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Ustrasana (Camel pose) - Issues and solutions

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

Ustrasana Pose Potential Problem Areas Image
            · Neck and shoulders

            · Thoracic part of trunk

            · Lumbar part of trunk

            · Legs

            · Feet and ankles

            Pregnancy




Neck and shoulders

In the full version of this pose, the head is allowed to hang backwards so the neck is in full extension. Although lowering and lifting into this position requires strength in the neck flexors, if the neck is healthy (and the thoracic spine is also in full extension) then, once the head is in position, the neck muscles can relax with the weight of the head causing mild traction of the neck. One problem is that it is rare for the thoracic spine to be in sufficient extension for this to be safe for the neck. The result is that, instead of the neck being in traction plus extension (back bend), the neck ends up with something more like compression plus extension (back bend), potentially putting excessive compression into the back part of the cervical spine. This can cause discomfort even for relatively healthy necks but is likely to be particularly problematic for those with significant levels of osteoporosis because the bones become fragile enough to be damaged. In practice, there is another reason not to adopt this head and neck position – as it also tends to increase the loading in the lower back (again less of a problem if the thoracic spine is in full extension) – which needs to be protected in this pose.

So, far more commonly, the pose is practised either with the head facing forwards (chin tucked in and cervical spine in mild flexion) or with the head only very slightly looking up (so the curve of the cervical spine continues the curve of the thoracic spine). In both these positions, the neck flexor muscles have to work hard to take the weight of the head. For most people who are ready to start working with this pose, this is fine – but, where sufficient strength is lacking, it is sensible to work with alternative back bends (e.g. cobra and bridge) until one has developed the required strength in the neck. However, there is a version of camel pose (where one kneels with toes curled under and heels, shoulders and head against wall and then one lifts the hips forwards) which does not require neck strength. Obviously, where discomfort is experienced in the neck area, alternative back bends should be practised until the source of the neck discomfort is understood and sorted out.

In the full version of camel pose, the arms are in a backwards position relative to the trunk. Those with frozen shoulder type problems may find this position uncomfortable. However, there are lots of arms positions one can use - such as arms pointing forwards, or sideways or upwards - so shoulder problems need not be inhibiting with regard to practising camel pose.


Thoracic part of trunk

Unless one has sufficient mobility in the upper back with regard to extension (back bending), one will not be able to move safely into the pose. The pain / damage is more likely to be felt in the neck, lower back or knees than the upper back, as these are the areas that will tend to get compromised to compensate for lack of movement in the upper back. So those with stiff upper backs or some degree of excessive thoracic kyphosis (e.g. ‘dowager’s hump’ type issues) should not attempt to practise the camel pose. Instead, they can work on mobilizing the upper back (e.g. the spinal movements of cat breathing) and on practising less demanding backbends such as cobra and bridge pose.

Camel pose, whether one holds the position or one moves in and out of it with the breath, is very demanding of the heart, encouraging the heart to beat harder and faster. This is generally beneficial for the heart as it gives it a bit of a “work-out” – helping it to stay fit and strong. However, for those with an already compromised heart, there is some danger that the heart will be asked to do more than it can cope with. Such people should listen to/feel how their hearts are responding and should only practise the pose for short periods (if at all) until the heart has built up its strength and stamina again. Although, in practice, those with a compromised heart usually are also somewhat stiff in the upper back and so would not typically be practising the camel pose for that reason.

When holding this pose, the breath is heavily restricted. It is restricted in the upper and middle part of the lungs, since the spine and ribs are held in an extreme position. It is also restricted somewhat in the lower part of the lungs, as a result of the abdomen being pulled taut so that the diaphragm has to work harder when it contracts. This is generally beneficial for the muscles of respiration, which are either being stretched (which helps to improve their elasticity) or having to work hard against resistance (which strengthens them). However, some people may find this uncomfortable at first and feel that they can’t breathe (cf. asthma) – such people need not hold the pose, but can move in and out of it until they feel comfortable holding it. Again, typically, those with this sort of issue with breathing will tend to be also somewhat stiff in the upper back – making this pose unsuitable for them anyway.


Lumbar part of trunk

The lumbar spine is protected from being taken into excessive (and compressive) extension (back bending) by strength in two areas. The front thighs (quadriceps) need to be engaged to hold the pelvic girdle stable and abdominal muscles need to be engaged to steady and control the position of the front base of the rib-cage. Engaging the abdominal muscles happens automatically if the head/shoulders/arms/hands are not supported – which I think is a good reason for not using such supports. I find that keeping the quadriceps engaged is best done by making sure the hips stay over the knees, pressing the pubis forwards (or drawing the tail-bone downwards) and then pressing the lower legs downwards.

Where strength and stamina is lacking in these two areas, I think it is best to develop the strength before attempting camel pose. However, there are some versions where a little less strength is needed. The version where the head and shoulders rest against the wall (see earlier) requires little strength in the abdominal muscles (as the weight of the trunk is supported by the wall instead of the abdominal muscles), but still requires strength in the quadriceps to lift the hips up. Versions where the hands /arms press down against a chair also reduce the work the abdominal muscles have to do – in theory, the same is true of having hands resting on heels, but that requires one to have sufficient suppleness to practise safely. [Obviously, those with recent abdominal operations should not attempt any version of this pose!]

Those who are tight in the hip flexor muscles will be less able to tilt the pelvic girdle backwards – unless extreme, this is unlikely to stop one from being able to practise the pose, but, visually, it will tend to look like one is going less deep into the back-bend. And they may well find working on stretching their hip flexor muscles leads to a more satisfying feeling when practising camel pose.

Those with a tendency to excessive lumbar lordosis (excessive inward curving in the lower back), and those with a highly mobile lower back, do need watch for over-arching of the lower back. This need not be a problem as long as one practises the pose so as to keep the lower back long (e.g. abdomen and quadriceps strongly engaged) – and, indeed, if practised well, the strengthening aspect of the pose is likely to be highly beneficial.


Legs

The legs are not in an extreme position so one might think that there is little likelihood of problems. However, with the quadriceps very strongly engaged, the pull in the knee area can sometimes feel a little too strong and/or the quadriceps can get tired. With regard to both problems, the thing to do is to hold the leg position of the pose for less long until the required strength and stamina is developed. And to ease the knee joints and thigh muscles with some gentle bending and straightening movement at the knee joint. Moving between up-kneeling and down-kneeling (whilst keeping the trunk upright) will help with developing strength and stamina in the thighs and resistance in the knees.

I find that if I attempt to practise the pose with the hips not over the knees (i.e. backwards of the knees) then I tend to experience a strain in one of my knees. I think this is due to the load on the quadriceps being increased – and thus the forces pulling at the knee joints are greater. So, where knee discomfort is experienced, it is worth taking extra care of the positioning of the hips and pelvic girdle. Obviously, when discomfort in the knees is experienced in the pose, one should not continue with practice of the pose.

Some people find the kneeling position uncomfortable – not because of their body’s condition as such. but because their knees don’t like resting on a hard surface. And, indeed, most people will find knee comfort is increased by practising with knees and lower legs resting on a square of folded blanket.


Feet and ankles

One can practise camel pose with the tops of the feet resting on the floor and toes pointing backwards. For most people this is comfortable, but those with tight dorsi-flexors of the ankles may experience discomfort in their shins or tops of feet as these muscles are stretched. The solution is to decrease the degree of plantar-flexion at the ankle – placing a thinly rolled-up towel under the ankles works well, as does placing a folded blanket so that it is under the knees and forelegs, but not under the feet.

Another option for the feet is to start with the tops on the floor (as above) and lift the heels (so the soles become close to vertical) and then curl the toes under so that they point forwards. If one is practising the pose with hands on heels, this has the benefit of lifting the heels and so requires the spine to extend backwards less far to enable the hands to reach the heels. However, many find the extreme toe position uncomfortable and inhibiting for pressing the lower legs and feet downwards (to help with keeping the quadriceps engaged). A solution would be to place a sufficiently thickly rolled-up towel under the ankles to reduce the pressure on the toes. One could also explore having toes curled the other way (toes pointing backwards) while the heels are lifted (so the sole is close to vertical) – but most people find this foot position even more uncomfortable.


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.

The camel pose is a fairly advanced backbend and thus not a pose to start exploring during pregnancy. If one is already experienced with camel pose, I would still advise practising alternatives instead. For example: sitting fish pose (from sitting, lean backwards and place hands on floor and then lift chest) or standing cobra (from standing, clasp hands behind back, draw hands downwards while rolling shoulders backwards, and then, lift arms away from back, encouraging chest to expand forwards). Other options to consider would be things like cat breathing (from all fours or standing cat) and sitting with a chair in front and resting hands and head on chair in such a way that encourages back bending of the upper back. There are lots of reasons for avoiding camel pose while pregnant such as the high degree of contraction required in the abdomen and legs and how demanding the pose is on the heart. Those who really want to continue with camel pose practice during pregnancy, I would strongly recommend only do so with the supervision of a yoga teacher highly experienced with teaching yoga to those who are pregnant.

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