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Prasarita Padottanasana (Standing Forward bend with legs wide) - Issues and solutions

List of some of the issues that can be relevant for practising this pose:


Prasarita Padottanasana Potential Problem Areas Image
            · Head below heart (two issues)

            · Lumbar Spine (two issues)

            · Hips/pelvic girdle

            · Knees/legs

            · Feet/ankles

            Pregnancy



Head below heart – Two potential issues here.

One issue is that, although taking the head below the heart is beneficial for most people, this is potentially unhelpful or dangerous for a few people – these are people for whom there is already a risk of stroke or too much pressure in the head. For this reason, taking the head below the heart is usually considered unwise for those with conditions such as: high blood pressure; previous history of stroke; tendency to headaches or migraines; and, possibly, for certain eye conditions like glaucoma. In addition, if one currently has a cold or a headache, taking the head below the heart may well feel uncomfortable. As with so many precautions, issues of whether they apply to you can found by observation of how one feels – if taking the head below the heart in this pose causes the following sensations, then avoid doing so (if not, then it is unlikely you will come to harm doing so) : feeling flushed or hot in the head or face; increased feeling of pressure in head or feelings of pressure pulses; face looking red; feelings of discomfort in the head or face. For some people, the gentler, more relaxed versions of this pose may feel fine, while the more strenuous, active ones (in which there is less encouragement of the relaxation and thus blood pressure lowering) may cause problems. Should you feel that taking the head below the heart is inappropriate, the pose can be modified by taking the forward bend only as far as taking the trunk to horizontal (thus avoiding taking the head below the heart). Alternatively, one can practise an alternative pose, such as a sitting forward bend with legs wide, where the issue of taking the head below the heart does not arise.

Another issue for some is that a too rapid lifting of the head from below the heart may cause the blood pressure in the head to drop a bit too low, so causing a feeling of dizziness or even fainting. This is particularly likely to be an issue for those who have a tendency for low blood pressure and when the pose is practised in a very relaxing way. The solution is to take care to lift out of the pose sufficiently slowly and / or consciously to activate muscles when lifting out of the pose so as to encourage blood pressure to rise a little. Another solution is to exit the pose by folding downwards or via the down-facing dog pose instead of directly rising up to standing.


Lumbar spine – Two potential issues here.

One is due to the fact that large forces are potentially acting across the lumbar spinal joint, particularly in the entry and exit of the pose. As a result, the muscles and ligaments of the lumbar back are at potential risk of strain (and hence injury). With the “soft” rag-doll type of approach to this pose, this risk is minimized because the center of gravity of the trunk is as close as possible to the vertical line going through the hips, and as a result of the very slow and gentle movements. Other approaches rely on taking a lot of care over the alignment of all the spine joints, so that one minimises bending at spinal joints. Everyone should take care of their spine when practising this pose, but this is particularly true for those who currently have, or have a history of, lumbar back strain, for those with a tendency to lumbar kyphosis, and anyone who begins to feel even the slightest hint of lumbar back discomfort when practising the pose. The slightest hint of discomfort in the lumbar area should be taken as a sign to exit the pose (with extreme care) and seek advice (e.g. from an experienced yoga teacher). Many would consider this pose to be counter-indicated for those with any degree of lumbar strain. A safer approach (for the lumbar spine) for getting some of the benefits of this pose is to lie on one’s back, bring knees to chest, loop a towel or strap around each ankle, then straighten legs into the air, and then move the legs apart, using the straps/towels to aid keeping the weight of the legs over the trunk.

Another issue is for those with a strong tendency toward lumbar spine lordosis (in a normal standing position, such people have very inward curving lumbar spine and may appear to be sticking their bottom out). In general, this pose would be very beneficial for the lumbar back for those with a tendency towards lumbar lordosis, as it tends to encourage stretching and relaxation of muscles which, in such cases, tend to be over-tight in the lumbar spine. However, some approaches to this posture - and some teachers - encourage one actively to try to put the lumbar spine into extension (back bend), particularly in the entry and exit of the pose – for most people, this is highly beneficial and safe. The potential problem is that those with a tendency to lumbar lordosis can easily take the lumbar spine too far into an extension (backbend), so they should be careful to avoid excessive backbends in the lumbar spine.


Hips/pelvic girdle

For most people, one or more of the hip muscles will tend to be limiting in this pose, in the sense of being stretched to their limits. Often, this is the hamstrings (in the back of the thighs), adductor (inner thigh muscles) or rotator muscles (many of which are deep hip muscles). Of itself, having tight muscles in this area tends to limit how far one can go into the pose, rather than being a precautionary issue. However, because tight muscles do limit how far one can go into this pose, ignoring this limitation, and trying to push beyond what the muscles will comfortably allow, will tend to cause problems in either the lumbar back area or the pelvic girdle (or at the muscles’ attachment points). Tight adductor (or rotator) muscles can usually be adapted for by simply practising with one’s feet a little closer together. Since those who are at high risk of lumbar back strain often also have tight hamstrings, it is particularly important to accept the limitations of tight hamstrings and adapt one’s approach accordingly.

Because of the relationship between the hamstrings and what is happening in the lumbar spine, many teachers recommend that one keeps the knees bent when first learning this pose – this maximizes the freedom of the spine to stay long and straight as the hips becomes flexed. Even with the knees bent, many find that they are not able to bring their trunk to rest between their thighs – and this is fine. More problematic is the tendency, when practised with bent knees, to allow the feet to roll inwards – see the next section. Those who are experienced with this pose and who have good body awareness, long, stretchy hamstrings and strong, robust lumbar backs can safely practise this pose, entering and exiting with legs straight quite safely. This can look quite impressive and beautiful, but is not necessary for obtaining the key benefits of practising this pose.


Knees/legs

It is not an essential part of this pose for the knees to be bent – but, at least when first learning how to practise this pose, it is highly recommended. In this, and most other standing poses, where the knees are bent, the integrity of the knees is protected by making sure that the knees move and point in the same direction as the feet. Most people have at least some tendency to allow the feet to roll inwards so the knee end up more inwards than the direction of the feet. Because doing this a lot can, over time, damage the knee tendons (and will tend to cause knee discomfort in those with already damaged or weakened knees), it is very important, if you practise this pose with bent knees, to be aware of the direction your knees point in. Then, should you notice that your knees tend to point inwards, you will find it helpful to consciously press the outer edges of your feet (or the pads of your little toe joints) downwards. (Since doing this usually brings the knees back into pointing in the same direction as the feet.) Should you notice that your knees tend to point outwards (very unusual), then you will find it helpful to consciously press the pads of your big toe joints downwards.


Feet/ankles

If one practises this pose with poor attention to the feet, there is a strong tendency to allow the weight of the feet to be mostly on the inside edge of the feet (i.e. feet rolled inwards). This is bad news for the feet (as well as the knees – see above) is it tends to crush the inner arches and exacerbate and encourage problems such as achy feet and plantar fasciitis. Such poor feet care also has implications higher up at the hips, pelvic girdle and spine within the pose.

If one practises with appropriate attention to the feet, then one has most of the weight moved to the outside edge of the feet whilst keeping the pad of the big toe joints pressing downwards into the floor. This activates and lifts the arches of the feet – which is generally good news, but, if one is not used to having one’s feet active in this way (or already have feet problems), then this can feel a little too strong. In the latter case, practising with feet a little closer together may allow one to get used to having one’s feet active in this way, without it feeling so strong in the feet.

Anyone who already has significant feet problems will probably find wide leg sitting forward bends a helpful alternative.


Pregnancy

Practising yoga in the first trimester is considered by most yoga teachers to be contra-indicated. The only explanation I have heard for this is that in the first trimester there is a fairly high tendency for spontaneous miscarriage and this could in principle be exacerbated by yoga (although, as far as I know, there is no evidence for this). Possibly a mid-wife or an expert pregnancy yoga teacher might be able to give a better explanation.

In the later stages of pregnancy, one of the issues that needs to be borne in mind is that the womb starts to press against the inferior vena cava (main vein in the trunk) and the aorta (main artery). This has implications for blood circulation to and from the legs. It is thus unwise to stand in static poses for more than a very short period - with risks of discomfort, tiredness (in legs) and an increased likelihood, over the long term, of getting varicose veins or tissue fluid issues (oedema) in the legs. With regard to this pose, this means that one wants to use variants that are gentle enough to safely practise in a smooth flowing way with little or no static holding of the leg pose and including as much leg movement as is feasible and pleasant.

Because of the increasing size of the womb, this pose is often suggested as an alternative to Uttanasana (feet together standing forwards bend). For experienced yoga students, this may be a good idea. However, in this case, it should be remembered that the forward bending aspect of the pose is key, not the abduction at the hip (legs wide) – that is, legs should be only as far apart as increases ease and comfort. Indeed, there is a strong argument to avoid actively stretching the muscles around the hips as the hormones (particularly in the later stages of pregnancy) encourage a softening and loosening of the muscles and connective tissue connected to the pelvic girdle. This increased looseness aids the opening required for delivery, but can have a longer term side effect of loss of strength and stability in this area. Thus, through most of pregnancy, poses like this should, if practised, be practised in a way that tends to develop strength and stability in the hip and pelvic girdle area (rather than looseness and flexibility).

Another issue is that the increasing size and weight of the womb has an impact on one’s natural standing posture in a way that can significantly, but temporarily, change the shape of one’s spine. Also the increased weight of the womb increases the forces acting across the lumbar spinal joints. For these reasons, the lumbar spine may well be more vulnerable to harm in this pose than before pregnancy – this means that the earlier comments regarding the lumbar spine are particularly pertinent when pregnant.

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