Category: Back pain

Pilates Breathing for Spinal Health and Flexibility

A dedicated Pilates practice can be a powerful tool to increase spinal health and flexibility, particularly when Pilates-method breathing is included. I struggled with back pain starting at 9 years old. I am hypermobile and my spine was like a Red Vine in the back of a hot car, all goo and no structure. I was able to touch my butt to my head, but not stand up straight.

Kristina in a deep backbend grabbing her ankles from behind and smiling

My backbend at age 36 was still pretty bendy

My posture was my primary struggle, cutting short my foray into gymnastics as a child and forever frustrating my dance technique. I just couldn’t hold myself up well, and it resulted in such intense lower back pain that it kept me home from school some days, laying on the floor with a heating pad.

As a kid in the 70s and 80s there were very few resources other than my pediatrician who gave me aspirin and some exercises that did nothing at all. I assumed it was something I just had to live with.

Pilates Improved my Back Pain

Nothing really made a huge difference until Pilates. Pilates entered my life when, at 32, I was training contortion 6 days a week at San Francisco Circus Center and manipulating my spine in all sorts of creative ways. Contortion had actually reduced my back pain by giving me an impressive new set of muscles, but I focused almost exclusively on back bending since we all like to do what we are good at.

Tiffany Parish, a member of the cutting edge circus and dance company Xeno and founder of Bodicraft Pilates, with the first person to teaching me Pilates breathing for spinal health. She showed me how changing my breathing patterns could unload my spine and get my hip flexors to chill out, helping me counter the compressive forces of contortion.

The Importance of Spinal Health for Longevity

While my struggle with spinal health and flexibility is extreme, it is not unusual. According to the Center for Disease Control, 30-40% of folks in the US have back pain at least once a year. Untended, postural issues and immobility can lead to a host of unpleasant structural issues that don’t get better with neglect.

The good news is that it’s never too late to start working on improving your spinal health and flexibility!

Numerous studies have shown that regular exercise is an important part of preventing and even reversing lower back pain. No one form of exercise has emerged as the silver bullet because the root causes of pain and the application of exercise is so varied, the important thing is to move, try out different forms of strengthening and stretching, and find what works best for you and your body.

Pilates Breathing for Spinal Health

Pilates breathing patterns that emphasize diaphragmatic and rib cage breathing. That means that the rib cage expands on the inhale and relaxes down on exhale. Diaphragmatic breathing gives us more access to our lung capacity and, importantly, it helps our back muscles to relax so that we can get some ease and movement into our spine.

As I explain in my post on diaphragmatic breathing and posture, this breathing pattern gives us more access to the “meat corset” muscles that support our spine and upper body. These muscles wrap around our waist and protect our spine while also supporting its natural flexibility.

This postural shift has potential benefits for folks with upper back and neck pain, since the muscles in those areas can sometimes take over if the diaphragm is sticky or sleepy. Last month’s post contains a breathing workout specifically designed for folks who suspect they may be breathing with their neck and shoulders.

Below is a slightly 20-minute workout with a series of simple but very effective Pilates exercises that focus on using diaphragmatic breathing to access the “meat corset” core muscles that help to lengthen, support, and stretch the lower back. I hope you find them useful.

Happy Bendings!

 

What is your “Core Muscle” Group and How Does it Work?

What is your core muscle group and how does it work? Practically every fitness program known to humanity talks at some point about “core muscles” and how to strengthen them. But what are your core muscles? Meet the team of muscles that works together to create mobility and stability throughout your body.

A lot of programs focus on the rectus abdominus muscles (known as the six-pack) but the six-pack is really just a supporting player.

The core muscles aren’t just on the front of your body. They make up a shape like a soup can with a top, sides, and bottom. The core muscles are constantly in dynamic interaction to provide both support and movement to your torso and internal organs and control how you breath, use the bathroom, have sex, digest food, and much more. They need to be trained together so that they can coordinate for both strength and flexibility.

 

Core Muscle group is like a soup can in the middle of the body

Core Muscle group is like a soup can in the middle of the body

What is Your “Core Muscle” Group?

The Diaphragm

Core Muscles The DiaphragmThe diaphragm is the top of the soup can, a big dome of muscle at the bottom of the rib cage. It attaches to our spine, rib cage, and the muscles all around our midsection, with holes in it where the aorta, vena cava, and esophagus pass through on their way to the lower body.

The primary job of the diaphragm is breathing. When it contracts, the dome drops down pulling air into the lungs. When it relaxes it lifts back up into its original dome shape as the lungs empty out. Having the ability to fully relax and contract the diaphragm is very important for taking full, deep breaths. This is called diaphragmatic breathing, not because it only uses the diaphragm (other muscles also play important roles) but because it makes full use of the diaphragm.

The diaphragm also works with the rest of the core muscle team to stabilize the upper body. When other core muscles aren’t working well the diaphragm ends up needing to work overtime as a stabilizer, making it hard to relax. This can have a big effect on important stuff like your breathing patterns and neck and back flexibility.

The Transversus Abdominus

Core Muscles Transversus AbdominusWhile the six-pack muscle is the showboater of the core muscle group, the transversus abdominus is the real power behind the throne. This is the deepest of the three muscles I like to call the “meat corset” because they wrap around our waist and, when they contract, they squeeze in to stabilize us from all sides. The meat corset makes up the sides of the soup can.

The TA attaches in back near your spine and wraps all the way around your waist where it comes together at a thin line of connective tissue in the middle of your belly. A happy TA works together with the other meat corset muscles as a primary stabilizer for the spine and entire upper body.

The Internal and External Obliques

Core Muscles External ObliquesCore Muscles Internal ObliquesThe obliques are the second and third layer of the famous meat corset. They wrap around your waist over the TA at slight angles, providing even more stability and adding a dynamic side-bending and twisting ability that gives our spine it’s famous mobility.

The meat corset muscles work in constant coordination with the diaphragm so that when the diaphragm relaxes and you exhale the meat corset ramps up to take over most of the job of holding you up. If the meat corset is sleepy and uncoordinated then the diaphragm doesn’t get to relax and you can end up with breathing issues, back and neck pain, poor posture, stiff spine, and a long list of additional issues.

Check out the work of the Postural Restoration Institute if you want to do a deep dive here.

The Pelvic Floor

Core muscle group pelvic floorThe pelvic floor muscles are a basket of interwoven muscle fibers that sits at the base of your pelvis. They are the bottom of the soup can.

The two main muscles are the levator ani and the coccygeus, that support your internal organs and have little holes in them to control your poop and pee, and the opening of the vaginal canal if you are AFAB (assigned female at birth).

The pelvic floor muscles are part of the intricate choreography of the soup can. When the choreography is off the pelvic floor can become sleepy and under-working, or stressed out and over-working, which can have unpleasant repercussions for digestion, pooping and peeing, and sex.

Core muscle group erector spinae back musclesThe Erector Spinae

The erector spinae are a bunch of small muscles that stick out all along your spine like little pine tree branches, connecting the vertebrae together. They are the solid seam in the side of the soup can that provides extra stability and helps to keep your body upright but mobile. If the rest of the soup can gets sleepy and squishy the erector spinae can end up very over-worked and tight. Unpleasant outcomes include tight back muscles, back spasms, and even displacement of the vertebrae.

Rectus abdominus core muscle groupThe Rectus Abdominus

Here we have arrived at the six-pack, all the way down at the bottom of the list. The rectus abdominus attaches to the bottom front of the rib cage and the top front of the pelvis. It’s sole job is to forward flex the spine (like in a sit-up) but it isn’t really awesome at stabilization. It’s a bit of a one-trick pony: very good at an important job but not good at anything else.

When the soup can is squashy the rec abs can end up over-working. You can tell if you have too much rec ab in your life if, when you try to do a sit-up, your abs push out instead of in. This ultimately robs you of a lot of your strength and stability.

Core Muscles IliopsoasHonorable mention goes to the Iliopsoas

Even though it isn’t technically part of the soup can, you can’t talk about core muscles without mentioning the iliopsoas. This is a loving union of two muscles, the iliacus and the psoas, that attach to the spine at the same place as the diaphragm and swoop down inside your body, through the pelvic floor, to attach to your upper inner thigh. I have a lot of content on the iliopsoas and how to fall in love with yours, so I wont get into too much detail here.

 

 

 

 

 

Key Takeaway about the Core Muscle Group and How it Works

The most important thing to remember about the core muscle group and how it works, is that these muscles all work together and what affects one of them, affects all of them.

The core muscles are always moving because you are always breathing and breath is the first and most accessible way to start to feel how they work and interact. Coming soon is a series of workouts and tutorials on how to coordinate and strengthen your core muscle group so that they work together as one happy team!

 

Happy Bendings!
Kristina

 

 

How to Have a Strong Flexible Psoas for Healthy Hips

A strong flexible psoas muscle is fundamental to a healthy back and mobile, balanced hips. The psoas attaches all along the lumbar spine in the lower back then swoops down under your internal organs to attach to the top inside of the femur. It is the only muscle connecting the upper and lower body, and it has multiple jobs including spinal support and movement, hip stabilization, and internal rotation and flexion of the thigh.

Drawing of the Iliopsoas

The Iliopsoas

Despite its extremely important role in our mobility (the psoas plays a part in anything we do from the waist down) it is often neglected. Part of this is because the psoas runs deep under other muscles and guts, so it’s hard to touch it or have a strong awareness of what it’s up to. It’s also because sitting too much, as most of us do, makes the psoas squashed, weak, and tight.

The Consequences of a Tight, Weak Psoas

Many people have issues strengthening and stretching their psoas and experience some kind of sub-optimal consequences. If you experience back spasms (“throwing your back out”), snapping hip syndrome, SI joint pain, sciatica, or myriad other issues, it’s good to take a close look at your psaos health.

My own psoas was very unhealthy during my years as a dancer and contortionist. It was chronically tight, which I found extremely frustrating. I over-stretched it and it spasmed on a regular basis. It wasn’t until I learned how to feel my psoas, which took some concerted work over a period of months, and strengthened it, that I was able to finally get it to relax and my hip flexibility and back health improved.

How to Have a Strong Flexible Psoas

The routine in this video is basically the format that I used to create a strong flexible psoas. I progressed slowly. It took me many months to be able to move through the exercises that I show in half an hour. In the beginning I kept offloading the work to the other hip flexors (see this post on hip flexor anatomy if you want to know who they are).

So you may want to just start with the first exercise, the foot slide on an elevated surface, and stick with that until you have a sensation of where the psoas is and how to use it, then progress slowly at the pace that works best for you.

 

This is not the most glamorous, social media-worthy work but it has changed my life to have a better relationship with my psoas, and I hope it changes yours too.

Viva el psoas! Hail the psoas! Psoas forever!

How “Fixing Your Posture” Could be Causing Your Back Pain and What to Do About It

 

Earlier this year I made a post called 4 Tips to Get More Flexible Without Stretching, and the #1 item on the list was to improve your posture. This post offers a deeper dive into posture, how some “fixes” can actually create back pain, and a checklist with alternatives.

We all know that hunching over like a buzzard is not good for us. The “tech neck”, rounded back, forward-thrusted head, and drooping shoulders characteristic of our modern lifestyle is obviously problematic. But how do you fix it? What should you do instead?

The most common “fix” that I see is to thrust the chest forward, lift the chin, and pull the shoulders “down and back” like a proud peacock. While this posture may work for peacocks, it isn’t so great for human anatomy and can actually cause more chronic pain, especially in the mid and upper back.

This tutorial is a little step-by-step bottom-up checklist for getting your bones stacked up and your muscles gently but firmly engaged for relaxed, healthy, mobile posture.

It is important to note that “perfect” posture is not a requirement for health or the same for all bodies. There is tremendous variety in the way our bodies are formed so this might not be what is optimal for you. This is just a set of guidelines you can use to check in with your body if you are having back pain or if you notice that your posture is feeling weird.

Posture Checklist to Align Your Spine

1. Notice How your Posture is Now

The textbooks have some guidelines for correct posture that I take as a loose jumping-off point, understanding that all bodies are different. Look for the landmarks of your ear, your shoulder bone, bone on the outside of your hip (the greater trochantur of the femur), the middle of the knee, and the ankle bone and get them all lined up one on top of the other.

Noticing where you deviate from this vertical line can help you identify some postural corrections that might help with chronic pain or tightness.

2. Check Your Pelvic Bones

All of us have different sizes and shapes for our hips, butt and bellies that make our posture look different, and that is part of what keeps the world interesting! Instead, I like to assess pelvic position using the bones, since those tend to be more (but by no means completely) consistent.

The two hip bones in the front (the anterior superior illiac spine or ASIS for those who care) and the pubic bone make a downwards-facing triangle in the front of the hips. With some variation for anatomy, you want to make these boney landmarks flat and symmetrical with each other so that the pelvis isn’t tilted side-to-side or front-to-back.

This generally involves a gentle engagement of the muscles of the pelvic floor and the illiopsoas. I have a number of workouts on pelvic stability if this feels mysterious and inaccessible for you and you can see how this looks in the video below at 2:00 minutes.

3. Engage Your Meat Corset

The meat corset is my fond nickname for a triple-layered band of muscles that wraps around your waist like a corset made of you. The transverse abdominus, internal obliques, and external obliques are a vital set of postural muscles, and like all postural muscles they are ideally awake and responsive almost all the time.

You can feel your meat corset by putting your hands on your waist and coughing or laughing. For postural work these muscles only need to be awake and lightly engaged. The “suck in your gut” cue that I loathe does not encourage sustainable posture, and endless crunches aren’t going to help either. I find that breathwork can be a good entrée to building that healthy meat corset structure.

Again, check out some of my workouts for some meat corset strengthening ideas and see the visual at 2:50 in the video below.

 

3. Open The Shoulders Without Squishing the Shoulder Blades

Forward rounded shoulders are the scourge of modernity, with so many of us sitting hunched over keyboards, phones, steering wheels, gaming consoles, textbooks, food preparation, sewing machines, antique scrolls, you name it. As previously stated, the common “fix” of thrusting the chest forward, squeezing the shoulder blades together, and lifting the chin is suboptimal. It strains and compresses the muscles of the upper back in a way they will not enjoy long-term and can create ongoing back pain if you try to maintain it.

Those gimmicky postural aides that encourage squeezing your shoulder blades together are just going to create a host of new issues for you.

The trick with shoulder blades is actually to pull them apart, while externally rotating the shoulder socket. This will get your upper back engaged sustainably while opening up the front of the chest and shoulder, and stacking that shoulder joint over your hip.

For an exercise to help you find this tricky position, please check out the video embedded below. For this specific tutorial skip to 4:00.

 

4. Stack that Ear

The head and neck come last, stacking them comfortably over the nice foundation you just built along the rest of your spine.

Many of us have a forward thrust to our head, so that the ear habitually sits in front of the shoulder instead of over it (see previous list of reasons). This position makes the neck muscles have to work much, much harder to hold up that heavy coconut of a head.

My favorite quick exercise to start to bring that head back in line is to interlace the finger into a basket cupping the back of the head, elbows wide, and gently press the head and hands together, feeling the inspiration of the muscles in both the upper back and the front of the neck. The chin should not be lifted or dropped, but remain parallel to the floor.

For that tutorial, skip to 6:30 in the video below.

 

Now What? Why is Good Posture so Awkward?

The first time I ran through this checklist and tried to align my posture correctly I got mad. How the hell was I supposed to walk around like this? It felt foreign, difficult, and uncomfortable.

The good news is that perfect posture is not a requirement for a rich, full, happy life or even for pain-free mobility. Like so many other things in life it is pretty much always a work in progress, something you chip away at, check in on, and use as a tool when you need it. If your current posture doesn’t cause you problems and is working for you, you may not need to change it. If you start to have pain, then running this checklist may provide relief.

When I was really dedicated to improving my posture to address my hypermobile back and a lower back pain I set an alarm on my phone to go off every hour on the hour to remind me to run through the check list. After a while I didn’t need the checklist, my body just started to remember to do it.

My posture now definitely isn’t perfect, but it’s good enough that I don’t have back pain any more and I still run through the check list if I’m on my feet for a long time or feel like I need it. It’s change the way that I walk and run, and vastly improved my forward bending which was always pretty crappy.

I hope this checklist is useful for you too!

Happy Bendings,
Kristina

 

 

4 Things You Can Do to Address Back Pain in Back Bends

Back bends can be a glorious part of your body’s movement practice. A healthy backbend feels great, benefits your spine, opens the front of your body, and can fill you with feelings of well-being. Plus it looks pretty.

Back bends can also cause back pain. The spine is a complex apparatus requiring care and understanding, and back bending puts a lot of pressure on the muscles, ligaments, discs, and joints. Proper preparation and technique in back bends can help you get the most out of your backbend without damage or pain.

Firstly, get to know your spine (you can get a nice overview in my Spinal Anatomy blog post) and what your spine likes to do. Everyone’s spine behaves differently, but most people feel their back bend in their lumbar spine.

If you take a photo or video of your back bend from the side, look at where you are bending and where you are sticky. Take special note if you have one spot that is doing the majority of the bending. In contortion we call this a folding back. Folding backs are particularly prone to wear in that one spot, requiring folders to focus extra hard on strength and technique.

With great flexibility comes great responsibility!

It is important to note that back bending should NOT be painful! A small amount of muscle soreness the next day from an intense back bending session is acceptable, but ongoing feelings of bruising, sharp pain, pain in the spine itself, feelings of being unable to bend forward after training, are all warning signs of over-bending. It is vital to take care of your back and address this pain, don’t push through it. Injuries from over-bending can be quite unpleasant.

For all you back benders out there, these four things are my guideposts for taking care of my spine while continuing to indulge my passion for backbends:

1. Warm up for Strength and Stability

Back bends require a thorough warm-up. My ideal back-bending warm-up includes:

  • A full body movement session to elevate body temperature
  • Waking up the core muscles especially the illiopsoas, transverse abdominus, obliques, and pelvic floor
  • Hip extension stretches and movements like lunges, back kicks, quad stretches that lengthen the front of the hips and energize the butt muscles
  • A thorough opening of the chest and shoulders that opens the pecs and diaphragm, prepares the shoulders for weight bearing in extension, and warms up the neck muscles
  • Movements that take the spine through all of its different ranges of motion including forward bending, twisting, and side bending before initiating the back bending
  • Starting the back bending with primarily active work (ie sliding into cobra, kneeling back extension, supermans, and other exercises where you lift into the back bend against gravity)

If you want to see some of my spine warm-ups please check out the FaB Video Club Membership or the free, shorter versions on my YouTube channel.

2. Extend the Hip Flexors before Back Bending

If you have a naturally bendy lower back, odds are that you also have tight hip flexors (see my blog post on Bendy Back/Tight Hips for more info). But regardless of your anatomy, consciously lengthening your hip flexors prior to and during your backbend works to protect the lumbar spine.

When the hip flexors are shortened the spine has a much longer journey to get to the same depth of backbend than it would when the hip flexors are lengthened. This places extra pressure on the lumbar spine, asking it to make a sharper, tighter bend.

If you’re having difficulty visualizing the difference please check out the video below to see the difference in action

Lengthening the hip flexors also inspires the butt muscles and pelvic floor to act as a strong base for the spine and it helps you use your illiopsoas muscles to support the lumbar spine.

Drawing of backbend with short hip flexors

Shortened hip flexors create more stress on the lower back in backbends

Extended Hip flexors in back bending

Extended Hip flexors enable more length in the lower back

3. Slow and Controlled Movement

I advocate for a warm-up that includes active backbends because as soon as we back bend from a vertical position it is terribly easy to just let gravity take your body down and lose control of the movement. This is never a good idea in a backbend.

In an ideal world, you should be in perfect control of your back bend at every stage of bending. This means you can go very slowly with no areas where you couldn’t stop, hang out, take a breath, reverse direction, and feel stable.

It is much harder to move slowly into a back bend than to move quickly but it will help you build the strength to keep you safe and make your backbends graceful. Train with patience, friends!

4. Move Your Spine in All Directions, Not Just Backwards

There are some coaches who advocate for avoiding during a back bending session.

Personally, I strongly advocate for incorporating strong twists and sidebends and even some gentle forward bending into your back bending sessions to give your back a break from all that compression. The muscles that we need for backbending are the same that we use in side, twist, and forward bending and the other movement can help to keep them dynamic and engaged.

Plus, I feel that if we are so deep in our back bending session that other movement becomes inaccessible we might be going too hard. I’ve seen too many back injuries over the years because of over-training and while it may feel like pushing hard will get you where you want to go a little faster, injuries really cramp your style and can take a long time to heal.

I particularly advocate for ending your session with these movements, especially forward bending, to decompress the spinal muscles and make space between the vertebrae.

 

I believe that back bends are not just fun and pretty, they are a range of motion that is natural to the human body and can promote our overall health and mobility. The difficulty is that they are not part of the movement repertoire that we learn in most fitness classes and back bending instruction is limited. They also challenge our nervous system and feel scary.

As a result many people experience back bends and painful and inaccessible. I’m hoping that with more information and a solid, patient practice you can find joy and pleasure in your spine’s natural extension.

Happy Bendings!