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Yoga poses and how it Works Part 2

Facet Syndrome

THE TINY SETS of joints that connect the vertebrae to one another are called facets. A major cause of back pain is facet joints that are out of kilter due to arthritis, unusual twisting activity or spasm. If a facet joint is responsible for the pain, the pain may radiate but you will not feel weakness or numbness or electric shocks. Some physicians, and I am one of them, believe that facet syndrome—pain because of a problem with the facet joints—can be due to tight muscles between two spinal segments beyond the joints themselves. In those cases, yoga stretches may be the perfect treatment.

Facet joints differ according to their function.

Facet joints
Facet joints



Tight muscles can cause “facet syndrome.”

Tight muscles can cause “facet syndrome.”
Tight muscles can cause “facet syndrome.”


Supta Virasana(Supine Hero Pose)

Benefits and How It Works: Trains the many intervertebral muscles to work together.
Contraindications: Hyperextension of the spine (lumbar lordosis), severe hip, knee or ankle arthritis or meniscal tears, recent abdominal or breast incision or hernia.

Helpful Hints: This is not about hyperextension but about getting the small of the back down to the floor. Many people need one or more blankets, or a bolster, under their backs. Please be very careful; ease yourself into the pose gently to protect your back.

The Pose: Kneel and sit back so your buttocks are between your heels. If you need to, sit on a block. Take two breaths. Place your palms on the floor beside your feet. Recline by bending elbows until forearms are flat on the floor. Slide elbows forward until the shoulderblades are on the floor too. Raise both arms straight over your head, laying the backs of the arms and hands on the floor. Stretch from your fingernails to your kneecaps. Let your lower back descend to the floor, or to a blanket, a block or a bolster.

Supta Virasana(Supine Hero Pose)
Supta Virasana(Supine Hero Pose)

LESS CHALLENGING VARIATION:

To safely move the facets, grasp the ankles of a friend standing on tiptoes behind you, at a distance of the arms’ complete stretch. The friend should then gradually tiptoe backward, and when you have used that extra aid to stretch further, the friend should go down on his or her heels. Repeat the tiptoe-back-and-descend procedure within safe limits.


Marichyasana I(Forward Bend with One Bent Knee Pose)

Benefits and How It Works: Separates upper from lower half of facet joints, enabling them to slide into the normal position. Stretches muscles that connect one vertebra to the next.

Contraindications: Ischial bursitis, herniated disc, osteoporosis.

The Pose: Sit with your right leg straight out in front of you. Bend your left knee so the shin is vertical. Wrap the left arm around the left shin high up near the knee, starting from the inside of the leg. Exhale and reach your right hand behind you until you are holding your left wrist. Take a breath. Exhale again, taking care to retain a straight back as you draw your torso forward with the left shoulder and elbow while pushing it forward with the back of your left upper arm. Breathe in and then exhale a third time as you descend symmetrically, bringing your sternum close to the inner right knee.

Marichyasana I(Forward Bend with One Bent Knee Pose)
Marichyasana I(Forward Bend with One Bent Knee Pose)



Matsyendrasana(Seated Twist Pose)

Benefits and How It Works: Gives controlled opening to all the facets on one side of the spine, and stretches the paraspinal muscles at the same time.

Contraindications: Total hip prosthesis, anterior shoulder subluxation, severe scoliosis.

Helpful Hints: Attempt to keep your pelvis level. Breathe by inflating both lungs as equally as possible.

The Pose: Sit with your right knee bent to the left, its lateral thigh and calf on the floor. Bend and lift the left knee, then place your left sole flat on the floor to the right of the right thigh. Angle the outside of the right upper arm to the left of the left thigh as you revolve your torso to the left. Bend your right elbow as you reach counterclockwise behind with your left hand, eventually to clasp your right and your left hand. Keep your head level as you turn it to the right. Sit tall. Breathe symmetrically.

Matsyendrasana(Seated Twist Pose)
Matsyendrasana(Seated Twist Pose)


LESS CHALLENGING VARIATIONS:

1.Rather than bending your right elbow around your left shin, keep the right elbow straight. Press it firmly against the outside of the left knee and walk the left hand counterclockwise behind you.

2.Reverse your legs from the versions above. Place your right hand on the mat beside and behind your right thigh, keeping the elbow straight. Place your straightened left arm to the right of your right thigh. Use the outside of the left thigh to lever the torso and twist somewhat less extremely and with more control to the right. Remember in both of these versions to sit straight and to revolve at the spine, not the sternum.


Supta Padangusthasana II(Reclining Hand to Big Toe Pose II)

Benefits and How It Works: Subtly twists and bends the entire lumbar spine to the side in a controlled way, opening the facet joints and sliding their surfaces past one another.

Contraindications: Acute hamstring or adductor tear, advanced congestive heart failure, advanced pregnancy (in which case, elevate the leg vertically while lying on the opposite side).

The Pose: Lie on your back, heels together, shoulders down toward your hips, head far from shoulders. Raise your right leg and bend your knee in order to grasp your big toe with the index and middle fingers of the right hand. Straighten the right knee and stretch the leg off to the right at 90 degrees until it lies against the floor. Gradually separate the two legs even further by pulling the right leg toward your right. Stretch your left leg maximally, sliding your left heel away from you as much as possible. This stretch is vital for aiding the facets.

 Supta Padangusthasana II(Reclining Hand to Big Toe Pose II)

Supta Padangusthasana II(Reclining Hand to Big Toe Pose II)



Parivrtta Janusirsasana(Revolved Head to Knee Pose)

Benefits and How It Works: Stretches interspinal muscles and moves the facet joints past one another, one side of the spine at a time. Most facet or intersegmental pain is in the thoracic spine. Using a twisting motion at the shoulder girdle together with iliopsoas muscles’ stabilizing influence on the lumbar spine forcibly but gently stretches the interspinal muscles while sliding the facet joints smoothly, with room for compensation by the vertebrae above and below any painful and tender section.

Contraindications: Recently herniated disc, osteoporosis, severe scoliosis, adductor or hamstring tear, ischial bursitis, anterior shoulder subluxation, pregnancy.

The Pose: Begin by sitting in Janusirsasana, right leg stretched out before you, left knee bent, left foot flat against the upper inner right thigh. Take a breath. Abduct and extend the left hip, widening the gap between right and left thighs. Your left shin will no longer make a right angle with the right thigh; rather, it will make an obtuse angle of perhaps 135 degrees or more. Then incline your right torso forward, bending as much as possible from the hip, and angling your right elbow to the inside of your right knee. Externally rotate the arm to catch the right big toe with the little finger side of the right hand. Elongate your spine as you exhale.

Parivrtta Janusirsasana(Revolved Head to Knee Pose)
Parivrtta Janusirsasana(Revolved Head to Knee Pose)


Press the outside right elbow against the inner right knee to revolve your right torso forward and your left torso backward. Inhale, and as you reach forward and behind your left ear with your left hand toward the right foot, exhale. Finally, press your right elbow against the inner knee one more time, and with your next exhalation lengthen the spine still more and twist as much as makes sense for you.

You may hear or feel the vertebral facets clicking into place as you do this on one side or the other or both.

LESS CHALLENGING VARIATIONS:

Simple and sensible variations have less forward bending and less twisting. Use walls, chairs, belts and bolsters to fit your needs and capacities, and be cautiously creative with your modifications.