Back pain and symptoms of sciatica are extremely common in modern society, if you’ve not directly experienced it yourself, you will know someone that has. It is the source of a huge financial burden to economies on top of the personal cost to the individual affecting their mental health, physical well being and confidence when it comes to partaking in social activities, the things that make life enjoyable.
It is no surprise that the internet is awash with people searching for stretches to help fix their back pain, inevitably you’ll come across the “magic stretch that will fix your back pain or sciatica in 36.5 seconds”.
But does it really?
There is a common misconception that back pain, and sciatica, are caused by tight muscles, muscles that just randomly decided one day to become tight, for no apparent reason. Yes this is a little sarcastic, but this misconception is the source of many minor back issues becoming chronic, as we have discussed in the recent podcast on chronic back pain.
If you’ve been searching for relief for your back pain, or even perhaps consulted your GP or a physical therapist (osteopath, chiropractor or physiotherapist etc) you will have almost certainly been directed to the child’s pose stretch. A simple way of stretching off your back tightness and alleviating all your back troubles. Is this really how it works? Of course not. We have mentioned stretches like the child’s pose and similarly the knee hugs many times over the years but today we will take a deeper dive into this particular stretch for back pain and sciatica, hopefully explaining once and for all why it is simply not a necessary stretch for you and your low back or sciatic pain.
Unraveling the Mystery of Back Pain and Sciatica
It would be sensible to have a brief recap of back pain and sciatica and what they are before we get into the child’s pose stretch specifically. Firstly, sciatica. This is not a problem but a symptom of an injury in the lower back, an injury, perhaps an injured disc or facet joint in the lower back. Sciatica can sometimes be present only in the leg, other times it will present alongside low back pain. The small nerves as they leave the spine run through little bony tubes between the vertebrae and these are tubes or tunnels that are vulnerable to a build up of pressure, for example when there is a low back injury to the disc or facet. There might even be direct pressure from a herniated disc onto this nerve root. Either way this injury can compress the nerve giving rise to sciatic symptoms down the leg. It could also give rise to general back pain.
For this injury to happen to the lower back, causing back pain or sciatica, it is commonly the case that there has been a repetitive strain to these structures in the lower back, creating weakness.
This next bit is important.
A one off event is then usually something involving forward bending, and load, for example, putting the socks on in the morning, lifting shopping out of the trolley into the car, picking up your child or grandchild. Something you’ve done dozens of times before. However as a result of the years of abuse, sitting for extended periods with a rounded lower back, at work, at home, traveling, the back is vulnerable and the tissues are finally weak enough to fail at that moment.
With forward bending, compression through the discs, and often some degree of rotation, or twisting.
Cue the onset of your back pain or sciatica. Have this mechanism of injury in your mind as we move forward through the article today. And if you are interested in a more thorough explanation of back pain or sciatica be sure to check out the dedicated deep dive episodes of the podcast.
Understanding the child’s pose stretch
This pose is a common yoga pose, and is popular due to the pleasant feeling of the back stretching as well as the ease with which the stretch can be done. Both yoga and pilates classes from all over, as well as many fitness classes in general will incorporate this stretch in some way.
If you’ve made a visit to your Doctor or the NHS guidance on back pain then you’ll have likely come across this stretch. Of course if you’re in pain you want something to feel better and make no mistake, this stretch feels nice for the vast majority! But what is the child’s pose specifically and why does it feel good?
The child’s pose stretch is done by starting in an all fours position and sitting back onto your heels accentuating a rounding motion at the lower back and a posterior pelvic tucking motion to flex the lower back, as if curling into a ball. This creates a lovely sensation in the lower back of the muscles stretching as you elongate the muscles and soft tissues, including the ligaments on the back part of the spine, and the back part of the discs. This has the added effect on the bony holes where the nerves exit the spine (mentioned earlier). Because those bony holes or tunnels are made up in two parts by the vertebrae on top and bottom, as you round the back, the hole becomes larger, thereby reducing the pressure by increasing the size of the space.
The hidden dangers: how the child’s pose stretch can exacerbate back pain and sciatica.
The biggest challenge with the child’s pose is the fact that it feels nice during the movement. Its prescription is made as a result of a failure to understand the primary mode of injury for lower back problems and the way in which modern life strains our lower back.
Firstly, the assumption is that the problem is that the back pain is caused by muscle tightness and that the muscle tension in the lower back is the problem. The reality is that muscles do not become tight for no reason, they become tight in response to an injury or some stimulation to contract.
With the way we use our lower back every day, with the average working adult spending 9.5 hours a day sitting, we find that the process of flattening and rounding of the lower back invades much of our daily lives. This flattening and rounding of the lower back over months, and more often years and decades, leads to the repetitive strain on your lower back that we mentioned earlier.
As you consistently flatten the lower back, you also have the effect of pulling the lower back muscles apart, elongating them. ALL DAY! If there is one thing that muscles do not like, it is holding a position, under load, for extended periods – minutes and hours.
An easy example here is thinking of a simple bicep curl. If you bend your arm by 30% before curling the weight, you shorten the bicep and this makes the exercise easier. If however you lean backwards, perhaps on an incline bench, and fully straighten your elbow, then try to curl the same weight, you will find your bicep feels MUCH WEAKER. Even though the weight is the same. Part of this is due to the levers and part due to the fact that the muscles generally feel weaker when contracted from an extended position, compared to when contracting from a shortened position.
Circling back to the lower back in that rounded position all day (sitting) not only are the muscles elongated, and posture dubious, but also the muscles are in a comparatively weaker position having to bear that stretch and load.
It is no wonder they become tight or tense.
This doesn’t even take into consideration the back injury yet, and the signals that travel from the injured lower back segments to the muscles to tell them to remain tense.
The fundamental mistake here is interpreting the tension in the back incorrectly, and assuming that it is a tension that should be alleviated by more stretching, as opposed to reducing tension by taking the muscles OFF stretch.
If you are someone who’s noticing that your back is feeling tight and that this has graduated to the back being tight and painful, then becoming aware that it is tight and painful and injured. Adding more stretching to the back only serves to reinforce the precise movements that have led to the overload of your lower back in the first place.
Unfortunately, because a stretch to a tense muscle always feels nice at the time, we can very easily fall into the trap of doing more stretching, and so child’s pose and other stretches like it become a staple way of us trying to ease the back tension and then back pain.
With each stretching episode, we feel we need to stretch more because the back is just so stiff. And so we continue to reinforce the problem further, we find we need to stretch again sooner and this vicious cycle gets more and more established.
We could summarize the danger of the child’s pose on even an “uninjured” back as being an exercise that only serves to enhance the already extreme levels of rounding that are taking place in your back on a daily basis. Targeted stretching should be there to work on movements that are not being done on a daily basis to preserve joint health and whole body mobility. Stretching should not be there reinforcing an already dominant movement direction.
But that is what a child’s pose stretch is doing for the majority of people.
Science behind the strain: why child’s pose stretch can be detrimental to your back injury
We’ve discussed the issue more globally that affects the lumbar spine when doing the child’s pose, but what is happening specifically in the region where we have an injury? Commonly the lower back is injured at levels L4, L5 and L5, S1. The last two joints in the spine. The stretching of the back part of these joints and the compression on the front of the disc is nearly always a factor and the instability that results, an inevitable conclusion.
For example, if we injure the knee joint, let us say the ligament that supports the inside of our knee, the medial collateral ligament, the knee’s stability will be reduced, it will become less stable.
The injury has created some degree of tearing or damage to the structures that support the junctions between two vertebrae. These tissues are trying to heal back together, to contract and restore stability. Simplistically speaking, we have two ends of a rope that has frayed, that are trying to come together again so that they can be mended and re-connected. At first, the junction where they rejoin will be different to the rope, the stitching will be a point of transition, but with time the stitches will assimilate and the rope would become whole again, strong and stable.
If however you are continually tugging at the rope, especially in the early days, you will be directly undermining this process, akin to “picking a scab” it will affect the completeness of the healing in the lower back and the integrity of that region as it attempts to heal.
It is this interruption that the child’s pose creates, added to the plethora of additional forward bending movements and positions that exact the same stretching and compressive forces on the low back every day.
The insidious nature of the child’s pose stretch and comparable knee hug stretch, is that they feel nice during the time we do them. Because stretches feel nice, period. Drawing back to the scab analogy, with a scab on our skin, if picked, we get some pain immediately which discourages us from doing so, or at least reminds us that we are interfering with a process that should be taking place without interruption. That is because our skin for obvious reasons needs to have lots of nerve endings as it is the place in which we interface with the outside world. We need to know what is happening there. Deep within our lower back however, we do not have this same “dialed in” sensory awareness, especially in the more ligamentous tissues. They are often quite slow to react to these issues and to make us aware that perhaps we have aggravated them. This is one of the reasons so often an activity on Day One, will not be problematic until the morning of Day Two, when the reaction to the aggravation has had a chance to set in and the inflammation build up. When you pick the scab, you see it starts to bleed again, and then you perhaps patch it up with a plaster or something to immediately deal with the reaction. This just is not possible in the lower back for obvious reasons.
In conclusion perhaps an equally big reason that the child’s pose is a problem is that it makes you “feel like” you’re doing something to help your back pain or sciatica resolve, when really there are no long term benefits to doing this sort of stretch, it does not contribute to your rehabilitation in any meaningful way. What’s worse is that it takes up time you could be spending doing the right sort of exercises that will help your lower back recover, heal and then rebuild resilience for the long term.
Dialing in your approach: alternative stretches for back pain and sciatica
Ultimately stretching is not something that is going to fix your back pain at all. That being said, there are stretches that make sense to help in the short term. Stretches that will be purposeful are those which provide a movement that is not usually done, therefore preserving joint health as mentioned earlier. The best stretch for lower back health and sciatica is the towel stretch. Let us explain why and how it is literally the exact opposite of the child’s pose stretch.
Firstly, it supports the natural neutral spine position in the lower back, as we mentioned this is something that many of us are eliminating every day on account of our profuse sitting. So it is working AGAINST the strains of daily life, not adding to them, like the child’s pose. As a result of supporting the neutral, the towel stretch unloads the discs in the low back, instead of compressing them more. It takes the ligaments on the back of the spine and the back of your disc off stretch as opposed to pulling on them even more. It also gives your muscles an opportunity to relax as it takes the pulling forces off them, giving them a much needed opportunity to ease.
You can see from this simple example that the towel is the archetypal opposite of the child’s pose or knee hug stretch and what it is doing in your back, be it healthy or injured, is offering support in a way that at least tries to make up for the torrent of abuse and forward bending our back is put under on a daily basis.
If you want some quick tips on how to do the towel correctly for your lower back then check out this short video on the towel stretch for lower back pain. You must however make sure that you do not rely only on stretches as these will not rebuild your back fully.
Exploring further: the critical role of strengthening in alleviating back pain
Restoring the health in your lower back and aiding recovery is a regenerative process. One which cannot be achieved by stretching which does not serve to increase the “capacity” of the musculature, or significantly contribute to the regenerative process and re-strengthening process of tissue healing. Granted stretches like the towel one mentioned above does have its value but it is important to understand the gaps in what various tools can do for your body. For example, if you try to build a wall with bricks but no mortar the wall just will not work.
This is where strengthening comes in. Learning to provide stability to the spine in the first instance, supporting stability, the polar opposite of full range of motion lumbar flexion like in the case of the child’s pose is essential. Building on this ability to stabilize the core and spine we must work on improving the strength and mobility for the hips so that they can work seamlessly with the core region of musculature to move the body in a safe and effective way. We go into great detail on how to strengthen your core to fix lower back pain in a previous episode of the podcast and that is certainly worth a read after this one for more detailed instruction.
In short it is muscular strengthening that, over time leads to a literal change in your body, a transformation. This change is something that is “semi permanent” and will be with you from one day to the next. So long as there is no neglect of your exercise regimen, you will find this creates an enhanced “suit of armor” for your back that is with you all the time. On top of that, the process of resistance training also helps guide the healing in the deeper structures of your lower back, for example the discs, triggering them to become stronger. This means that they will be more resilient to future episodes and injuries.
A comprehensive approach: lifestyle modifications for back pain management
We have spent a lot of time today talking about the role of activities, be they stretches to do or avoid as is the case with the child’s pose, and in the previous section, we discussed the prospects of resistance training being an essential pillar for your success in the recovery from back pain and sciatica. While these exercises are vital in the transformation of your body and recovery, they are active tasks which generally make up an incredibly small amount of your day or week. There are 168 hours every week and you MIGHT spend 5-7 hours doing these exercises or stretches if diligent.
What about the other 161 hours every week?
In reality much of back pain is maintained by poor habits we have developed, we are literally blocking our own healing process by persisting with unhealthy activities. Like the individual trying to lose weight or fix their diabetes who eats cake, sweets, chocolate and other sugary snacks while thinking that a small amount of cardio or activity, or a salad will change things.
We discussed the way in which we prevent our back healing with our daily practices and why this is so often a hidden factor in chronic back pain in an episode of the podcast previously. Suffice to say, without proper education and an awareness developing around how you are causing your back pain or sciatica to remain with the actions you take every day, you will constantly struggle to be rid of these symptoms even if you work hard on your exercises.
There is a phrase in the fitness industry “you can’t outwork a bad diet” and the same thing is true here, you cannot expect to see results with your back pain if you’re diligent with your exercises but ignoring how you use your body on a daily basis outside this 30-60 minute period.
Taking control of your back health
As a priority, if we are to resolve back pain for good, we must eliminate incorrect exercises. For reasons discussed in today’s episode, the child’s pose is one of those exercises that serves little purpose for the vast majority of those with back pain or sciatica. Yes it feels good, but it is actually making the whole problem worse and you are gradually becoming more and more dependent on the stretch while simultaneously weakening your back further.
We know this from experience with tens of thousands of patients and members over the years. Start now by replacing the unhelpful child’s pose stretch (or knee hugs) with your towel stretch. From here, make the time to engage with education to help you understand where you’re going wrong on a daily basis and “preventing the healing process from taking place”. At the same time you must begin a program of resistance training that focuses on safe spinal stabilisation and then gradually adds in gravity and load bearing exercises to guide the recovery process and rebuild your body to promote long term resilience in your lower back. If you do this right, you’ll find back pain is a thing of the past and you can get back to doing the things that you love!
If you’re not sure what you should do, or want the support and guidance to follow a proper program that ticks all the boxes then check out the premium page for more information on becoming a premium member and getting your Back In Shape for good!