I recently received the following email:
... I use your website and book as my most valuable yin yoga references. My best friend, and fellow yogini just fractured her spine at position L3. I am putting together a yoga rehab program for her. She has rec’d clearance from her doctors to practice yoga again now. I hold your expertise about yoga and anatomy in extremely high regard, and I would greatly appreciate your input on some ideas about utilizing yoga to treat the rehab of vertebra L3 as well as any poses you think would be contraindicated.
I am sorry to hear about your friend’s health challenge. It is great to hear that your friend has clearance from her doctors to do yoga: did they provide any guidance or suggestions of what not to do? I am not a doctor, and really can’t give any medical advice, but you already know that. What I could suggest is to follow the Goldilocks’ Principle: all tissues need some stress or they will atrophy, but too much stress will lead to degeneration. When we are injured, the distance between too little and too much is very small. Your friend needs to listen very closely to her body now. Fortunately, as a yogini, this is something she probably knows how to do already. [See this article on the how to apply the Goldilocks’ principles when we are injured.]
The spine needs stress to stay healthy, just as any tissues do. When injured, we want to start with minimal stress and then check out how the body feels, not just during the poses, but in the next couple of days. Try to correlate any discomfort/pain with what she might have been doing. There are 4 main directions that the lumbar vertebrae can move: flexion, extension, lateral flexion left and right. They don’t twist very much. Given this, I would suggest you start her off with very gentle poses that stress the lumbar in these 4 directions. For example:
Sphinx Pose - a gentle extension to compress the disks. Even just lying on her belly may give enough stress.
Child’s Pose, Butterfly - gentle flexion of the spine. She can use a bolster under her chest in Child’s Pose and just round forward a little in Butterfly, until she feels a stress along the lower spine.
Seated Side bends in Shoelace or Half-Shoelace - she can get a nice workout for her hips (which may be craving some stress since she isn’t too active in other areas) while leaning slightly to the left or right. Bananasana, short holds of maybe 1 ~ 2 minutes, may also be nice here.
Reclining Twists - while twisting doesn’t move the lumbar very much, it still maybe beneficial overall for her. Again, she can support herself by relaxing her knees on a bolster.
In addition to these yin yoga poses, which will directly stress the recovering area, she may want to rebuild the musculature in this area too. Gentle Cats (up cat/down cat) and some spinal flossing [scroll down in this this article to see how to floss the spine] might be great too. Eventually, strengthen the spine when it is held in neutral/“straight” like plank pose or crocodile, eventually Infant pose (shalambasana).
Your friend may be working with a physiotherapist and the physio will challenge her more deeply. Sometimes it is necessary to go into some pain, but that should be done by a professional who knows what she is doing. For her yoga practice, try to stay away from any movements that create pain.
Good luck! Let us know how it goes and what does work or not.