As yoga teachers, words are our most powerful teaching aide. We must ensure our words have the effect we intend.
The information in this article is based on some of the scientific literature on language, pain, and rehabilitation, all of which constituted the basis of my master's dissertation. I have distilled that knowledge into an online workshop for yoga teachers. Onto three things a teacher should avoid saying and why.
Thing Number 1
“Engage your abs to protect your back.”
The problem with this cue:
There’s probably nothing wrong with encouraging someone to engage their abs, the problem is the second part about protecting the back. This cue has several negative implications. First, it suggests that the back is weak and prone to damage. Many people with chronic back pain actually share the belief that the back is a vulnerable and poorly designed structure (Darlow et al., 2015). Sadly, this belief can contribute to more episodes of pain and greater disability.
Additionally, what is implied if the abs are not engaged? It can suggest that you might injure yourself if you do not engage your abs. However, injury and pain are complex and multifactorial. Furthermore, the claim that core stability prevents pain lacks evidence (Augeard & Carroll, 2019).
Many people with chronic back pain and no specific pathology habitually engage their abs much more than healthy, asymptomatic people. Learning to relax their abs can actually help reduce episodes of pain (O’Sullivan, 2012)!
What to say instead:
Engaging the abs might be a good idea, especially for physically demanding poses like handstand or whatever those gymnasts are doing with those Pilates balls. Just leave out the bit about “protecting” the back. And remember that abs switch on when they need to. Our body has an intelligence beyond the conscious mind.
Thing Number 2
“If you do that, you’re going to injure yourself.”
The problem with this cue
Examples of this cue include the following:
If your knee rolls in during a lunge, you'll damage your cartilage.
If you do too many handstands, you'll injure your wrists.
If you flare your ribs, you'll compress your back.
If you round your back in a forward fold, you'll damage your discs.
This cue has at least three problems. Firstly, variation between individuals makes it impossible to predict what will injure one person and not another when it comes to the low loads found in a yoga practice. Though we might assume everyone’s skeleton and muscles all look the same, there are many variations between individuals. For example, though the norm is to have 12 thoracic vertebrae and 5 lumbar vertebrae, around 8% of people have some variation on that (Tins & Balain, 2016). For example, they might have one extra lumbar vertebra or they might have a thoracic vertebra that functions as a lumbar vertebra (meaning it functions lordotically and its facet joints match those of a lumbar) or they might have a sacral vertebra that is mobile and functions as a lumbar.
Secondly, this line of thinking does not account for our body’s inherent ability to adapt to loading. The tissues of our body adapt to training: muscles get strong, tendons get stiffer, joints become more resilient.
Finally, this reductionist way of thinking amounts to a philosophical error known as the “single cause fallacy.” We humans like to draw associations between causes and effects. However, injury is often really complex and multifactorial. Thinking injury is down to a simple factor, such as where someone’s elbow are pointing in chaturanga, does not take into account the complexity and unpredictability of injury. I once pulled a muscle in my back while eating cereal at breakfast. No one could have predicted that. And was it down to my posture at that moment or was it precipitated by previous factors such as how I’d slept the night before or the workout I’d done the day before?
What to say instead
Rather than trying to predict what will cause injury in someone which primes them for a bad experience, encourage movement exploration in your clients. Remind them that they are the authority over their body so it is up to them how much or how little they do in your class and remember that you are their guide and no more than a guide.
Thing Number 3
“The spine is like a credit card.”
What is wrong with this cue?
This analogy has been used as a warning as to what can supposedly happen to our spine when we repeatedly bend it, or in more technical terms, take it through repeated bouts of flexion and extension. If you bend a credit forwards and backwards repeatedly, the card will eventually break.
However, the spine is a complex structure made up of bones, muscles, ligaments, nerves and other tissues while a credit card is one thin piece of plastic. Most importantly, discs are alive and respiring, meaning they are composed of living cells using oxygen and nutrients like all other living cells in our body. Everyday loading, including bending your spine forward and backward, is understood to strengthen discs while being immobilised weakens them (Fearing et al., 2018).
What to say instead
Rather than referring to the spine as a delicate structure, it is more reassuring — and more accurate — to talk about the spine as an adaptive, strong, resilient structure. Yes, yoga students should always listen to their bodies and modify their practice accordingly but it is better to use reassuring language about the back than it is to be "overly cautious."
Why all of this matters
Fear-based beliefs are consistently associated with more severe disability and can predict the progression of disability over time (Zale & Ditre, 2015). In other words, people with more fear around pain and movement are more likely to experience disability from an injury or pain. Additionally, there is strong evidence that practitioner beliefs influence client beliefs, which means that if you hold fear-based beliefs, you are likely to influence your clients to hold similar beliefs (Darlow et al., 2012), which can then increase the incidence of future disabling pain (Alyousef et al., 2018)!
Knowing about the body is not just an amusing pursuit for the academically minded. A basic knowledge of anatomy and physiology can dramatically help us use our bodies better, get more out of life, and live to our fullest potential!
What do you think?
Can you think of any other fear-based cues that might have unintended negative implications? Comment below!
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Want to learn more cool physiology facts to make you an even better yoga teacher? Join our 8-week Physiology of Yoga book club which begins in September 2023.
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References
Alyousef, B., Cicuttini, F. M., Davis, S. R., Bell, R., Botlero, R., & Urquhart, D. M. (2018). Negative beliefs about back pain are associated with persistent, high levels of low back disability in community-based women. Menopause, 25(9), 977-984.
Augeard & Carroll (2019). Core stability and low-back pain: A causal fallacy. Journal of Exercise Rehabilitation, 15(3), 493.
Darlow, B., Fullen, B. M., Dean, S., Hurley, D. A., Baxter, G. D., & Dowell, A. (2012). The association between health care professional attitudes and beliefs and the attitudes and beliefs, clinical management, and outcomes of patients with low back pain: a systematic review. European Journal of Pain, 16(1), 3-17.
Darlow, B., Dean, S., Perry, M., Mathieson, F., Baxter, G. D., & Dowell, A. (2015). Easy to harm, hard to heal: patient views about the back. Spine, 40(11), 842-850.
Fearing, B. V., Hernandez, P. A., Setton, L. A., & Chahine, N. O. (2018). Mechanotransduction and cell biomechanics of the intervertebral disc. JOR Spine, 1(3), e1026.
O'Sullivan, P. (2012). It's time for change with the management of non-specific chronic low back pain. British journal of sports medicine, 46(4), 224-227.
Tins, B. J., & Balain, B. (2016). Incidence of numerical variants and transitional lumbosacral vertebrae on whole-spine MRI. Insights into Imaging, 7, 199-203.