Supine Twists - Issues and solutions

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

            Pregnancy








For those who already have neck problems, rotation about the neck can be something that needs to be done with care. Because the weight of the head is supported by the floor in supine twists, it tends to be much easier (than for sitting or standing twists) to practise the neck movement with appropriate care and attention. Even so, those with neck problems should separate the neck movement from the other movements of the exercise and so should be able to give full attention to the sensations from the neck. They should also move slowly so as to be able to stop the movement at the first signs of discomfort. Those who have really stiff necks may find it best to omit the neck rotation part in supine twists.



Some people may find that, in some of the supine twist exercises, the arm movement is uncomfortable or indeed impossible – cf. “frozen” shoulder type issues. In some cases, this can be accommodated by simply moving the arm less far. In other cases, a different version of a supine twist will be needed which either does not involve arm movement or uses a different sort of arm movement.



In twists in general, breathing via the expansion and contraction of the rib-cage is very restricted. This is not normally a problem, but those who are used to primarily breathing via the expansion and contraction of the rib-cage (rather than “abdominally”) may well find the experience uncomfortable or even distressing, although it is very unlikely to do any physical harm. One option is to work dynamically in and out of the twist with the breath. Another is to go less far into the twist.



In most twists, the majority of the spinal rotation will occur in the cervical spine or in the lumbar spine – the thoracic spine has articulation surfaces that restrict the degree of rotation to just a small amount. At the transition between the lumbar spine and thoracic spine, there is a fairly sharp change in the degree of movement possible making this area relatively at risk. For healthy spines, rotation movement is great for micro-circulation in and to/from the spinal joint tissue (cf. a cloth or sponge being twisted in water and then opened out) and thus for helping to maintain the health of the spine. However, the rotation movement does have the potential to aggravate already existing spinal problems, especially where the spinal alignment is poor. Thus those who already have spinal problems or discomfort in the lower back should practise twists gently – taking particular care to be aware of sensations from the lumbar spine and avoid going so far into a twist that discomfort begins to be felt. This means that only twists that can be practised slowly with good control should be practised. Those who have strained their lumbar back will tend to get on better with twists that have the knees away form the chest and those with a tendency to lumbar lordosis will tend to get on better with twists that have the knees close to the chest. The key thing to remember, as with all yoga practices, is to observe one’s sensations and discontinue that particular practice at the first hint of discomfort.



Tight hamstrings really only limit how far one can straighten the legs in Jathara Parivrtti – this pose can be easily practised with the knees bent without losing the key aspect of the pose which is rotation of the spine.


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 lie on one’s back 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 supine twists this means that one is best to omit twists that start from lying on one’s back and instead go for the ones that start from lying on one’s side – and go for the dynamic versions rather than static ones.

Another issue is that the increasing size of the womb restricts the rotation movement that is possible in the lumbar part of the trunk – and, in any case, one does not want to distort the abdominal area excessively. This means that one should avoid moving too far into a twist and should go for versions that tend to encourage the spinal rotation more in the thoracic rather than lumbar part of the spine. One way to do this is to have the knees close to the chest; another is to have the arm position away from the trunk (higher than shoulder level).

A positive aspect to twists that involve arm movements at shoulder level or higher is that they can be great at helping to release tension that tends to build up in the chest muscles as the breast size increases through pregnancy.

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