Forward folds and back pain: what you need to know

Forward folds are one of the most basic, instinctive stretches out there. How many times have you heard the phrase “I can’t even touch my toes”? It’s one of the most common excuses for not doing yoga that I hear. For those who can get a little deeper into folds, these poses are very calming and grounding. However, all too often they aren’t practiced properly and can result in injury of the hamstrings and the back. For many people with sore backs associated with tight hamstrings, forward folds are the obvious solution. However, when the legs are stretched to their maximum the lower back can become strained. 


So how do forward folds work? You’ll know what they look and feel like, but from an anatomical perspective there’s a lot going on. At the hip sockets, forward flexion (folding) occurs, facilitated by the external hip rotator muscles and hip adductors. The knees straighten as the hamstrings release and lengthen, -usually the main thing that you feel. Alongside this, the erector spinae on the back and muscles of the calf release. The erector spinae muscles run down the length of the back, connecting to the pelvis. I’ll come back to these muscles in just a moment.

The hamstrings are intrinsically linked to the pelvis as they originate on the low sit bones. This means that they are directly attached to the pelvis via tendons. At the other end of the leg, the hamstrings are connected to the lower leg and the tendons behind the knee. Due to this, contraction of the hamstrings bends the knee, releasing the tension you feel in forward folds. 

When someone folds beyond what their hamstrings will allow, the hips are forced into extension, the opposite direction to where they should be. This is due to the hamstrings pulling the sit bones of the pelvis towards the backs of the legs. This in turn over-stretches the  erector spinae as they are pulled further down, which can lead to injury and back pain. It is therefore really important to listen to your body and avoid “yanking” yourself forward. Instead gently encourage a deeper fold, using a small amount of aid from your hands, as you exhale. On the inhale, stay where you are or even come slightly out. 

If you find that even sitting with your legs stretched out pulls on the hamstrings, then don’t attempt to fold. Work on being able to sit with straight legs and spine before you try to fold. Just lengthening your spine will stretch your hamstrings. If your back is really rounded when you sit, you can pop a block underneath you. Again, focus on getting the spine upright rather than folding. 

Bending the legs can help take of the pressure from the hamstrings, especially if forward folds really are tricky for you. Additionally, slightly bent knees facilitate forward movement of the pelvis, especially for anyone with lumbar lordosis (overarch of the lower back). This will also protect the knees from hyperextension when they become locked straight. Just a micro bend to the knee is needed to prevent damage to this important joint.

Other things to consider are your entry and exit into standing forward folds. The problem with the question “swan dive forward” is that many people will arch the back, jutting the chin forward as they fold. This means you’re essentially doing a back bend to get into a forward fold. Doesn’t sound great does it? This unsupported arch can put excessive pressure on the lower back, especially if you already have a lumbar lordosis. 

In seated folds, it is common to see lots of people rounding their thoracic spine so as to get their head on their legs. This isn’t great for either the spinal discs or the hamstring attachments. Rounding compresses the vertebrae discs by pinching at one end and squeezing out at the other. In extreme cases this action can be linked to bulging discs. The hamstrings are also forced into a deeper stretch by this movement, hence why the connective tissues between hamstring and pelvis can be damaged.

On the other hand, jutting the chin out and compressing the backs on the neck can also be damaging to the spine, so try to keep all of the back fairly neutral.

In short, don’t yank yourself too deep into a fold, bend your knees if needed, keep the spine flat, and make sure you enter folds safely. And if you still don’t feel happy with forward folds, or are still experiencing back pain, talk to an experienced yoga teacher or physiotherapist. For more yoga tips, articles and sequences, click here to read more.

References: Key Muscles of Yoga; Key Poses of Yoga; Julie Gudmestad for Yoga Journal.