Yoga is one of today’s most popular fitness systems. It offers the potential to increase health, vitality, and be a valuable approach to rehabilitation.
Yoga, however, can actually cause injuries. To deliver its benefits, yoga practice must comply with the anatomical and mechanical design of the body. Simply moving from our intuition cannot overcome a lifetime of poor posture and harmful habits in our daily life.
Correct postural alignment in yoga determines the result of practice. Alignment allows yoga poses to go deeper while remaining safe and therapeutic. Alignment is not the final appearance of a pose; instead it is dynamic, based on the intention to move in the direction of an aligned posture. Ultimately, posture can only be in alignment or misalignment; there is no neutral or in-between.
Healthcare professionals who can provide easy-to-understand, anatomical and mechanical guidance can best serve their yoga-practicing patients. At the same time, yoga possesses its own alignment principles that are sophisticated and highly therapeutic. Incorporating yoga’s alignment principles into a chiropractic approach brings valuable insight and additional therapeutic tools that can be used with yogis and non-yogis alike.
Yogis typically value a healthy lifestyle and understand the importance of a properly functioning spine and the energetics associated with it. They have a strong interest in anatomy and postural alignment. The yoga community as a whole is aware of injuries that occur directly from yoga practice and broadly accept yoga therapy in the arena of injury rehab and prevention.
The following alignment principles are basically simple and are common sense. As with any new endeavor, it takes practice to make them feel fully natural should there be many habits to change. They do not hamper the flow of a practice or from its advancement.
Twist from the spine, not from the hips or shoulders
Revolved postures are specific movements for the spine. Often, not considering this fact, students allow their hips or shoulders to shift and participate in the twist, defeating the value of the pose. The spine functions as a standing wave, requiring stable ends (the hips and shoulders) in order to produce fluid movement along its course.
Twists should initiate from the region of the spine that is least mobile. For most practitioners, that will be the mid to upper thoracic spine. Students should resist the habitual tendency to allow the more flexible lumbar or cervical regions to overpower the twist, essentially stopping the thoracic spine from participating. When it comes to cervical spine issues, limited thoracic mobility is a common cause. Enabling revolved postures to mobilize the thoracic spine is a valuable tool to address neck, head, and jaw pain and dysfunction.
The chest in on the front body, the shoulders are on the back
Although obvious, these positions are constantly reversed, not only during yoga practice but in daily living, as well. When the shoulders round forward, their joint mechanics and muscle balance are compromised, becoming a precursor to labral tears and rotator cuff injury. Habitual poor posture and movements that round the upper back and shoulders restricts the already limited extension of the upper thoracic spine. Forward rounding exacerbates muscle imbalance, which places strain on the foundation and tethering of the head and neck.
Consistent with the demands of front body activities, flexibility and strength of the anterior shoulders and chest is approximately 30% greater than that of the upper back. Yoga students should strive to engage the back body muscles with greater intention in every posture. Plank Pose strengthens the Serratus anterior, drawing the inferior tips of the scapulae toward the rib cage. Cobra Pose is a powerful isometric for the Latissimus dorsi, which transfers the power of arm movement to the back musculature.
An additional point of view to consider: since the arms attach to the shoulders, the arms are appendages of the back body, in spite of their application in most front body activities.
For the most part, engaging the arms follows the course of the Latissimus dorsi. The goal is to use the muscles below the axilla and avoid shrugging the shoulders:
1. Prepare by inflating the upper, anterior quadrants of lungs. This initiates the upper
thoracic spine into extension and creates an inflated barrier to resist the shoulders from
rounding forward. Maintain the lifted and expanded upper chest even upon exhalation.
2. Draw the inner portion of the heads of the humeri posterior
3. Glide the lateral edges of the scapulae medial as the clavicles widen laterally
4. Press the lower tips off scapulae anterior
5. Draw the lower rib cage posterior
Basic spinal mechanics
Flat curves are more flexible but provide less stability and are susceptible to ligament sprain.
Deep curves are less flexible but will be more stable. Deep curves can potentially compress discs, spinal nerve roots, and constrict facets, particularly upon lateral flexion.
When a yogi initiates a posture, they should lengthen spine in axial extension for greater and safer mobility. Once the desired position of the pose is reached, the lengthening is softly released, allowing the curve to deepen for stability.
Muscles along the convexity of a curve are chronically lengthened and stretched, due to a longer course they must take along the spine. This makes them less efficient and weaker. Muscles inside the concave side of the curve shorten, becoming more efficient and stronger. This muscle imbalance is readily seen with the lateral curve of scoliosis, where the muscles of the concavity overpower the weaker muscles of the convexity, exacerbating the condition.
Although it may seem counterintuitive, when side bending, the yoga should lengthen the side being bent toward to prevent deepening the concavity and compressing the spine.
One of the ways that yoga therapy addresses the issue of scoliosis is by strengthening the convex-side muscles and reducing the power of the concave-side muscles. By balancing one-legged on the convex side, those muscles must accommodate for weight bearing and will unilaterally strengthen and shorten. This effect not only strengthens concave muscles but also other lateral-body muscles, such as the Peroneus, Gluteus medius, and Psoas muscles.
To address the concavity, place a yoga block under the foot of the standing leg, with that foot further from a wall. This will allow the concave side of the body to drop and traction, lengthening the muscles, which will reduce their power. Raise the concave-side arm up the wall to flatten the curve from above while providing stability to the posture. When performed correctly, the effect is immediately noticed with the scoliosis significantly reduced. This becomes a home care procedure, only done on one side in the necessary configuration.
The Ilio-lumbar ligaments
The integrity of the lumbar spinal curve requires strong Iliolumbar ligaments that anchor the lumbar spine to the pelvis. Because these ligaments do not fully form until adolescence, poor postural habits or injuries can result in the formation of longer, less supportive ligaments with the likelihood of chronic lumbar instability. The person then must rely on balanced lower torso musculature to compensate, both on a gross mechanical level and intersegmentally (many ligaments have embedded muscle fibers).
To find muscular balance the strategy is simple is concept: that is to maintain an egg-sized curve at the L3-5 level in all poses and at all times. The goal is not to flatten the lumbar curve and “crush” the egg, nor allow the curve to increase to the size of multiple eggs.
The common movement of flattening the lumbar spine rolling into a ball by bringing the knees to the chest is discouraged. The yogi learns to rock their pelvis into forward flexion to enable the sacral base to drop anterior and deepen the curve. Once the egg-sized curve is established, the tailbone isometrically presses forward, acting as a brake to resist further deepening. Tight hamstring muscles can restrict pelvic flexion, causing the pelvis and lumbar spine to flatten with forward folding postures. This precise size of the curve is important in back-bending poses, which can cause compressive trauma and pain. This procedure also allows more thoracic extension to occur in the back-bend, an action that is often becomes inaccessible once the lumbar spine hyper-extends.
To protect the lower spine, yoga utilizes an energetic system called Bandhas. The bandhas, which correspond with the pelvic and thoracic diaphragms, compress air within the abdominal cavity, carrying weight bearing forces on the spine anteriorly and significantly reducing disc pressure.
How to engage the Bandhas:
1. Scoop the tailbone forward
2. Scoop the tip of the breastbone posterior
3. Draw the navel posterior
Scooping of the tailbone is essentially an isometric contraction with no significant movement of the coccyx possible. It does, however, engage the perineum and the action helps to stabilize the sacroiliac joints and L5-S1 region. Drawing the navel posterior resists the apex of the lumbar spine from drifting anterior. Scooping inward of the xiphoid process limits hyperextension of the lower thoracic and the production of what is often called a “banana back”. “Scooping” is a more effective cue than others often used because it engages the pelvic and thoracic diaphragm more directly, therefore better able to compress air volume in the abdominal cavity.
These and many more instructions can be shared with patients to ensure that they benefit from their yoga practice and avoid injury. As competent healthcare professionals, tips and tools are expected by our patients and will be gratefully received.
Conclusion
Yoga is a sophisticated and viable form of structural therapy as long as it is practiced with skillful alignment. It is not whether a particular pose will be either therapeutic or injurious; instead, it is the skillful performance of the pose that determines the outcome. As professionals who treat practitioners of a widely popular fitness program, a deeper understanding of yoga alignment allows us to serve that demographic competently.
Reference material
Weiss, Steven, MS, DC, RYT, The Injury-Free Yoga Practice, Manatee Press, FL 2013.
Weiss, Steven, DC, C-IAYT, Yoga Alignment Principles and Practice, Ingram Spark, 2019.
Kapangji, I.A., The Physiology of the Joints, Vol 1, NY: Church Livingston, 1982.
Kapangji, I.A., The Physiology of the Joints, Vol 2, NY: Church Livingston, 1982.
Kapangji, I.A., The Physiology of the Joints, Vol 3, NY: Church Livingston, 1982.
Keller, Doug, Anusara Yoga, Hatha Yoga in the Anusara Style, VA: DoYoga Productions, 2001.