"My middle back is tense and hurts almost all the time," said the young man slumped in my office chair. "I'd like you to show me how to stretch it out." He was quite surprised when I told him his back needed to be strengthened, not stretched, and he needed to stretch his front body, not his back.
I see an epidemic of slumping all around me, and it contributes not only to problems in yoga poses but also to back pain and other significant medical problems. Happily, you can use a well-balanced yoga practice to help correct the muscle imbalances that cause you to slump, at the same time relieving midback pain and creating a beautiful, upright posture.
The muscle imbalance that causes slumping may begin to develop early in life, when as children we have to round the spine to reach the back of a chair. Eventually, the muscles of the front body become short and tight and the muscles of the back body become weak and overstretched, causing the spine to curve backward and the head to poke forward. This slump of the midback—the thoracic spine—is called a kyphosis.
The thoracic spine is prone to excessive kyphosis for several reasons. First, a normal thoracic spine has a mild amount of backward curve, which balances the normal forward curves of the lower back and neck. Second, the rib cage tends to limit the mobility of the thoracic spine. The 12 ribs attach to the 12 thoracic vertebrae in back and to the breastbone in front, forming a protective cage around vital organs. But when the thoracic spine begins to curve excessively, the rib cage's natural tendency to immobility can result in a "stuck" midback.
The third reason for excessive kyphosis is our everyday movement and sitting habits. If you spend a lot of time with your head and arms forward, the natural curve in the thoracic spine will increase. And if you sit slumped, your weight hangs on the ligaments of the spine. The back muscles are in a lengthened position and not engaged; eventually, they become weak and overstretched and lose their ability to hold us in an upright position. As the back muscles weaken, the soft tissues of the front body—including the front spine ligaments, the tiny muscles between the ribs (intercostals), and the abdominal muscles—begin to shorten. Shortening of the abdominals can be exacerbated by a fitness regimen that overemphasizes abdominal strengthening exercises, like crunches, without balancing them with back-strengthening exercises.
While bad posture habits can cause a mild to moderate kyphosis to develop, more severe kyphosis can indicate significant medical problems that require expert professional attention. Conditions such as osteoporosis, extreme scoliosis (spinal curvature), and ankylosing spondylitis, a painful form of rheumatoid arthritis that attacks the spine, can cause severe and painful kyphosis. If you have one or more of these conditions, the careful, therapeutic application of yoga asanas can help, but it would be a good idea to get advice from a medical expert and an experienced yoga teacher first.
The Cost of Slumping
Once established, hyperkyphosis contributes to a variety of health problems. As the kyphosis increases, the head migrates forward, causing chronic neck tension. Increased kyphosis can also limit our ability to breathe freely. The collapsing chest compresses the diaphragm at the base of the rib cage, and the tightness of the intercostals restricts the lungs' ability to expand. This limitation is a liability in daily life as well as in any yoga practice, especially pranayama, but it is even more troubling for anyone with a lung problem such as asthma or chronic obstructive lung disease.
While the severe kyphosis associated with diseases like osteoporosis, scoliosis, and ankylosing spondylitis can cause severe health problems, as well as significantly limit overall mobility, even mild to moderate postural kyphosis can get in the way in yoga. It's especially problematic in backbending poses, when the whole spine should share in the curve. If the thoracic spine is stuck in a forward bend, then the lower back and neck, which are naturally more flexible in backbending, tend to overwork. The resulting localized excessive backbending, or hyperextension, contributes to compression and pain in the lower back and neck.
Because of the decreased mobility of the rib cage associated with increased kyphosis, the ability of the spine to twist can also be restricted. Limited rotation can cause difficulty in most standing poses but is especially problematic in pronounced twists like Parivrtta Trikonasana (Revolved Triangle Pose) and the many seated twists.
The Slumping Antidote: Yoga!!
A well-rounded yoga practice will gradually reduce excessive kyphosis.
Valuable poses are included to stretch out shortened chest and abdominal muscles and the front spine ligaments.
A yoga class also includes poses to strengthen the back body. The muscles that hold us upright are called, appropriately, the erector spinae. They are the large muscles that lie on each side of the spine and extend from the pelvis to the upper back. When they contract, they pull the spine from a forward bend to a backbend.
Practice often your new kyphosis awareness several times throughout the day, at home, at work, and in your yoga practice. If you find yourself constantly slumped down in your chair, perhaps it's time for a new one. Can you keep your chest open in your yoga poses? Be especially careful with forward bends, as it's easy to collapse into an excessive kyphosis. Learn to pause for a moment as you begin each pose, to feel the vitality of the support muscles of your back, the spaciousness of your lungs, and the openness of your heart. Over time, this practice of opening your heart will contribute not only to changing your posture but also to the development of compassion. In just this way, the physical practice of asana changes our outlook on the world and the way we interact with other beings.