over the unconscious triggering of the reflexes in response to stress, which helps us to become more resilient to future stresses. In addition, by unwinding the tension of the reflexes we are able to keep an upright posture through our elder years… Thomas Hanna devotes a whole section in his book on Somatics to “The Myth of Aging”. Such is the profound and wide-ranging benefit of regular practice of Hanna Somatics and gentle yoga.