Inverted and in Trouble

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I've often noticed that posture problems previously corrected in yoga can resurface when students begin work on inversions. It's as though we revert to old patterns and habits when we're turned upside down, just as people often revert to old coping mechanisms when stress is high. Unfortunately, old and incorrect habits of posture make for an uncomfortable, and sometimes injurious, yoga inversion.

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A forward head posture makes a classic case. After years of tipping the head forward and down to see a printed page or computer keyboard, or to engage in fine eye-hand coordination, the head and neck seem to become "stuck" jutting forward, probably due to soft tissue (muscles, ligaments, and other connective tissue) shrinking to fit the habitual position. While work in a variety of yoga poses will help stretch out the shortened soft tissue and strengthen the muscles that hold the head centered in place, all of that training seems to get lost when you turn upside down. Imagine the awkwardness and terrible compression on the neck in Sirsasana (Headstand) practiced with the head forward of the line through the torso and legs.

Alignment: The Good, the Bad, and the Ugly

In optimal alignment, whether upside down or right-side up, your body should form a vertical line from the ear to the shoulder, to the hip, to the knee, and to just forward of the ankle. This vertical line indicates that the centers of your body weight—the pelvis, the chest, and the head—are centered over each other. If one section shifts forward, then another must shift backward to compensate, and the line that should be vertical becomes curved like a crescent, or even like an "S". These crescents and curves change the way your body relates to gravity, resulting in painful compression on the inside of a curve (the concave side) and uncomfortable strain in muscles trying to support off-center body parts.

Common misalignments and their discomforts include forward pelvis (this causes the crescent shape, with the ankle and ear behind the center of the pelvis), which compresses the lumbar spine; and forward feet, with a bend at the hips causing the legs to angle forward so that the pose looks like a "Y" with one arm missing. The latter position is usually caused by tight hip flexors that prevent the hips from fully extending to bring the legs up in line with the body, and it causes painful muscle overwork in the lower back as you hold up the weight of the forward legs. The forward head in Sirsasana, mentioned above, causes compression in the cervical spine, which can contribute to wear and tear on the facet joints on the back of the cervical vertebrae (otherwise known as arthritis in the neck). The discs that separate the vertebrae in your neck were designed to support the weight of your head, usually 10 to 12 pounds or more, so it's possible that excessive compression also contributes to degenerative changes in the cervical discs, including thinning and weakening that can lead to disc bulging and even herniation.

Find the Vertical Line

As a teacher, you'll be doing your students a great service if you can train your eye to see the vertical line of their poses from the side. It's easiest to see, of course, while they're upright in Tadasana (Mountain Pose) or Vrksasana (Tree Pose); after that, you can move on to the inversions. Once you can visualize the vertical line, you'll be able to see what part of the body isn't in line, and then give useful feedback about how to correct the problem and eliminate the discomfort and pain that goes with it. Setting up a plumb line beside your student (in line with the points described above) will help you see what's not in line.

If a student is significantly misaligned while upside down, check first that they can correct the problem while upright. Standing against a known vertical line will give students feedback so they can learn the proper alignment kinesthetically (by feel). Have the student stand up against a narrow vertical structure (such as the sharp edge of a doorjamb or the inward-projecting corner of two walls), with the back of the skull, the mid-thoracic spine (about the bottom tips of the shoulder blades), the middle of the sacrum, and the back of the heels just touching that structure. To maintain the normal cervical and lumbar curves, the back of the neck and back of the waist will curve softly away from the narrow edge.

Possible Remedies

If the coccyx (tailbone) touches the wall and you observe lumbar hyperextension (the back waist is two to three inches or more from the wall), the hip flexors are probably tight and the abdominal muscles weak. This will undoubtedly cause a hyperextended, overarched lower back or feet forward of the vertical line—or both—in inversions. Students with this problem need to work on hip flexor stretches such as Virabhadrasana I (Warrior I Pose) and abdominal strengthening poses. On the other hand, for students with the pelvis forward of the feet and chest (the crescent shape), simply standing against the wall edge gives them the feedback they need: They should bring the pelvis slightly back and the chest up and forward, but balance the two actions so their weight is centered evenly between the heels and balls of the feet.

Usually students with a forward head will tilt their chins up to get the back of the skull to the wall's edge, which causes (or increases) neck hyperextension (overarching). Work on chest-opening poses, especially supported backbends, which will help stretch out the tight neck and chest muscles, including the sternocleidomastoid on the front of the neck and pectoralis major on the front of the chest. Setu Bandha Sarvangasana (Bridge Pose), however, isn't a good pose for this job, because it puts the head forward of the chest.

The students' best help overall is a teacher with a well-trained eye and a clear understanding of the vertical line. Once students have the feel of verticality while upright, they'll need to practice that awareness while upside down. Sirsasana and Pincha Mayurasana (Feathered Peacock Pose) can actually be practiced at the same wall or door edge, though less experienced practitioners will need a spotter. For Sirsasana, place the palms flat on the walls near the edge, so the back of the head will be on the edge. The inner forearms should provide support to the head. For Pincha Mayurasana, the palms of the hands are flat on the floor with the fingers near and pointing toward the walls. I haven't yet figured out how to do Adho Mukha Vrksasana (Handstand) and Sarvangasana (Shoulderstand) against the wall edge.

Julie Gudmestad is a certified Iyengar Yoga teacher and licensed physical therapist who runs a combined yoga studio and physical therapy practice in Portland, Oregon. She enjoys integrating her Western medical knowledge with the healing powers of yoga to help make the wisdom of yoga accessible to all.