This is a very important subject for me because it holds a number of personal experiences of having, as people would say a ‘bad back’. I have always been a very active person so having a bad back seriously impinged on me as a person. First hurting my spine in my teens whilst working as a chambermaid making a bunk bed. Then again my thirties. In the 70s and 1980s the treatment for me was to put a board under your bed and just wait it out. The worst incident led to six month off work a mind numbing pain and guilt experience. I looked fine, however, I felt so sick all the time I couldn’t eat my weight dropped to 7 stone. People were also talking about having a bad back was a great way to have time off work. Obviously they had never had a bad back so I carried a lot of guilt about peoples thinking that I may have been deliberately not wanting to work so the effects for me were not just physical they also affected my family life because I couldn’t do a lot. Struggling to stand dress myself so I was extremely hard work because I was in pain and could see no end to it. Looking back I feel I was depressed, I was getting nowhere with the medical profession and because of this and the what to me felt like a long length of time, It seemed then that this could be my life from now on.
I had a lot of experience of the effects living in a household with my mother having had polio in the spine as a child and the effects this had on our family. It felt like this was happening to my family and how I missed being able to do normal family life I became fearful. I feel this helps me appreciate the other effects a problem with the spine will have. Part of which was being frightened to do any exercise in case the slipped disc slipped out again so anyone with non-specific lower back pain may have considerable fears for hurting themselves, I will need to take this factor into account when running my yoga classes.
So having talked about some of the problems surrounding difficulties I had. I am excited about embarking on the research to find out in more depth about the spine or as it is also known as the vertebral column and how to care for it. A lovely description from the Back Book by Jane Hobden and Sue tucker describes the back as “Like a the skeleton in a leaf the spine provides the back with support and flexibility. Having a strong healthy back is central to our Physical wellbeing.” Is it because we can’t see it (the spine) that we take it for granted? You don’t know how important the spine is until there is a problem The back book says back problems effect nearly one third of adults every year. Should we be teaching back care to our children so that they can better look after themselves? Yoga exercises for the young not only to care for your spine and keeping it flexible but also to help in some of the stresses they will find themselves in, in school and beyond?
In this age of cutbacks in the NHS and problems with childhood obesity don’t we owe it to ourselves to be more informed and pro-active? Couple this with an even tougher labour market where people are afraid to take time off work, women have been having babies in the staff toilets. Looking after ourselves and our spine makes perfect sense.
So let’s start in the beginning, the first structure that is formed in the womb of a baby is the spine. Everything else comes from this. So the health of the spine is crucial for us. The hips legs shoulder girdle arms head. So if your movements during the day originate in the spine then your actions are correct. Awakening the Spine In Dru Yoga we are told to visualise all our movements as beginning in the spine this is especially so of the Energy Block Release sequences especially 1 and 2 which give all the parts of the body the correct exercise which will tone strengthen and add flexibility to your body.
I will begin by describing The Spine it is not straight but has three natural curves seen from the side of the body looking like a lazy S shape. The backward curves are called kyphosis and the forward curves lordosis. These bones or vertebrae encase the important spinal cord that is approximately 17/18 inches long and fluid and the meniges 3 layers of membrane as in the brain to encase the spinal fluid this is the super highway of messages from the brain to the body for movement and for the workings of our organs. A healthy spine will have thirty three vertebrae or bones. Each one separated by a membrane called a disc comprising of the annululus fibrosis, an outer tough cartilidge binding the vertebrae together, and the inner nucleous pulposus this inner allows cushioning of the vertebrae and the brain from shocks. Each needs to be kept hydrated to work at optimum efficiency this is why drinking water is important so that the disc can maintain its elasticity to allow the spine to function correctly acting as shock absorbers for the spine when we move. Each vertebrae has a body the main weight bearing part is the foramen and a spinous process and a transverse process Lammiae these are the two small plates of bone that join in the back of the vertaebrae. Pedicles short thick bumps that project backwards. Transverse Processes these are bony projections on either side of the vertebrae where the laminae join the pedicles. Muscles and ligaments attach to the spine on the transverse processes. Facet joints these are the spinal joints, the areas of the spine where on vertebrae comes into contact with another.
Coming from the base of the head the first 7 mobile vertebrae are called the cervical the area named for the neck region each bone has a number beginning with C1 The classification correspond to the region of the neck C1 is also the vertebrae which allows the head to move in an up and downward direction this is called the Atlas followed which turn to the right or left, these are also the most delicate of the vertebrae.
Followed by the thoracic (upper back) beginning with T1 to T 12 as there are 12 mobile bones in this section They also form attachment sites for the ribs and their muscles so are not able to be as flexible. They protect the vital organs situated in the chest. Next come the Lower 5 mobile vertebrae called the Lumbar L1-5. The attachment sites for the pelvis and its muscles ligaments and nerves. This area is very common for non-specific lower back pain, Next comes the five Sacral S1-5 fused together when we are teenagers as is the Coccyx fused together so are also immobile.
The three curves also increases the strength of the spine help to maintain balance and act as shock absorbers when walking and running and also help protect the vertebrae from fracture.
This super highway of information is dispersed throughout the body by nerves coming from the intervertebral canals that exit the spinal column. These are also named to correspond to the area they come from.
The muscles and nerves that are attached to the spine. Attached to the nerves are tendons that connect muscles to the bone and assist in concentrating the extension and flexion of the muscle on bones.. Ligaments link bones together adding strength to joints. They also limit movements in certain directions. Muscles provide movements of the body and help maintain position of the body against different forces such as gravity. Helping hold the spine upright is the task of several muscle groups. Strength and flexibility is very important in all these muscle groups Dru Yoga is important in keeping the spine healthy. The transverse abdominus Lumbar Multifidus and Psoas Major.
Movement of the spine flexibility, The joints between individual vertebrae are not very flexible. However when a number work together thy give the spine a wide range of movement. Arching forwards and backwards twisting from side to side and circling around involving both these movements. It is the ligaments that are attached to the bones these are then attached to the tendons and muscles that stabilise the spine during strong movements. When the muscles are contracted the spines moves, the ligaments are elastic and the spinal column bends and twists. Gravity and our weight work against us so we need strong and flexible attachments and muscles to keep upright there are movements that we have to perform for work or carrying books to schools whilst we are still developing all these things have the potential to give us a bad back even sneezing! I know this as I did. So we all need to adopt these four rules, I wish I had known this when I was younger and I would of taught my children this to them because without a strong supple back potentially courting problems. I am going to adopt the 4 key things a trained occupational therapist advises in her book a little book about your back Think straight, think close think supple and keep moving taken from Ann McNells book A little book about your back.
The forward curve of the neck is what enables us to turn our head from side to side and looking down and upwards and the Atlas and Axis vertebrae working in tandem. The one thing I realise is that the song the knee bone is connected to… is in fact correct everything works in sequence with one another. It takes a number of vertebrae working with the ligaments and tendons and muscles to be able to move. When we want to lift or stand up it is the extensors that work found in the back and the flexors that allows us to bend. If we get overweight especially at the front we are more prone to a bad back because of the stress that extra weight puts up our bodies. This is why some pregnant women in the later stages of pregnancy have problems with their backs. The lumbar area is a place where a lot of non-specific pain occurs these are the biggest vertebrae and have the biggest load and tension put upon them they are supported by our core stability muscles that are very important in our Dru Yoga practice Referring to the need for” the deep postural muscles to be able to hold and sustain our posture in an optimum position without this it can lead to musculo skeletal pain” courtesy of my Dru Yoga manual book 1 page 13. We learnt in week one with the Dru Yoga course the importance of this engaging your core to protect your back when commencing physical exercise. These core muscles are situated around the lumbar region continuing like a sling between the legs. They are Transversus abdominis, lumbar multifidus, and pelvic floor muscles.
The transversus abdominis are the deepest of the four muscles groups having a very important stabilising role for the spine also working with the Lumbar Multifidus. When working against gravity in any way it is always contracted. It can be weak and sluggish in some people. After abdominal surgery previous back injury poor posture or sitting too much. Lumbar multifidus works with the transversus to create a strong to us and bending back. Together they create the stable corset around the centre of the body, supporting the spine so that excess strain is kept away from the joints discs and ligaments. The pelvic floor forms the base of this deep corset, made up of muscles ligaments and fascia being the sling that supports your bladder and bowel and in women the vagina and uterus. Attached at the front to the pubic bone and at the back to the coccyx. Engaging the core stability muscles keeps everything where they should be offering support to the spine and all the internal organs by doing this it helps to avoid injury and to maintain optimal skeletal health. Dru Yoga helps in achieving and maintaining optimal spinal and musculature supporting health.
There are three main sections of the spine that move a total of 24 vertebrae. These are: the cervical descending from the head, seven vertebrae in all I have already discussed C1 and C2 in the movement of the neck.
Then comes the Thoracic mid back already partly discussed there are 12 of these the main function to protect the heart and lungs which are protected by the ribs so movement in this area is limited.
Finally the low back the main function of these 5 larger lumbar vertebrae is to act as shock absorbers when lifting and carrying heavy objects and stopping shocks to the brain.
How do we maintain a healthy spine? Exercise is very important the correct exercise For me I found at the Allergy show in London 2015 Dru Yoga a form of exercise that suits my age and Tai Chi and energy work I perform. Understanding about the spine and working with the muscles the core stability and the correct position of a neutral pelvis to help maintain a healthy spine, not sitting too long, keep good posture practice the asana Tadasana which enables one to stand correctly and connect with our environment the earth and sky. Drinking water to keep the body and spinal discs hydrated They start to dry out when we are 25 so drinking water is vital. Keeping flexible working within the four rules I have just learnt from the Little book about the back think straight think close think supple and keep moving and keep walking apparently 80% of bad back can be traced back to lack of exercise walking then fits the bill courtesy again of the little book of the back and finally working on weight reduction.
Common problem of the Back that may not seem relevant but are, are caused by poor posture, tension from, grinding teeth, flat feet wearing high heels for ladies that cause the spine to go out of alignment and shorten the muscles in the legs if worn all the time not wearing shoes, then work related especially for Carers of ill and disabled people. Then we move into wear and tear caused through age and or misuse. Arthritis, Lumbago, Osteoporsis very prevalent in Western societies and number one place for this is Norway, herniated discs, sciatica, bad back associated with long haul flights driving long distances as a job for muscles Fibromeyalgia and M.E . What falls into the specific low back pain? Accidents, birth defects, pain around the tail bone caused through a fall. Fibrositis pain and stiffness in the muscles may be caused by prolonged tension, infections such as Ankylosing spondylitis inflammation of the joints between the spinal vertebrae, Coccydnia osteoporosis and osteopenia arthritis osteo and rheumatoid, herniated discs, Nonspecific low back pain, As reported in the Lancet 10/10/2016 affects all ages is a leading contributor to disease burden worldwide. Treatment guidelines Triage a very small percentage have a medical serious pathology. The management is seen as education re-assurance analgesia. On this note advice on how to lift correctly and ways of working to minimise stress on the back at home carrying shopping less weight more trips evenly divided and incorporating the 4 rules I discussed earlier. The use of ice and wrm paks At work there maybe occupational advice available as so many days are lost through bad backs back supporting chairs not sitting too long in one position getting up and having a walk around to loosen off the back etc making sure the person knows there is help and other therapies that may help Cranial Sacral Osteopathy, Reflexology. that may help like Physiotherapy, Massage, Shiatsu, Bowen, Osteopathy. Sound Therapy I have had great success with back problems over the 13 years I have been practising.
What seems to me to be missing is the prevention. Which I feel should begin on inception to school learning how to take care of our backs would save employers the N.H.S. billions and help people become more aware and in charge of themselves.
How can people with non-specific lower back pain be included into a Dru Yoga Class. Dru now run a specialist course for back pain that Yoga teachers can do as an add on. When I qualify I will do this and offer this separately for people who may be a little afraid of joining a regular class this can with their confidence built up lead into them joining a mainstream Dru class. This I believe is a great add on to do specifically focusing on back care awareness. Those who do not want to be labelled by attending such a course can still join the normal class, with adaption made to take into account the lower back That is the amazing thing that is Dru all the contra indication as well as adaptations are shown with each asana and sequence we learn. This didn’t happen when I was training with the British Wheel of Yoga another reason why I champion Dru. Just the act of being proactive and joining a class can have a huge effect on the persons they will gain as they progress in the class learning about core stability the spine the muscles the way they work, the effects stress can have on the back, EBR1 and 2 working with all the body parts and working on the koshas. The Asanas being able to actually do some exercise with a teacher who knows what they are doing so they can feel safe to dip their toes into the exercise waters. Build up, with practice, their flexibility, core strength and how to look after their spine gently encouraging it back into a healthy state. Take some of the exercises away with them to practice really feel back in control instead of out of control and depressed this will also help alleviate their fears and help them gain confidence in their own body and what they can do. Being part of a class can also help uplift ones mood too.
The great use of adaptions for all exercises and the knowledge I have gained will enable me to advise my students. In the book Dru Yoga book Stillness in Motion by Annie Jones, Anita Goswami and Chris Barrington explain that Yoga can help with dehydrated and compacted discs exercise and relaxation can be revitalised by carefully designed Yoga and relaxation programmes. A healthy spine also means a healthy body. It also means a vibrant mind too. They recommend the Bridge and The Maltese Cross and the Cobra to restore a healthy back and take the student through a wide range of movement for the spine. I also believe from my experience of self- empowerment work that the affirmations Dru use do help people move their mind set so that they come to feel more in con troll of their life. So I feel, working with affirmations to help the person readjust their thinking and the difference the person will also feel physically to a more positive view of themselves and their spine.
I will begin with introductions at every class to the Yoga students asking for any injuries strains stiffness or difficulties they may have so I can tailor the class specifically for them making sure I speak in an empowering positive way, By having this new way of the working and empowering people I feel would of benefitted me when I had these episodes, even though I have had a number of incidents with my spine really on refection I feel I did not fully appreciate the mechanics of the workings and inter-connectedness of every ligament and muscle that would help restore my health. This essay has helped me and will help me with my joined up thinking and for planning for my Yoga sessions. Beginning with the warm up this is especially so of recruiting the core muscles that will stabilise the body and spine. Beginning with the warm up giving directions for alternatives. Helping people to have fun thereby removing some of their anxieties. With reminders to engage core muscles and work within your own comfort zone as everyone is different giving alternatives and demonstrating the Dru way of keeping the arms and legs soft not over extending or overarching working with the Breath bringing in the Koshas that we are working with subtle energies not just our bodies this will I feel if they have taken any other Yoga classes differentiate from many other Yoga forms I have studied. Taking the class through the lying down exercise to recruit and find out where your core is and then explaining why we engage the core and keeping timely reminders about engaging the core which is done on an exhalation out breath. This can be demonstrated and practised with the group lying down on their backs with the knees bent It can also be practised by standing in Tadasana and saying to the group that you will feel an upliftment in your pelvic floor and for the core muscles on an out breath feel as if you are pulling your lower stomach away from your underwear . The student can safely engage these muscles and gauge for themselves their position and strength. This simple exercise would also help to highlight any sensitive areas of the spine. However simply lying on the floor may be too uncomfortable for some people this in itself would indicate possible problems with the spine and act as a starting point for future exercises. Explaining how when we sit our spine is put under x4 more pressure than standing this exercise when performed correctly with the core muscles engaged can help their posture and spinal alignment. Comparing and contrasting the information from Osteopaths in the back book and The exercise from the Little book about the back, this and (the Bridge) Setbundanasana asana Marjarisana commonly known as the cat will help to develop flexibility in the Spine practised on the knees and hands making sure the alignment points are covered hands under shoulders knees under hips The pelvis should be in a neutral position neither tipped forward or backwards there should be a natural curve in the back. The abdominal muscles should be relaxed. Keeping the pelvis and spine still, the abdominal muscles should be drawn in (below the navel) towards the spine preferably following an out breath this position should be held for ten seconds. If the pelvic floor muscles can also be contracted the intensity of the work of the Transverse Abdominus will be increased. At this point, the Lumbar Multifidus is also working although this may be more difficult to gauge. The abdominal wall should be slowly relaxed before the whole exercise is repeated. It may seem imple but very important in the participant being able to locate their core muscles.
This can also be practised standing up if there are problems getting down on the floor or back up so this also takes into account any wrist or shoulder difficulties. The Posture Tadasana also fits this comparison standing twists in DRU Tri-spinal release Backwards and Forwards bends Side extensions as done in the Energy Block Release sequence 1 the Foundation EBR of Dru . Arm wrap as done in the Eagle posture. All correspond with Dru however I feel the flow of not just the EBR1 sequence but the flow of the whole class gives a much more structured supported way of working under guidance of a qualified teacher that is able to watch for alignment points adopt these alignment practices enable the student to, as they will see it take care of their own back and feel more in control of their body. Coupled with a wonderful relaxation at the end when they can relax know that they have done a good job. Rather than trying the exercises at home after one or two sessions with a Physiotherapist and no one at their home to encourage or advise or as they may see it a watchful and qualified eye.
What adaptations would I make in a Yoga class for non-specific back pain? As a new teacher my lesson plans would always carry the alternatives as standard to take any difficulties that ay present and will take this always forward with me. I would include the exercises above to help develop a stronger core with encouragement and if more difficulties in Standing for any length of the it is possible to do the EBR1 sequence sitting from finger flicks to Spinal twists. Encourage them to work within their own body limitations obviously as time progresses with these exercises they will gain more strength and flexibility. Downward Dog can be done standing with hands on the wall. When they get stronger EBR2 The first part of this sequence is very gentle Energy sequences like salute to Druva will help with their feelings of well being as with the Earth sequence. The Tree Asana can be done against a wall for instance . A number of the exercises can be learnt and progressed through in stages the beauty and benefit of this system of Yoga. These are just some examples of the way I feel I can work with students with non-specific back pain and I am sure in the 5 Dru books remaining on my training course my in depth knowledge and understanding will increase.
Conclusion.
I believe, based on my own experience I also had a flattening of the spine curvature which meant I had great difficulty in being flexible something I feel coupled with all the other issues I have had will help me empathise with the students. When this is combined with the clients I have seen as an alternative therapist over the last fifteen years whose lives and their families have been seriously impacted by having a bad back. It cannot be over-estimated at the serious effects this can have on individuals and families I feel this will enable me to be better able to help students with ‘ bad backs’ to receive a a targeted lesson plan to help them.
However beginning by early prevention and education in Primary schools is far better than action after an injury. The NHS is overstretched seriously overstretched and on the work front million days are lost through bad backs so why are we not looking at early preventative care? Lives are badly affected because of bad backs. So surely by being proactive at an early age introducing Dru Yoga in schools and after school clubs by informing and educating young people you are giving them the information to be able to make their own choices. There needs to be a complete plan from having sought medical advice looked at various ways of being pro-active taking into account everything out there that may help using analgesia in the prescribed manner, a total plan that covers every aspect of the persons life in a structured way to help them move into optimum for them back health.
Personally for me at the age of 63 after not doing any exercise for 8 years before I started Dru. because of being a carer has made an immense change in me especially after not looking after myself physically. Dru has and is improving my back lessening the stiffness and pain and feeling more in control mentally more aware because of this, there are as I see it huge benefits in practising Dru Yoga. It is a gentle way to improve one’s care of the spine and because of this easy to tap into exercise programme also available online one can have lifelong help and guidance not only in back care but also in ways to help stress release and from my research I have discovered that stress can cause neck and back pain. So I would not hesitate to spread the word of the benefits of practising Dru Yoga. Being able to feel in control of your own life and able to help keep it in optimum condition when this is combined with a healthy eating plan and attention to ones weight so much the quality of your life will be improved. Thank you Dru.
Bibliography
Dru Teacher training course material and diagrams.
The Back Book Jane Hebden and Sue tucker with consulting Osteopath Deborah Doole
A Little book about your back Ann Mcnell
The Lancet Journal Oct 2016 Edition.
Stillness in Motion Annie Jones, Anita Goswami and Chris Barrington.
I had a lot of experience of the effects living in a household with my mother having had polio in the spine as a child and the effects this had on our family. It felt like this was happening to my family and how I missed being able to do normal family life I became fearful. I feel this helps me appreciate the other effects a problem with the spine will have. Part of which was being frightened to do any exercise in case the slipped disc slipped out again so anyone with non-specific lower back pain may have considerable fears for hurting themselves, I will need to take this factor into account when running my yoga classes.
So having talked about some of the problems surrounding difficulties I had. I am excited about embarking on the research to find out in more depth about the spine or as it is also known as the vertebral column and how to care for it. A lovely description from the Back Book by Jane Hobden and Sue tucker describes the back as “Like a the skeleton in a leaf the spine provides the back with support and flexibility. Having a strong healthy back is central to our Physical wellbeing.” Is it because we can’t see it (the spine) that we take it for granted? You don’t know how important the spine is until there is a problem The back book says back problems effect nearly one third of adults every year. Should we be teaching back care to our children so that they can better look after themselves? Yoga exercises for the young not only to care for your spine and keeping it flexible but also to help in some of the stresses they will find themselves in, in school and beyond?
In this age of cutbacks in the NHS and problems with childhood obesity don’t we owe it to ourselves to be more informed and pro-active? Couple this with an even tougher labour market where people are afraid to take time off work, women have been having babies in the staff toilets. Looking after ourselves and our spine makes perfect sense.
So let’s start in the beginning, the first structure that is formed in the womb of a baby is the spine. Everything else comes from this. So the health of the spine is crucial for us. The hips legs shoulder girdle arms head. So if your movements during the day originate in the spine then your actions are correct. Awakening the Spine In Dru Yoga we are told to visualise all our movements as beginning in the spine this is especially so of the Energy Block Release sequences especially 1 and 2 which give all the parts of the body the correct exercise which will tone strengthen and add flexibility to your body.
I will begin by describing The Spine it is not straight but has three natural curves seen from the side of the body looking like a lazy S shape. The backward curves are called kyphosis and the forward curves lordosis. These bones or vertebrae encase the important spinal cord that is approximately 17/18 inches long and fluid and the meniges 3 layers of membrane as in the brain to encase the spinal fluid this is the super highway of messages from the brain to the body for movement and for the workings of our organs. A healthy spine will have thirty three vertebrae or bones. Each one separated by a membrane called a disc comprising of the annululus fibrosis, an outer tough cartilidge binding the vertebrae together, and the inner nucleous pulposus this inner allows cushioning of the vertebrae and the brain from shocks. Each needs to be kept hydrated to work at optimum efficiency this is why drinking water is important so that the disc can maintain its elasticity to allow the spine to function correctly acting as shock absorbers for the spine when we move. Each vertebrae has a body the main weight bearing part is the foramen and a spinous process and a transverse process Lammiae these are the two small plates of bone that join in the back of the vertaebrae. Pedicles short thick bumps that project backwards. Transverse Processes these are bony projections on either side of the vertebrae where the laminae join the pedicles. Muscles and ligaments attach to the spine on the transverse processes. Facet joints these are the spinal joints, the areas of the spine where on vertebrae comes into contact with another.
Coming from the base of the head the first 7 mobile vertebrae are called the cervical the area named for the neck region each bone has a number beginning with C1 The classification correspond to the region of the neck C1 is also the vertebrae which allows the head to move in an up and downward direction this is called the Atlas followed which turn to the right or left, these are also the most delicate of the vertebrae.
Followed by the thoracic (upper back) beginning with T1 to T 12 as there are 12 mobile bones in this section They also form attachment sites for the ribs and their muscles so are not able to be as flexible. They protect the vital organs situated in the chest. Next come the Lower 5 mobile vertebrae called the Lumbar L1-5. The attachment sites for the pelvis and its muscles ligaments and nerves. This area is very common for non-specific lower back pain, Next comes the five Sacral S1-5 fused together when we are teenagers as is the Coccyx fused together so are also immobile.
The three curves also increases the strength of the spine help to maintain balance and act as shock absorbers when walking and running and also help protect the vertebrae from fracture.
This super highway of information is dispersed throughout the body by nerves coming from the intervertebral canals that exit the spinal column. These are also named to correspond to the area they come from.
The muscles and nerves that are attached to the spine. Attached to the nerves are tendons that connect muscles to the bone and assist in concentrating the extension and flexion of the muscle on bones.. Ligaments link bones together adding strength to joints. They also limit movements in certain directions. Muscles provide movements of the body and help maintain position of the body against different forces such as gravity. Helping hold the spine upright is the task of several muscle groups. Strength and flexibility is very important in all these muscle groups Dru Yoga is important in keeping the spine healthy. The transverse abdominus Lumbar Multifidus and Psoas Major.
Movement of the spine flexibility, The joints between individual vertebrae are not very flexible. However when a number work together thy give the spine a wide range of movement. Arching forwards and backwards twisting from side to side and circling around involving both these movements. It is the ligaments that are attached to the bones these are then attached to the tendons and muscles that stabilise the spine during strong movements. When the muscles are contracted the spines moves, the ligaments are elastic and the spinal column bends and twists. Gravity and our weight work against us so we need strong and flexible attachments and muscles to keep upright there are movements that we have to perform for work or carrying books to schools whilst we are still developing all these things have the potential to give us a bad back even sneezing! I know this as I did. So we all need to adopt these four rules, I wish I had known this when I was younger and I would of taught my children this to them because without a strong supple back potentially courting problems. I am going to adopt the 4 key things a trained occupational therapist advises in her book a little book about your back Think straight, think close think supple and keep moving taken from Ann McNells book A little book about your back.
The forward curve of the neck is what enables us to turn our head from side to side and looking down and upwards and the Atlas and Axis vertebrae working in tandem. The one thing I realise is that the song the knee bone is connected to… is in fact correct everything works in sequence with one another. It takes a number of vertebrae working with the ligaments and tendons and muscles to be able to move. When we want to lift or stand up it is the extensors that work found in the back and the flexors that allows us to bend. If we get overweight especially at the front we are more prone to a bad back because of the stress that extra weight puts up our bodies. This is why some pregnant women in the later stages of pregnancy have problems with their backs. The lumbar area is a place where a lot of non-specific pain occurs these are the biggest vertebrae and have the biggest load and tension put upon them they are supported by our core stability muscles that are very important in our Dru Yoga practice Referring to the need for” the deep postural muscles to be able to hold and sustain our posture in an optimum position without this it can lead to musculo skeletal pain” courtesy of my Dru Yoga manual book 1 page 13. We learnt in week one with the Dru Yoga course the importance of this engaging your core to protect your back when commencing physical exercise. These core muscles are situated around the lumbar region continuing like a sling between the legs. They are Transversus abdominis, lumbar multifidus, and pelvic floor muscles.
The transversus abdominis are the deepest of the four muscles groups having a very important stabilising role for the spine also working with the Lumbar Multifidus. When working against gravity in any way it is always contracted. It can be weak and sluggish in some people. After abdominal surgery previous back injury poor posture or sitting too much. Lumbar multifidus works with the transversus to create a strong to us and bending back. Together they create the stable corset around the centre of the body, supporting the spine so that excess strain is kept away from the joints discs and ligaments. The pelvic floor forms the base of this deep corset, made up of muscles ligaments and fascia being the sling that supports your bladder and bowel and in women the vagina and uterus. Attached at the front to the pubic bone and at the back to the coccyx. Engaging the core stability muscles keeps everything where they should be offering support to the spine and all the internal organs by doing this it helps to avoid injury and to maintain optimal skeletal health. Dru Yoga helps in achieving and maintaining optimal spinal and musculature supporting health.
There are three main sections of the spine that move a total of 24 vertebrae. These are: the cervical descending from the head, seven vertebrae in all I have already discussed C1 and C2 in the movement of the neck.
Then comes the Thoracic mid back already partly discussed there are 12 of these the main function to protect the heart and lungs which are protected by the ribs so movement in this area is limited.
Finally the low back the main function of these 5 larger lumbar vertebrae is to act as shock absorbers when lifting and carrying heavy objects and stopping shocks to the brain.
How do we maintain a healthy spine? Exercise is very important the correct exercise For me I found at the Allergy show in London 2015 Dru Yoga a form of exercise that suits my age and Tai Chi and energy work I perform. Understanding about the spine and working with the muscles the core stability and the correct position of a neutral pelvis to help maintain a healthy spine, not sitting too long, keep good posture practice the asana Tadasana which enables one to stand correctly and connect with our environment the earth and sky. Drinking water to keep the body and spinal discs hydrated They start to dry out when we are 25 so drinking water is vital. Keeping flexible working within the four rules I have just learnt from the Little book about the back think straight think close think supple and keep moving and keep walking apparently 80% of bad back can be traced back to lack of exercise walking then fits the bill courtesy again of the little book of the back and finally working on weight reduction.
Common problem of the Back that may not seem relevant but are, are caused by poor posture, tension from, grinding teeth, flat feet wearing high heels for ladies that cause the spine to go out of alignment and shorten the muscles in the legs if worn all the time not wearing shoes, then work related especially for Carers of ill and disabled people. Then we move into wear and tear caused through age and or misuse. Arthritis, Lumbago, Osteoporsis very prevalent in Western societies and number one place for this is Norway, herniated discs, sciatica, bad back associated with long haul flights driving long distances as a job for muscles Fibromeyalgia and M.E . What falls into the specific low back pain? Accidents, birth defects, pain around the tail bone caused through a fall. Fibrositis pain and stiffness in the muscles may be caused by prolonged tension, infections such as Ankylosing spondylitis inflammation of the joints between the spinal vertebrae, Coccydnia osteoporosis and osteopenia arthritis osteo and rheumatoid, herniated discs, Nonspecific low back pain, As reported in the Lancet 10/10/2016 affects all ages is a leading contributor to disease burden worldwide. Treatment guidelines Triage a very small percentage have a medical serious pathology. The management is seen as education re-assurance analgesia. On this note advice on how to lift correctly and ways of working to minimise stress on the back at home carrying shopping less weight more trips evenly divided and incorporating the 4 rules I discussed earlier. The use of ice and wrm paks At work there maybe occupational advice available as so many days are lost through bad backs back supporting chairs not sitting too long in one position getting up and having a walk around to loosen off the back etc making sure the person knows there is help and other therapies that may help Cranial Sacral Osteopathy, Reflexology. that may help like Physiotherapy, Massage, Shiatsu, Bowen, Osteopathy. Sound Therapy I have had great success with back problems over the 13 years I have been practising.
What seems to me to be missing is the prevention. Which I feel should begin on inception to school learning how to take care of our backs would save employers the N.H.S. billions and help people become more aware and in charge of themselves.
How can people with non-specific lower back pain be included into a Dru Yoga Class. Dru now run a specialist course for back pain that Yoga teachers can do as an add on. When I qualify I will do this and offer this separately for people who may be a little afraid of joining a regular class this can with their confidence built up lead into them joining a mainstream Dru class. This I believe is a great add on to do specifically focusing on back care awareness. Those who do not want to be labelled by attending such a course can still join the normal class, with adaption made to take into account the lower back That is the amazing thing that is Dru all the contra indication as well as adaptations are shown with each asana and sequence we learn. This didn’t happen when I was training with the British Wheel of Yoga another reason why I champion Dru. Just the act of being proactive and joining a class can have a huge effect on the persons they will gain as they progress in the class learning about core stability the spine the muscles the way they work, the effects stress can have on the back, EBR1 and 2 working with all the body parts and working on the koshas. The Asanas being able to actually do some exercise with a teacher who knows what they are doing so they can feel safe to dip their toes into the exercise waters. Build up, with practice, their flexibility, core strength and how to look after their spine gently encouraging it back into a healthy state. Take some of the exercises away with them to practice really feel back in control instead of out of control and depressed this will also help alleviate their fears and help them gain confidence in their own body and what they can do. Being part of a class can also help uplift ones mood too.
The great use of adaptions for all exercises and the knowledge I have gained will enable me to advise my students. In the book Dru Yoga book Stillness in Motion by Annie Jones, Anita Goswami and Chris Barrington explain that Yoga can help with dehydrated and compacted discs exercise and relaxation can be revitalised by carefully designed Yoga and relaxation programmes. A healthy spine also means a healthy body. It also means a vibrant mind too. They recommend the Bridge and The Maltese Cross and the Cobra to restore a healthy back and take the student through a wide range of movement for the spine. I also believe from my experience of self- empowerment work that the affirmations Dru use do help people move their mind set so that they come to feel more in con troll of their life. So I feel, working with affirmations to help the person readjust their thinking and the difference the person will also feel physically to a more positive view of themselves and their spine.
I will begin with introductions at every class to the Yoga students asking for any injuries strains stiffness or difficulties they may have so I can tailor the class specifically for them making sure I speak in an empowering positive way, By having this new way of the working and empowering people I feel would of benefitted me when I had these episodes, even though I have had a number of incidents with my spine really on refection I feel I did not fully appreciate the mechanics of the workings and inter-connectedness of every ligament and muscle that would help restore my health. This essay has helped me and will help me with my joined up thinking and for planning for my Yoga sessions. Beginning with the warm up this is especially so of recruiting the core muscles that will stabilise the body and spine. Beginning with the warm up giving directions for alternatives. Helping people to have fun thereby removing some of their anxieties. With reminders to engage core muscles and work within your own comfort zone as everyone is different giving alternatives and demonstrating the Dru way of keeping the arms and legs soft not over extending or overarching working with the Breath bringing in the Koshas that we are working with subtle energies not just our bodies this will I feel if they have taken any other Yoga classes differentiate from many other Yoga forms I have studied. Taking the class through the lying down exercise to recruit and find out where your core is and then explaining why we engage the core and keeping timely reminders about engaging the core which is done on an exhalation out breath. This can be demonstrated and practised with the group lying down on their backs with the knees bent It can also be practised by standing in Tadasana and saying to the group that you will feel an upliftment in your pelvic floor and for the core muscles on an out breath feel as if you are pulling your lower stomach away from your underwear . The student can safely engage these muscles and gauge for themselves their position and strength. This simple exercise would also help to highlight any sensitive areas of the spine. However simply lying on the floor may be too uncomfortable for some people this in itself would indicate possible problems with the spine and act as a starting point for future exercises. Explaining how when we sit our spine is put under x4 more pressure than standing this exercise when performed correctly with the core muscles engaged can help their posture and spinal alignment. Comparing and contrasting the information from Osteopaths in the back book and The exercise from the Little book about the back, this and (the Bridge) Setbundanasana asana Marjarisana commonly known as the cat will help to develop flexibility in the Spine practised on the knees and hands making sure the alignment points are covered hands under shoulders knees under hips The pelvis should be in a neutral position neither tipped forward or backwards there should be a natural curve in the back. The abdominal muscles should be relaxed. Keeping the pelvis and spine still, the abdominal muscles should be drawn in (below the navel) towards the spine preferably following an out breath this position should be held for ten seconds. If the pelvic floor muscles can also be contracted the intensity of the work of the Transverse Abdominus will be increased. At this point, the Lumbar Multifidus is also working although this may be more difficult to gauge. The abdominal wall should be slowly relaxed before the whole exercise is repeated. It may seem imple but very important in the participant being able to locate their core muscles.
This can also be practised standing up if there are problems getting down on the floor or back up so this also takes into account any wrist or shoulder difficulties. The Posture Tadasana also fits this comparison standing twists in DRU Tri-spinal release Backwards and Forwards bends Side extensions as done in the Energy Block Release sequence 1 the Foundation EBR of Dru . Arm wrap as done in the Eagle posture. All correspond with Dru however I feel the flow of not just the EBR1 sequence but the flow of the whole class gives a much more structured supported way of working under guidance of a qualified teacher that is able to watch for alignment points adopt these alignment practices enable the student to, as they will see it take care of their own back and feel more in control of their body. Coupled with a wonderful relaxation at the end when they can relax know that they have done a good job. Rather than trying the exercises at home after one or two sessions with a Physiotherapist and no one at their home to encourage or advise or as they may see it a watchful and qualified eye.
What adaptations would I make in a Yoga class for non-specific back pain? As a new teacher my lesson plans would always carry the alternatives as standard to take any difficulties that ay present and will take this always forward with me. I would include the exercises above to help develop a stronger core with encouragement and if more difficulties in Standing for any length of the it is possible to do the EBR1 sequence sitting from finger flicks to Spinal twists. Encourage them to work within their own body limitations obviously as time progresses with these exercises they will gain more strength and flexibility. Downward Dog can be done standing with hands on the wall. When they get stronger EBR2 The first part of this sequence is very gentle Energy sequences like salute to Druva will help with their feelings of well being as with the Earth sequence. The Tree Asana can be done against a wall for instance . A number of the exercises can be learnt and progressed through in stages the beauty and benefit of this system of Yoga. These are just some examples of the way I feel I can work with students with non-specific back pain and I am sure in the 5 Dru books remaining on my training course my in depth knowledge and understanding will increase.
Conclusion.
I believe, based on my own experience I also had a flattening of the spine curvature which meant I had great difficulty in being flexible something I feel coupled with all the other issues I have had will help me empathise with the students. When this is combined with the clients I have seen as an alternative therapist over the last fifteen years whose lives and their families have been seriously impacted by having a bad back. It cannot be over-estimated at the serious effects this can have on individuals and families I feel this will enable me to be better able to help students with ‘ bad backs’ to receive a a targeted lesson plan to help them.
However beginning by early prevention and education in Primary schools is far better than action after an injury. The NHS is overstretched seriously overstretched and on the work front million days are lost through bad backs so why are we not looking at early preventative care? Lives are badly affected because of bad backs. So surely by being proactive at an early age introducing Dru Yoga in schools and after school clubs by informing and educating young people you are giving them the information to be able to make their own choices. There needs to be a complete plan from having sought medical advice looked at various ways of being pro-active taking into account everything out there that may help using analgesia in the prescribed manner, a total plan that covers every aspect of the persons life in a structured way to help them move into optimum for them back health.
Personally for me at the age of 63 after not doing any exercise for 8 years before I started Dru. because of being a carer has made an immense change in me especially after not looking after myself physically. Dru has and is improving my back lessening the stiffness and pain and feeling more in control mentally more aware because of this, there are as I see it huge benefits in practising Dru Yoga. It is a gentle way to improve one’s care of the spine and because of this easy to tap into exercise programme also available online one can have lifelong help and guidance not only in back care but also in ways to help stress release and from my research I have discovered that stress can cause neck and back pain. So I would not hesitate to spread the word of the benefits of practising Dru Yoga. Being able to feel in control of your own life and able to help keep it in optimum condition when this is combined with a healthy eating plan and attention to ones weight so much the quality of your life will be improved. Thank you Dru.
Bibliography
Dru Teacher training course material and diagrams.
The Back Book Jane Hebden and Sue tucker with consulting Osteopath Deborah Doole
A Little book about your back Ann Mcnell
The Lancet Journal Oct 2016 Edition.
Stillness in Motion Annie Jones, Anita Goswami and Chris Barrington.