Herniated Discs - My story

Bikram Yoga: Dealing with Low Back Injuries

This testimonial is the story of my personal recovery from debilitating pain from herniated discs through the practice of Bikram Yoga. This yoga gave me back my life. In the depths of my pain, I remember sitting in the car with my husband outside one of our favorite restaurants just crying. I was in so much pain, I couldn’t even imagine enduring the suffering of a nice, romantic dinner.

Those who have experienced back pain know what it does to your life. The following is my story and experience. I have included a posture-by-posture list of my personal approach to the practice for back pain-sufferers. I offer the information to help you on your way. People write me daily asking if Bikram Yoga will work for them. I am not a doctor. It worked for me. The principles work. The only way you can find out is to try. The principles that apply to herniated lumbar discs also apply to herniated cervical discs. For those of you suffering chronic pain, I also recommend reading “Healing Back Pain” by John Sarno.

My story

I injured my back in the fall of 2001, shortly after I had started practicing yoga. I had spent my youth playing sports, and most recently rugby, running and weight lifting. A lifetime of aggressive and contact sports culminated in two herniated discs in my low back at S1/L5 and L5/L4. They caused acute low back and sciatic pain radiating down to my left knee.

I was in pain constantly, even in my sleep. The pain was so acute some days that my husband had to put my shoes on my feet. It was excruciating to go to work, to rest, to sleep, to walk, to drive.

My doctor told me I had three options: live with the pain, undergo a discectomy or take cortisone shots for the rest of my life. At this point, I had begun to practice at a wonderful studio in Burlington, Vermont under Bikram Certified teachers Kelley Lyons and Amy Nietzberg. I decided see if Bikram Yoga would help first.

It was no miracle cure from the start. Classes were hard and uncomfortable. I had set backs regularly. At the time, my job only allowed me to attend 3 to 4 times a week. Some days I didn’t think I could go through the pain and challenge of a class, but I always felt better (increased range of motion, better sleep, less pain and an ability to participate in more) after attending.  

Over eighteen months, I saw slow progress. The miracle happened when I started practicing two times a day. It took me 10 days of doubles to be pain free. I kid you not. PAIN FREE. I could sit without a back support. I could roll over at night. I could put my pants on standing up.   

I kept it up for two months, resting on Sundays. I had a few set backs in the first couple of years. Under extreme stress or after moving or shoveling snow for hours in the Vermont winter, I have had times where I get sore again. Once, I threw my back out. I have found that the quicker I get back to yoga and the more classes I can take, the faster I recover.  

Now, five years out from the initial bad spell, I live a free, active life. I hike, waterski, shovel, stand on my head. There are no yoga poses that I skip or avoid. I haven’t thrown out my back in over two years. I am nine months pregnant and have experienced no back problems at all in the entire pregnancy.

I recognize that double classes are not possible for all of us. With less frequent practice, the healing (and strengthening) will simply take more time. Be patient with yourself and your students. Be strong and work hard. All you need is your body and this yoga to heal yourself.

Anatomy of Back Pain

Once a herniation, always a herniation. Intervertebral discs function to cushion the spine and absorb shock. A herniated disc is essentially a disc with a hole in it. In a herniation, the annulus fibrosis (the tough outer membrane of the disc) is breached, and the softer, inner membrane (the nucleus pulposis) extrudes. Pain occurs when the extrusion comes into contact with a nerve.

A traumatic accident or years of accumulated abuse and degeneration of the tough outer walls most commonly cause herniated discs. Recent studies report that by the age of 20, nearly all Americans have some degeneration of the lumbar discs, but not all people experience pain. Most people with painful, herniated discs have either tight hamstrings (creating downward pressure on the pelvis) and/or weak abdominal muscles. Both cause a state of nearly constant forward bending in the low spine.

The spinal nerves are located on the back side of the spine. When a person bends forward, the front of the vertebrae move closer together. This forces the disc toward the back of the spine, and the spinal nerves. Persistent, unsupported forward bending will cause or aggravate back pain from herniated discs. It is essential, especially in the beginning of healing for the student to be very cautious with forward bending. Remember that bad posture, driving, working on the computer, slumping on the couch, gardening, etc, are all forward bends.

For most people, when their low back hurts, they lean forward and touch their toes. This is exacerbating the back pain. It will sound counterintuitive to most people to backward bend when they are sore, but it is essential to make that philosophy shift. Instead of leaning forward, a back pain-sufferer should try a supported standing backbend (like the set up for camel with the hands on the low spine) throughout the day as needed. It will be hard and sometimes painful in the beginning because of the trauma-like tension in the muscles and inflammation.

That has been the hardest point for me to get my students to understand. I have watched students yank on their toes in the final stretching, skip camel, drop into child’s pose between postures and do the whole class with their gut hanging out. After years, they cannot understand why they are not healing. When they finally understand and embrace the anatomy of their back pain and try the postures the right way, they begin to live without pain.

Back pain sufferers need backward bending to strengthen and relieve pain. In a backbend, the backside of the vertebrae come together, moving the discs (and their extrusions) away from the spinal nerves, thus relieving pain. Pain relief may not be instantaneous because there is often a good deal of swelling in the area and tension in the muscles from experiencing pain. Time will help. In the beginning, do like Bikram says and “kill yourself” in backward bends. That is how you will heal yourself.

Second, it is important for those with herniated discs to begin strengthening their abdominal and back muscles. One can never heal or repair a herniated disc. The hole will always be there. The student must develop enough muscle strength to support the lower back and prevent aggravation. That means: SUCK YOUR GUT IN. Throughout the class, draw the abdominal muscles in during all postures, even backward bending. Wind-removing pose is one of very few times in class that the abdominal muscles are not contracted. When you are walking, lifting, bending, pay attention to your abdominal muscles and suck them in.

Third, spine twists are a healing movement for herniated intervertebral discs. The rotation of the vertebrae serves to draw the extruded material back into the disc. Any time the low back has been compacted or strained, a spinal twist (like the reclined abdominal twist) will help undo the damage. A student with back pain must work the spine twist in triangle as well as the final spinal.

What to do in class:

Here are the four main concepts to work on during class:

  • Easy does it in forward bending
  • Back bend like crazy
  • Suck your gut in
  • Spine twist like there is no tomorrow

The following is a list of modifications (from my experience) that may need to be made in the BEGINNING of a student’s healing process while there is a lot of inflammation in the lumbar spine and trauma in the muscles. It is important not to become dependant on these modifications. They are temporary changes to help you get through the tough times. As you are able, you will move back to the regular execution of all postures. You’ll have your head to your knee in no time!

Pranayama - Take this opportunity to drag your abdominal muscles in as much as possible. Remember that a strong belly means a strong back.

Half Moon - The side bending is helpful in relieving the tension in the muscles around the lumbar spine. Use it to help you feel less uncomfortable. Draw the belly muscles in and lift up out of the waist as you bend to the side.
Backward bend, backward bend, backward bend. Remember to keep those elbows locked so you don’t sink into your lower back. Concentrate on lifting your chest as you arch back.

Hands to Feet - Take it very easy. Try bending your knees to get your hands to the floor. If that is too much, walk your hands down your thighs instead of keeping your arms with your ears. If putting your hands on the floor is too much, bring your hands to your thighs, chin up, suck in your stomach and flatten your back. No rounding when the pain is acute. You should look like an upside-down letter L from the side.

Awkward - Great. Work the backbend in part one like it is your job. Work your abdominals throughout.

Eagle - No problems.  Again, stomach in. 

Standing Head to Knee - This one is a challenge in the beginning. If you can reach your foot, try standing up a little higher with it and sucking your abdominals in when you feel sore. If you cannot reach your foot due to pain, stand up straight and lift your thigh as high as it will go. DO NOT GRAB YOUR KNEE OR YOUR THIGH. This will put more pressure on your low back. As you are ready, contract the abdominals and begin to round forward and reach toward your foot until you can grab it. I cannot over-emphasis, DO NOT GRAB YOUR KNEE.

Standing Bow - Work it as strongly as you can, its good for you!

Balancing Stick - You may not be able to come down to parallel because your arms and torso drag on your lower back fairly intensely. If not, set it up. Step forward and stand rock solid like a statue. Belly in, of course. Over time, start to take it down inch by inch.

Standing Separate Leg Stretching - This posture may strain the low back in the beginning, but it is important to get a stretch to those tight hamstrings. Try hands to the thighs or hands to the floor in between your feet (depending on your flexibility) with a flat back, stomach in just like suggested in Hands to Feet.

Triangle - Another good one. Pay attention to your spine twist.

Standing Separate Leg Head to Knee - Similar to balancing stick, you may only be able to set it up. Step out, arms strong, belly in and turn to the side. Build the strength in your abdominal muscles and in time you will be rounding down with the best of them.

Tree - Work those abs.

Toe Stand - Test it out. Sometimes the bend forward hurts in the beginning. It is a great posture to stretch and strengthen, though, so get back to it as soon as possible.

Savasana - Many students want to bend their knees up in Savasana. Try to not. When you stretch your legs out, if your lower back is achy, dribble your knees up and down like they were basketballs. That should shake out some of the tension in your lower back muscles and relieve the cramping.

Wind-removing - The only reported problem is picking up the foot. Sometimes the pull on the front of the spine by the psoas muscles doesn’t feel good. Do what you need to do to get your leg up. Enjoy how the floor is supporting your whole spine.

Sit up - None in the beginning. Roll over and push yourself up. Over time, though, try to get back into them. They are not a permanent modification. They will help to strengthen the abs.

Cobra - Work your hardest even though it may be sore in the beginning. It is good for you.

Locust - Just do your best. It will help to strengthen your back, but your legs may feel too heavy in the beginning. Lock your legs tight. Work them off the floor as you can.

Full Locust - Go for it!         

Bow - Another good one that may feel like cramping in your low back. Work through it while respecting your limitations (and don’t baby yourself).

Fixed Firm - Tight hip flexors (psoas) will pull acutely on the low back in this one. That may be uncomfortable, but it is important to get them a good stretch. Do the best you can. Concentrate on lifting your chest once you can get to the floor. That should take some of the pressure and acute bend out of the lumbar spine. If your lower back is really crampy, try squeezing and then releasing your glutes.

Half-tortoise - Walk your hands down your thighs to come to the floor (contracting the abdominal muscles). If that is too much, skip it for a while.

Camel - Sore or not, camel is your friend. Don’t be scared. Camel is here to help. Do your best.

Rabbit - Go easy or skip in the beginning. Like half tortoise, you can walk your hands down your thighs if you need to and then set it up.

Head to Knee - Try it, but bend your knee a TON, and then just drop your head on your knee. Over time, work your heel out away from your body.

Final Stretching - Bend your knees if you need to, to get your feet. Chest up, flat back, stomach in. As you develop strength and flexibility, you will be able to bend forward with the rest of the class. ALWAYS SUPPORT YOUR LOWER BACK WITH YOUR ABDOMINALS IN ALL FORWARD BENDS.

Half Spine Twist - So, so, so good for you. Twist it out. Use your abs (it is a great strengthener for the obliques) to twist. Again, pull in on your abdominals, lift up out of your waist and rotate.

Kapalbhati - This is a great opportunity for you to develop strength in your abdomen. Work it. Enjoy it.

Keep working at it.  You don’t have to live in pain anymore.  Remember,

“Never too late, never too bad, never too old, never to sick to start from scratch all over again.” - Bikram Choudhury       

The author of this article is now the owner of a successful Bikram Yoga studio in Portsmouth, NH. You can find her on the web at www.bikramyogaportsmouth.com. Sara receives lots of emails from around the globe. Before you write, please consider these frequently asked questions:

 

Why Bikram Yoga? Bikram Yoga is the series that I used and it worked. That’s why I recommend it to my students, my friends and my family. It is a therapeutic series and has an even balance of back bending and forward bending. Bikram Certified teachers are some of the most rigorously trained teachers in the United States. All Certified Bikram teachers have attended a 500-hour, intensive training and completed a 6 month internship. Part of that training is in yoga therapy, yoga for the infirm and anatomy and physiology. All Bikram teachers are required to attend re-certification every three years.

I have herniated discs in my neck. Will Bikram Yoga help me? The same principles apply to cervical and lumbar discs.  

I live too far to study with you. Where else can I find Bikram Yoga? You can find certified teachers and Bikram Yoga studios all over the world by using the “Class Finder” at www.bikramyoga.com. If you live in an area without a Bikram studio, you can find the Bikram Beginning series in book, CD and cassette form at the same website. Questions about ordering? Use the contact information at www.bikramyoga.com.

My doctor told me not to backbend and not to twist. Will Bikram Yoga hurt me? Remember that Sara is not a doctor and does not know you as a student. If you have questions about the series, bring the Bikram Yoga book to your physical therapist to ask about the individual postures.

Can you prescribe a series of postures for me? The Bikram Yoga series is a beginner-accessible series of therapeutic postures suitable for all ages and levels of abilities. It is the series of postures that I used and worked for me, so I'd recommend them.

There is no Bikram near me, but I want to practice under a teacher at least in the beginning. What should I look for? Look for a teacher with a minimum of 500 hours of training. Remember that Registered Yoga Teachers (registered by Yoga Alliance) can have only 200 hours of training. Find out about their training in yoga therapy or anatomy and physiology. Talk with your teachers about their experience in working with back injuries. If they send you into a series of forward bends, hit the road.

In the beginning of your healing process, be cautious of practices based on vinyasa or “flow” yoga, as they include a lot of forward bending. Examples are classes called Flow, Vinyasa, Jivamukti, Power, Ashtanga or any other discipline with a lot of sun salutations or “vinyasas.”. These practices will be available to you later when you are through the acute stage of your pain.