Ep 122: Herniated Discs? How To Teach Students Who Have Them

Ever had a student tell you they have a herniated disc? They sound serious and can make you feel fearful that you might do something to "make it worse." But students with disc issues can practice yoga safely when you understand what herniated discs actually are, which movements require your thoughtful consideration, and how different styles of yoga can help to support healing. This episode breaks down how to teach students with herniated discs, from the initial conversation (gathering important information) through practical modifications to understanding when slower, more restorative practices might be exactly what these students need.

I'll cover: 

• Understanding Herniated Discs from an Anatomy & Pain Science Perspective
• What Questions to Ask Which Will Inform Your Teaching
• Movement Considerations 
• Different Yoga Styles as Therapeutic Options
•  Practical Modifications for Common Poses
• Using Language That Reduces Nervous System Threat
•  When to Refer to Medical Professionals

Teaching students with herniated discs requires understanding pain science, thoughtful modification, awareness of different practice styles, and clear scope boundaries, but it's completely within your capacity as a yoga teacher.

Resources Mentioned:

Sequencing for Different Injuries (FREE)  - How to structure classes for students with different injuries

Teaching Students with Injuries Mentorship - Six-month program with real students, real-time application, ongoing support covering anatomy, pain science, injuries, nervous system, recovery strategies, and sequencing

Transcript

Monica 3:59

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. In this episode, we're gonna get really specific, again, with a student scenario you might encounter. Question. Have any of your students ever told you that they have a herniated disc in their lower back? What was your first thought? Was it something like, Ooh, this sounds serious. It's a spinal injury and I don't want to make it worse. Should they even be in my class because I'm planning on doing a lot of back bending and then you feel anxious Because herniated discs sound really serious and you're worried that if you modify it incorrectly, you could cause the student further harm. If this fear feels familiar to you, then this episode is for you because today we're talking about how to teach students with herniated discs. We're gonna cover what herniated discs. Actually are anatomically and from a pain science perspective why people with herniated discs feel so intimidating to teach what movements. You should be thoughtful about how different styles of yoga can support students with disc issues and when to refer out. I want you to feel much more prepared the next time a student tells you they have a herniated disc. Okay? First. Herniated discs do require you to be thoughtful in your teaching, but you don't have to be afraid of these students, right? Understanding what's actually happening, knowing which movements to approach carefully and offering intelligent alternatives is completely within your capacity as a yoga teacher. You just need to be thoughtful and informed, and that's what I'm gonna help you with in this episode. Let's start with what a herniated disc actually is, because understanding this helps reduce some of the fear surrounding them. Your spine has cushions between the vertebrae called inter retrieval discs. Each disc has a tougher outer layer and a softer gel likes. Center, a herniated disc happens when the outer layer develops a tear or a weakening, and the inner material bulges or pushes out. This can sometimes press on nearby nerves, which can cause pain, numbness, or tingling that radiates down the back of the leg. here's where modern pain science becomes really important. Just because someone has a herniated disc doesn't mean that they'll experience pain. Studies show that many people have disc herniations visible On an MRI, but no symptoms at all. And conversely, someone can have significant pain with a relatively small herniation. The size of the herniation doesn't always correlate with the intensity of the pain, so just keep that in mind. So, yes, there is a structural issue, but the pain experience is influenced by stress, sleep, fear about the injury, beliefs about what the spine can or cannot handle, past experiences, and many other factors. This matters for how you approach teaching these students. You're not just thinking about protecting a damaged disc. You're creating environments where the nervous system feels safe enough to explore movement without triggering excessive protective response. Let's talk about why herniated discs feel so intimidating to teachers, because getting really clear on the fear might help you to move through it. First, the word herniated sounds serious. It sounds like something that requires. Medical expertise to manage. And while these students should absolutely be working with medical professionals, that doesn't mean that they can't also practice yoga with appropriate modifications. Second, there's this fear that you'll make it worse. You worry that if you cue the wrong movement you could cause the disc to herniate further or create more nerve compression. that fear comes from the fact that you do care about your students, but it can also paralyze you too. So I want you to be mindful of how you feel when you hear a student has a herniated disc. Third herniated discs often involve nerve pain, which can be unpredictable. A student might be fine one day and experiencing significant radiating pain. The next, that variability can feel overwhelming when you're trying to plan modifications for them. And fourth, there's often this belief that students with herniated discs should not be in group classes at all, that they need one-on-one physical therapy before they're ready for yoga. And while there are absolutely cases where that's true, many students with disc issues can benefit enormously from a thoughtful yoga practice. understanding these fears will help you see them for what they truly are. When a student tells you they have a herniated disc. You should thank them for telling you, and then ask some clarifying questions like when it happened and whether they're working with anyone, because this gives you context about whether this is acute or chronic and what other support they have. You should ask about specific symptoms like radiating pain, numbness, or tingling down the leg. This is important because nerve symptoms require extra caution. Then ask what movements they've noticed aggravated. They might tell you that forward folds or forward bending or twisting increases their pain, but this information will directly inform you of any modifications you wanna offer or any changes to your sequence that you might want to consider. And then tell them that you'll offer alternatives. Remember, you're not diagnosing their issue. You're not promising that yoga is gonna heal their disc. You're gathering information and confirming that you'll modify, and this is part of your job. Now let's talk about which movements require thoughtful consideration for students with herniated discs. Generally, you wanna be cautious with deep spinal flexion, especially loaded flexion, where the spine is both rounding forward. And bearing weight. This is because flexion can increase pressure on the disc and potentially increase nerve irritation. So poses like deep forward folds, especially if the student is rounding their spine, will warrant some modification. You also wanna be thoughtful about rotation, particularly rotation combined with flexion. Twisting while the spine is rounded, can create shearing forces on the disc. So seated twists where the student is slumping forward or standing twists where they're collapsing into rotation We will need careful queuing and some attention from you. Extension meaning back bends can actually feel okay for many students with disc issues because extension tends to reduce pressure on the front of the disc Where herniations most commonly occur, but everybody is different. So your job is to offer options and let your students explore, and you want to reduce impact and compression when possible. So jumping sudden movements or poses that create a lot of compressive force through the spine might not feel good. The key principle is this. You are reducing demand on movements that tend to aggravate disc issues while still offering a meaningful practice. Not every student with a herniated disc should be in a vinyasa flow class. In fact, different styles of yoga can offer significant benefits and sometimes slower. More restorative practices are exactly what these students need. A student with an acute disc herniation who's experiencing a lot of nerve pain Might benefit much more from a restorative yoga practice than from trying to modify their way through a flow class. Restorative yoga allows them to explore gentle supported positions for extended periods of time. This will give their nervous system a chance to calm down, Which can actually reduce pain perception. The practice becomes less about movement and more about creating safety and ease in the body. Or yin yoga can also be valuable for students with disc issues, particularly in the later stages of recovery. The long holds in moderate ranges of motion can help maintain mobility. Without triggering protective responses, but you definitely wanna make sure they're not going too deep into flex based poses. Think about pranayama and meditation practices because they offer tremendous value Because they directly address the nervous system. Remember, pain is influenced by stress, fear, and nervous system state. Teaching a student breathing practices that shift them into a parasympathetic state or meditation practices that help them relate to sensation differently can be just as therapeutic, if not more than the physical poses you teach in your movement based classes. When a student tells you they have a herniated disc, one of your options is to invite them to explore a different style of practice entirely. I've often said something like. Given what you're experiencing with your back, you might find that a restorative class or breath work sessions would be more supportive right now because these practices can help calm your nervous system, which often helps with pain. This reframe is important because it helps students understand that yoga isn't just about Asana. There are many ways to practice and finding the approach that serves their body. Right now is an intelligent choice. We work through this extensively in my mentorship program, how to help students find the right practice for their current needs, and how to structure different class formats for different populations. Let me give you some practical modifications for common poses. For forward folds invite students to keep length in the spine rather than rounding forward. They can bend their knees generously, use blocks underneath their hands, or take a supported version with their hands on a chair. If chairs are available in your classes, the goal is to maintain the natural curves of the spine rather than creating deep flexion. For downward facing dog. Some students with disc issues find this fine, but others don't offer a gentle variation of puppy dog pose or child's pose. As an alternative, if they're taking downward facing dog, encourage them to seek length through their spine. For twists, invite them to sit or stand with a neutral spine before rotating. Avoid teaching rounded twists, and they might choose to reduce the depth of the rotation as well for cat cow. Some students will find the gentle movement helpful. Others might find even small amounts of spinal flexion uncomfortable. Invite them to reduce the range or skip it entirely. For back bends. Many students with disc issues can explore these, but start gently supported bridge with a block underneath the sacrum. Gentle cobra poses sphinx pose. These allow for extension without deep. Compression and if you're teaching core exercises, focus on exercises that maintain neutral spine rather than deep spinal flexion, plank variations, side plank bird dog. These build core stability without the deep crunching that can aggravate disc issues. The words you use when offering these modifications matter enormously for students with disc issues. If you say something like, if you have a bad back, don't do forward folds, you have reinforced that their back is bad and it's damaged and that they can't do certain things. This increases fear and protective responses. Instead, use language like if deep. Forward folding doesn't feel good for your spine today, or if you're noticing sensitivity in your lower back right now. These are temporary descriptors that don't make their spine sound permanently compromised. I also avoid saying things like, this will protect your disc because that reinforces vulnerability. Instead, I might say. This variation reduces demand on your lower back or this option will offer your spine more support. And I normalize modifications by actually teaching them to the entire class instead of singling a student out, Being mindful of your language will help students feel like they're making smart choices rather than accommodating a physical limitation. Now, let's talk about when you should encourage a student to work with a medical professional before participating in group classes. If a student says they have a herniated disc but hasn't been formally diagnosed or evaluated. Encourage them to go get it checked out, especially if they're experiencing new or severe symptoms. If a student is experiencing significant nerve symptoms like numbness, tingling, or weakness, that's affecting their ability to walk or perform daily activities, they need medical attention before coming to a group yoga class. If a student's symptoms are getting worse despite modifications and rest, that's a sign that they need more targeted intervention. If a student is in the acute phase right after a disc herniation and experiencing severe pain, they likely need rest and possibly medical treatment before they're ready for group classes as well. I am totally honest with students and I will tell them it sounds like your back is really reactive right now, and I think it would be helpful to work with a physical therapist first and then come back to class when things have calmed down a little bit. Remember, stay within your scope of practice. You should not advise them on surgeries or medications. This is not within your scope of practice. The point is you can work with many students who have herniated discs, but you need to know when the situation requires more than a yoga class can provide. I wanna mention that everything we've covered today, understanding herniated discs from an anatomy and pain science perspective, structuring different class formats for students with various injuries, knowing which modifications to offer. Using language that reduces threat and determining when to refer out. This is exactly what we work through. Am I teaching students with injuries? Mentorship. In the mentorship, you bring your actual students with their real injuries, and we work through modifications, sequencing, and communication strategies together. What if you don't have a student with a particular injury? That's okay. You could still bring an example student and we could work through an injury that they have. We cover specific injuries in depth. We practice having these conversations and you get ongoing support as situations come up in your teaching. If you are realizing you want more comprehensive guidance on working with students who have serious injuries like herniated discs, that's what the mentorship provides. I am working with a teacher right now that has a student who is recovering from hip replacement surgery. This teacher is learning everything she needs to know about hip replacements and how she should approach conversations with the student and how to accommodate this student. In her classes, I have another teacher who has a student with SI joint pain and an elevated pelvis. This teacher is learning how to teach the student what is happening in her body, and the teacher is using strategies that she's learned from the mentorship to ease the student's pain. While she moves, I have a free resource that's going to help you think through sequencing for students with injuries. and it walks you through how to structure your classes when you have students with different types of pain and different needs. You can grab it below in the show notes and if you're ready for ongoing support, where we work through students with herniated discs, shoulder injuries, hip issues, and. Everything else you encounter in your teaching? my teaching students with injuries. Mentorship is six months with two calls per month, and we cover anatomy, pain, science, specific injuries, the nervous system recovery strategies. And sequencing all in the context of your actual students. You can learn more at the link in the show notes below as well. Remember, herniated discs involve the disc material pushing out through a tear in the outer layer, but pain doesn't always correlate with the size of the herniation. Be thoughtful about deep flexion rotation combined with flexion. And compression consider inviting students to explore different styles of yoga, like restorative yin or pranayama practices that address the nervous system differently. Offer modifications that maintain spinal neutrality, use language that reduces threat, and know when to refer out. Students with herniated disc can practice yoga safely when you're thoughtful about modifications, when you help them find the right style of practice for their current needs and. When you have meaningful conversations with them about their experience. Check out the resources in the show notes below. These are trainings that were designed with application in mind, so with you learning and then applying in your classes. I'm so glad you're here and I'll see you next week on the podcast. Okay, bye.