How to Sequence for Low Back Pain


Hi there, Wellness Entrepreneur. Welcome back!

Today we’re going to be talking about how to sequence for low back pain specifically. And, you can incorporate these philosophies into a Vinyasa flow yoga class, yoga therapy class, private session and coaching. So this is very versatile work, and you might decide to utilize all the modalities or techniques yourself depending on your training and your expertise. Or you might choose to focus on one area and refer out to other practitioners who specialize in modality, complementary to what you do so then your students, your clients, your patients can get that holistic approach. It’s up to you.

This is important so you are aware that low back pain is not only just from the flexibility of the low back region. There are so many sources of why someone may have low back pain or kind of an annoying ache in their low back that just never seems to resolve. And you can thread this work into your classes and private sessions no matter if you work with the physical body, the mental body, the emotional body one or all.

Where You Can Start When You Teach A Class Or A Session

For me personally, when I teach a yoga class or I’m in a private session, I like to start with the nervous system. And so in terms of yoga sequencing for the low back, this is typically how I begin. And the reasoning is because most students and clients are busy with their lives, so they rush into a class or session most of the time. Unconsciously, their nervous system is a little wired and it’s important to help them to ground and transition so they can be more open and receptive to the style of work that you do. Also, that way, if there are fascial and muscle restrictions, you’re not having to work through the layer of nervous system tension first to get down to true muscle or fascial restrictions.

So for a moment, think about the style you typically teach or coach. How can you calm your student or client’s nervous system right in the very beginning? So I’ll give some examples. For a Vinyasa class, maybe it’s starting class standing or sitting, just pausing and breathing. And you don’t have to give a specialized breath technique. It can be just observing the breath, just taking a moment of stillness.

If it’s this yoga therapeutic style class, maybe it’s starting in a restorative posture and holding the space to allow them to just be for a moment. So much in life, we’re moving from one thing to the next, to the next to the next. And to have the space to just pause and be is so transformational.

If it’s coaching work you do, even through Zoom, maybe it’s a moment to pause, reflect, set an attention, place one hand on the heart, one hand on the belly, close the eyes, connect to the breath. Maybe it’s a pause to notice emotions. What is the baseline beginning of the session? Are they coming in feeling anxious? Are they excited? Are they happy? Are they a little deflated for a reason? Just giving them again the space to notice and become aware.

Noticing And Waiting For The Energy Shift

Even in my business coaching, I do this. I notice how someone shows up to a call. I observe their breath. Is it in the chest? Are they calm? Are their shoulders by their ear? And sometimes before I even start the conversation, I won’t say anything. I’ll just take that moment to connect with them on Zoom, looking through the camera into their eyes until I see the breath shift. And that’s the key, whether you’re in a class or online or one-to-one, it’s just waiting for that shift in energy. And maybe you can feel the shift or you can objectively see the shift by noticing how your students posture changes, how their breath changes. When you detect that shift, then you can begin to get into the detailed work.

The Causes of Low Back Pain

So for me, when I’m sequencing, when I noticed the students, their nervous system has downregulated, I’m holding the space for safety, for calm, grounded, openness to explore, then I move into the physical body. So again, depending on your training and your expertise, you may refer out for movement. However, if you’re teaching a class, this is typically what the students are expecting when they come into your class, specifically for low back pain. There are many sources in the physical body that could be the reason for their low back issue. For example, maybe they have restricted hamstrings pulling the pelvis into a static posterior pelvic tilt position putting excess pressure on their discs, or they have restricted and weak psoas compressing the spine, possibly a weak core, which there’s so much just in the core itself, hypertonic glutes, overactive glutes, glute amnesia, underactive glutes, weak glutes, lack of mobility in the spine, inextension, flexion, rotation, one or all.

Any of these, these are just the start, any of these can lead to different diagnoses such as arthritis, degenerative disc disease, degenerative joint disease, stenosis, herniations, so many issues and you don’t necessarily need to know the specific diagnosis, but if you’re watching your students move, you can begin to gather the root source of their issue.

For me personally, when I’m sequencing a class, it’s bringing these different components into one session. Or if I’m working one-to-one with someone, I work through these different layers session by session. It really depends. So you can sequence either for a class and in its entirety or session by session one-to-one.

You can also address the mental and the emotional body here. Notice if there’s restrictions, whether it be in the fascia, decreased space in the spine, muscle tension from stress, or emotions that are stored in the body never acknowledged and processed through. Again, what you choose to focus on can be due to your expertise, your training, or if you are a well-rounded yoga teacher, meaning you work on many different areas, you can shift the focus class to class, session to session. There is no right way.

You can read more on helping your clients to heal holistically through the Yoga Kosha Layers here: https://igniteurwellness.com/holistic-healing/

How Yoga Can Help Address Low Back Pain Issues

And that’s personally why I love a modality like yoga, because it’s so powerful to address these different layers, these different facets of how we’re made up as a human being altogether as one. But that’s just my bias. From the yoga-ing and coaching model, the practice of self-study can reveal patterns of thinking, patterns of movement that’s maybe serving an individual or not in terms of their low back health. And through queuing in classes, students can become aware of these patterns or by asking questions in one-to-one sessions. Both can help slowing students down as you transition in and out of poses and these can help them to understand how they move.

So for example, bending forward into Uttanasana or forward bend, if it’s done slow or without any queuing at first, just allows them to become aware of how they unconsciously choose to move. And then yes, you can correct them into a neutral spine and pelvis, educate cue on how to hinge at the hips, how to gain mobility in the hips so they have the availability to even do that in the first place. But first, it is so helpful for them to realize, “Wait a minute, how did I just move? What did I just do?” Most people aren’t aware how they bend forward day-to-day, moment to moment, to pick something off the ground because how they bend forward on the mat is how they bend forward off the mat. So helping to increase that awareness allows them to catch themselves in the moment off the mat. And instead of always bending forward through their spine, going into a posterior pelvic tilt for example, they can learn how to reinforce that movement and mobility in their hips by choosing to flex through the hips.

Strategic Sequencing for the Low Back

For example, this helps with long lasting change, this awareness. So in terms of sequencing, how can you bring this all in? So if the student is first grounded, their nervous system is regulated, you began with gentle movement to warm up those big muscles, especially the muscles that are impacted by stress, anxiety, uncomfortable emotions. And then you’re strategically moving through the hips, the lumbar spine, the thoracic spine, even the neck, shoulders, the lats for example.

And a lot of teachers, teacher trainings will say, just warm up the whole body. Or it can seem like that if you are in a class. It feels like you’re just doing a full body warm-up. But as the teacher, as the one who’s sequencing, you want to be strategic. And how are you going to move through the hips? Get the hips moving in all six of the directions? How are you going to warm up the spine in flex extension side, bending rotation? Same with the thoracic spine. Strategically warming up, helping them again to have that awareness as you warm up the shoulders, the lats. Helping them to become aware. Do they overextend the spine as they reach their arms overhead, for example, especially in that lumbar region.

Then weaving in strengthening of the core, strengthening of the hips, helping them to become aware of how they strengthen. Do they overdo? Do they hold themselves back? Can you guide them through subtle strengthening where less is more and yet powerful? Can you weave in the breath through the challenging postures as well? Through the moments of stillness, can you cue messages, pauses to help them become aware and guide them on how to bring the work off the mat, coach them on how to get curious about their choices, their decisions, hold the space for them to feel to process. This all can be done in one class, in one session.

The Importance of Sequencing

If you sequence this way, then they leave feeling complete. If you do it well, your students, your clients won’t realize the complexity of all that you did. They will just leave feeling whole with new ways to carry this off the mat and implement it into their life. So each class or session, you can shift the focus. Classes and sessions can stay fresh and inspired even when there is a lot of repetition, because repetition is part of influencing that change in their patterns of how they think, how they move, how they feel or don’t feel. That is the practice of self-study, which will help with low back and all the layers that contribute to low back discomfort like the nervous system, like stress, like emotions.

So I’ll put it together for you and more of a therapeutic class type setting because that’s what I really specialize in or a one to one setting. I’ll have the students come in. I like to connect with the students, whether it is one-to-one or group setting, just have a conversation, get a baseline, get a feel of where they are. And then I have them transition into an awareness of their breath and their nervous system. So if it’s one-to-one, maybe they’re pausing on the table, maybe they’re pausing in a seat or I’m setting them up in a restorative posture on the mat, just taking the time to acknowledge the breath. In a one-to-one, I might choose to work on the psoas, helping them feel into their belly, the expansiveness as they inhale. If it’s guiding them on the mat. It might just be a specific breath technique, depending on the level of the students who are in the class. And then I begin with the gentle movement, slow, mindful and strategic. Strategically working through the large muscle groups of the body, the major joints of the body with queuing to help them be aware of how they’re unconsciously at first, choosing to move what might be a more efficient movement pattern and giving them the space to explore.

So from my physical therapy hat, from my yoga therapy hat, I might have them explore using props or shortened range of motions or change in speed. Eyes open or closed are many different examples. So they can feel into their body and notice what feels good, what doesn’t, and why. And if I’m focusing on the low back, how does each of these movements and the different ways that they choose to move, how does that impact the low back indirectly or directly? Then they give them space to pause. There’s a lot of pausing and stillness and slowness in my class, which makes sometimes the therapeutic style, even though it’s considered to be “easy poses,” it’s not an easy class sometimes.

But then how do they move in life? How does this compare when they’re rolling off their bed or transitioning from on the ground, playing with their children? How do they sit on the ground and then choose to stand, for example. How are they lifting? How are they engaging their core? Does their belly out when they engage their core? Or are they over tucking their tails, so to speak when they engage their core overdoing? Can they feel the core? Do they notice the difference between erectus abdominus core engagement versus a transverse abdominus? Is the pelvic floor overactivated or can they not even detect the pelvic floor at all?


There’s so many ways to bring in this queuing, this guidance, this awareness, these awakenings, these insights. And you can just choose one thread of this for one session or one class and just extrapolate on it. So a lot of this starts right from the gentle movement, and we spend a good deal of the time, especially in my therapeutic classes, supine on the ground on our back, which I think is a little bit different as to how we spend our day.

Most of the time, our ankles, our knees, our below our hips, so gravity is always cooling that blood flow down. And this gives an opportunity for our legs, those big muscles of our hips and our thighs to restore, to replenish, time off the feet or time off of that sitting position. So we do spend a lot of time on our back allowing for that restoration and replenishing. And then gently moving to sitting, quadruplet, bringing in the movements of the spine and all its directions, movements of the hips, movements of the spine in its entirety, getting into movement of the thoracic spine, the neck, the shoulders, bringing in more vigorous movements, even standing postures, incorporating the queuing of efficient movement strategies, engaging of the core, strengthening of the hips.

We go through this and then towards the end of a class or the session, we’re bringing it back down to the mat. We’re reflecting again, thinking of ways to implement this into their life, how to bring it off the mat, how to bring it all together, allowing a moment of reflection. And then again, downregulating the nervous system because through challenging poses, even stillness and pausing, the nervous system can go into a stress response, and that’s okay, that’s normal.

We give time for the downregulation to happen again. And then it’s the cumulation. If it’s a class, it’s Shavasana. In private session I often do Shavasana as well. Or if it’s more of a coaching session, a revisiting of the strategies, the takeaways, the feelings, the things the student can take off the mat, off the session and into their lives. And in this way, this is why I love this type of work, because the shift is less from the diagnosis and less of the focusing on the pain.

Of course, sometimes I do check in with a number scale, and I guide them through a number scale to help determine the amount of effort they should put in or how intense a pose or stretch may be. But it takes the shift from the pain and into feeling their whole body as an entity. It also gives them hope because now they’re leaving with new ways of moving, new ways of thinking, new ways of viewing life. It’s holistic, it’s all encompassing. It’s in my mind what wellness really is.

So these were some ideas for sequencing, for low back pain to compliment this blog. You can also look back to previous blog on healing and the low back here: https://igniteurwellness.com/compound-effects/

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Alison McLean

"I help the Entrepreneur reduce stress and live a more fulfilled and balanced life."