In my 15 years of clinical practice at Vital-Balance, this subject comes up very often with patients that want to be proactive about their spinal health. The answer is, for the most part, yes. In specific cases it is not. My first advice about any physical activity that is causing actual “bad” pain, is to stop that activity immediately and consult with a health professional to determine the problem. I say “bad” because there is “good” pain with physical exertion also.
“Good” pain shows you are pushing your limits. Something that can be deceptive about some physical activity is that we feel great while performing the activity. However, over time, pain and dysfunction develop that we do not mentally connect to this activity because it does not happen at the moment we are doing it.
Yoga is an ancient practice that has many positive affects to the human mind and body. It is a great discipline to adopt for health maintenance. That being said, I have NEVER met a Yoga professional (no matter how famous and knowledgeable) that has any sort of analysis to assess each individual in order to see what poses would be good or bad for their structure. It is a one size fits all discipline/practice. This is one of two deficiencies that Yoga practitioners have failed to address over its long history.
There are probably a few reasons for this, one being that it is seen as not just a physical, but a spiritual pursuit. As we are all aware, most spiritual pursuits are very personal, based on “belief” and not open to change because they have their own “truth”. Science and evidence-based thought looks to improve and become more efficient over time. I’m writing this for those who pursue Yoga more focused on physical and mental benefits associated with all forms of disciplined movement/exercise. This is not something written to address anything related to the spiritual “belief” of Yoga. That is personal and not my concern as a clinician.
This first issue, of a one size fits all approach could be remedied with a simple physical exam and posture analysis to assess what poses would be most beneficial for each individual. It would also rule out certain poses that could actually harm an individual according to their natural structural issues. For a deeper analysis, X-ray analysis could be beneficial in specific cases, when warranted.
A brief example of what I’m describing is as follows: if a postural exam of a specific person reveals that this particular person has a marked loss of the normal lumbar lordosis (Low back curve). Often, patients like this feel a “good stretch” and momentary relief from associated low back pain if they perform poses that hyperflex the low back forward (like reaching down and touching your toes). This physical stretch/pose feels good in the moment and can make the person feel like they are doing something that is good for their low back. The problem is that this stretch/pose is actually making their low back physically worse over time.
This stretch continues to reinforce the actual structural problem by decreasing the healthy low back curve. This weakens the extensor muscles in the low back by continuously stretching them. Loss of the normal low back curve leads to neuromuscular/articular dysfunction, lumbar spine degeneration (discs, joints and ligaments) and low back pain (disability).
Therefore, specific people with a flat low back, should never perform Yoga poses that require hyperflexion of the lumbar spine. This does not mean that other Yoga poses would not be greatly beneficial to an individual with this structural issue. It only means that screening a person will allow the individual to focus their practice on poses that specifically balance their own structural issues. This, in turn, would lead to a more balanced, stable/strong and healthier physical structure which seems to be the goal of the practice of Yoga.
The more severe issue with Yoga practice comes from the poses that no one should be doing. I will use one example. There are some poses that the various branches of Yoga prescribe that no person should attempt because they provide little actual benefit as opposed to the long-term costs. These poses can be replaced by more efficient and safe moments. The most obvious being hyperflexion/compression of the cervical spine. I am describing the second, third, fifth, eighth and twelfth images below as examples:
What I’m proposing is a more “functional” approach to Yoga that moves along with the advances we have made over the centuries in the fields of biomechanics, biophysics and structural spinal models. Combining the ancient wisdom of the vast majority of the physical and mental benefits that Yoga provides, while using the advances of the above fields of knowledge to make it more focused on individual needs and individual health.