Alignment and Awareness
A benefit of our yoga practice is to learn correct body mechanics, many times throughout our days we have postures and movement patterns that cause pain. Being aware of how you move your body and correct alignments can allow you to live pain free 🙂
If you have a poor movement pattern, most likely you will repeat that poor movement pattern in your yoga practice, thus bringing on pain. This is not bad, use the practice to help find the correct movement pattern and to retrain your body to habitually fall into correct movement patterns, then your pain will be gone forever.
If you have a pain that is actively aggravating you it is important to continue your practice! It will help you, but please be intelligent about how you practice; you will have to modify many of the poses to not aggravate your pain or to rehabilitate the area. If you listen to your body and what movements feel good—especially while in a pain flare up—your body will tell you what movements are healing for you!
Also, remember stress is usually the root of most chronic pain! Remove stress and tension from your body and the pain will go away . . .
And then there is the emotional aspect, and this area I want to tread on lightly, sometimes we will experience pain that is rooted in our emotions. Certain areas of our body are connected with certain emotions, many times healing our emotions, attitudes, and responses will release the pain—and vice versa, we may release the pain with a yoga pose and at the same time the emotional aspect will release . . . which many times leads to a bout of tears or unexplained happiness right there on your mat 🙂
Correct alignment is not always the easiest position to hold, many muscles that need to work to hold you in alignment have become weak, and other muscles have become tight and pull you out of alignment—these muscles need to be stretched and relaxed. Once the weak muscles get stronger and the tight muscles relax the correct alignment will be much easier to hold.
Shoulders
Most of us do not realize how much shoulder movement we have! Our scapula (shoulder blades) can elevate, depress, abduct, adduct, and rotate both inward and outward! The more you can move your scapula the better, the muscles that move the scapula can get tight and scapula movement becomes very limited.
Correct shoulder positioning requires you to think more about your shoulder blades (scapula) than the shoulder joint itself. To “broaden” your collar bones inwardly rotate of the lower tip of your scapula, think of holding your scapula against your rib cage—neither overly abducting nor adducting (pulling your shoulder blades apart or together). Feel as if your heart is in the center of your body, there is space all around the heart so it has room to beat; your heart is open on all sides. Most yoga poses will align your shoulders just as this, the trick is to move your body into the pose and find this positioning while you are in many different positions! As we move into Chaturanga (and other positions), we put resistance on this position strengthening those muscles. Sitting here practicing the alignment without resistance is good to feel the position, now we are going to practice the position while adding our body weight to the equation . . .
Your shoulders in Chaturanga / updog /downdog
The old fashioned “push-up” position has our hands to high and wide, this makes our scapula elevate and pinch the upper back and neck area. When we correctly align our shoulders in Chaturanga our wrists are by our waist, elbows close to ribs, shoulders down and rotated open, collar bones broad (lower tip of scapula rotated inward).
In upward facing dog many of us tend to “sag” between our shoulders and let them round forward. As you move into upward facing dog your scapula need to slide down your back lifting your heart upward—this scapular depression is a good posture exercise strengthening the lower trapezius. We can also practice scapular depression every time we pick up to jump back to Chaturanga, by making sure we “pick up” by sliding our shoulder blades down, pushing the floor away..
In downward facing dog the most common “incorrect” pattern is to let our shoulder blades pinch together closing the space behind your heart. In down dog we need to pay attention to move the shoulder blades apart (scapular abduction) and toward our hips.
Also hands should be shoulder distance apart; most of us need to rotate our shoulders and hands outward slightly to help reduce the risk of impingement.
Your shoulder position in poses such as trikonasana (and pravritta), and parsvakonasana
In many of the standing poses we tend to reach with the arm hyper-extending the shoulder joint instead of twisting the spine. Get your shoulder in correct alignment and then do not change the angle at your shoulder joint, enter into the pose as far as your body will go—your arm may not be vertical, but more horizontal, that is OK, as your spine starts to twist deeper your arm will rotate more vertical.
Your shoulders and binding
To get a bind, you need to have enough hip/back flexibility to lean forward far enough to get your elbow to clear your shin, also if you have hip tightness your knee will flare outward making it further harder to wrap your arm around—pay attention to not let your knee flare in these binds as that adds stress to the rotator cuff muscles around the shoulder joint. Once you get your elbow clear of your shin, you need to internally rotate your shoulder to correctly align to wrap your arm around your back. Once bound, make the conscious effort to roll your shoulder open externally and depress your scapula.
Your shoulders in Urdhva Dhanurasana
Tight shoulders keep you out of this back bend just as much as spinal flexibility! If you struggle getting your arms overhead and straight then this pose will be a struggle as well. Elevating your hands on your instructors’ ankles or a block will make it easier to push up into Urdhva; keep working in downward dog with your shoulders, down dog will help to open your shoulders for this pose.
Your shoulders in headstand
Headstand actually requires a good bit of shoulder flexibility. If you have a hard time raising your arms overhead, then you will have a hard time getting into correct position to balance in headstand. In headstand, the scapulae need to abduct, depress, and rotate outward broadening the back to allow the correct arm position as the feet walk toward the elbows. As lift off begins the muscles surrounding the shoulder blades are bearing most of the body weight, and will be strengthened 🙂
Spinal alignment
Spinal awareness is good to develop! Most of us understand the importance of being tuned into our spine and posture; 80% of the adult population will suffer from back pain at some point.
Neutral Spine
Neutral spine is your normal anatomical alignment of the spine, a slight ‘S” curve as you move from your neck or cervical vertebrae, down the thoracic vertebrae, to the lumber vertebrae and coccyx or tailbone (there are actually 4 curves to the spine). If your spine were totally straight it would not have much spring action when you walk or run, it is the curves that give our spine “shock absorption”, however if the curves are exaggerated the spine is less stable (especially in the lumbar spine). You may have been born with an abnormally straight or curved spine, in that case if you were born with a straighter spine—keeping the spine flexible is important; if you were born with a very curved spine then maintaining strength of the back and abdominals is important to help support the spine. However most of us were born with a perfect spine . . . and let posture pull us out of alignment. There are 3 common mis-alignments I am going to address:
Common Mis-alignments
Forward head posture:
This is common in people who sit over a computer or desk for long hours, drive for long hours, or sit in front of the tv too long . . .
Forward head posture causes a lot of spinal problems! The head weighs up to 30#, and this weight pulling on the spine causes back and neck pain, just aligning your head and neck can cure head aches by relieving pressure at the base of the skull. Forward head posture also results in a loss of lung capacity affecting our entire cardio-vascular system. If you find yourself in forward head posture, practice “head retraction” lengthening the back of your neck while you move your head slightly back and upward while bring your chin is parallel to the floor.
Rounded back and shoulders (kyphosis) and Swayback (lordosis):
If you tend toward kyphosis or rounding your spine, it is important to recognize the difference between forward bending at the hips and forward bending at the waist. Forward bending at the waist is easy, requires very little muscular effort; however it puts uneven weight on the spine and can be the cause of back pain. Forward bending from the hips requires more muscular effort (you are moving more of your body) but keeps the spine in a more favorable position. If you tend toward kyphosis, back bending, paying attention to spinal extension, and chest opening postures are good.
If you tend toward lordosis or arching your lower back too much, you will not enjoy back bends; you are already back bending too much in the lumbar spine so your body will want the counter-stretch. Lordosis is usually the result of weak abdominals, practicing and maintaining a posterior pelvic tilt will help correct the posture, strengthen your abdominals, and ease pain in the lumbar spine.
In our movement patterns it is helpful to know that the lumbar vertebrae are made specifically to bend forward and backward or flex and extend in anatomical terms. The thoracic vertebrae (you can identify your thoracic vertebrae easily—as they each attach a rib) are specifically made for twisting, and the cervical vertebrae (neck) do it all, flex, extend, and twist.
Your spine is meant to bend forward and back, and move in all directions—so do not rigidly try to hold it straight at all times, pain occurs when the spine is chronically held in one position without the counter balance of the opposing position.
Finding Neutral spine:
Stand tall, tilt your pelvis forward and back, then bring it level, remember the cue to picture your pelvis as a bucket filled to the brim with water—spill no water, float your ribs above your hips, imagine you are “long waisted” and keep the waist long on both the front and back of your body—too often when we try to correct our posture we go too far the other direction and pop our ribs out in a “Barbie doll” posture, to position your shoulders think of your scapula—hug them to your rib cage, and lengthen the back of your neck is if a thread is attached to the top of your head gently pulling upward.
Many yoga poses will challenge us to find this alignment while we move in a myriad of positions! This is good; this teaches how to connect with the feeling of neutral spine while we move about our days. Some poses are designed to round the spine, extend the spine, and twist the spine releasing tension and tightness, and allowing blood flow in and around the spinal discs and nerves. If you know you have a habitual posture issue, pay special attention to correcting that in your yoga practice, and it will stay with you as you step off your mat. Your abdominals or “bandhas” are the key to support of the spine, which is the abdominals main job; to stabilize the spine while we move. Keeping your attention on the inner lift of your bandhas will naturally keep you in neutral spine—not only on your mat but all day long. Remember my saying . . . only after 9pm do you release your bandhas 😉
On the mat, the most common areas of mis-alignment:
Chaturanga – this position makes the abdominals work harder to hold neutral spine, the habit is to let the back/hips sag, use your abdominals to prevent sagging. If you have a hard time connecting with that action stick your hips up higher than you think they should go.
Upward Dog – the same habit here is to let the pelvis sink and lower back arch leading to pain in the back. Use your abdominals to tilt your pelvis posteriorly (tuck your tailbone toward your legs) while in upward dog to correct this and contract your quadriceps (thigh muscles) trying to keep your knees and thighs off the floor.
Urdhva Dhanurasana and other similar backbends – the habit here is to crunch the vertebrae in the lower back instead of keeping the spine long as you lift upward; keep a posterior pelvic tilt keeping length in your spine while you push up into and hold a back bend.
Sacrum and Sacro-Iliac Joint
I want to direct our attention toward the sacrum, the sacrum is part of the spine, it consists of 5 vertebrae fused together to form a single bone. The sacrum is what transfers the weight of our upper body into the pelvis and hips, it “attaches” our spine to our pelvis with the Sacral-Iliac Joint (SI Joint), a synovial joint with a little movement. Because of the sacral connection to both the spine and pelvis the movement of both the spine and pelvis can affect your sacrum.
The sacrum has an “identity complex”; it is not sure whether it is part of the spine or part of the pelvis. If we imagine the sacrum as part of the spine, when we twist and move we would stabilize the pelvis and move the sacrum—this could be problematic in twisting postures as it would put a pull on one side of the SI joint potentially pulling it out of alignment. If we imagine the sacrum as part of the pelvis, then as we move the SI joint stays securely seated in its groove on the pelvis as the spine takes the movement. This tends to be a healthier way to imagine the sacrum and SI joint. The sacrum is meant to tilt slightly forward and back—the anatomical term given is nutation (nodding forward) and counter nutation. This sacral movement allows the sacrum to act as a pump, circulating fluid and nutrients around the vertebrae, sacral joints, and spinal cord; however we need to keep the sacrum stabilized in twisting postures and assymetrical postures. So again we are working with a balance, a balance between keeping the sacrum flexible but also stabilized.
Pain in the SI joints can be difficult to diagnose as it is commonly confused with sciatic pain. If you have pain off to the right or left side on the back of your pelvis, most likely it is a pull in the SI Joint. If you suffer from SI joint pain:
In Twisting postures
When twisting pay attention to picture your sacrum as being part of the pelvis, stabilize the sacrum in the pelvis and twist in the thoracic spine—to do this for example in Marichyasana C twisting to the right, you would slide your left leg and hip forward so your hips are not square, this position keeps the sacrum stabilized to the pelvis as you twist.
In forward bending
Pay attention to keep your glutes (spelled b-u-t-t) relaxed in forward bending postures; this will allow the sacrum to tilt easier in the pelvis helping to maintain your natural lumbar curve as you bend at the hip joint. If you contract the glutes in forward bending it pulls the sacrum in the opposite direction (the gluteus maximus attaches to the sacrum). In one legged forward bends such as the Janu Sirsasana series, keep your hips square—do not pull the bent knee back beyond 900, this position will stabilize the sacrum square to the pelvis as you bend forward.
In Backward bending
Back bending postures can help re-seat the sacrum correctly and usually feel therapeutic to someone suffering from SI joint pain; pay attention to back bend with a posterior pelvic tilt helping to align the sacrum in the pelvis.
A healthy sacrum is a movable sacrum!
If you have good movement in your sacrum in forward bending it will feel as if your sitting bones can spread a little as you bend forward and the sacrum tilts anteriorly (nutation). In backward bending postures, the sacrum should slightly tilt posteriorly (counter nutation) and there is a little movement in your sitting bones—they slightly move toward each other as the sacrum tilts posteriorly.
For those who are flexible you can try to feel this in (if you are tight around your hips, hamstrings, and lower back you will have a hard time feeling these movements):
Prasarita Padottanasana A – while in this pose lift your tailbone even higher, if your sacroiliac joints permit you will feel something peculiar, a spreading of the sitting bones. This is nutation.
Quadruped position – cat back stretches, in the rounding phase is one of the easiest positions to feel counternutation.
Downward Facing Dog – overextend your spine in downward dog, move first into nutation, you will feel the sitting bones spread, now see if you can tuck your tailbone (NOT tilt your pelvis) and contract your abs, feel the sitting bones moving back together. Alternate between nutation and counternutation in down dog and feel your sitting bones and thighs spread apart and move together. In downward dog we actually want a more neutral position of the sacrum so it is in neither in nutation or counternutation.
Upward Facing Dog – do a lazy up dog on your hands and knees, allowing your tailbone to lift. This is nutation, now become active in up dog and do a nice posture on the tops of your feet and hands, contracting your quads, you should feel Counternutation.
Knees
The knee joint is the largest and strongest joint in our body and toting our weight around from place to place is its forte! Yoga is not an activity that puts the knee at risk to injury; however we do need to be concerned with existing knee injuries and yoga postures. When the knee joint is fully extended or fully flexed it is in its safest positions, anywhere in between can tax the knee, however many people have tightness that prevent them from fully flexing the knee leaving the knee open to injury.
The knee is basically two bones butted up against each other (the femur and tibia), tendons and ligaments hold it together with some protective discs called menisci that go between the two bones.
These menisci are what give the joint its ability to absorb shock, overly active individuals may tear or pinch the menisci leaving pieces to float around in the knee causing pain and locking in the knee. Other common injuries come from the patella (knee cap) being pulled out of its groove; this can be from over-pronation of the foot or quadriceps muscles that are tight and/or weak and pull the patella out of alignment.
Individuals who have suffered with anterior or posterior cruciate ligament (acl or pcl-two little ligaments that criss-cross inside the knee holding the femur and tibia together) tears or sprains need to be very cautious working with lotus positions.
The menisci and most ligaments have a very poor blood supply, once injured they are slow to heal and many will require surgery to repair.
What can we do??
The answer is simple! Regular and prolonged muscular tension applied to the extended knee joint helps to strengthen, support, and re-align the knee.
During standing poses (and particularly during the Prasarita Padottanasana series) pay attention to keeping your knee extended (not hyper-extended) and the quadriceps gently contracting. Moving the body while keeping the legs firm strengthens the connective tissues that support the knee. Even outside of classes you can stand in Prasarita Padottanasana position and move the upper body and arms in different positions while staying firmly grounded and stable with the thigh muscles contracting. After a few months of these exercises the connective tissues will have gained enough strength and integrity (at least in the absence of serious injuries) to withstand reasonable stresses on the knee—include working in to lotus positions.
Also if you have tightness in your hips your knee joint is at higher risk of strain; if the hips do not twist to allow a certain movement, the knee will—and a twist in the knee is not good (the hip joint is designed to twist . . . however the knee joint is not!). One of the best ways to protect your knees is to keep your hips flexible!
Other poses that heal or affect the knee joint:
- In the Janusirsasana series the bent leg position of external rotation of the tibia while internally rotating the femur (turning the sole of the foot upward as you forward bend makes those movements happen) puts the knee it a more anatomically correct flexed position. The assist of gently pressing down on that leg while forward bending has been therapeutic for many people with knee pain.
- In Marichyasna B&D, after placing the leg in lotus, scoot the lotus knee over toward the grounded foot, this position puts less twist on the knee—but may make balancing and binding more difficult, so only do this move if necessary.
- When working into any lotus positions (half or full), fully bend the knee and move the entire leg as one solid unit (the femur and tibia are moved together—not separate).