A LOOK AT THE LOWER BACK
Back pain is one of the world's biggest health problems. 85% of people will have back pain at some stage in their lives and of these 80% is lower back pain. For many individuals it is chronic and persistent.

Understanding basic anatomy of your spine is an important part of empowering you to effectively deal with your lower back pain. The spine holds us up against gravity, houses and protects the spinal cord and allows for movement. Not only does the lower back, or lumbar spine, have to hold us up against gravity but it also has the added stress of bearing the weight of everything stacked above it. The lumbar spine is also less stable because it is ‘free floating’. The upper back, or thoracic spine, is attached to the ribs which limits its movement and makes it more stable.

Between each vertebra is a cylinder shaped disc which is filled with a jelly-like protein. Its job is to absorb impact, distribute pressure and create space between each vertebrae to allow for movement. There is a common misconception that you can get a ‘slipped disc’. The discs do not move, the top and the bottom rims of the disc are firmly attached to the vertebrae above and below it. What can happen is that the discs ruptures, where some of the jelly-like protein leeks out causing irritation to surrounding tissues, or bulge, where it pushes on surrounding nerves and cause pain. You can read more about the anatomy of the spine in my recent article Anatomy 101 - the spine.

POSTURE AWARENESS
The most common cause of lower back pain is from an accumulation of repeated poor posture or from prolonged standing or sitting. This causes weakness in the muscles, which makes them more prone to injury. Your back might suddenly ‘go’ when you lift something heavy or twist awkwardly, but it is likely that there was a weakness in the support system of the spine for much longer than you realised. Posture awareness in standing, sitting and moving throughout your day is a very effective place to start when you are working with persistent pain. Notice if you favour one hip when standing, tip your pelvis forward or back, jut your head forward, hunch your shoulders or slump them forward. Another observation exercise is to notice where you might be gripping or tensing muscles. When we have persistent pain we often go into protection mode. This will slow down or prevent the injury from completely clearing up. Take posture checks throughout the day, especially if you sit for long periods. Avoid crossing your legs, check the position of your pelvis. See can you sit up on your sit bones, lengthen through the spine to the tip of your crown, and soften your shoulders.

EXPLORING LOWER BACK LOVE IN YOUR PRACTICE
If you are in the acute phase of lower back pain I suggest you let it settle before you try this sequence. If you are mildly symptomatic or you are going through a pain free period, this sequence will build strength where there is weakness and release areas where there is tightness. There are minimal twists, forward folds and backbends which can aggravate lower back pain. The key to lower back health is building strength in the 3 pillars of spinal support – psoas, multifidus, quadratus lumborum, with additional support from the TVA and the rectus abdomens. Core strength will also help stabilise the lower back, as long as the full 360 wrap of the core is considered, not just the front of the core. This sequence also includes MFR, or myofascial release. It is an invaluable tool for tissue hydration, circulation, pain management, releasing adhesions and injury recovery. It is also used for building healthy muscle and connective tissues, increasing the glide between the layers and relieving physical and mental tension. You can read more about the MFR in my recent article MFR + yoga.

The sequence starts with MFR on the feet to build a strong platform of support to create your posture awareness from. You will then work down the whole spine with your MFR balls. For more details on these techniques go to MFR + yoga. The second row starts with a simple leg lift. Pause before you lift your leg to take time to draw your full 360 core in towards the spine, press through the heel, and secure the spine and hip in place. The last mini flow in this row is my favourite way to strengthen the outer hip muscles. Focus on the outer hip of the standing leg hugging into the midline in this mini flow. The main job of the leg lifting is to add a weight challenge. The third row is a standing flow which focuses on slow movement to create stability and strength. In the final row you finish with a nice restorative pose with a rolled up blanket under your neck, a low folded blanket under your shoulder blades and a bolster under your knees.

ALIGNMENT CUES
Have a read of the tips below and either print out the sequence or save it onto your device:

Move through the sequence slowly, particularly when transitioning from pose to pose.
This sequence is intended to be part of your lower back care routine not as a once off practice. Add it into your weekly routine.
Practise the full sequence once or twice a week or even better take sections of the sequence and do a little each morning as your daily back care routine.
If a pose isn’t working for you, skip it and come back to it at another time when your lower back is feeling stronger.
Use the breath guide in the sequence to help you link breath with movement in the flow. Inhale is indicated with a ‘+’, exhale is a ‘-”.

MFR
No.2 - Upper back (rhomboids & erectors)
Compression - from supine with knees bent, place 2 x balls between the shoulder blades either side of the spine, gently press down with an inhale and release on the exhale x 5 breaths.
Sheer - inhale open arms out to the sides, exhale hug arms around your chest x 5.

No.2 - Lower back (quadratus lumborum & erectors)
Compression - from supine with knees bent, place 2 x balls above the back of the hips either side of the spine, gently press down with an inhale and release on the exhale x 5 breaths.
Sheer - slowly lift and lower one knee at a time towards your chest x 5.
Roll & cross fibre - roll up and down the lower spine below the ribs.

No.2 - SI joint (quadratus lumborum & erectors)
Compression - from supine with knees bent, place 2 x balls at the back of your upper hips, gently press down with an inhale and release on the exhale x 5 breaths.
Sheer - slowly lift and lower one knee at a time towards your chest x 5.

To save the images for personal use click and hold down the image until the ‘save image’ option appears; on Mac hold down ‘control’ and click the image to get the option box; on PC right click on the image to get the option box. Scroll down in the ‘option box’ and click ‘save image’.

Ruth Delahunty Yogaru