Disc Herniation/ Mild Flexion OK?

Yoga Discussion General Yoga
#1

I work with a 55 year old male client that has recently discovered he has a disc herniation in L5-S1. He started to have symptoms 2 years ago, but he was never xrayed, and he had the worst symptoms of it back in August 2010. Since working with him (last 3-4 months), he is seemingly doing much better. He feels stronger, has less pain, and is enjoying his workouts more. Yoga has helped him more than a lot of other attempts at getting healthy (massage, physical therapy) He skins up mountains with skis and does a lot of hiking/ ski touring on the mountains in Aspen, CO. What is odd about him feeling better is that up until finding out about his disc injury, we have done a lot of forward flexion. Since finding out, I suggested we take out forward flexion, but he doesn’t seem to want to change much about the practice we have done because it has helped him a lot (a lot of core work, twisting, lateral side bending, back strengthening) We took out all movements that brought him into flexion, but he kept wanting to go into child’s pose and thinks it “feels good”, as well as folding forward in pigeon. I think most of what has helped him is the core strengthening, but I worry about having him continue to go into child’s pose even and even worry about some side bending and twisting and aggravating the problem.

If he thinks child’s pose “feels good” should I take this as a cue that it is OK to do? He also really enjoys doing child’s pose and reaching to one side. His pain is often in the “mid back on one side of the spine and radiates down into his glute a bit” He feels like this helps stretch it…

Confused… Help!
Thanks a bunch!
Namaste
Erika

#2

Hello Erika,

I have several thoughts on this to share with you, however what is best is for me to have time with the student in order to see, feel, sense, and assess.

Fortunately you were trained in therapeutic applications of yoga. As such, your teacher should be available to you so that you can receive guidance which aligns with the style or methods of your training AND prevents the student in question from being harmed by the practice, whether he is currently aware of it or not.

When there is a herniated or slipped disc that disc almost assuredly moves rearward from its rightful place, toward the spinal canal. I personally do not allow students with such issues to do forward bends until the disc has returned to its rightful place. When the lumbar spine is in flexion the space on the anterior side gets smaller while the space on the posterior side gets lager. This effectively aids the disc in jutting toward the back body. Should that movement take the disc as far as the spinal canal it can be excruciatingly painful.

In the yoga in which I practice, train, and teach, we provide the tools and a sound (safe and effective) way to use them. Then it is up to the student to take hold of the tools. If a student wants to forsake my cautions at home i their personal practice, fine. Many students have yet to comprehend and accept the concept of personal responsibility. When they get hurt it is either the fault of yoga or the fault of the teacher. However, in class I am responsible for student well being and so when it comes to safety issues we’re simply going to follow instructions.

When it comes to safety issues I do not “suggest”, though there are plenty of other instances where I do.

What feels good to us is not always what is good for us. If that were the case many of us would be sitting around with a vat of gellato or a carafe of wine. Sometimes what is good for us we resist like the dickens. So unfortunately that, in most people, is not a good barometer. Recall, this is outlined by Patanjali when he lists the kleshas as five obstacles to our progress.

The teacher does not sacrifice their truth for that of the student.