Question
I have experienced low back pain for 6 months now.  I had twins a year ago.  Eight weeks after I delivered them via c-section I began a yoga workout 2-3 times per week.  After 5 months into yoga workout my lower back started hurting and it progressed for about 3 months.  I went to a chiropractor only for it to get a little better, then worse.  I then went to an acupuncturist and he's helped tremendously.  I still suffer from pain that I don't think I should have to live with. A recent MRI showed a L5-S1 broad based central 5mm disk bulge. (My lower back & the sciatic nerve bother me most days.)   Can you help me make more sense of this, along with suggestions on what treatments work best.  Physical Therapy is what we are planning on, but I don't have confidence-should I?

Answer
Cameron,

I am a yoga instructor with expertise in prenatal and postnatal fitness and yoga. I generally do not recommend that postnatal women take a "regular" yoga class until their baby is 9 month to 1 year old. It can take this long for the abdominal organs to return to their approximate pre-pregnancy position and can also take at least this long for the abdominal muscles to regain their original length.

Think about how much your abdominal muscles stretched in pregnancy and the fact that your abdominals can not possibly support you properly in many yoga positions so you end up over-compensating with your low back muscles and this can cause a variety of injuries and dysfunctions of the pelvis and spine.

Also during the first few months postpartum the pregnancy hormones have disappeared and the softened tissues in the body begin to harden again and this can result in some injuries as well if the body was not properly balanced in pregnancy and also postnatally. So your injury may have been a combination of the moves you were doing, how your body was compensating and also the disappearance of the pregnancy hormones.

Most yoga postures also work the internal organs and if your internal organs are not in the place they are supposed to be this can cause issues with your yoga practice as well.

I strongly recommend that postpartum women take only postnatal exercises classes with an instructor that is highly trained in this area. These classes target building the core strength and using the abdominal muscles properly as well as help to correct organ displacement faster. Many of these classes also allow you to bring baby along.

As far as what I recommend now? The pigeon posture is great for sciatica but you want to make sure you are doing it correctly so check with a yoga teacher. I would avoid any other yoga at this time until your back pain resolves. I recommend getting instruction on "posture reeducation" and building your awareness of how you sit, stand, carry your child and sleep. These things are most likely to be contributing to your daily pain and correcting them could likely make things much better. You may need to be given some specific exercises to help re-educate your body back to a healthy posture.

Karen Prior, RYT
Director of Mamaste Yoga