9 Tips for Staying Safe in Yoga Classes

by Nina Zolotow

No one can completely guarantee you’ll never hurt yourself while doing yoga. After all, no physical activity is risk free. You could hurt yourself walking your dog, taking care of your garden, or even just sitting at your desk. But there are some common-sense approaches you can take that will greatly reduce your chances of injuring yourself. And, as you’ll see when you read through these guidelines, taking these approaches will also enable you to practice your yoga poses mindfully—paying attention to pain levels, breath, energy levels, and motivations for doing poses or not doing them—which is one of the aims of the asana practice. 

I put together these nine guidelines a few years ago by consulting with a physical therapist, Shari Ser, and a medical doctor, Baxter Bell, both of whom are long-time teachers of yoga. 

1. Inform your teacher. If you’re taking a class, tell your teacher about any injuries, illness, conditions, or problems that might affect your ability to do certain poses or put you at risk so your teacher can help you figure out what you should not be doing and give you alternatives or at least understand why you’re choosing to do something different at times. 

2. Pay attention to pain. Learn to tell the difference between sensations that are potentially good for you, such as the healthy stretch of a tight muscle, and those that are potentially injurious to you, such as over-stretching a tendon or ligament, or compressing structures to the point of injury. And keep in mind that the closer pain is to a joint, the greater the potential is for a problem. If you catch yourself moving into a sensation that feels dangerous or that you are concerned about in any way, try backing out a bit, perhaps by letting go of a stretch or by using a prop. If you can’t back out for some reason, come out of the pose and rest (see below). 

3. Listen to your breath. Although your breath may come more quickly in demanding poses such as backbends or long-held standing poses, gasping for breath indicates you’re over-stressing yourself, so see if you can back out of the pose a bit, possibly by using a prop. If you can’t back out for some reason or if doing that doesn’t help you catch your breath, come out of the pose and rest (see below). Also, as you practice, notice if you are holding your breath because this is a possible sign you are becoming a bit fearful or anxious, or reacting to pain. If you realize you are reacting to pain, back out of the pose until the pain is gone or, if the pain stays, come out of the pose altogether. However, if you realize that you are just holding your breath, try to consciously relax your breathing. 

4. Rest if you need to. If you feel you’ve reached our limit with your time in a pose, no matter what the rest of the class is doing, come out and take a rest. Likewise, if you are suddenly sweating much more than normal, this may also be a sign that you’re over-stressing yourself, and you should take the same precautions. Some suggested ways to rest include: 

• If you’re doing supine poses (on your back), rest in Relaxation pose (Savasana).
• If you’re doing prone poses (on your belly), rest in Crocodile pose.
• If you’re doing seated poses on the floor, rest in Easy Sitting Pose (Sukasana), where you sit with crossed legs, or in Thunderbold Pose (Vajrasana), where you sit on your heels.
• If you're seated on a chair, come into seated Mountain Pose.
• If you’re doing standing poses, rest in Mountain Pose (Tadasana).
• If you are doing inverted poses, come down into Child’s pose.

If you feel like you just can’t finish the rest of a class, either let the teacher know so they can give you a resting pose to finish with or just lie down in a comfortable Relaxation pose (Savasana) Don’t just leave in the middle of a practice, without cooling down. 

5. Stay balanced. If you are weak or have trouble with balance, use props, such as a chair or the wall, to stabilize yourself so you don’t fall over and can practice with confidence. You can practice with your back to a wall, with one foot on the wall in standing poses, or with a hand on the wall in certain poses. If you know you have problems with balance, come to class early and stake out a place next to the wall so the wall will always be there when you need it. 

6. Use props. Even if you have not been specially instructed to use a prop and you know that it is important for your safety (to keep you from over-stretching or falling or to use as padding for sensitive areas), go ahead and use it. And if you know you typically need a certain prop, such as a block or blanket, have one ready at your side before class starts. 

7. Resist peer pressure. If your class is doing a pose that you feel is beyond your capabilities or that you just aren’t ready for, just don’t do it. Ask your teacher for an alternative or take a resting pose. Or, you can just watch the others do the pose, and learn through observation. If your class is consistently too challenging for you, look for another class that fits your level of ability, such as an eight-week introductory series for beginners, an Accessible Yoga class, class that is designed specifically for older students or people, or even just a class in a different style of yoga. 

8. Only do inverted poses if they’re okay for you. Inverted poses are contraindicated for people who have uncontrolled high blood pressure, for those who are having eye problems, such as glaucoma or detached retina, and for other conditions. And if you are having neck problems, refrain from Headstand, Shoulderstand, and Plow, please. If you have no contraindications and want to learn inversions, start by finding a special class, series, or workshop that is designed to introduce you to step by step to the inverted poses, so you can learn to practice these poses safely, under the careful guidance of an experienced teacher. 

9. Talk to your doctor and/or physical therapist. If you have had a surgery or if you have a medical condition or an injury, before you return to your yoga class or home practice, explicitly ask your doctor or physical therapist which physical actions are safe for you and which are not. Don’t wait for a medical professional to tell you! Some medical professionals don’t really know what a yoga class is like, even while they recommend “yoga.” Some imagine it’s just a gentle stretching session and might not even consider that you could be going upside down, twisting yourself like a pretzel, or sweating from a vigorous practice. So when you are checking in about whether you’re ready to practice yoga yet, consider bringing a yoga book with you so you can show the doctor or physical therapist the types of poses you normally do. You should also ask some specific questions, such as: 

• Can I go upside down for long holds or even short ones?
• Can I twist my spine or round my spine forward, backwards, or side to side?
• Can I cross my legs?
• Can I put pressure on this or that part of my body, such as my knees or wrists?
• Can I stand on one leg?
• Can I practice in bare feet?
• Is my recovery from a serious illness, such as cancer, at a place where I can safely increase my physical activity?
• Is it safe for me to do a vigorous practice that makes me sweat and exert myself? Is it okay for me to hold standing poses for long periods of time that require endurance and strength?
• Is it all right to stretch an injured tendon, ligament, or muscle now?
• Would any of the medicine I am taking interfere with my practicing by making me dizzy, unfocused, distracted, off balance, or sleepy?
• How long should I wait before returning to class or home practice? After surgery, how long do I wait before it is safe to stretch the area where my incision or scar is? If I have had a joint replacement or repair, such as a hip or knee, is there a limit to my range of motion in certain directions that I should honor?

It’s your one and only precious body, so I believe it makes sense to be cautious and follow the recommendations you receive.

This post was edited by Patrice Priya Wagner, Managing Editor of Accessible Yoga blog and member of the Board of Directors.

To order Jivana Heyman's book Accessible Yoga in the U.S., go to Shambhala Publications, Amazon, Barnes and Noble, Indie Bound (for independent bookstores), or your local bookstore. People in other countries who want the order the book see How to Order "Accessible Yoga" from Countries Outside the U.S.

How Yoga Builds Strength AND Endurance

by Ram Rao

Yoga is both an endurance training system as well as strength training. Let me tell you how I reached this conclusion.

Endurance Training: Endurance training is also referred to as aerobic exercise as it ensures that the energy demands are continuously met during the exercise regimen. Endurance training improves functional capacity and involves activities like bicycling, walking on a treadmill, swimming, rowing, cross-country skiing, and other fitness exercises that increase stamina.

Resistance/Strength Training: Resistance training or strength training involves physical exercises that induce muscular contraction and strengthen the muscles. It is primarily an anaerobic activity that provides significant functional improvement including increased muscle, tendon, and ligament strength and toughness, improved joint function, increased bone density, improved cardiac function, and enables muscles to recover for the next burst. Resistance/strength training increases the force output of the muscle through incremental weight increases and also uses various forms of exercises and equipment to target specific muscle groups.

Reasons why practicing yoga asanas is endurance training:

Endurance training uses both physical and mental strength to improve functional capacity. It is a common practice to incorporate several minutes of meditation either before or after a yoga asana class that helps with concentration and to develop mental strength. Holding a yoga pose for a length of time requires discipline and commitment. This builds confidence and slows down the chattering in the mind. The practice of simply holding a pose helps to overcome mental negativity and the fear of pain.

Asanas require for the practitioner to cover more ground with fewer steps, develop a longer stride and maintain a smooth and steady pace. This requires flexible hip flexors for greater hip flexion, well lubricated joints, and properly stretched muscles.

Breath. Breath-endurance training involves the aerobic system and requires oxygen to adequately meet energy demands during exercise. Asana practice emphasizes the use of breath and to move through various poses with continuous inhalation and exhalation. Breath practice is an integral part of yoga, and practitioners and students resort to ujjayi pranayam to lengthen the inhalations and increase lung capacity. This in turn delivers more oxygen to the body and helps with overall performance and efficiency.

Core strength. Endurance training increases stamina and endurance. Asanas help to keep the body strong, centered, and powerful. Asanas not only assist in building strong abdominal muscles but also help to strengthen the back and hips, thereby improving stamina.

Focus. Endurance training requires developing an inward and mindful state and athletes are always encouraged to “stay in the moment.” Focus (dharana) and being in the moment (dhyana) are integral to asana practice. Yoga practitioners constantly focus on their inhalation/exhalation, movement, and nuance of a pose and sustain that pose by ‘being in the moment.’

Reasons why practicing yoga asanas is resistance/strength training:

Resistance training/strength training involves a lot of movement and muscular contractions thereby providing functional benefits to muscles, tendons, ligaments, and joints. Resistance/strength training uses various forms of exercises often requiring special equipment to target specific muscle groups. Asanas use the body’s own weight as resistance to build strength and balance thus strength gains are achieved without elaborate and expensive weight-training equipment.

Yoga poses place the body in many positions that require strength and stability. In addition, any extended hold of a pose requires contraction of several muscles. These muscular contractions help more muscle fibers to be recruited, resulting in improved strength gains. A continuous muscular contraction helps to lengthen, tone, and strengthen the muscles. An asana flow sequence that calls for moving into several poses sequentially is a physically demanding practice that provides students with opportunities for continued strength gains.

In conclusion, yoga increases muscle strength, power, and endurance through weighted exercises. By holding the body in specific poses, yoga helps to improve balance, strength, and stamina. Asanas improve circulation, digestion, balance, flexibility, and agility. Keeping the body in certain postures and focusing intensely on moving through and holding each of the poses not only improves strength, balance, and concentration but also builds endurance. Thus in my opinion, a consistent yoga practice is both strength and endurance training.

Rammohan (Ram) Rao comes from a family of Ayurvedic practitioners and Vedic teachers in India tracing back to the illustrious Vedic-acharya Rishi Kaundinya (although Ram admits he cannot do the Eka pada or Dwi pada Kaundinyasana). With a doctorate in Neuroscience, Ram was a Research Associate Professor at the Buck Institute for Research on Aging. He focused on various aspects of age-associated neurodegenerative diseases with emphasis on Alzheimer’s disease. In addition, Ram completed the academic training at the California College of Ayurveda (CCA) and received his certification as Clinical Ayurvedic Specialist. He has been a faculty member of the California College of Ayurveda and teaches in their Nevada City location. Ram is also a dedicated Hatha yoga practitioner and is a Registered Yoga Teacher from Yoga Alliance USA. In his spare time he offers consultations in YAMP techniques (Yoga, Ayurveda, Meditation & Pranayama). Ram has published several articles in major Yoga/Ayurveda magazines and has been a featured speaker in several national and international meetings and symposia. He is a member of the National Ayurvedic Medical Association (NAMA) and is on the Research Board of the Association of Ayurvedic Professionals of North America (AAPNA).

This post was edited by Patrice Priya Wagner, Managing Editor of Accessible Yoga blog and member of the Board of Directors.

° FOLLOW Accessible Yoga on Facebook, Twitter, Instagram, and YouTube. 

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° DONATE here to help us bring yoga to people who don't have access or have been underserved, such as people with disabilities, chronic illnesses, children with special needs, and anyone who doesn't feel comfortable in a regular yoga class.

To order Jivana Heyman's book Accessible Yoga in the U.S., go to Shambhala Publications, Amazon, Barnes and Noble, Indie Bound (for independent bookstores), or your local bookstore. People in other countries who want the order the book see How to Order "Accessible Yoga" from Countries Outside the U.S.

Featured Video: Dancer's Pose with Chair by Janis Ware

We love this customized version of Dancer's pose (Natarjasana), in which the chair is used to support the back leg. For those who have trouble reaching the back foot, this allows the practitioner to work on improving balance on one foot while at the same time staying more stable.



Janis Ware, RYT200, is an Accessible Yoga Ambassador and Certified Teacher and is Trauma Informed Yoga Certified. She teaches in Iowa, in the DesMoines area, including at a holistic wellness center, an adult ed class, a church, a class sponsored by a cancer organization at the Y, and a 55+ retirement community. Her students have ranged in age from young adult to 97! Nearly all tell her they come to the class because it is adaptive and accessible. They want to feel better in their bodies, minds, and spirits, want to practice yoga and hope they've found a safe space to do so.


This post was edited by Nina Zolotow, Editor in Chief of the Accessible Yoga blog and co-author of Yoga for Healthy Aging: A Guide to Lifelong Well-Being.

° FOLLOW Accessible Yoga on Facebook, Twitter, Instagram, and YouTube. 

° REGISTER here for our next conference. 

° DONATE here to help us bring yoga to people who don't have access or have been underserved, such as people with disabilities, chronic illnesses, children with special needs, and anyone who doesn't feel comfortable in a regular yoga class.

To order Jivana Heyman's book Accessible Yoga in the U.S., go to Shambhala Publications, Amazon, Barnes and Noble, Indie Bound (for independent bookstores), or your local bookstore. People in other countries who want the order the book see How to Order "Accessible Yoga" from Countries Outside the U.S.

If It's Not Working For You, It's Not Working For You

by Nina Zolotow

Did you ever do a yoga pose, breath practice, or meditation and start to realize that what it was supposed to be doing for you wasn’t exactly taking place? Well, I certainly have. When I started taking a pranayama class from my favorite yoga teacher, Donald Moyer, after the class I felt irritated and depressed instead of calm. Meanwhile, everyone else was raving about how quiet and relaxed they felt! I gave the class four tries, and every time ended the same way. So I quietly dropped out. 

Eventually I gathered up the courage to tell my teacher about my reaction to the style of pranayama he taught. He surprised me that he understood because he’d come up with his own way of teaching pranayama after he’d had negative reactions to the way his teacher, B.K.S. Iyengar, taught pranayama. He then counseled me to practice whichever way did work for me, even if I was in class with him where he was teaching his style of pranayama, or else I could just refrain from doing any pranayama and quietly relax. Thank you, Donald!

I think it’s essential for everyone to understand that traditional yoga relaxation techniques don’t work for all of us. People are just very different from each other and have different things going on at any given time. For example, simple breath awareness is considered to be calming and a good way for a beginner to meditate. But some people, especially those with anxiety, find that focusing on their breath makes them feel panicky. And for people with depression, certain practices, such as meditation and yoga nidra, can even be dangerous because sitting or lying still with their eyes closed can send them into a downward spiral. 

In addition there are other purported benefits for particular yoga poses and practices that not everyone experiences. For example, supported forward bends may be quieting and soothing for many people but for some they’re aggravating or depressing. Likewise, backbends are traditionally considered uplifting, but they might be agitating or just not effective for others. 

So it’s important for all of us to be honest with ourselves when we are not experiencing what we were expecting. And if you conclude that a practice is not working for you, it’s not working for you! Once you acknowledge this, you can open up to some alternatives. The wonderful thing about yoga is that it is such a rich and varied tradition, with so many different options and possibilities, that there’s a good chance that by exploring and experimenting you will find something that works for you.

In today’s post, I’m going to make some suggestions for things to try when your relaxation techniques are not working for you. One good thing about these alternative techniques is that if you feel more relaxed, less anxious, or less depressed when you’re practicing them, then they are working! 

When Relaxing Isn’t Relaxing

When you’re stressed out, anxious, or depressed, it’s possible that a more active yoga practice will be easier for you—the physical challenges and mindful movements will engage your mind. That will give you some respite. So in general, if an hour of Restorative Yoga makes you restless or miserable, try an active practice instead. However, it’s still important to try to reduce your stress levels. So here are some ideas for different things you can try at the end of an active practice when classic relaxation techniques just aren’t working for you.

Eyes Open: If closing your eyes in Savasana, in any restorative pose, or in meditation causes agitation or brooding, try keeping your eyes open but with a soft focus. Gaze downward instead of straight out at the world. Try opening your eyes fully, one half, or one quarter, and see what works best for you. These positions are actually traditional and are called full-moon eyes, half-moon eyes, and new-moon eyes. 

Covering Yourself: Sometimes lying on your back can make you feel exposed and vulnerable, especially when you’re anxious. So for Relaxation pose or any restorative poses where you lie on your back, you can try covering yourself with a blanket. Sometimes that helps you feel more protected. If not, try the next suggestion.

Crocodile Pose: If lying in Relaxation pose on your back makes you feel uncomfortable, you can try lying on your belly in Crocodile pose (Makrasana) instead to see if that is more comforting. If your lower back curves too much in Crocodile pose, place a folded blanket (long rectangle) under your lower belly. 

If you don’t find Crocodile comfortable, you could try a supported version of Savasana (because raising your torso higher than your legs might feel better than being flat on your back) or even a side-lying Savasana.

Supported Child’s Pose: If classic restorative poses where you lie on your back, such as Reclined Cobbler’s pose, supported versions of Savasana, and Bridge pose with straight legs, make you feel exposed and vulnerable, practice Supported Child’s pose instead. Many people actually find hugging their bolsters very comforting. You can turn your head to the side and keep your eyes open if that helps; just be sure to turn your head to the other side for an equal amount of time. If you can’t practice on the floor, you can practice this pose using two chairs or you can try it on your bed at home.

Supported Inversions: A supported inverted pose is any supported pose where your heart is higher than your head, even just slightly higher. Examples of supported inverted poses include Viparita Karani (with legs up the wall or legs on a chair), Standing Forward Bend with head support, Supported Bridge pose with bent or straight legs, and more (see All About Supported Inverted Poses). 

Because spending time in a comfortable pose in which your heart is above your head triggers the Relaxation response due to our basic physiology, these poses don’t require a mental focus the way meditation and restorative yoga do. So you can keep your eyes open and even listen to relaxing music while you are practicing them and you’ll still quiet your nervous system. These are also great alternatives to forward bends, which cause some people to brood and others just find unpleasant. Of course, as with any pose, if you feel bad in an inverted pose, come out of the pose immediately. 

Choose Appropriate Breath Practices: I actually feel that for some of us (like me!) breath practices can have a very powerful effect on the nervous system. So I think that if doing a breath practice makes you feel uncomfortable in any way, either during or after the practice, you should not do it. For one thing, contrary to what you may have been told, not all breath practices are calming. Practices that encourage you to take a longer and/or deeper inhalation are stimulating and can actually be agitating for some. For some of us, it is generally a better strategy to practice only calming practices, which encourage a longer exhalation, or balancing practices, which have inhalations and exhalations of the same length. But if all the practices you try don’t work for you, they’re not working for you! Try practicing simple breath awareness instead.

Sometimes doing breath practices in Child’s pose where you sense your breath in your back body rather than your front body works well for those who feel anxious doing breath practices on their backs or even in a seated position.

However, if none of these alternatives work for you—for some, focusing on the breath in any way makes you anxious—the solution is to do other things instead. Try meditating with a mantra or an image you hold in your mind rather than on a physical sensation in your body.

This post was edited by Patrice Priya Wagner, Managing Editor of Accessible Yoga blog and member of the Board of Directors

° FOLLOW Accessible Yoga on Facebook, Twitter, Instagram, and YouTube. 

° REGISTER here for our next conference. 

° DONATE here to help us bring yoga to people who don't have access or have been underserved, such as people with disabilities, chronic illnesses, children with special needs, and anyone who doesn't feel comfortable in a regular yoga class.

To order Jivana Heyman's book Accessible Yoga in the U.S., go to Shambhala Publications, Amazon, Barnes and Noble, Indie Bound (for independent bookstores), or your local bookstore. People in other countries who want the order the book see How to Order "Accessible Yoga" from Countries Outside the U.S.

Core Qualities of Yoga, Part 8: Self-Awareness

This post is part of a series that explores a variety of core qualities and suggested practices to consider for inclusion in your classes and private sessions (whether on a mat, in a chair, or a combination of both).

by Beth Gibbs

"The path of understanding follows an ascending spiral rather than a straight line."
--Joanna Field

In a nutshell, self-awareness is the process of finding mindful ways to understand oneself at all levels of being. An investigation of self-awareness from the yogic perspective provides a path to Self-awareness with a capital ‘S.’

Self-awareness is closely aligned with our intuitive wisdom, our ability to see, understand, and accept our thoughts, emotions, beliefs, habits, and behavior with compassion and without judgment. When this skill is actively employed, we see our reality as it is, and not hidden behind a veil of wishful thinking or denial. Then we can consciously choose to make changes, remain unchanged with full awareness of the consequences, or find acceptance and peace of mind if change is not possible.

Self-awareness with a capital ‘S’ is less about thinking and more about observing. It’s not a static state. We don’t get it and keep it. It ebbs and flows and changes, but the trick is to observe, understand, and experience the ups and downs of life with clarity, contentment, and resilience.

Here is one of my favorite practices to get in touch with the ability to be Self-aware.

Practice: The Shelf Meditation

The first time Joseph Le Page, my yoga teacher, read this to our class, we were in the Florida sunshine lying on our mats on the grass, feeling warm and peaceful. Here is my summary of this guided meditation. You can record and play it back or use it as a guide for journaling.

1. Make yourself as comfortable as possible. You can lie down, sit up, or settle into any position that will help you relax and feel at ease.

2. Visualize a shelf. It can be made out of anything you like: wood, glass, stone, and so on.

3. Place on the shelf an image of your purse or wallet, cell phone, and symbolically everything connected with your identity that can change: name, address, driver’s license, health insurance card, credit cards, phone number, email, contact lists, Facebook groups, smart phone apps, etc. Notice that everything connected to your identity can be put on the shelf but you are still here, independent of them.

4. Now place on the shelf an image of your friends and family. Remember you are taking a little vacation from them. You will return to them at the end of the exercise. Notice that although they may be dear to you (or not!), you are independent of them.

5. Now place on the shelf all of your life experiences up to this point in time. Include all the joys and sorrows. They too can be independent objects for you to observe. Notice too that the way you perceive these experiences may be very different from the way you perceived them when they happened.

6. Finally, place an image of your body on the shelf and take a look at yourself from outside of your body. Observe with detachment everything and welcome every observation with friendliness and compassion and without judgment. Notice that even your body can be an object to observe.

7. Now notice who is observing everything on the shelf. Try to place that observer on the shelf. You will discover that the observer can’t be placed in space and time like everything else on the shelf. The observer sticks like glue. No matter how hard you try to put it on the shelf, it remains the center of yourself, nearer to you than your body.

8. Notice the qualities of the observer, which is Self-awareness. It is not separate from existence. The world around you and the objects on the shelf are all parts of the same awareness. Notice that unlike everything on the shelf, this Self-awareness is not limited by space. It cannot exist only in the body since the body is on the shelf. It is not limited by time because in the few minutes it took to do this exercise, everything on the shelf may have changed. But this Self-awareness has not.

9. Now notice that this Self-awareness is whole and content. Although it may be a part of life on the shelf, its sense of satisfaction, peace, joy, and enlightenment is innate, and does not depend on interactions with any of the objects on the shelf.

10. Notice this sense of wholeness and allow it to expand through your entire being in a way that feels comfortable. Know that this wholeness, this awareness, this freedom from limitation is your true nature, your true Self-awareness. Rest in this wholeness for as long as you like.

11. As you begin to return to your everyday reality take a moment to reflect on your relationship with everything on the shelf. Has anything changed? Do you see anything differently? Where should you place your priorities? What changes, if any, would you like to make to bring your life into alignment with this sense of wholeness? Reflect, contemplate, journal, or draw about this if you wish.

12. Re-establish your relationship with everything you put on the shelf — your identity, friends, family, and your life experiences. But now do it using any new perceptions you may have gained by exploring your Self-awareness.

It helps to remember that the road to Self-awareness is a marathon – not a sprint. A consistent and personally appropriate yoga and meditation practice provides the needed training.

Elizabeth (Beth) Gibbs, MA, C-IAYT, is a certified yoga therapist through the International Association of Yoga Therapists and is a guest faculty member of the Kripalu School of Integrative Yoga Therapy. Her masters’ degree in Yoga Therapy and Mind/Body Health is from Lesley University in Cambridge, MA. She is the author of Ogi Bogi, The Elephant Yogi, a therapeutic yoga book for children. For more information please visit her website at: bethgibbs.com

This post was edited by Patrice Priya Wagner, Managing Editor of Accessible Yoga blog and member of the Board of Directors.

° FOLLOW Accessible Yoga on Facebook, Twitter, Instagram, and YouTube. 

° REGISTER here for our next conference. 

° DONATE here to help us bring yoga to people who don't have access or have been underserved, such as people with disabilities, chronic illnesses, children with special needs, and anyone who doesn't feel comfortable in a regular yoga class.

To order Jivana Heyman's book Accessible Yoga in the U.S., go to Shambhala Publications, Amazon, Barnes and Noble, Indie Bound (for independent bookstores), or your local bookstore. People in other countries who want the order the book see How to Order "Accessible Yoga" from Countries Outside the U.S.

Intervertebral Disc Herniations and Bulges—And Yoga

Vertebrae and Vertebral Discs 

by Andrew McGonigle

This is the first in a series of posts that I'm delighted to be writing for the Accessible Yoga Blog, which will be about some of the most common injuries and medical conditions that students show up to yoga classes with. This is a topic that I am really passionate about, and a book that I have written about this subject, called Common Injuries and Conditions: A Practical Guide for Yoga Teachers, will be published early next year. In each post I will provide some up-to-date information about the injury or condition and then relate this to practicing and teaching yoga. The details I will include here are by no means exhaustive and are simply intended to be a guide. The suggestions are not a replacement for the personal advice of a healthcare professional. 

Before I begin, here’s a little about me. After originally training to become a medical doctor, I moved away from western medicine to pursue a career as a yoga teacher, massage therapist, and anatomy teacher. I have been practicing yoga and meditation since 2005, and have been teaching strong, grounding, and inclusive classes since 2009. I combine all of my skills to teach anatomy and physiology in Yoga Teacher Training courses and as part of my own trainings. For more information about me please visit: www.doctor-yogi.com.

About Intervertebral Discs 

Intervertebral discs are really remarkable structures that are found between the vertebrae of our spine (see illustration above). They have the multiple roles, including providing the primary support for the vertebral column, permitting all the required movements of the spine, and absorbing shock. 

The discs accounts for around 25% of the overall height of the spine. We are tallest first thing in the morning when the discs are their most plump, and we slowly become shorter during the day as the discs subtly flatten under our body weight. So always measure your height first thing in the morning! 

These discs have a central, gelatinous structure that is surrounded by a tough but elastic region. The discs are interwoven with their neighboring vertebrae and are supported by many spinal ligaments.

Intervertebral Disc Herniations and Bulges 

As a result of the natural aging process, the elastic material in the discs begins to be replaced by more fibrous tissue. An older disc is therefore less elastic, and its ability to respond to all the demands put on it decreases. The intervertebral disc also has no direct blood supply by the third decade of life and absorbs its nutrition from neighboring areas. 

An intervertebral disc herniation or bulge occurs when part of the disc pushes outward beyond its normal boundaries. The term ‘herniated’ disc is used when the distance of the displacement is less than 25% of the total disc circumference while the term “bulging” disc is used when the distance of the displacement is greater than 25% of the total disc circumference. The vast majority of bulges or herniations occur in the backward direction and slightly to the side. 

By the way, the discs cannot “slip” out of place. This term makes me think of a game of Jenga! Also, a “ruptured disc” is also not an accepted medical term and suggests trauma when none might have occurred. 

What Does the Research Tell Us? 

One study, Herniated lumbar disc in BMJ clinical evidence, suggests that only 1% to 3% of people seen with lower back pain in primary care have a herniated intervertebral disc. 

Disc bulges and herniations are highly prevalent in pain-free populations and their presence is not strongly predictive of future lower back pain. One landmark study Evaluation and Treatment ofAcute Low Back Pain in Am Fam Physician 75 showed that in a group of 20-year-olds who were not experiencing back pain, 30% had bulging intervertebral discs. 

A second review Diagnostic Evalution ofLBP. Reaching a Specific Diagnosis Is Often Impossible in Archives of Internal Medicine 162 reported that in a group of 50-year-olds who were not experiencing back pain, 60% had bulging discs. Furthermore, when a person who has a herniated disc also has back pain, there is often a poor correlation between the extent of the herniation and the levels of pain and disability experienced. A systematic review of the literature found that 50% of patients had spontaneous resolution of herniated discs after conservative treatment. This review also reported that the more severe the herniation the greater the chance of spontaneous resolution! 

In a Nutshell: Disc herniations and bulges are part of the natural aging process, are not always associated with back pain, and can often heal without surgical intervention. 

Advice for Yoga Students 

If you have a disc herniation or bulge, always get the go-ahead from your healthcare practitioner before practicing yoga. But when you get the go ahead, don’t be afraid to move your spine! Movement is medicine and motion is potion. So move your spine through its full, pain-free range as often as possible. Some suggested asanas include Seated Cat-Cow, gentle side bends, and controlled twists. 

Remember that our bodies have the most incredible ability to heal and that no experience is permanent. Try to be patient as you continue to practice yoga. Restorative yoga asanas are a great option for when a lot of movement doesn’t feel like the right choice. 

No teacher or therapist, no matter how experienced, can you tell you which movements will work for you and which movements won’t. You must be guided by your own experience in each moment. If you feel pain during a movement, then you can decrease the intensity of the movement or rest. If you’re not feeling pain, then keep doing what you’re doing! 

Advice for Yoga Teachers 

If your student has a disc herniation or bulge, start by checking with them that they have been given the go-ahead to do yoga by their healthcare professional. If they confirm that they have, encourage them to move their spine within its pain-free range of motion. But keep offering them the option to decrease the intensity or to rest at any time. I often share that my definition of an “advanced” yoga practitioner is one who takes rest when they need it. 

And always keep in mind that that each student’s experience of an injury or condition is completely unique to them, so an individualized approach is absolutely key. This means teaching the student, not the injury or condition.

As a teacher, it is essential to avoid the trap of telling students what their experience is going to be, for example, “avoid spinal flexion because it will feel painful.” No amount of experience gives any teacher the ability to predict the future. A more appropriate way of phrasing this could be to say, “I suggest paying close attention to how your back feels during the different positions and movements that we explore, always backing off if you feel strong discomfort.”

Andrew McGonigle originally trained to become a medical doctor, but moved away from western medicine to pursue a career as a yoga teacher, massage therapist, and anatomy teacher. He has been practicing yoga and meditation since 2005, and has been teaching strong, grounding, and inclusive classes since 2009. He combines all of his skills to teach anatomy and physiology in Yoga Teacher Training courses and as part of his own trainings. Andrew is indebted to his teachers, who include Hamish Henry, Paul Dallaghan, Eileen Gauthier, Kristin Campbell, Anna Ashby, Richard Rosen, Sally Kempton and Jivana Heyman. For more information about Andrew please visit: www.doctor-yogi.com, Instagram @doctoryogi1, and Facebook @doctoryogiandrew. 


This post was edited by Nina Zolotow, Editor in Chief of the Accessible Yoga blog and co-author of Yoga for Healthy Aging: A Guide to Lifelong Well-Being.

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