Ep 114: How to Teach Yoga to Students with Lower Back Pain

Students with lower back pain is one of the most common complaints that yoga teachers encounter, yet most teachers feel completely unprepared to help students with back injuries. If you've ever felt like you're not sure how to respond when a student asks, "Will this pose hurt my back?" this episode is for you. 

Learn the essential conversation framework for talking with students about lower back pain, the core principles that will help guide your teaching decisions, and specific modifications for forward folds, Downward Facing Dog, Cat/Cow explorations, and Plank variations. This episode will help you feel more confident teaching students with lower back pain instead of avoiding them, and it offers specific cueing language for each modification.

I'll also give you the exact questions to ask before class and discover how to create a collaborative relationship (between you and your student) instead of an anxious one.

You'll leave with a clear understanding of what's within your role and what's not. Learn why teaching students with back pain is absolutely within your scope, plus when you should refer students to medical professionals.

Download 10 Questions to Ask Injured Students (free) and get the exact framework for supportive conversations about pain. This tool removes guesswork and helps you approach injured students with confidence.

Related Episodes:

• EP 84: Sciatica: What Yoga Teachers Should Understand
• EP 80: Why Is The Psoas Muscle So Important?

Free Resources:

• Sequencing for Students with Injuries
• Half Pigeon Pose: Avoiding Pain & Injury

Want to Go Deeper?

• Within Your Scope Workshop
• The 1st Step to Teaching Students with Pain
• Teaching Students with Injuries 6-Month Mentorship

Transcript

Monica 4:00

Welcome to the Essential Conversations for Yoga Teachers Podcast with me. I'm Monica Bright and I've been teaching yoga and running my yoga business for over a decade. This is the podcast for you. If you are a yoga teacher, you're looking for support. You love to be in conversation, and you're a lifelong student. In this podcast, I'll share with you. My life as a yoga teacher, the lessons I've learned, my process for building my business and helpful ideas, tools, strategies and systems I use and you can use so that your business thrives. We'll cover a diverse range of topics that will help you, whether you're just starting out or you've got years under your belt and you wanna dive deep and set yourself up for success. I am so glad you're here. Listen, I don't take myself too seriously, so expect to hear some laughs along the way. Now let's do this together. Welcome back to the podcast. I'm Monica, and I'm so glad you're here. Here we talk about the anatomy, the injuries, the nervous system insights, plus all the real life knowledge you wish had been included in your yoga teacher training. If this is your first time listening, let me introduce myself. I'm a yoga teacher who specializes in teaching teachers how to work confidently with students who have injuries and pain. I've focused my continuing education in biomechanics, human movement, pain science, and injuries, But more importantly, I've personally experienced many of the common yoga injuries myself, and I've spent years working with injured students, and I know what it's like to feel completely unprepared when a student tells you they're experiencing pain. So here's what we're covering today. I'm going to help you understand what's actually happening when someone experiences pain, Why it's not what you probably learned in your teacher training, and most importantly, exactly what you can say and do to help these students feel safe and supported in your classes. By the end of this episode, you'll have a framework for creating an environment where students with back pain can explore movement confidently. Let's start with something that might make you feel a little bit better. Lower back pain is incredibly common. studies show that up to 80% of adults will experience significant lower back pain at some point in their lives. So when a student mentions that they have back pain, they're not the exception, they represent the majority. Now you might be thinking, but Monica isn't working with students who have pain outside of my scope of practice. I hear this all the time, and I understand why it feels safer to avoid the whole situation. But here's the reframe. You're not diagnosing injuries or treating medical conditions. You're creating an environment where people can explore movement safely, and if you're teaching movement, you have a responsibility to understand how to make your classes accessible to real students. Who come to class. Think about it this way. If a pregnant student shows up to your classes, you learn to create a safe environment for them. If a student is new to yoga, you meet them where they are. Students with back pain deserve the same consideration. You don't need to be a physical therapist to help them. You need to understand modern pain science, create safe spaces for movement, exploration, and offer options without reinforcing fear. That's absolutely within your scope as a yoga teacher, here's where I need to share something that you probably never learned in your teacher training, and this is really important, so I'm gonna take a moment here to explain it. Pain is not simply damage. Pain is a protective output from your brain. Your brain is constantly receiving information from your body, from your environment, from your past experiences, from your beliefs and emotions, and it's making a decision. The decision is, do I need to protect this person right now? And when the answer is yes, it produces pain as a signal to get your attention and encourage protective behavior. This is crucial for you to understand as a teacher because it means that pain doesn't always equal tissue damage. Someone can have significant tissue changes and feel no pain. Someone can have minimal tissue changes and feel a lot of pain. The brain is evaluating threats. Not just tissue state. So when a student tells you they have lower back pain, what they're telling you is that their nervous system has been producing pain signals in response to certain movements, positions, or context. Your job is not to fix their back. Your job is to create an environment where their nervous system feels safe enough to explore movement again. This completely changes how we approach teaching these students. We're not trying to strengthen weak areas or stretch tight areas or fix structural problems. We are helping students gradually build confidence in movement, reduce the threat their nervous system perceives, and discover what feels okay in their body right now. So let's talk about that moment when a student tells you that they have back pain, I'm gonna give you a simple framework that will make these conversations so much easier. When a student comes to your class and they tell you that they have back pain first, you should thank them for telling you that. Say something like, thank you so much for letting me know. I really appreciate you sharing that with me. This immediately creates a supportive dynamic and reduces. Any shame or fear they might be feeling about having pain, then ask them a few simple questions like, can you tell me a little bit about your back pain? Or are there certain movements or positions where you notice it more? This gives you valuable information. You are not trying to diagnose what's wrong with their back. You're trying to understand what their nervous system is currently perceiving as threatening. Next ask, have you been working with a physical therapist or a doctor for this? If they say yes, you can ask, have they given you any guidance about movement or things to explore? This shows you're respecting their medical care and you're not trying to override what their healthcare providers have said. Finally, and this. Could arguably be the most important part. You can tell them that during class. I'm gonna offer lots of options and variations, and I would love for you to explore what feels okay in your body today. If something doesn't feel right, you can always choose a different option or you could choose to rest. Does that sound okay? When you say that you are creating autonomy, you're making it clear that they are in charge of their own experience and that there is no right or wrong way to move. That's it. Thank them. Ask them about their experience. Ask if they're working with anyone And confirm that they have permission to explore and modify. This entire conversation takes maybe 60 seconds, but it completely changes the dynamic from fear to curiosity. Now I wanna talk about what you're actually creating in your class for students with back pain. This is important because the old model for working with people with pain was about preventing harm and fixing problems. The new model based on modern pain science is about creating safety and building. Capacity. When someone has back pain, often what's happened is their nervous system has become protective around certain movements. Maybe they bent forward one day and they felt pain, and now every time they go to bend forward, their brain says, wait, this might be threatening. Let me produce some pain to make you careful. This is a normal protective response, but over time it can lead to fear avoidance where people stop moving in certain ways altogether, which actually makes things worse. your job as a yoga teacher is to create an environment where students can gradually re-explore movement in a way that feels safe. We call this graded exposure. You're not forcing them into positions into certain asanas. You're inviting them to explore small, manageable amounts of movement and build from there. This means a few things practically. First, you offer lots of options, not because some options are wrong and some are right, but because different bodies feel safe with different movements on different days. Second, you use language that reduces threat rather than increases it. And third, you normalize pain as a normal human experience, not a sign of brokenness. Now let me give you some practical examples of how this looks in your teaching for forward folds, like standing forward fold. instead of saying, this will hurt your back if you don't bend your knees. You might say, as we fold forward, notice how different amounts of knee bend can change the experience for you. You might explore with straight legs or bent knees, or deeply bent knees. There's no right answer. Just notice what feels manageable for you today. See the difference? You're not prescribing a modification to prevent injury. You're inviting exploration and building body awareness. For a pose like cat cow, instead of queuing a specific range of motion, you might say, we are going to explore some spinal movement. Start with really small movements, maybe just a tiny arch and a tiny round. From there, you can explore making the movements bigger, if that feels okay, or you can stay with small movements. Both are perfect and neither are wrong. This is about exploring what your spine can do comfortably. Today for downward Facing Dog, instead of saying Bend your knees to protect your back, try saying something like Downward Facing Dog offers us a chance to explore. Some of you might find that Bent knees feels better today. Some might prefer to keep your knees on the ground and just reach your arms forward in puppy dog pose. or you might feel great with straighter legs. Try different options and notice not what's harder or easier, but what feels manageable and okay today in your body. For poses that involve holding positions like plank, you might say something like, we're building capacity here, so you might stay for the full time, or you might choose to lower your knees and maybe you take tabletop or push back to child's pose or another resting position. The goal is to find the amount that challenges you just enough without overwhelming your system. Only you know where that edge is. The common thread in all of these is that you're creating options without labeling them as better or worse, and you're putting the power in the student's hands to notice what works for them. Okay. The words you use in class matter enormously because language can either increase threat or reduce it in the nervous system. Let me give you some examples of language shifts. Avoid saying things like this will hurt your back if you, or you're going to damage your spine if or bad for your back. This language increases fear and makes the nervous system more protective, which can actually lead to increased pain sensations. Instead, use exploratory language, like notice what this feels like, or explore what works for you, or you might try this option and just see how it feels. Avoid language that implies brokenness. Like for those of you with bad backs or if your back is messed up, pain doesn't mean you're broken. Pain means your nervous system is being protective. If you take anything away from this episode, let it be that now focus on normalizing the experience. You could say, if you are experiencing back pain, or for those of you who are noticing discomfort in your back, and avoid prescriptive language, that takes away autonomy like, you must do this or never do that. This increases threat because it implies danger. Instead, use invitational language like you're welcome to try or an option here is, or you might explore and here's a big one. Avoid connecting specific movements to pain outcomes. Don't say, this will fix your back pain, or This stretch will release your tight muscles and stop the pain. We cannot promise that, and it actually sets up an unhelpful expectation. Instead, focus on the process. Let's explore some movement together or we're building confidence in your body's ability to move, or you're learning what feels okay for you today. Now even when you use all the right language and options, sometimes the student can experience pain during class, and this is the moment that terrifies a lot of teachers. But here's what you need to understand. Pain during movement isn't necessarily a sign that something is wrong or that you failed as a teacher. Remember, pain is the brain's protective output. Sometimes when someone is re-exploring movement after avoiding it, the brain might produce pain even when the movement is safe. This is actually normal and it's information. So if you notice someone grimacing or stopping check in quietly with them, you might say, are you okay? What are you noticing? If they say they're feeling pain, remember to respond calmly and matter of fact, okay, well let's dial it back. You might try a smaller version of that movement, Or you might choose to find a resting position or a variation of child's pose just so you can breathe. There's no rush and there's no expectation from you. We're just exploring what feels manageable today. You are not panicking, you're not apologizing. You're normalizing that sometimes the nervous system says, yeah, that's enough for now, and that's okay. That's the system doing its job. After class, you might check in again and ask, how are you feeling? I noticed that you modified that pose, And then just be quiet and let them share and listen to what they say. Then you might say something like, thank you for listening to what your body was telling you. That's exactly what we want. You're building awareness of what feels okay and what doesn't. Over time, as you keep exploring, you might find your comfort zone expanding. Or you might find that certain movements just aren't for you right now, and that's completely fine. You're reinforcing that they've done the right thing by paying attention and you're removing any pressure they need to be able to do everything that you're teaching. One of the principles I've learned from my studies and even in my own injuries is that when someone has pain, often they've been avoiding certain movements out of fear, but avoidance actually reduces capacity, which can make the nervous system more protective, which can increase pain. it is a vicious cycle. The way out is through gradual. Safe exploration. We're not trying to push through pain. We're trying to build confidence and capacity in small increments. It's, this is why offering variations and options is so powerful. A student might start with the smallest version of a movement, maybe just a tiny forward fold with very bent knees, and they do that for a few classes and their nervous system learns, okay, this is safe. Then maybe they explore slightly less bent knees. Then maybe a little bit more, and over time they're gradually expanding what feels okay. This isn't about achieving a correct final position. Some students might always prefer bent knees for forward folds, and that's perfect. I, myself enjoy bent knees in forward. The goal is reducing fear, building confidence, and helping students discover that movement can be safe and even enjoyable. As a teacher, your role is to create the environment where this gradual exploration can happen. You do this by offering options, using language that reduces threat, normalizing the experience of pain and celebrating small wins. I wanna talk briefly about when it's appropriate to suggest that a student see a medical professional. Because knowing when something needs more attention is also a part of being a responsible teacher. If a student describes pain that's severe and unrelenting, getting progressively worse over time, accompanied by other concerning symptoms like numbness or tingling, Sensation that's spreading weakness in the legs or loss of bladder or bowel control. These are signs that they should get medical evaluation. You can say something like what you're describing sounds like it would benefit from evaluation by a doctor or a physical therapist. I'm absolutely happy to continue working with you in class and helping you explore movement, and I'd also encourage you to get that checked out so we can make sure you're not missing anything important. That might seem like a lot to say and how do you even get those words together to say and sound, clear in your response. but I promise you the more you, just talk it out and say the words, it gets easier. If a student has been dealing with pain for a long time and nothing seems to help, It is also appropriate to suggest they work with someone who can give them more individualized attention. You might say, it sounds like you've been dealing with this for a while, and sometimes working one-on-one with a physical therapist can be really helpful because they can take more time to understand your specific situation and create a plan that's tailored specifically for you. Suggesting medical care doesn't mean you failed. It means you're looking out for their wellbeing and recognizing the limits of what you can provide in a group class setting. So let's recap what we've covered today because I know this might be a different way of thinking about pain and movement than what you learned in your teacher training. Pain is a protective output from the brain, not simply tissue damage. When a student tells you they have back pain, they're telling you their nervous system has been protective around certain movements. Your job is to create an environment where they can safely re-explore, movement, and build confidence. When a student mentions they have pain. Thank them. Ask them about their experience. Ask if they're working with anyone and confirm that they have autonomy to explore and modify during class. This creates safety and collaboration. Offer lots of options and variations, not because some are wrong and some are right, But because different students feel safe with different movements, use exploratory language that invites curiosity rather than prescriptive language. That increases fear. If someone experiences pain during one of your classes, stay calm. Help them find a more manageable version or a position that they can rest in. Okay. Afterwards, reinforce that listening to their body is a good plan. Over time, you're helping students build capacity through gradual safe exploration. Your role isn't to fix their pain. Your role is to create an environment where students can discover that movement can be safe, build confidence in their body's abilities, and reduce the fear that often accompanies pain. Everything that we've talked about today will help you feel more confident with students who have back pain. But here's the thing, this modern pain science approach applies to all types of pain, not just back pain, but knee pain. Shoulder pain, neck pain, hip pain. The principles are the same, and there's so much more to learn about how to integrate this into your sequencing, your language, and your overall teaching philosophy. These are the questions we work through. Am I teaching students with injuries? Mentorship, we go deep into modern pain science, anatomy, understanding the nervous system on a deeper level, and recovery strategies that you can implement into your classes. But more than information, you get personalized feedback on your teaching. You get to ask questions about your specific students and situations, and we look at your language. Your sequencing and how you create environments where people with pain feel safe. If what we covered today resonated with you and you're thinking, yes, I wanna bring this evidence-based approach to my teaching, I would love to invite you to learn more. You can find all of this information on my website in the link teaching students with injuries. I'll link it below and we meet twice a month for six months, and by the end, you'll be teaching from a completely different paradigm, one that's grounded in modern science and actually serves your students who are experiencing pain and injury. I also wanna point you to a free resource. I've created a guide called 10 Questions to Ask Injured Students, and it gives you a framework for those initial conversations that we talked about today. You can access it for free on my website. The link will be below in the show notes. Thank you for being here and for caring enough about your students to learn a different approach. This is not easy work, I'm not gonna lie. It requires letting go of some of the things you might have learned in your training and embracing a more nuanced understanding of pain and movement, but it's so worth it. Because you'll be able to serve your students in a way that actually helps them build confidence rather than reinforcing fear. You don't have to be perfect. You don't have to know everything. You just need to be willing to learn and to create space where students feel safe to explore. That's enough. You are enough. If you enjoyed this episode, share with another yoga teacher who might be struggling with this same fear. And if you have questions or topics you'd like me to cover, send me a message. I'll see you next week. Until then, keep showing up for your students and keep learning. You are doing important work.