Can forward folding postures be bad for hyperkyphosis?

Many questions about Yin Yoga and specific spinal conditions addressed here.
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Bernie
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Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Can forward folding postures be bad for hyperkyphosis?

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I was recently asked the following question about rounding the spine:
  • Dear Bernie Clark, Thanks so much for your amazing work. I really love your recent books. After listening to 2 of your interviews, I wanted to mention two points and ask your opinion.You had mentioned about "rounding the spine". A lot of people have already a strong tendency to round the spine in daily life. Even youngsters. So during the practice if it is encouraged, this postural habit sinks deeper. I see this all the time in Yin classes. Whom already have a strong kyphosis, really enjoy rounding. So instead of the right or wrong, I believe we need to see what the students actually need to learn and transform. In this case, I think a lot of people need to learn to strengthen their erector spinae muscles first and after that they are most welcome to relax and release... I wonder what is your opinion on these subjects. Kind regards, Urun.
Hello Urun and thanks for reaching out. You made a couple of points so let me try to address them separately:

1) "A lot of people have already a strong tendency to round the spine in daily life. Even youngsters. So during the practice if it is encouraged, this postural habit sinks deeper.."

Well, I disagree. There are many causes of hyperkyphosis, which is an exaggerated forward curvature of the thoracic spine. It can be due to the vertebrae becoming overly wedged shape, which often shows up in teenagers and more in girls than boys. It can be due to osteoporosis and degeneration of the discs or vertebrae, again creating too much wedging. It can be caused by fractures, congenital conditions, or Ehlers-Danlos syndrome. These causes all involve bony deformations and are not caused by yoga. But, yes, sometimes hyperkyphosis can be caused by chronic postural problems which may weaken the restraining ligaments and muscles that normally keep the spine in a neutral position. This also is more common during the teen years and more common in girls than boys.

But, let’s not over-worry our students! Beware the nocebo effect (see this article if you don’t know what a nocebo is.) Postural hyperkyphosis is caused by slouching for hours upon hours every day. Hunched over a computer at work and then slouching in your couch at night watching t.v. may make your spinal ligaments overly lax and thus cause the problem. But, 10 or 15 minutes of spinal flexion once or twice a week in a yoga class is not going to cause this problem.

I would not want to place fear in the minds of my students of creating hyperkyphosis from a few forward folds in a yoga class. Indeed, even those who have hyperkyphosis due to postural habits need to take their spine through its full range of flexion. My intention for students is to regain and maintain their optimal range of motion and that includes the spine and spinal flexion. Let’s suppose someone has a range of thoracic flexion of 50 degrees, but during their slouching postures their thoracic spine only flexes 40 degrees. Why not let them play their edges and keep that full range of motion?

Certainly, we can also help them re-establish the strength in their muscles and fascia to combat the chronic flexion their posture has created, (see your 2nd point below), but let’s not lose their full range of motion in the process. I believe it is quite appropriate to take our thoracic spines through the full range of flexion and extension, and I don’t see how doing this briefly a few times a week is going to create hyperkyphosis.

2) "I think a lot of people need to learn to strengthen their erector spinae muscles first and after that they are most welcome to relax and release"

I would agree that there is value in strengthening the back muscles, but postural hyperkyphosis is caused by lax ligaments. There are many ways to strengthen the back muscles (See McGill’s Big Three for some methods I prefer to use), but how do you suppose we strengthen the back ligaments? There is only one way to strengthen fascia: load! We have to stress fascia to stimulate growth. Bones and cartilage are stimulated by compression, but ligaments? The only way is via tension. And, how do we apply a tension to the spinal ligaments? You may be thinking, “flexion?” and you would be right. So again, let’s not be afraid of flexing the spine: it is the only way to stress the spinal ligaments. But, yes—add some strength training too for the back muscles. That is always a good idea.

Of course, all these suggestions are merely ideas to test out. Every body is different. These suggestions will not work for every body. For an elderly student with osteoporosis and severe hyperkyphosis, specialized assistance must be sought. Each students has to check out what happens when she tests these ideas and decide what works best for her. It is always best to work with a qualified teacher or therapist and not just take stuff off the internet without due consideration.

I hope these thoughts help.
Cheers
Bernie
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