Yoga That's Safe for My Spine

An experienced physical therapist has the advice you need

In my work as a physical therapist I’m often asked by my patients about the practice of Yoga. Many of them suffer from back pain or have undergone spine surgery and want to know if Yoga would help them improve their mental and physical health. Below, is a recent question from one of my patients and my response.

yoga, meditating at sunset on the beachPatient's Question: I’m personally interested in starting Yoga. I have been working out in a gym regularly for the past 10 years and consider myself to be in pretty good shape. Unfortunately, I was involved in a car accident. My doctor prescribed a course of physical therapy to help me recover. I’m concerned about making my injury worse or setting back my recovery by working out at the gym. Would Yoga be a good way for me to exercise until I can return to my regular work out?

Answer: Yoga can help but Yoga can also injure.
Exercise is crucial for recovery and Yoga can be a gentle way to get movement back into your life. Patients benefit from Yoga for many reasons. Here’s what a regular Yoga practice may do for you:

  • Provide pain relief 
  • Improve your mind/body connection
  • Increase strength and flexibility
  • Teach relaxation and calming techniques
  • Improve your energy level
  • Stabilize your metabolism

A regular exercise plan should also include some cardio because there are huge benefits from getting the heart rate up. I prefer 'minimal joint loading' exercises, such as biking and swimming! Although pain from many types of joint injury can be managed by participating in cardiovascular exercises, Yoga’s gentle movements can be a wonderful complement to the healing process.

What’s the Best Way to Start?
There are many different types of Yoga. Most sessions typically last an hour and include breathing exercises, meditation and holding poses (sometimes called postures) that stretch and tone a variety of muscle groups.

To help my patients visualize how Yoga can benefit the spine, I use a very simple analogy:

  • Think of your spine as 2 graham crackers, with a marshmallow in between and a rubber band around the concoction. The 2 graham crackers represent the vertebral bodies of the spine, the marshmallow is the disc in between and the rubber band represents the ligament and muscles that surround them.
  • The tighter the rubber band is, the more it compresses the graham crackers and smushes the marshmallow. When a patient stretches, the “rubber band” loosens the pressure on the graham crackers and reduces the load or compression of the marshmallow. Yoga, when done properly, can similarly affect the spine.

Exercise is crucial for recovery and Yoga can be a gentle way to help you “get back on your feet.”  Yoga may help promote circulation, relaxation, strength and flexibility. Just remember that "pure plane movements" (eg, moving forward then backward) are essential until your body becomes more flexible. In other words, move carefully forward, then sideways and extremely cautiously backward.

  • Absolutely no movements that combine bending and twisting.
  • To allow the muscles to adapt and become comfortable with these movements, hold poses for at least 30 seconds without bouncing to help minimize potential injury.

Before incorporating Yoga into your workout routine, obtain your doctor or physical therapist’s approval first.

Finding a Certified Yoga Instructor
Ask your doctor and/or therapist if he/she can recommend a certified Yoga instructor; preferably someone with 500 hours of instruction. Some classes at Yoga centers are taught by teachers with 200 hours of instruction. Look for small class sizes and a teacher that closely monitors movements and poses yogis closely. It is important that the teacher be aware and make gentle adjustments or offer modifications to class participants as necessary.

Avoid: There are also weekend Yoga certification options more typically offered through large gyms— with big Yoga classes (50 people or more). A teacher with that level of experience would not be the right choice for someone recovering from injury or surgery.

Restorative Flow
There are many types of Yoga and levels of difficulty. I suggest starting off with a type known as Restorative Flow. It is just that—it restores the flow from one part of your body to another with slow and controlled movements and poses that emphasize stretch and most importantly breathing.

Go Slow, Listen to Your Body
When healing from an injury, it’s important to take it slowly. Listen to your body and let it guide you to movements that feel safe and comfortable. Don’t push beyond that for now. Talk to your instructor before class and let him/her know that you have a compromised joint (eg, spondylosis) or are recovering from injury. Ask about modifications that do not include bending and twisting combinations or “advanced” postures that may over load your joints.

For most patients/people a beginner or restorative Yoga class is best. If you are on budget (classes can cost $10 and up), consider purchasing an instructional DVD, Yoga stretch belt and block. Some DVDs offer program variations of 20 to 60 minutes and are very educational and easy to follow.

Remember: Listen to your body. "Stretch pain" is okay, "Sharp pain" is not.

Good luck and keep on moving!