How to Bend and How Not to Bend

Round-backed bending is ubiquitous in modern urban culture. It damages the back. Recognizing this, many health advocates recommend bending at the knees. Done to excess or with poor form, this damages the hips, knees, ankles, and feet.

Surprisingly, poor bending form abounds even in fitness and wellness classes.

People sometimes equate being able to touch the toes with flexibility. An imprecise and insistent pursuit of this kind of “flexibility” causes disc damage, hyper-extended spinal ligaments, and a lot of pain. Let’s examine do’s and don’t’s in bending more closely.

DO

Don't

1. Don’t Round the Lower Back. The most common mistake in bending is to round the back, either distributing curvature throughout the spine or concentrating most of it in one spot. If your pattern of bending includes rounding the lower back, this is a particularly risky mistake. Being at the bottom of the heap, the lumbar discs are already particularly vulnerable to wear and tear, bulging, herniation, and sequestration. Rounding the lower back while bending puts additional strain on them. The amount of loading is high because our upper bodies are heavy (especially our heads) and the lever arm is long (Torque = weight X distance.) You may know people who bent to tie their shoelaces or perform some other seemingly innocuous task on the ground, and then couldn’t straighten back up. Those people were probably rounding their lower backs, possibly with the additional danger of a twist added in. The brain reacts to the threat / damage by seizing up muscles in the area. Ouch! In my classes I go so far as to say that people who bend well will probably never have a back problem, while people who bend poorly almost certainly will. It's very important to get bending right!

1. Don’t Round the Upper Back. Rounding the upper back is problematic for an entirely different reason. The discs in the upper back don’t generally herniate or get severely damaged. This is partly because the rib attachments to the thoracic vertebrae help fortify that portion of the spine. The problem that results from repeatedly rounding the upper back while bending is that the spinal ligaments gets distended.

Ligaments are like band-aids that go from bone to bone and whose function is primarily structural support. They are a backup system for our muscular support. In situations when there is more challenge and distortion than our muscles are strong enough to handle, or when muscles don’t have time to fire, such as in a jolting accident or jump, then the ligaments keep our joints safe. Ligaments are supposed to have some degree of stiffness. Ligaments aren’t an elastic kind of tissue. Once stretched too far, they are permanently distended, and no longer serve their role as the backup system to support the spine. Extreme forward bends that come from the back and not the hips cultivate ligamentous laxity more than muscular flexibility. It is counterproductive and results in losing important structural insurance. This is what we see happening in the backs, hips, and knees of athletes and yogis who push too far in poorly executed forward bends as well as other distortions. Charlotte Bell, an Iyengar yoga teacher and author of Mindful Yoga, Mindful Life, had a hip replacement in 2015. She warns us “I know a number of serious practitioners who are now in their 50s—including myself—who regret having overstretched our joints back in the day. All too many longtime practitioners now own artificial joints to replace the ones they overused.”

1. Don’t bend with your legs internally rotated and/or tail tucked When the legs are internally rotated (toes and knees pointed inwards), the head of the femur grinds inappropriately against the hip socket (acetabulum), wearing down the cartilage and causing arthritic change. In 2013, Lady Gaga canceled her “Born this Way” tour due to chronic pain from a severe cartilage tear in her hip. Lady Gaga is known for being health conscious and a yoga enthusiast. Though dancing in high heels night after night certainly puts wear and tear on the body, a yoga practice should support, not exacerbate the problem. “My injury was actually a lot worse than just a labral tear,” she told reporters. “...The surgeon told me that if I had done another show I might have needed a full hip replacement. It took over two years after my surgery to be able to correct my alignment and continue working.”

These pictures of Lady Gaga show that a) she has a tendency to internally rotate her legs while standing and b) she bends forward in the yoga pose with toes pointed in and a tucked pelvis. This puts stress on the hip joint, pushes the ball of the femur into the cartilage of the hip socket, and can overstretch the ligaments of her spine, sacroiliac joint, hip, knee, and foot.

1. Don’t push beyond your range of motion in the hips If you run into resistance in your hip joints when bending, don’t force past it. Dr. Chris Woollam, a Toronto sports medicine physician, says he started seeing “an inordinate number of hip problems” among women aged 30 to 50 who were practicing yoga. “Maybe these extreme ranges of motion were causing the joint to get jammed and some to wear,” Woollam says. “If you start wearing a joint down, then it becomes arthritic. So you’re seeing these little patches of arthritis in an otherwise normal hip that seems to be related to these extremes of motion or impingement or both.” I suspect that some of the hip problems that get chalked up to extreme range of motion, are actually due to alignment problems. Most yoga classes, Pilates training, and gym routines teach students to stand with parallel feet. By Gokhale Method standards, this constitutes internal leg rotation. Indigenous people have their feet facing outward in the range of 5-15 degrees, and their legs are correspondingly externally rotated. It is our opinion that instructions to have parallel feet contribute to stress and arthritic changes in the hip joints, especially when combined with forward bends and other hip motions.

How well do you stack up when bending in your daily life and when exercising? How far along are you in your hip-hinging journey?