Yoga Pose Breakdown: The Forward Fold

By Alayna Cronk, DC

Forward Folds, (Uttanasana), is considered a beginner move that just about anyone can do, to some degree. It is a common pose that is often revisited throughout the duration of a single class. Bending over, while reaching for those ten toes with palms/feet flat on the mat and legs fully extended shouldn’t be all that difficult, right? A “healthy” person, with no history of musculoskeletal injuries, may not have trouble carrying out the proper biomechanics this pose requires. However, someone who may be new to yoga, have low back pain, hip impingement, or even a hamstring tear will have more difficulty performing this pose and will likely “cheat” their way into the fold. To perform the pose correctly, there are several different mechanisms within the body that must fire appropriately to fully engage into an intense bend like a forward fold as well as a number of factors to consider when you want your hands to touch the floor without creating the onset of pain or injury. Essentially, you are taking your body and folding it in half – so what appears as a “beginner” move may actually not be all that simple.

Let’s illustrate. Picture an advanced yoga student who appears to have no problem with literally any yoga pose from beginning to advanced. Movement and transitions appear effortless and when it comes to a “simple” move such as a forward fold, this student bends at the hips until her hands are placed directly in front of her feet. Good for her, right? Not exactly. Let’s take a closer look. Although her hands and feet are flat on the floor (which is optimal), her mid-back is rounded out which means she is hinging from her waist, and not her hips. Moving down, we see that her tailbone is tucked under causing her hamstrings to shorten and not lengthen as intended. Her knees are locked tight and straight with the weight on her heels, but she is leaning back into her heels rather than have the weight evenly distributed in a straight line. So, by first appearances this girl has got this move down, however, when we look closely at her form she is cheating her way into the pose only to have her feet/hands touch the ground. Now once, twice, even three times is likely going to be ok when performing a pose like this. But, when uttanasana is widely used through a single practice, and that student attends yoga multiple times per week – those “cheats” will catch up to her causing stress as well as improper load on the affected joints increasing the possibility of injury.

Essentially, forward folds should be somewhere along the lines of active relaxation. You want to be working into the pose. Challenge yourself in achieving greater depth, but there should also be a sense of ease where you find this pose comforting. When the comfort stops and the pain appears, that is your edge. The place where you need to stop deepening into the stretch and just hang out. When this place of “good pain” becomes easier, then it’s time to push a little further.
In any movement performed by the body, there will likely be limitations in regards to structure, or the body’s soft tissues (muscles, ligaments, tendons, fascia), and bone anatomy. Let’s take a closer look in how anatomy could affect your forward fold starting from the low back to feet.

Low back: The low back has 5 lumbar vertebrae and discs that lie in-between each vertebra that act as a cushion. The outer part of that disc is called annulus fibrosus – which is dense and fibrous. The inner part called, nucleus pulposus is a composed of a gelatinous texture. When there is added force from the vertebrae above, that soft texture in the middle seeps out, ultimately putting pressure on the nerves and causing severe pain in the back and oftentimes into the leg(s). So what can cause enough pressure for that herniation to occur? If a person continually folds over from the waist, he/she is rounding out aspects of the upper and lower back, creating that pressure over and over again. The lumbars and surrounding structure will weaken over time, eventually giving out and cause injury. Even though you are not putting any direct “weight” onto the spine, you are loading those individual vertebrae every time you flex forward ultimately weakening them.

Hips/Pelvis: The acetabulofemoral joint is where the acetabulum (large part of the hip) meets the femur (thigh bone) and where the weight of the body is supported. Typically, males have a much narrower socket than females where the femur fits in, creating more difficulty in obtaining the kind of flexibility involved with folding to the floor. However, the soft tissue component should make up for the limitation – meaning men may need to lengthen that soft tissue that has been shortened by daily life, like sitting at a desk for 8 hours a day/5 days a week. Due to our sedentary lives, we lose much mobility within our functional range, creating stiff muscles which compromises our joints. Sitting for periods of time can weaken the external rotators of the hip (Piriformis, Gemellus Superior, Obturator Internus, Gemellus Inferior, Quadratus Femoris, and Obturator Externus). These muscles fan from the different parts of the sacrum and attach to the femur. When these are tight, they inhibit that forward tilt the pelvis needs to get your body moving forward, actually causing your sacrum to be tucked under creating a posterior pelvic tilt, forcing a round back and ultimately leading to low back which is why it is so important to not round out the mid back and bend from the waist, but to hinge from the hips.
The pelvis makes up much of the mechanism in forward flexion, then the lumbars pick up where the pelvis leaves off. The pelvis will tilt forward to its max at nearly ninety degrees in flexion. The lumbars jump in at this point and take the body forward even further. In addition, this is why if you have tight muscles in the low back and/or hamstrings, it creates more difficulty in reaching the full depth of the fold.

Hamstrings: Forward fold engages the posterior chain, so hamstring length is essential in attacking this pose properly. There are three hamstring muscles (Biceps Femoris, Semitendinosus, and Semimembranosus). These muscles start at the inferior part of the pelvis and attach at the knee. When tight, these three muscles will pull on the origin points at the Ischial tuberosity, putting the pelvis into retro version (tilting it back), causing the lumbar vertebrae to tilt forward in forward flexion. This can cause strain in the attachments of the vertebrae, it’s attaching ligaments and surrounding soft tissue, as well as making any active low back injury or disc herniation worse.

Knees: So how much bend should you take in those knees then? If your hamstrings are tight, it would be assumed to take a more drastic bend. The other option is to fold at the hips until you feel the pull on your hamstrings, then stop at your threshold, with a slight microbend. There appears to be a lot of debate on this topic throughout the yoga community. It seems like every class is different. Some teachers guide you to fully bend the knees, and some desire a slight, and some not at all. Results continue to vary in the research. However, take into consideration that dominant injury with a yoga student who practices moderately is proximal hamstring tendon injuries. If you have pain at your sit bones, you likely have a condition resembling this one. This occurs when the hamstring muscles are overstretched and loads the tendon that attaches the muscle to the ischial tuberosity. In my opinion, I would rather have a student find their personal edge, take an appropriate bend in the knee to what is comfortable with you. There is no reason to push yourself in a direction that will result in injury.

Feet: Feet ideally should be placed next to each other. Many people put the weight of the body into the toes and ball of the foot, this would be incorrect. By doing this, you would shorten the stretch of the posterior chain that should be activated. Also, it is harder to balance with weight shifted forward as well as putting a strain on your knees and hips. By placing the weight into the heels, and by contracting the muscles in the toes so that they come off the mat, not only are you utilizing proper form and technique, but you are essentially activating all of the grounding muscles giving you a better workout and a stronger pose. This also helps to ensure that hips are over knees and knees are over ankles, and you are not leaning back into the pose, not allowing for a complete stretch.

How to: Begin by placing your hands on your hips, this ensures you are moving from your pelvis and not your waist. Keep your spine straight, your core engaged, or contracted in and a slight microbend in your knees. Think about trying to make your belly button touch your spine. When this is complete, slowly hinge from the hips until at about ninety degrees. When you feel you are at your “edge” or as far as your body will allow you, you can move your hands to meet the floor (or blocks) or place them on your legs avoiding the knees. Let your head/neck relax into the stretch as you breathe deeply.

There is no rule that says you absolutely have to touch the ground or this will not be considered a forward fold. There is absolutely no shame in setting aside blocks to use in some or all positions. The goal in yoga is for you to take your body as well as your mind into a place it hadn’t had the ability to go before you began your practice. This is a beautiful thing. Do not destroy it because you want to achieve something quicker than your body is allowing you. Those “edges” are there for a reason. If we did not have them, how would we ever be able to better ourselves? Flexibility takes time. A lot of time. It is not a race. It is something that can take years to achieve. Only you know the limits of your body, listen to it.

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