I herniated a disc in the lumbar region of my spine practicing yoga. It was excruciating. I cried, not from the pain, but from the frustration and helplessness I felt. I have an active yoga practice and movement is important to me. To be injured so acutely that I could barely move was a physical, mental and emotional shock. I also felt betrayed by the practice that I had invested so much time and energy in. I eventually came to realize that it was not yoga, but my own misuse of the practice that was to blame.
The pain was a sudden herniation that came in the middle of one of my least favorite poses, eka pada sirsasana, and I knew immediately what had happened. What I did during the first hour after my herniation is a good summary of the steps I also took over several months to heal the injury.
My first reaction was that I could quickly ‘push’ the disc back in place. Most herniations happen in forward folds, as mine did. Of course, most herniations do not happen during a yoga practice - they happen when someone bends over to pick up a heavy object. Since forward folds cause herniated discs, I reasoned that backbends would be healing. I’m not sure how, but somehow I managed to wriggle myself into a bridge pose, pain throbbing through my body. I visualized my disc oozing back into place. Unsurprisingly,that did not work. I stood up with difficulty, and went to the shower and stood under the hot water for several minutes. I couldn’t move well enough to actually bathe myself, but the standing and the heat was a good combination. Next I took a walk with my boyfriend. Normally, I’ll walk 2-4 miles. This time, we made it slowly, carefully, to the end of the block before I had to turn around and come back. The amount of energy that pain management required was astounding. I was exhausted. That day, I got a heating pad and ibuprofen.
The first day was the worst. I would rank that an 8 on a pain scale of 1-10. Sitting was very painful, and trying to sit on the toilet was an embarrassing ordeal. I needed help getting into and out of a car. I felt helpless. And I dreaded going to bed since sitting and lying down was the most uncomfortable. I set up pillows so that I was lying on an incline rather than flat on my back. I arranged a rolled up blanket under my knees. Then I took 800mg of ibuprofen. Bedtime was the only time I took any type of painkiller.
The next day, Monday, my pain was a 6 on a scale of 1-10. I had a meeting at work that I couldn’t miss. I rode the bus into work, standing even though there were plenty of seats. It was the most uncomfortable bus ride I’d ever experienced. I stood through my meeting and for the rest of the day.
As the week went on, the pain slowly but steadily diminished. I made sure to follow a specific routine each day to help heal the injury.
I used a heating pad almost constantly for the first two weeks. I can’t tell you how much better it made me feel. It reduced pain and promoted healing. The standard recommendation for many musculoskeletal injuries is RICE (rest, ice, compression and elevation). But heat is the body’s own healing response. The heat and swelling that accompanies a sprain, for example, is not a symptom of the torn ligament, but a symptom of the body healing by increasing blood flow to the area to bring platelets, plasma and white blood cells that will clear out and area and repair the damaged tissue. When you apply ice to an injury, it restricts blood flow to the area and prolongs the healing process.
I am generally reluctant to take any pain-killers, even ibuprofen, except in rare cases. I knew if I dulled the pain of the injury during the day, then I wouldn’t learn from it. I wouldn’t know which movements made things worse and which movements made things better. I needed the constant feedback from my body about how to move and when to rest. After all, a big part of the reason for my injury was not listening to signals my body was giving me (Betrayed by my body Part 1).
At night, I took 600mg of ibuprofen for the first week so that I could sleep. I knew that sleep would be important for the recovery process. For sleeping, I propped myself up on pillows so that my upper body was on an incline and placed a rolled up blanket under my knees. I was fully supported in a position that minimized the pain. During the second and third weeks, I took 200-400mg at bedtime depending on what I felt like I needed.
In the first days after the initial herniation, yoga was almost impossible. But I made sure to walk as much as I could. Each step was painful, but I knew it was helping. Movement increases blood flow, which facilitates healing. On Thursday, 5 days after the initial injury, I got on my yoga mat to see what I could do. I started by just lying down and assessing the situation. I did a couple of bridge poses.
I wondered if I could do wheel. I have a strong and regular practice of wheel pose, so this was not a ‘challenge’ pose for me, which is important to note. I wouldn’t recommend that a newer practitioner to yoga try a pose like this if they are injured. But I tried it, and it was a revelation - the first time in almost a week that I was pain free. Even though I knew that backbends would help the situation, I was still astounded at the degree of relief I felt in this pose. From that point on, it became a daily part of my healing regime.
Within two months I was back to practicing Ashtanga intermediate series on a regular basis. I need to be much more cautious about the primary series because of the number of forward folds it contains. I can generally get through about half of a primary series before my back tells me that it’s had enough. And nowadays, I listen when my back speaks!
Poses to heal a herniated disc
Generally speaking, gentle and strengthening backbends are going to promote healing in this region by applying gentle pressure towards the back of the disc and by increasing blood flow to the area. Standing poses also provide strengthening and engagement of stabilizing muscles close to the vertebral column. The following poses are ones I did regularly in the first 3 months after my injury. They helped enormously in the healing process.
1. Cobra pose (modified)
Lie on the floor on your stomach. Reach both arms out in front of you with palms down. Your arms should be wider than your shoulders. Gently press into your hands to lift your head and chest off the ground. Keep your neck neutral and your gaze at the floor in front of your mat. Try to release muscular effort in the back and glutes, using your arms for support. Hold for 5-10 breaths.
2. Warrior 2
Stand with your feet about 3 feet apart on your mat. The distance will vary depending on your height, degree of flexibility and strength, and yoga experience. Take a stance that is challenging, but that you can maintain without strain. Turn your right foot towards the front of your mat and your left (back) foot to the side of your mat. Slowly bend your right leg so that your knee is over your ankle. Extend your arms towards the front and back of your mat at shoulder height. Hold for 5 breaths. Repeat on the other side.
Variation: Set up your Warrior 2 as described above. On an inhale, straighten your front leg and raise both of your arms over head. On an exhale, return to your warrior 2 pose. Repeat 5-10 times then do the same thing on the other side.
3. Extended side angle
Set up your Warrior 2 as described above. Rest your right elbow on your right thigh and extend your left arm towards the front of your mat. Focus your attention on lengthening the left side of you body. Take 10-20 breaths here. Repeat on the other side.
4. Bridge pose
Lie on your back with your knees bent and feet on the floor about hip width distance apart. Place your arms on the ground alongside your hips, with palms down and your elbows straight. Press into your feet and your hands to gently lift your hips off the ground. The purpose here is not to lift into your deepest bridge pose, but to find a lift that requires 30-40% engagement of your back muscles. Keep your hands rooting into the floor. Make sure that your knees do not splay out wider than your hips. Hold it for 2-4 minutes.
For a less intense version, place blocks under your feet.
5. Bird dog
Come into table position with your hands slightly in front of your shoulders and your hips over your knees. Place a blanket under your knees if you experience discomfort. Reach your right arm out in front of you with your elbow straight and your fingertips on the ground. Then extend your left leg behind you parallel to the ground. Don’t try to ‘square’ the hips, but do try to roll the left inner thigh up towards the ceiling. Draw in lightly through your lower abdomen and extend your chest forward.
If you are comfortable with your breath and your balance, try lifting your right arm off the floor, bringing it parallel to the ground as well. Hold for 5 breaths and repeat on the other side. You can try 2-5 rounds of this pose on each side.
6. Sphinx pose
Lie on your stomach with your elbows beneath your shoulders, forearms on the ground and palms flat. An alternative if this feels too intense on your lower back is to have the elbows slightly forward of the shoulders. Gently lift your sternum forward and up, with the intention of arching through the upper back. Draw in the lower abdomen so that you do not rely exclusively on the lower back for the backbend. Extend the lower rib cage towards the front of your mat and aim your tailbone towards the back of your mat. Look at the floor about two feet in front of your mat so that you do not strain your neck. Try to take about 20 breaths here and then rest by lying flat with your head turned to one side. Repeat for another 20 breaths if you are able.
7. Locust variations
a. Half locust
Lie on your stomach with your arms straight alongside your body, palms up. Spread your toes and reach your feet towards the back of your mat, maintaining an awareness and light engagement of your legs. Keep your feet and your hands resting on the floor as you inhale and lift your head and your chest up. Keep your head and neck in a neutral position by gazing at the floor a few feet in front of your mat. If you notice that your glutes are fully active, try to release them to about 20-30% engagement. Your glutes are needed for extension at the hip, but if you use them to their maximum, they will put pressure on your sacroiliac joint.
b. Variation 1
Set up as in half locust. If you are able to breathe comfortably in this pose, then slowly lift and lower one leg at a time, as if you were using a very slow swimming kick. Keep your awareness focused on your glutes so that you do not rely too much on those muscles.
c. Variation 2
Set up as in half locust. If you are able to breathe comfortably in this pose, then slowly lift your arms so that your elbows are bent and your arms are reaching out to the side. Try to bring both arms roughly parallel to the ground. Inhale and reach both arms out and front of you, still parallel to the ground. Exhale and draw your arms back to the original bent position. Repeat 5x and then rest.
8. Staff pose
Sit on your mat with a folded blanket or towel under your hips. If you have very tight hamstrings, you will need extra support under your hips. You will know you are sitting at the right height when you are able to keep your back relatively straight and feel the engagement of your lower back muscles comfortably working. Extend both legs out in front of you with your ankles flexed. You may need to put an additional small blanket under your knees if you feel pressure in the back of your knees. Place your hands on the ground or blanket next to your hips. If your hands do not reach the ground, place a block or a book underneath them. Sit up straight with your gaze towards your toes. Reach the crown of your head up towards the ceiling and take long slow deep breaths. Try to hold for 2-3 minutes.
9. Cow-faced pose on blankets
Sit on your mat with a folded blanket or towel under your hips. Bend your left leg so that your left foot rests just outside of your right hip. Then bend your right leg and cross the right leg over the left leg. Both legs will be more horizontal than vertical, but getting the legs exactly in position or stacking the knees is not necessary.
If your hips are very tight and you are not able to come into a close approximation of this leg position, then simply sit on your blanket with your right leg crossed over your left leg. Use the extra lift of the blanket to seek evenness of the sits bones reaching down. Lengthen your spine towards the ceiling and take several long breaths.
If this pose does not cause any discomfort on your lower back, then you can try to lean forward slightly, but make sure not to round your back. Hold for 5-10 breaths. Repeat on the other side.
10. Savasana with blanket under knees
Lie on your back with your knees supported by a rolled up blanket or bolster. Rest your arms by the sides of your body with your palms facing up. Close your eyes and let your eyes drop deep into their sockets. Using your breath, release tension in your face and your neck. Allow your body to feel heavy on the ground. Relax your breath and be at rest. Stay for 8-15 minutes.