Degenerative Disc Issues and Foot Neuropathy
I have a prospective student with these two issues.
I am working my way through the online Chair Yoga course which I signed up for 2 months ago. I had an email from a prospective yogi who wants to attend my seniors class because he has the following issues:
- chronic back disc degeneration
- neuropathy cannot sit cross legged or legs straight due to muscular and nerve pain
I went back on some notes and all the fabulous material provided for the Chair Yoga course and note that for the disc degeneration – that is mentioned in the Anatomy for the Spine under Issues and Conditions – this gentlemen is planning to come to my yoga classes and I am feeling a little concerned that he could be bringing conditions that I have not yet come across, he is only 44 years old but must have a lot of limitation as he is ok with coming to the seniors group (I guess just a little concerned that given his issues he may come along and say he hurt himself at yoga etc – you worry about the opportunity people can take to sue you).
Of course I understand that I will have to have a conversation with him to understand a little bit more about his conditions and I guess give him the easiest of poses to get him stretching etc, that I am not concerned but it’s just to check with you how serious his conditions are and if you have had anyone in the past with these conditions and how you handled it.
Then the second issue neuropathy – that is also covered in the Anatomy of the Legs & Feet – under the Issues and Conditions section – poses for that being foot stomps etc
With all your experience, how would you handle someone with these conditions ? Your advice and any help you can offer is so greatly appreciated – thanks
Answer from Justine
I’m glad he found you!! The good news is it is chronic disc degeneration – I take that to mean there is no disc herniation (please double check with him, to be sure.) It may be that he has Degenerative Disc Disease (DDD) – and that is often throughout his entire spine. It is a thinning of the discs – the main thing is axial extension (lengthening the spine from the tailbone all the way through the crown of the head) while seated, standing and before any movement, to avoid compression to the discs. He can do very gentle, limited forward bends, but do make sure he is tilting his pelvis forward (sticking his tailbone, or ‘tail feathers’ toward the wall behind him) before any going forward, and keeping the spine long, i.e. not hinging in the spine to get more forward. (think of the ‘cactus arms’ forward bend Sherry does in her chair classes). Cue for him to really pull his belly in so he has that muscular support engaged to protect his lower back.
Gentle movements in all directions are good, to get the discs imbibed with fluid….this can help create more space in the discs and more room for the spinal nerve roots to exit the spine. Lateral bends are great for stretching the Quadratus Lumborum Muscles – those are key players in back pain, when they are tight they can pull the vertebrae together and cause more compression. Gentle twists with NO leverage should be okay – repeating several times each direction to ‘floss’ the spine so to speak, then holding the gentle twist for several breaths to stretch the spinal musculature. Have him start with very small movements and slowly ease into slightly larger movements if he feels okay. Any pain, come out immediately. You might offer for him to pad the chair with a blanket to make it softer – I know that helps my back when I am acute (I have DDD, bulging discs and spinal stenosis, the padding can ease the pressure on the spinal column that can create more nerve pain.)
As far as the neuropathy in his feet, please ask him for more information. Is it due to nerve compression in his spine? I want to rule out neuropathy from pharmaceuticals (chemo), diabetes or another source. The foot drop might be helpful as it stimulates the nerves, but have him start by dropping the foot from only about an inch off the floor to make sure it doesn’t create pain. It may be from tight muscles in his back compressing the spinal column and nerve roots, possibly tight muscles in hips compressing the sciatic nerve, or tight muscles in his legs stopping full nerve conductivity to the feet. Ask him if they are painful – like burning or a needle sensation – or is it that his feet are numb? If it is burning or a needle sensation, the foot drop may not be advised at all! Strap stretches for the legs, ankle circles, foot stretches are all good. Reverse pigeon will be very helpful – but crossing his leg might not work. He may be able to try having the bottom/supporting foot further away from him to ease the angle in the top hip. Just getting into that position may help, without adding any forward bending. Make sure he is sitting with his back supported on the chair, so he doesn’t roll his pelvis backwards.
Below is a video clip (1st Video) with a version of tadasana standing (great for axial extension!) – have him hold the chair or put a hand on the wall if balance is an issue – followed by a foot stretch at the wall. Tell him to be GENTLE with himself!
The videos (2 & 3) below you can share with him, or teach him how to do at home:
Video 2 – He can even do in bed! One of the BEST for easing low back pain.
Video 3: I’m sharing this clip mostly to show the alignment of the spine – same would apply in a forward bend from a chair – only going so far as he can keep the spine long. Just a nice one for him to learn good body mechanics not only for class, but for life!!
I understand your worry about him hurting himself! You will get a better feel for him once you meet him. Know that you are trying to help him……and let him know you are teammates – you need his help to keep him safe. No pushing through pain or pressing too hard. Encourage him to rest when needed (or wanted!!) My guess is when he tries Yoga – and linking movement to breath – he will start to get relief quickly. Breathe….and trust yourself!!
I hope this helps 🙂
Thank you for your service to others!