Healing Lower Back Pain

     Lower back pain is one of the most common chronic ailments in America. This is partly because of all the sitting we do. One of the consequences of sitting is shortened psoas muscles. This can cause pulling on the lower spine, leading to chronic back pain.

     The psoas muscles originate along the sides of the lumbar spine, going underneath the lower abdominal organs, and crossing over our pubic bone at the front of the hip joints, then attaching to the inner thigh. ​

​     When the psoas muscles are tight, they shorten and pull on the lower spine, straining the discs. If one is tighter than the other, it can pull the spine out of alignment, which also strains the discs and vertebrae, causing discs to buldge or even herniate. It can also lead to spasms of other muscles. 

     Because the psoas muscles overlap tendons of the diaphragm, diaphragmatic breathing can be extremely helpful. Shallow breathing not only causes muscles to tighten, but it also sends the body stress signals, which affects our nervous system.

     When we deepen our breath, not only do the psoas muscles relax, but we are also relaxing our nervous system. To practice diaphragmatic breathing, imagine that inside your belly there is a balloon that your breath fills with air. Direct your breath into that area, noticing how your lower abdomen expands and then deflates.

     Exercise: Lie on your back on the floor and focus on your breathing for several breaths. As you exhale, feel your pelvis release. You may notice that the arch in your lower back will soften towards the floor. I find that this usually takes 10-15 breaths. Don't actively try to flatten it - let it passively fall. This is what I focus on while I'm in Savasana. It feels as though on each exhale, the lower back muscles are moving closer to relaxation.

     Now bend your right knee and pull it toward your chest, holding it with your hands. At the same time, reach the left heel away from you in the opposite direction. Take 10 breaths here and then do the same on the opposite leg.

     Since it's difficult to deliberately flex or relax our psoas muscle, like we can our bicep or hamstring, it can be one of those muscle groups that is tough to identify and work with. In order for a shortened psoas to lengthen, first it needs to be strengthened.

Navasana (boat pose) is great for strengthening the psoas.

Exercise: Sit with your knees bent and both feet on the floor. Place your hands behind your knees and lean back, keeping your spine straight. As you rock back on your sit bones, but not so far that you come onto your tailbone, raise your feet off of the floor, keeping your spine straight. Keep lifting your feet as long as you feel strong and steady. Focus on keeping your thighs spiraling inward, your chest lifted, and your shoulders back. Extend your arms forward, parallel to the floor. If you notice your pelvis is tipping back, hold onto your thighs with your hands. 

Warrior I is great for lengthening the psoas muscles.

Back beds require full extension in both hips.

Exercise: Bridge pose also requires full extension in both hips and is more available to most people than a full back bend. Lie on your back and bend your knees, placing both feet on the floor, hip width apart, about six inches away from your pelvis. As you press into your feet, particularly the big toes, lift your pelvis into the air. Placing a block in between the knees keeps them from rotating outward.

     When working with the psoas, it is important to tilt your pelvis as if you're scooping your tailbone under. We naturally tend not to do this - again because of the psoas.

     Another important muscle group to focus on are the hamstrings. If you do nothing else, stretching your hamstrings daily will have a huge impact on not only your lower back, but your knees and hips as well.
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     Your hamstrings originate on the back of the pelvic bones and attach to the backs of the knees. The hamstring muscles run down the back of the thigh. Their tendons cross the knee joint and connect on each side of the tibia. Tight hamstrings cause the pelvis and hips to tilt backwards, leading to back problems. Most people have tight hamstrings, especially runners.
     My friend, Thomas Lyons, MD, an orthopedic surgeon here in New Orleans, told me that he does dozens of knee replacements that could have been prevented by just stretching the hamstrings. Tight hamstrings cause a huge amount of tension on the knees.​​

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Exercise: Padangusthasana (Forward Fold)
Stand upright with your inner feet parallel and about six inches apart. Contract your front thigh muscles to lift your kneecaps. Keeping your legs strong and active, exhale and bend forward from your hip joints, moving your torso and head as one unit. Place the index and middle fingers of each hand between the big toes and the second toes. Press your toes down against your fingers. With an inhalation, lift your torso as if you were going to stand up again, straightening your elbows. Imagine making space in your lower back, lengthening your front torso - on the next exhale, fold over as you lift your sitting bones. Release your hamstrings and hollow your lower belly, lightly lifting it toward the back of your pelvis. For the next few inhalations, lift your torso strongly as you continue to actively contract your front thighs; on each successive exhalation, strongly lift your sitting bones as you consciously relax your hamstrings. Imagine your spine cascading away from your pelvis towards the floor. Take 5-10 breaths here as you continue to focus on your body as well as your breath.

     Yoga is great for releasing tension and strengthening some of these core muscles. In working with the lower back, our most important aim is to strengthen the core. I have dealt with lower back problems most of my life due to scoliosis, and I've tried it all - chiropractors, acupuncture, medication, epidural injections, and more. Since I started practicing yoga, I have noticed more of an improvement than from all of those other modalities combined. 

     I hope this helps some of you - let me know how it goes! Thanks to my teacher Stephen Link for modeling poses for me. His website is www.sarangayoga.com