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Old Forum Pilates and Yoga after after McGill

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Sexton1

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Dear All,

Just a general question that doesn't concern StrongFirst specifically but that Pavel and a few other people on here may be qualified to answer:

Given the standard Pilates or Yoga class involves a great deal of bending (forward bend, child's pose etc.) should they be considered safe for the back?

The conventional view, which seems to be supported by some people's experience, is that Pilates and Yoga are good for the back, but Stuart McGill seems to insist strongly (I hope I'm not misinterpreting him) that his research indicates bending stresses the back in ways that can be dangerous (and yet in his writings he never says anything as definitive as "stop doing Pilates," only that it can be dangerous for some people).

I ask this question because I'm considering adding Pilates and/or Yoga to my training mix on days when I'm not using kettlebells, and I've had some (minor) back trouble in the past.  I know Pavel has said in the past that Yoga is good for general health, and Dr McGill doesn't explicitly rule Yoga or Pilates out, but what he says about bending makes me concerned.

 

 
 
Jack, not all backs are flexion intolerant. There are too many variables to say for sure.  Maybe you find a yoga teacher whose approach and advice agrees with your back - we can't,say from this distance.

The one personal observation I can offer is that people think I do yoga but I don't.  Buy Jon Engum"s Flexible Steel if you' re read Super Joint and Relax Into Stretch; start with those two if you're u haven't.  Take a Flexible Steel workshop.

-S-
 
I just recently saw some articles by a guy who seems very opposed to working in end ranges of motion or with any spinal flexion whatsoever. Just by looking at the words in the links, he is kind of opposed to anyone flexing the spine.

http://www.rdlfitness.com/avoid-yoga/
http://www.rdlfitness.com/avoid-kettlebells/
http://www.rdlfitness.com/avoid-turkish-get-up/
http://www.rdlfitness.com/how-to-train-the-core-properly/

How does anyone know if he is flexion intolerant?
 
Many yoga and Pilates intructors fail to emphasize the importance of tipping the hips forward when bending forward.  I believe that's where it goes wrong.  Keep the focus on the hips, and keep the back mostly neutral.  Just one opinion...
 
Anna is spot on.
Bend at your hips, instead of just flexing the lower back. Go as far as you can go and stay there. Use your own muscles to reach forward. Never let anyone push your back into flexion.
Spinal flexion by itself is not bad. The cat-cow stretch for example is very safe. Child’s pose too, although here you can minimize spinal flexion by opening your knees wide, creating space for your hip.
I can understand your confusion though. McGill is very anti-flexion.
 
Anna is spot on.

Bend at your hips, instead of just flexing the lower back. Go as far as you can go and stay there. Use your own muscles to reach forward. Never let anyone push your back into flexion.

Spinal flexion by itself is not bad. The cat-cow stretch for example is very safe. Child’s pose too, although here you can minimize spinal flexion by opening your knees wide, creating space for your hip.

I can understand your confusion though. McGill is very anti-flexion.
 
Spinal flexion, by itself, _is_ bad for some backs.  It's a question for your doctor.

The general guideline is that everyone should avoid spinal flexion under heavy load, but that most people tolerate some spinal flexion with no load or only a light one.  The OP says, " I’ve had some (minor) back trouble in the past," so I continue to advise caution.

A further qualification - when we speak of spinal flexion, flexion intolerant backs, and the like, we're generally referring to the lower back, the lumbar spine.  Most people don't have issues with bending their upper back, the thoracic spine, even under a fairly substantial load, although as a rule, one should do this only with a good reason, e.g., it is part of some deadlifter's style but they have worked up to it gradually over time.

Anna, I don't believe trying to tip forward at the hips is sufficient for things like touching your toes - of course it helps, but you have to bend your spine or you won't reach the ground.  And for some spines, even a little lumbar flexion is a problem, even unloaded.  The issue in a class setting is that when an individual student doesn't have sufficient hip and hamstring range of motion to tip their hips forward, the teacher can't pay enough careful attention to each person and the spinal flexion happens more than it should, and more than it would in the presence of better hip and hamstring mobility.

The safest way to bend is to follow the guidelines Pavel, Jon Engum, and I, and many others have given - look for space in each intervertebral joint and try to spread the bending across as many as possible.

-S-
 
The point is that the movement itself is a normal human movement. Just like extending your leg or bending your hip.

It isn't intrinsically bad, unless it's done in an unsafe manner such as under load or pushing beyond what your flexibility allows.

No one here is telling him to go crazy with his back. He's only confused because McGill's work appear to condemn spinal flexion in almost any way.
 
"Dr. McGill is an expert in spine biomechanics."

And he agrees that simple spine flexion movements such as cat-cow and child's pose are not bad.

When loads on the spine are small, movement is healthy. We often recommend the cat-camel motion exercise taking the spine through an unloaded range of motion. - Stuart McGill

Yes, he even says it's healthy.

So I don't really see how my advice or posts are contradicting anything McGill says. It just looks like you have a personal problem with me since that thread about long rests and S&S.

McGill constantly warns against spinal flexion under load and/or first thing in the morning, such as doing sit-ups shortly after waking up. He has also written and researched extensively about spinal flexion under different conditions. That is why sometimes he appears to be against spinal flexion itself. His work is often misquoted. Which is the reason I felt the need to clarify things to the original poster, until you came and tried to invalidate my advice.

By the way, just because someone is an expert doesn't mean he can't be wrong. For example, McGill dismisses John Sarno's method of dealing with chronic back pain. Well, it turns out that Sarno's method was the only method that got rid of my back pain after 5 years. I went to chiropractors, physical therapists, orthopedists, and nothing worked. But Sarno can't be right because McGill is an expert and he says it doesn't work, right?
 
I thought everyone here was in agreement?

Spines are always in flexion in everyday movement aren't they.  Or should be.  The hip alignment is important too.  The spine has to be mobile - ie. both flex and extend.   I'd be surprised if S. McG thought differently.

Rounding the back is ok in a toe-touch.  Rounding the back in NOT ok in a deadlift (load the hips not the spine).

I would suggest Jack you understand your early back problem from an FMS screen/point of view.   As it would be a weak point no matter what movement (yoga/pilates, kettlebells etc) you do if not rehab-ed correctly.  This forum is a great place to get advice on that - Brett Jones, Steve (here in this thread) and their recommendations.
 
I see two things to take away from this discussion;

1 - expert tuition is worth the money and can save you from lot of pain and/or wasted time.

2 - if you ANY concerns about any type of movement(yoga, KB's, BW, barbells etc) and your ability to perform safely, seek advice from a qualified physician with specific knowledge and experience of the topic. Ideally, refer to points 1 AND 2.
 
This thread reminds to me of why I chose to teach privately.   Each person is different, and each person needs a medical diagnosis followed by, as Paul Sellers puts it, "expert tuition."   In the case of skills training, I believe a group setting can be very effective, but in the case of someone with an injury or other chronic condition, one-on-one "expert tuition" is vital to achieving the best outcome.

-S-
 
Greensoup,

The only thing I would definitely avoid is that guy's blog.  If you listened to him you would avoid the following:

Avoid the Hip Thrust
Avoid Kettlebells
Avoid Overhead press
Avoid Ab wheel rollouts
Avoid Olympic lifts
Avoid Lunges
Avoid Assistance exercises
Avoid Turkish get ups
Avoid Thick bar training
Avoid Rest-ice-compression-elevation
Avoid Leg curls
Avoid Leg extensions
Avoid Cardio machines
Avoid Cardio rest days
Avoid Support gear
Avoid Focusing on the stabilizers
Avoid Resistance bands
Avoid Advanced training techniques
Avoid Wide stances or grips
Avoid Functional training
Avoid Peak contractions
Avoid Suspension training
Avoid Pullovers
Avoid Powerlifting for general training
Avoid Grip training
Avoid Kipping pull-ups
Avoid Periodization
Avoid Cycling
Avoid Yoga
Avoid Rest, ice, compression, and elevation
Avoid the Jefferson lift
Avoid the Floor press
Avoid Lifting too fast

Bret Contereas talks about avoiding movements and that guy here: http://bretcontreras.com/definitely-avoid-movement/

Regarding spinal flexion, it is an individual thing and many people confuse spinal flexion with hip flexion.

Jack, researching it further is the best thing you can do and seeking out a professional evaluation should probably be included in that.
 
With Pilates and yoga, as w/ kettlebells and anything else (see youtube HAH!), there are incredible, genius level instructors/coaches and at other end of spectrum those that are flat out dangerous and should be prevented from practicing. Important to "do your homework" before choosing one.
 
I think there's been a misunderstanding. Pnigro, you stated "McGill’s work appear to condemn spinal flexion in almost any way." This statement was made and yet you also mention that he is okay with the cat/camel. Those two statements are contradictory to me. So whatever you may think may be happening against you personally, I read Steve's mention of McGill being the expert to mean that he has the hours of research under his belt and, while not perfect, he is a trusted resource for many of us, both trainers and medical professionals. I can also tell you that while it's great that you got results from a particular style of treatment that McGill may not like, there are plenty of folks who have been helped by McGill's methods and none of that discounts the benefits you've received. The mind is a powerful force and being that all pain is experienced in the brain, there is no doubt that a cognitive approach (CBT has been shown to be very effective against back pain and many other ailments) would be helpful when other, more physically focused, methods might not. However, McGill has seen disk degeneration and rupture in the lab and therefore has the "expert on the physical components of back pain" pretty much locked up, although I'm sure he has his biases.

I think there is one thing that needs to be recognized. The reason for all this concern with repeated end range flexion and loaded flexion is the degradation of the annular fibers of the disk which happens when the integrity of the fibers is compromised and the nucleus moves. That can result in dehydration, disk rupture and extrusion, all which have ripple effects throughout the person's body and psyche which can last far beyond the actual injury.

Being goal oriented creatures, people will attempt deep forward flexion because they see their classmates do it and/or aren't given proper cues to make sure the movement is coming from the right place. Include into that the study results that upwards of 70% of non-symptomatic people have disk herniations upon being imaged, McGill is right to tell people to be cautious because it's not all the braced (albeit ineffectively) flexion that causes pain, it's the unbraced "I'm just going to pick up my keys, or tie my shoes" flexion that finally causes the herniation that encroaches on the nerve and sends lightning down your leg. It's silly to say that all yoga and pilates are dangerous just as much as it is silly to say all yoga and pilates are beneficial even though there are studies showing yoga and pilates being beneficial for low back pain. When it comes to yoga or pilates, one can have an incredibly effective practice if they focus on improving motion at the hips and providing support against flexion and rotation. Rotation is another bugger we need to control against since so many people try to maximize rotation through the lumbar spine, when it needs to come primarily from the thoracic spine. In all cases, very slow graded introductions to new movements or degrees of movement should be done by anyone who has had a prior injury. There is no greater predictor to an injury that having had one in the past, so this point should not be overlooked.

tl;dr: everyone stay chill and focus on your hips
 
Thank you for your post Joe.

I replied to the question because I understand where the original poster is coming from. I read a book and some articles by McGill several months ago and I also ended up feeling like one should be avoiding most movements involving flexion. I became a little paranoid about flexion after reading all his studies and articles on the subject.

He also talks about the implication in the spine of many common exercises such as leg raises and superman, so one can become fearful and start questioning everything with "Is this going to be bad for my back?"

But that is just an impression one gets after reading his works. He clearly isn't against spinal flexion per se. That is what I was trying to clarify.
 
Pnigro

N=1 means nothing, Not all that familiar with Sarno's work, but your logic is faulty. Just because it worked doesn't mean that it worked the way Sarno says it worked. Not picking on Sarno, I was much better at fixing people's backs when I believed what I was doing, once I realized that the science didn't make sense, I was less believable and was less successful, until I reached a new paradigm.  Lot's of variable's go into who gets better from what. Mcgill is a meticulous researcher, he's no more anti flexion than he's anti gravity. I'm sure he occasionally picks things up off the ground, and encourages his clients to do the same. There are some conditions where it can be beneficial and tolerated, and some where it can cause a lot of pain and misery. ( I guess I include gravity and spinal flexion)
 
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