Betrayed by my body Part 1: How I herniated a disc practicing yoga

On September 7, 2014, I herniated a disc in my lumbar region while practicing yoga. As a yoga student and teacher, it has been hard to come to terms with that fact. I believe that yoga heals all kinds of ills - physical, mental and emotional. I believe that yoga is safe. I believe that yoga can be practiced by anyone. This injury was a shock and a heartbreak. My physical practice is important to me. Movement is important to me. And this injury temporarily took movement and my physical practice away from me.

I was doing my regular Sunday morning practice at home because my teacher was away for the week. I started later than usual, and had already taken my dog for a walk, so I felt warmed up. Everything was going great. I was doing second series ashtanga. All the poses felt deeper than usual. My head easily reached my shins in forward folds. My kapotasana felt wonderful - I could reach my hands to the middle of my feet, which is deep for me. And it felt so good that I held it for 10 breaths. As I approached eka pada sirsasana, I thought, “this is the day that my foot stays without me holding it”. In this pose, you bring one foot behind your head, then you lean forward over your other leg. For a couple of years, I’ve been able to get my leg behind my head, even hook my foot behind my neck, but I always need to hold onto it so it doesn’t snap back out. But today felt different. Everything felt different - fluid, easy, deep. Before I got to the pose, I was thinking about it. I was so sure it would happen, that I had a plan. I would ask my boyfriend to take a picture, then I would send it to my teacher. I debated in my head about the caption - either ‘breakthrough’ or ‘Look Ma, no hands’. I was leaning towards ‘breakthrough’, because that’s what it felt like. All of this internal dialogue happened before I even attempted the pose. And then it was in front of me. I took a deep breath. I wriggled my right leg behind my head. I squirmed, pushed, wriggled some more. It was deep, but I still had to hold onto it. Darn it, I thought. Around this time, I noticed a slight twinge in my lower back, but I ignored it. Everything was going so well that I ignored a key piece of advice that I give to my own students - ‘listen to your body’. I ignored the twinge. And I folded forward. I made it about halfway when I felt a blinding pain explode across my lower back. The next couple of seconds were a blur, but I ended up lying on my back, pain throbbing through my body, looking up at the ceiling. I knew instantly that it was a herniated disc in the lumbar region.

Intervertebral discs lie in the spaces between the bodies of the vertebrae. Their jobs are to provide shock absorption and facilitate movement around the vertebral column. They consist of a fibrous outer ring and a jelly-like inner substance called the nucleus pulposus. When a disc herniates, the nucleus pulposus basically squeezes out through the fibrous outer ring into the surrounding space. This can sometimes happen with no apparent ill effects. There are a certain percentage of folks walking around at any given time with a herniated disc that they know nothing about. But when the nucleus pulposus squeezes out and puts pressure on a spinal nerve, the pain is intense.

 [image from Wikipedia]

[image from Wikipedia]

Between each successive vertebra, two nerves exit the spinal canal and travel out to muscles and organs. If a spinal nerve is compressed by the nucleus pulposus of the intervertebral disc, it can send a pain signal along its entire pathway. This can be experienced as muscular pain, even though there is no muscle damage. This is basically what happens when you experience a disc herniation. The pain I felt was not muscle pain, but the pain signals triggered by the disc pressing against the nerve.

 [image from www.hopkinsmedicine.org]

[image from www.hopkinsmedicine.org]

 

I felt ashamed and betrayed. I felt ashamed because I was the yogi who always said how safe yoga was, how it is a system of healing. And I don’t deny that injuries happen, but I attribute them to user error. For example, there is a case written up in the clinical literature about a woman who was on drugs and fell asleep in paschimottanasana for 4 hours. When she woke up, she had permanent nerve damage in both legs. Do we blame the yoga? Of course not. No one recommends this pose for 4 hours. It was a clear case of user error.

And now I was forced to ask if my injury, too, was user error. Although I think there were other contributing factors, which I’ll discuss, the short answer is yes, it was user error. I had been forcing that pose for a long time.

I hated that pose. Now I realize my hatred was probably my mind’s interpretation of my body’s dire warning signals. I don’t hate other difficult poses, such as kapotasana. It’s not that kapotasana is a joy, but I don’t have a strong aversion to it. I find it difficult and I often have to brace myself mentally before entering kapotasana, but I don’t HATE it. But all the leg behind the head poses are different. This should have been my first warning sign.

My second warning sign happened just before the injury hit. I felt that twinge, but I ignored it because I was not IN the moment. I was anticipating the moment that I would send an image to my teacher. I was anticipating her reaction. And I was anticipating my own joy at a breakthrough that was three years in the making. I was not experiencing things as they were happening, but instead focusing on an imagined outcome that had already taken root in my brain.

And I felt betrayed because this sort of thing is not supposed to happen to me. I practice yoga regularly. I walk. I ride my bike. I stay active. And I’m not that old - 39. I thought that herniated discs were for inactive people; people who sit on their couches in the evening, at their desks during the day. But wait. I do that. I sit at a desk during the day. I sit on a couch at night. The only difference between me and those people I imagined were getting herniated discs was the yoga and exercise. So what if it’s not the yoga that is dangerous, but the sitting?

We are starting to learn about the dangers of sitting. There are reports that it is as dangerous as smoking in terms of mortality (1). And recently we learned that regular exercise doesn’t even counteract the effects of sitting. People who sit for long periods during the day are at increased risk for cardiovascular disease, cancer and other disease (2). But sitting also affects your short-term health and your musculoskeletal system. Sitting in a chair puts increased pressure on the lower back, causing weakness of the muscles and ligaments of that area. And it was that weakness, despite the daily yoga and regular exercise, that allowed for the disc to herniate.

So yes, I injured myself practicing yoga. But I don’t blame the pose, or the yoga. I blame my own lack of attention and my habit of sitting at a desk all day. I would not have herniated my disc if I had not put my leg behind my head and leaned forward. But the weakness that created the herniation would not have been there if I had not been sitting for years of my life.

Coming soon:

Betrayed by my body Part 2: How I healed my herniated disc with yoga

Related: Therapeutic Yoga for the Lower Back

(1) Levine, James A. 2014. Get up! Why your chair is killing you and what you can do about it. Palgrave Macmillan Trade.

(2) Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS and Alter DA. 2015. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults. Annals of Internal Medicine 162:123-132.