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© The Breathe Trust and Embodied Asana LLC | Unless Otherwise Noted Illustrations by Sharon Ellis or Lydia Mann Unit 4-1

UNIT 4: The Spine

UNIT 4: The Spine

4.1 PHYSICAL EXPLORATION: THE CURVES OF THE SPINE

CERVICAL

THORACIC

LUMBAR

tasya saptadha prantabhumih prajna— Yoga Sutras of Patanjali, 2.27

“The attainment of clarity

is a gradual process.”

—as translated by T.K.V. Desikachar

KEY POINTSUse this space to reflect on your experiences of the curves of your spine, where the weight travels in your

spine, or anything else that came up for you during the

movement exploration. Be prepared to discuss in class


UNIT 4: The Spine

4.2 A BRIEF HISTORY OF THE SPINE

Here are some images that help highlight Leslie’s “brief history of the spine.”

SINGLE-CELLED ORGANISM >> Takes in nutrients and releases

by-products.

PSEUDOPOD >>

Developed the ability to locomote via

movement.

BACTERIUM WITH FLAGELLA >> Developed specialized structures for

locomotion.

PLATYHELMINTH >>

Developed a simple nervous system to

organize and coordinate movement and

other activities.

PRIMITIVE FISH >> Developed a bony, articulated spine

to protect the nervous system. The

articulated nature of the spine allows for

movement.

SALAMANDER >>

Developed limbs to move on land. Limbs

and spine remain low to the ground and

undulation remains lateral, similar to the

fish.fish.

LIZARD >>

Developed a primary curve in the spine,

resembling the shape of a Roman arch.

This shape is stronger than a flat spine.

CAT >>

Develops a secondary curve in the cervical

spine, in addition to the primary curve

present earlier, increasing mobility and

raising senses higher off ground.

PRAIRIE DOG >> Developed ability to sit on hind legs to

raise senses still higher. When supported

on hind legs, its forelimbs are freed to be

used to manipulate its environment.

PRIMATE >>

Not a true biped. Does not exhibit the 2nd secondary curve, which is unique

to spines in humans.

HUMANS

Developed the unique trait of having a lumbar curve, which brings our center of gravity

over our legs. Our upper limbs are free to be used to manipulate the environment.


UNIT 4: The Spine

“The more critical the central nervous

system becomes to a living organism,

the more important it is that it evolves

to develop a protective structure. In

the case of the human spine: you need

sthira, protection, the boundary to

protect it from damage, as well as

sukha, the ability to change shape,

move and respond to your environment.

The solution nature came up with was

an articulated series of bony structures

stacked one atop the other that created

a space within them. What an elegant

solution to the contradictory demand

for sthira and sukha!”

—Leslie Kaminoff

KEY POINTSBe prepared to discuss in class


UNIT 4: The Spine

4.3 GEEK OUT: VERTEBRAE

Please use the space below to draw the two views of a vertebra along with Amy.

Then, use the bolded terms to label your drawings.

ELEMENTS OF A VERTEBRA, BIRDS-EYE VIEW:

body of the vertebra where most of the weight travels, made of

spongy bone

articular arch creates a space called the “vertebral foramen,”

through which the spinal cord travels

pedicles (there are 2 in this view)

the “feet” of the articular arch

transverse processes (there are 2 in this view)

spinous process / posterior process both names for the bumpy part of the spine

that we feel when we run our fingers down someone’s back

spinal cord bundle of nerves that carries information to

and from the brain

ELEMENTS OF A VERTEBRA, FROM THE SIDE:

body of the vertebra

superior articular process articulates with the inferior articular process

of the vertebra above

inferior articular process articulates with the superior articular process

of the vertebra below


UNIT 4: The Spine

4.4 GEEK OUT: DISCS

Please use the space below to draw the two views of an intervertebral disc along with Amy.

Then, use the bolded terms to label your drawings.

ELEMENTS OF AN INTERVERTEBRAL DISC:BIRDS-EYE VIEW FROM THE SIDE

Nucleus pulposus inner jelly-like substance, receives and distributes the force that comes into the disc

outwards in every direction

Annulus Fibrosus outer ring of fibrous material (fibrocartilaginous connective tissue) arranged in diagonal spiraling rings; contains and resists force from within from every direction


UNIT 4: The Spine


◻Describe the two regions of a single vertebra, and how they work together, in terms of sthira and sukha.

(Additional reference chart on page 22 of this document,

showing the varying shapes of vertebrae in specific regions of the spine.)

◻Describe the two parts of an intervertebral disc that we explored here, and how they work together, in terms of sthira and sukha.


UNIT 4: The Spine

4.5 GEEK OUT: LIGAMENTS

Four ligaments that run the length of the spine:


◻Shade in the four longitudinal ligaments to correspond with Amy’s colored tape in the video:

◻Our four lengthwise spinal ligaments play both a sthira and a sukha role in the spine. In your own words, describe one way in which they support each quality.

▶ Anterior Longitudinal Ligament (purple in video)

▶ Posterior Longitudinal Ligament (blue in video)

▶ Ligamentum Flavum (yellow in video)

▶ Supraspinous Ligament (red in video)

In addition to these lengthwise ligaments there are shorter intervertebral ligaments that connect processes of

one vertebrae to the next, included in the diagram below:

interspinous ligaments: connect adjacent spinous processes

intertransverse ligaments connect adjacent transverse processes


UNIT 4: The Spine

4.6 PHYSICAL EXPLORATION: PRIMARY AND SECONDARY CURVES

Leslie will lead us through the following

movement exploration:

“(…in savasana) put your awareness

into the shape of the curve of the

back of the heel. Notice that it curves

towards the surface of the floor. If you move your awareness upwards

from that shape, you’ll notice that

there’s a curve that goes in the

opposite direction.

The Achilles Tendon region curves

away from the floor. We’re going to keep paying attention to this

alternating series of undulating

curves as we travel up through the

body. These shapes are going to

be a reflection of the primary and secondary curves of the spine.”

EXPERIENTIAL NOTESUse this space to record any impressions from the

movement exploration.

◻Which regions of your spine exhibit a “primary curve”? Which regions of your spine exhibit a “secondary curve”?

◻Did this exploration of primary and secondary curves in other parts of your body influence your experience of the curves of your spine? Please explain.


UNIT 4: The Spine

4.7 STHIRA AND SUKHA OF THE SPINE

ANTERIOR COLUMN (FRONT)

Primary responsibilities:

▶ weight-bearing

▶ weight-supporting

▶ weight-redistributing

(sukha quality within the sthira)

▶ resists compression

More sthira:

▶ bodies of vertebrae +

discs +

ligaments

POSTERIOR COLUMN (BACK)

Primary responsibilities:

▶ redistributing forces created in movement

▶ providing space for the spinal cord

▶ protecting spinal cord

(sthira quality within the sukha)

▶ resists tension

More sukha:

▶ processes of vertebrae +

synovial joints +

ligaments

“When you move your spinal column in any direction out of

neutral, you are generating forces within the discs and ligaments

that want to return it to where it came from. We refer to this as

the ‘intrinsic equilibrium of the spinal column.’”

—Leslie Kaminoff


UNIT 4: The Spine

KEY POINTSBe prepared to discuss in class..

◻Describe the anterior and posterior columns of the spine in terms of sthira and sukha.

◻Describe how the vertebrae and discs work together in the spine in terms of sthira and sukha.

◻Leslie introduces the idea of the “intrinsic equilibrium of the spinal column” by offering the idea that the spine is a “neutral-seeking structure” on a mechanical level. In your own words, please explain why this is true.

EXPERIENTIAL NOTESUse this space to record any impressions from the movement exploration

◻ROLL-DOWN, ROLL-UP: Please reflect on the movement experience led by Leslie. You don’t need to answer all these questions, rather use them to get your creative juices flowing:

◾ What did you notice when you watched Leslie lead the student through this exploration?

◾ What about when you did it, yourself? What was easy? What was hard?

◾ What felt like it was moving a lot? What felt like it didn’t want to move as much?

◾ Did you have a different experience from other “roll-down, roll-up” experiences because you were

focusing on the back, and then the front of the spine?


UNIT 4: The Spine

4.8 EMBRYOLOGY: THE WHOLENESS OF THE SPINE

“The idea that we are many separate pieces

that are somehow put together with a little

cushion in between does not reflect the way that our spine developed. The spine had, as

its first experience, a wholeness to it that then, with the development of the bony

support, segmented itself into the vertebra.”

—Amy Matthews

KEY POINTSBe prepared to discuss in class.

◻Does the idea of the “wholeness” of the spine change or reinforce ideas you had?

◻Does the information in this module change how you experience your spine?


UNIT 4: The Spine

4.9 SPINAL MOVEMENTS AND RANGE OF MOTION

We’ll focus on 5 movements of the spine:

▶ Flexion

▶ Extension

▶ Lateral Flexion

▶ Axial Rotation

▶ Axial Extension

4.9 SPINAL MOVEMENTS AND RANGE OF MOTION

We’ll focus on 5 movements of the spine:

EXPERIENTIAL NOTESWhat was your experience in the movement exploration? Please use this space to record any impressions.

◻You may use the questions below to get your creative juices flowing, but you don’t need to answer them all:

◾ What did you notice about your spine in movement? Asymmetries? Places that move easily? Places of congestion?

◾ What are your preferences in these movements? Which spinal movements were more or less comfortable, enjoyable, familiar for you in this exploration?

◾ What about your experience of lateral flexion (side-bending). Did a slight twisting between your vertebrae help you to create that shape?

◾ Did your experience change when Leslie offered the idea of imagining the 3-dimensionality of your movements?

◾ What about the idea of finding “a little movement in a lot of places”?

◾ How was your experience of spinal flexion? Is this a shape you normally avoid, or one that you explore as much as spinal extension? How did it feel in this instance?

◾ What was your experience of a neutral spine after spending time exploring all the other movement possibilities?


UNIT 4: The Spine

Flexion = shape of the primary curve

▶ increase of primary curves, decrease of

secondary curves)

▶ Anterior part of spine is more convex, posterior

part of spine is more concave

▶ ex: shape of “Cat”

Extension = shape of the secondary curve

▶ increase in secondary curves, decrease in

primary curves

▶ Anterior part of spine is more convex, posterior

part of spine is more concave

▶ ex: shape of “Cow”

Axial Rotation: Often called “spinal twisting”; articulation between vertebrae that results in a twist, with one end of the

articulating vertebrae moving in one direction and the other end in the other direction


UNIT 4: The Spine

Lateral Flexion: Often called “side-bending”; articulation between vertebrae that results in some or all of the spine moving

to one side and creating the shape of a ‘c-curve’

In order to keep side bending in the side-to-side plane, a combination of lateral flexion and axial rotation might be involved to accommodate the three-dimensional shapes of the facet joints along the spine.

Axial Extension: decrease (or flattening) of primary and secondary curves; cues such as “flat-back,” “stand up straight,” and “lengthen your spine”* are calling for axial extension

*Note that axial extension doesn’t actually lengthen the spine. It moves the head and tail away from each as

the curves flatten, but the length doesn’t change. Examples of axial extension in asana:


UNIT 4: The Spine

“Axial extension is a flattening of the primary and secondary curves. You lose some of the spring-like shock absorbing ability of the spine when you are in axial extension. Neutral spine means you’re not doing flexion, extension, axial rotation, lateral flexion or axial extension. It means that you’re just maintaining your primary and secondary curves in a neutral way.” —Leslie Kaminoff

4.10 BACK PAIN: WHAT TO WATCH FOR

“The question of pain is about both the sensation and what gives rise to that sensation – and about how quickly we begin to try to manage the experience and to figure out what we can do to prevent it. With pain we get reactions to pain, and the anticipation of pain, and ways to shut down around avoiding pain. In engaging with the wholeness of a person we can find other parts of their body where they can engage with a spectrum of movements, and find what actually brings them comfort.” —Amy Matthews

Findings from studies cited and larger images may be found in the charts in page 22 of this document.

KEY POINTSBe prepared to discuss in class.

◻Amy and Leslie challenged some common assumptions about back pain and the diagnoses people receive based on imaging techniques (MRI, etc.)

◾ Did they offer any ideas that support your experience or observation? Did they offer any ideas that seem to contradict your experience or observation?

◻What about ideas offered here about the role of the teacher…

◾ Have you thought about how you might handle students who come to you with pain and other conditions?

◾ What can you offer? What is beyond how you see your role as a teacher?


UNIT 4: The Spine

4.11 WHAT HAPPENS WHEN YOU TAKE THE CURVES OUT?

“Play with flattening out your curves and letting them return, and see

as you do this where you feel effort

accumulating, where you feel a familiar

experience, where you feel ease.” —Amy Matthews

EXPLORATION NOTESReflect on your experience during the movement exploration of taking the curves out of your spine, and then allowing them to return.

Be prepared to discuss in class.


UNIT 4: The Spine

Anatomy in Action: ◻Please describe what you see in these images framed by the concept of “balanced joint space” and “a little bit of movement in a lot of places.” When might the position on the left be appropriate and under what circumstances might it be problematic? EXTRA CREDIT: When might the position on the right be appropriate and under what circumstances might it be problematic?

◻“Stand up straight” is a direction that’s commonly given in yoga and other circumstances, and with positive intentions. Does what you learned in this unit make you question that verbiage? Or the results that might emerge? What might be an alternative instruction that doesn’t call for axial extension?

◻When you start teaching, you’ll probably have students who come to you and say, “I have back pain. What poses should I avoid?” What kind of questions might you ask them? What might you recommend?

◻Did any of the information that Amy and Leslie presented in this unit surprise you?

◻Did you learn anything surprising about your own spine during the explorations?


UNIT 4: The Spine

Unit 4: Terms and Definitionsaxial extension:

a flattening, or diminishing, of the curves of the spine so that the head and tail move away from

each other

axial rotation: also called spinal twisting; articulation between

the vertebrae that results in a twist, where one

end of the spine rotates one way and the other end

rotates the other way

cervical spine: the seven top vertebrae in the neck; has a

secondary curve

coccyx: the tail; made up of several fused vertebrae below

the sacrum; not weight-bearing

intervertebral disc: fibrocartilaginous structure between the bodies of each pair of vertebrae; plays the role of helping to

absorb weight and transmit movement through the

curves of the spine; includes an inner and an outer

part:

◼ nucleus pulposus inner part; fluid, gel-like structure at center of disc; receives and distributes force outward in

every direction; absorbs some force and helps

pass force/weight on to the next vertebra

◼ annulus fibrosus outer ring of fibrous material made of fibrocartilaginous connective tissue; contains and resists force from the nucleus pulposus

within; strongly connected to the vertebral

body above and below; arranged in oblique

spiraling layers which both allow some

movement in various directions and also

resist too much movement in

any direction

lateral flexion: also called side-bending; articulation between the

vertebrae that results in moving to one side or the

other in a ‘c-curve’

lumbar spine: the five vertebrae in the lower back; has a secondary curve

neutral extension: also called neutral spine; a state where the curves

of the spine are present and balancing each other,

where each curve of the spine is neither being

flattened nor deepened, where the pathway of weight (in theory) can travel through the bodies of

the vertebrae with the least amount of muscular

effort (depending on one’s relationship to gravity)


UNIT 4: The Spine

spinal ligaments: ligaments running between the vertebrae

and lengthwise along the spine connecting

help support the wholeness and continuity

of the spine

◼ anterior longitudinal ligament: connects the fronts of the vertebral bodies

and discs from the basilar portion of the

occiput to the front of the coccyx; envelops

the front of the spine; “front of the front”

◼ posterior longitudinal ligament: connects the backs of the vertebral bodies

and discs; inside the articular arch in front

of the spinal cord; “back of the front”

◼ ligamentum flavum: connects along the inside of the articular

arch behind the spinal cord; named

“flavum” because of its yellow color; “front of the back”

◼ supraspinous ligament: connects along the back of spine,

connecting the tips of the spinous

processes together from the skull to the

tail; “back of the back”

◼ interspinous ligaments: connect the spaces between adjacent

spinous processes

◼ intertransverse ligaments: connect the spaces between adjacent

transverse processes

vertebra: the landmarks of a vertebra include:

◼ body: in the front; generally round shape;

composed of mostly bone; where of the

weight travels through.

◼ articular arch: in the back; provides a protective casing

around the spinal cord; includes synovial

facet joints to facilitate spinal articulation

◼ vertebral foramen: space within the articular arch of each

vertebra that creates a lengthwise tunnel

within which the spinal cord travels

◼ intervertebral foramen: space between the articular arches of

adjacent vertebrae that creates an opening

for spinal nerves to exit and enter

◼ pedicle: the base or “feet” of the articular arch

where it joins the body

◼ transverse processes: projections to each side of the articular

arch; provide attachment points for

muscles and ligaments


UNIT 4: The Spine

◼ spinous process: also called posterior process; projection

on the back of the articular arch; what we

feel as bumps along our spine in the back;

provides attachment point for muscles

and ligaments

◼ articular processes: each vertebra has two superior and two

inferior articular processes; they are the

joint surfaces that participate in synovial

facet joints with neighboring vertebrae;

covered in hyaline cartilage

◼ facet joints: also called zygapophyseal joints; synovial

joints between adjacent articular processes

“As yoga educators, our

primary goal is not to fix what has gone wrong, but to focus

on what’s still going right.”

—Leslie Kaminoff

thoracic spine: the twelve vertebrae with ribs; has a

primary curve

sacrum: the lowest weight-bearing portion of the spine;

made up of several more or less fused vertebrae;

has a primary curve

spinal extension: a spinal action where the back surfaces of the

spine move towards each other; an increase in

secondary curves and a decrease in primary

curves; not necessarily the same

as back-bending

spinal flexion: a spinal action where the front surfaces

of the spine move towards each other; an

increase in primary curves and a decrease in

secondary curves; not necessarily the same as

forward-bending

Suggested Reading in Yoga Anatomy

▶ Chapter 2

▶ Chapter 3, pp 49-50

ADDITIONAL RESOURCES (http://fundamentals.yogaanatomy.net/glossary/):

▶ Video Glossary – Muscles of the Spine


Reference Images

UNIT 4: THE SPINE

Form follows function at every level of the spine:

View of vertebrae from the top


Reference Images

UNIT 4: THE SPINE

Disc Injury Diagram and Rates of False Positive MRIsTHE BOTTOM LINE:

If we gathered a group of middle-age folks (45 average age) who have NEVER

had back pain before and performed MRI scans on them all, here’s what we

would find:

FALSE POSITIVE RATES FOR LUMBAR MRI

INVESTIGATION:

DISC PATHOLOGY:

Root Deviation or Compression

Bulge Protrusion Extrusion Combined: bulge, protrusion, extrusion, sequestration

Borden et al. – 20% – NA –

Jensen et al. 52% 27% 1% 84% –

Boos et al.* – – 13% – 4%

Greenberg et al. 39% 18% 57% –

Weishaupt et al. 24% 40% 18% – 4%

Wood et al (11)* 53% 37% – 63% –

AVERAGES 38% 29% 9.5% 60.5% 4%

* Because these investigations used a ‘high risk’ asymptomatic group of people, i.e., people whose occupation required frequent heavy lifting, twisting, and bending; frequent exposure to vibration; and sedentary occupations, I have EXCLUDED the results from the averaging above.

COURTESY OF CHIROGEEK.COM © 2002-2006 DR. DOUGLAS M. GILLARD DC

▶ 38% would have disc bulges

▶ 29% disc protrusions (aka: contained herniations)

▶ 10% disc extrusions (aka: non-contained herniations)

▶ 4% of nerve root compression by the disc herniation

▶ 0% disc sequestrations (aka: free fragments, which hurt

IN SUMMARY:

60% of asymptomatic middle-aged people would have findings of disc bulge or worse (protrusion, extrusion) on MRI.

KEY POINTS UNIT 4: The Spine - media.yogaanatomy.netmedia.yogaanatomy.net/...4-worksheet-39bjgk68.pdf · UNIT 4: The Spine UNIT 4: The Spine ... locomotion. PLATYHELMINTH >> ... Please

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