I'm a yoga teacher and I get low back pain!
As teachers, sometimes it helps if we experience first hand what we are helping others to fix.
My low back pain is a dull ache that more often that not follows from carrying a heavy back pack or my daughter or both. It happens a lot when walking.
Figuring that I should be able to solve this problem, the methods that I've tried so far include
It occurred to me that the reason trying to use my abs to alleviate my low back pain doesn't work is because the abdominal muscles don't directly on the lumbar spine! (By the way, if you've used your abs to succesfully counteract back pain then ignore all of this. For me, contracting them, whether the rectus, or the obliques didn't work.)
Yes the abs do cross the waist, but that doesn't mean they affect the lumbar spine directly. And yes, the transverse abdominus connects to the lumbar spine, but not in a way that can directly affect the shape of it, or relieve low back pain.
The abs act on the ribcage and pelvis. Yes they bend the lumbar spine front and back and sideways but they do that by pulling on the pelvis and ribcage. As for twisting? Well that happens in the thoracic spine which is the part of the spine that the ribs attach too.
And locust pose doesn't help much either.
Locust pose does work on the spinal erectors. However it should be pointed out that the spinal erectors are more than one muscle. And they work in a few different ways. And while doing locust is helpful for strengthening the back of the spine, particularly the back of the ribcage, it still doesn't train the muscles that act on the lower back, at least not in a way that helps alleviate low back pain. Well, it didn't help mine get any better.
The muscles that do connect to the lumbar spine and act on it directly are the psoas and the multifidus. The mulitfidus attaches to the back of the spine and so you might be inclined to group them in with the spinal erectors. The psoas attaches to the front of the lumbar spine.
So lets say that you don't want to read all the fascinating anatomy details. (common neil, get to the point. I want to fix my back pain not learn about every muscle in my body even if it is interesting to you.)
One exercise that you can work on is straightening your lower back without using your abs.
You may have done exercises where you tilt your pelvis backwards (while sitting or standing) so that your lumbar spine straightens. Then you tilt your pelvis forwards to return to the normal curve of your lumbar spine. (I call this bending the spine backwards.)
The idea in this exercise is to focus on sucking the back of your lumbar spine backwards. If you were standing or sitting against a wall, you would focus on feeling the back of your lumbar vertebrae (and by feel I mean direct your awareness to the back of your lumbar spine) and suck it backwards.
One important postural point. Sit up tall or stand up tall while doing this. Pull your head back and up and your chin in. And lift your front ribs a little.
Look for a feeling of tension in the back of your lumbar spine but try to get this tension without activating your abs. Have some of your awareness on the front of your belly and notice if your abs tense when you suck your spine back. If they do you're doing it wrong. (And that is "wrong" as defined by this exercise. Engaging your abs isn't bad, just in the context of this exercise it is.)
Now find that same tension while standing upright. Once you can get it while standing try walking around while maintaining that feeling.
The multifidus attach to the back of the spine. Actually they are a series of muscles that attach from the transverse process or "side bars" of lower vertebrae to attach to the spinous process (rearward point ridges, spines or pointy bits) of vertebrae above. From what I've read they cross two to three (or maybe even four) vertebrae to do so. From behind they look like a series of upward pointing chevrons or arrow heads.
Working from bottom to top, these muscles, when active, will cause the lumbar spine to bend backwards.
(Note that the multifidus are present for the whole length of the spine. In this article we are concerend with these muscles only where they act on the lumbar spine.)
In part that is because of the discs between each vertebrae. These muscles are located behind the stack of discs that separate the bodies of your vertebrae. Because of that when active they contract the back of the spine and open the front of the spine bending the vertebral column backwards.
If we have a muscle, or muscles to act on the front of the lumbar vertebrae to pull downwards, this other muscle can counter act the action of the multifidus. These muscles could then act together to erect or straighten the lumbar spine.
My feeling is that an erect lumbar spine is one that will be less likely to cause back pain. And so far it seems to be helping.
(This is not an argument for keeping the lumbar spine straight at all times. However, when carrying things, when walking, you may find that it helps. Ideally, what you will learn from this article is a way of activating the muscles of your lumbar spine so that you can use them at will, particularly to combat lower back ache when it happens.)
A picture is in order, a metaphor. If you have two groups of people erecting the pole of a circus tent, both pulling on ropes from either side, as the pole gets close to erect the team on the slack side can add tension so prevent the pole from going past vertical.
As the pole reaches vertical, both teams can equalize tension on their ropes so that the pole stays upright, even when disturbed. (And if you really want to focus on details, you can also have to more teams on either side to prevent sideways tilting. However for our lumbar spine model that is a bit excessive right now. Lets assume that the pole is stable from side to side because it has sticky out bits to stop if from falling to either side.)
The multifidus can be one team acting on the back of the spine.
The psoas can be the other team acting on the front of the lumbar spine.
The psoas major goes down and forwards from the lumbar spine to the front lip of the pelvis. It wraps around the front of the pelvis and from there moves back and down to attach to the top of the thigh bone.
Activating the psoas and multifidus together can help to straighten the spine.
If you learn to activate these muscles together you may find that you can alleviate low back pain.
So how do you do it?
Take a rest for a minute, grab a coffee, glass of water or cup of tea or milk or juice. And take a toilet break if you need to. The explanation that follows is a little wordy. Also while you are at it you might take the time to read the mula bandha article. Why? Because you need to use your pubococygeus muscle to pull your tail bone forwards.
Actually, I'd suggest activating the whole pelvic floor complex.
First activate pubococcygeus by pulling your tail bone towards your pubic bone. This will push up on the front of the top of the sacrum just a little.
(The top of the sacrum is called the base. Which sounds kind of silly unless you think of it as the base for the vertebral column. By pulling the tailbone forwards, it is the front of the "base" that lifts and that can be the start of straightening (even a little) your lumbar spine.)
In turn the front of the sacrum will push up on the front of the lumbar spine, giving it a nudge towards upright ness and yourself a nudge towads a pain free lower back.
So that your sacrum has more room to tilt backwards you need to spread the top of your pelvis. Do this by pulling your sitting bones inwards. If you pull your sitting bones inwards, your pelvis will hinge at the pubic bone and SI joints and open at the top. It helps if you think of the connection between the sacrum and pelvis as a "joint." Likewise the connection between the two sides of the pelvis at the pubic bone.
So how do you pull your sitting bones inwards? By activating the coccygeus muscle. The muscle attaches between the tail bone and the ischial spine on each side of the pelvis. The ischial spine is just above the sitting bones. It's just below the upper sciatic notch. The upper sciatic notch is where the piriformis passes through to attach the sacrum to the top of the thigh bones.
Anyway, to activate your coccyceus, pull your sitting bones towards you tail bone or think of pulling your tail bone towards both sitting bones at the same time.
If you are doing it right the gluteus maximus will stay soft.
Next activate iliococcygeus by pulling the tail bone towards a point just in front of the sitting bones.
Iliococcygeus attahces to a sheet of connective tissue just ahead of the coccygeus. After activating coccrygeus, you can "spread" the tension forwards from the sitting bone.
Diagramatically, you can activate pubococygeus first which creates a line of pull between your tailbone and your pubic bone. If you practice squeezing and relaxing you should be able to learn to feel when this muscle is activating. Next you activate the coccygeus whose line of pull radiates out to the side. From there activate iliococcygeus whose line of pull is inwards and more forwards from iliococygeus. Then increase the forwards pull on your coccyx or tailbone by pulling your anus forwards. Then activate levator prostratis or levator vaginae by pulling the perineum (just in front of the anus) forwards.
Puborectalis is like a lassoo from the pubic bone to the rectum. You can practice activating this muscle by pulling your anus towards your pubic bone. For guys, the levator prostratis supports the prostrate. It's just in front of the anus or if you like, at the base of the scrotum (but behind the pubic bone.) For ladies, I'm guessing that you'll be able to activate levator vaginae by pulling forwards from just in front of the anus.
All of these actions together activate the muscles of the floor of the pelvis but more importantly they help to tilt the sacrum backwards while at the same time spreading the top of the pelvis to give the sacrum room to tilt the pelvis backwards.
I'd suggest practicing these while sitting and then while standing and then while walking around.
The next action phase is to activate piriformis.
This muscle attaches to the top of the sacrum, below the SI Joint.
It reaches outwards, forwards and down to attach to the top of the thigh bone.
Keeping the other actions (and while standing so that your thigh bones are stable), focus on the portion of the sacrum above the tailbone and suck this forwards. You should feel a "tension" that radiates out to the sides of the sacrum, but in front of the butt muscles.
The idea of activating piriformis is to assist in tilting the sacrum backwards so that the front of the sacrum, just below the lumbar spine, levers upwards. Also, it is to oppose the pull of the psoas major on the thigh bone.
The amount of movement between sacrum and pelvis is small (but in women it tends to be greater because of the demands of giving birth) however, by activating these muscles, my belief is that it tells the body to straighten the lumbar spine. (The assumption is that the body is an "intelligent" mechanism with "programming" such that the parts, when allowed, work naturally together. So if you tilt the sacrum backwards, the tendency is hopefully for the lumbar spine to straighten, or to be easier to straighten. A straight and stabilized lumbar spine will hopefully lead to the elimination of low back pain.)
Now with these actions, to activate your psoas, suck the front of your lumbar spine forwards and down. You may find that your belly pops out a little as you do this. If so you are probably doing it right. As the psoas activates it pushes forwards on the intestines which in turn push on outwards on the front of your belly.
Next keep the psoas action and suck the back of your lower back back, as you did before.
What you may get is a feeling of stiffness in your lower back (like someone stuck a broom stick up your you know what.) Try to hold that stiffness. Walk around with it. Then release it.
The goal here is not to keep this stiffness but to be able to activate it at will. Ideally what will then happen is that your multifidus will naturally activate when required. But until you reach that point you may have to train them. While all of those activations seem a lot to do, if you practice them they can become second nature. Not to the point where you hold them automatically all of the time, but to the point where you can activate them at will without having to try.
The idea of practicing activate is so that you can then activate it when your back starts to ache. Then you can see for yourself if this works or not.
Another possibility for dealing with back pain is to activate the multifidus with a top down approach, which may perhaps obviate (or eliminate) the need for activating the psoas.
If you look at the multifidus from the side, imagine activating the multifidus by starting from the upper vertebrae. If the upper vertebrae is held stable (perpaps by pulling the head and ribcage upright) then activating the multifidus can cause the lumbar spine to straighten without using the psoas.
Pull your head back and up so that your neck is long. Lift your chest slightly. Try to keep your ribcage and thoracic spine still. Focus on the back of your upper lumbar vertebrae. Draw or suck it backwards. Then focus on the vertebrae below. You may find that you can straighten your whole lumbar spine this way.
You can also experiment by starting on your lower thoracic vertebrae. Try straightening your lower thoracic spine using your multifidus, and then straighten your lumbar spine from the top down.
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