illustration by @ksenia_sapunkova

    Modern Yoga: Rethinking Outdated Cues

    Kerry McInnes·
    #teach
    ·

    Yoga teachers and practitioners know that great alignment cues can make all the difference in our practice. Unfortunately, some common cues undermine the body’s natural intelligence by interfering with the brain’s natural ability to direct movement patterns. One prime example of this has been written about ad nauseum: the glute softening cue (see here, here, and here). Specifically, many yogis have long been told to relax their glute muscles in backbends such as locust or bridge. But your glutes are actually responsible for extending your hips in those poses. So relaxing them during hip extension is absurdly counterproductive. While this oft-used cue takes the cake, today we will look at two other examples of verbal cues in yoga that interfere with our body’s natural intelligence and should be dropped from our cue tool belts.

    Lift the pelvic floor

    The pelvic floor muscles line the bottom of the pelvis and support the undercarriage of our torso. They naturally contract and relax during functional movement. Proper pelvic floor muscle function is necessary for stability of the pelvis and lumbar spine, support of the pelvic organs (i.e., bladder, uterus, rectum), all bathroom functions, and sexual function.1 Somehow, perhaps because of its relationship to Mula Bandha, the root energetic lock, some yogis have come to the conclusion that we should consciously be squeezing our pelvic floor muscles throughout practice. Not only is this contrary to the natural function of the muscles, but it may also contribute to holding patterns in the pelvic floor that can lead to a pelvic floor disorder!

    Pelvic floor disorders encompass a set of conditions where the pelvic floor muscles fail to perform their tasks. They are extremely common — one study in the US found that almost one quarter of women have at least one type of pelvic floor disorder.2 The underlying causes of a pelvic floor disorder are vast and complex. According to the mainstream media, the global cure to any pelvic floor disorder is Kegels, Kegels, and more Kegels! Kegels are pelvic floor exercises used to strengthen the pelvic floor muscles. While Kegels and the like can be helpful for treating some pelvic floor disorders, they are not a widespread cure.3,4 This is because not all pelvic floor disorders stem from underactive pelvic floor muscles. In fact, there is a whole category of pelvic floor disorders where the problem lies with overactive pelvic floor muscles.1,4 These are aptly named “overactive pelvic floor disorders”.1

    I often hear the pelvic floor lift cue in standing twists such as prayer twist or lunge twist. Here I am in lunge twist allowing my pelvic floor to speak for itself….and you’d never even know it!

    To make a long story short, understanding and treating pelvic floor disorders is complex and is best left to a specialist. Further, verbal cueing aimed at contracting the pelvic floor muscles is beyond the scope of what a yoga teacher is trained to do. The good news is, unless you are dealing with a pelvic floor disorder, in which case you should seek professional help, your pelvic floor muscles know what to do! Your brain has unconsciously learned how to contract and relax these muscles during a variety of movements since you first began to move, so it is unnecessary to consciously squeeze these muscles during your practice.

    Draw Belly into Spine

    The belly-to-spine cue, such as “pull your belly button towards your spine” is related to the second energic lock, Uddiyana Bandha, also known as the upward flying lock. You’ve probably heard this cue used in many poses such as downward dog, baby cobra, locust, mountain, and many more. In non-yoga circles, such as the physical therapy world, the belly-to-spine cue is described as a spine stabilizing maneuver called “abdominal hollowing”. Abdominal hollowing became a popular mechanism during exercise because of its supposed ability to activate the deepest of the abdominal muscles, the transverse abdominis. The transverse abdominis used to be considered the most important muscle for stabilizing the spine.5 So as you can imagine, abdominal hollowing was prescribed during exercise to improve spinal stability. More research into spinal stability, however, has led us to understand that spinal stability is not the responsibility of a single muscle, but rather the task of a large group of muscles acting in concert.6,7

    The belly-to-spine cue is often used in poses requiring core control. Here I am in a challenging table variation without sucking anything in!

    While our understanding of the complex nature of spinal stability has progressed, the abdominal hollowing cue still lingers. Many studies have looked into the abdominal hollowing technique to see if it provides any benefit during exercise. The results, of course, are a mixed bag but the consensus seems to be that abdominal hollowing is unnecessary.8–11 So, if you hear this cue in class, you won’t be doing a disservice to your body to politely ignore it. That said, I also see no harm in embodying this cue — there is certainly no danger in abdominal hollowing. But why waste your precious energy — your body knows what to do!

    Let Your Body Do Its Thing

    We have seen two prime examples of how embodying traditional cues isn’t always helpful — the extra effort of squeezing your pelvic floor muscles or sucking your belly inwards doesn’t provide any benefit. Further, these actions can work against the body’s natural intelligence and may even cause problems down the road (i.e., overactive pelvic floor disorder). Avoiding these unnecessary cues creates less confusion for the body and allows the practitioner to save their limited mental and physical energy for the rest of their practice. Just remember, your body has been learning and moving your entire life — it knows what to do!

     

     

    References

    1. Padoa A, Rosenbaum TY. The Overactive Pelvic Floor. (Padoa A, Rosenbaum TY, eds.). Cham: Springer International Publishing; 2016. doi:10.1007/978-3-319-22150-2.
    2. Nygaard I, Barber MD, Burgio KL, et al. Prevalence of Symptomatic Pelvic Floor Disorders in US Women. JAMA. 2008;300(11):1311. doi:10.1001/jama.300.11.1311.
    3. Butrick CW. Pelvic Floor Hypertonic Disorders: Identification and Management. Obstet Gynecol Clin North Am. 2009;36(3):707-722. doi:10.1016/J.OGC.2009.08.011.
    4. Faubion SS, Shuster LT, Bharucha AE. Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clin Proc. 2012;87(2):187-193. doi:10.1016/j.mayocp.2011.09.004.
    5. Miller MI, Medeiros JM. Recruitment of internal oblique and transversus abdominis muscles during the eccentric phase of the curl-up exercise. Phys Ther. 1987;67(8):1213-1217. http://www.ncbi.nlm.nih.gov/pubmed/2956614. Accessed September 5, 2018.
    6. Mcgill SM, Grenier S, Kavcic N, Cholewicki J. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol. 2003;13:353-359. doi:10.1016/S1050-6411(03)00043-9.
    7. Cholewicki J, VanVliet JJ. Relative contribution of trunk muscles to the stability of the lumbar spine during isometric exertions. Clin Biomech (Bristol, Avon). 2002;17(2):99-105. http://www.ncbi.nlm.nih.gov/pubmed/11832259. Accessed July 30, 2018.
    8. Grenier SG, McGill SM. Quantification of Lumbar Stability by Using 2 Different Abdominal Activation Strategies. Arch Phys Med Rehabil. 2007;88(1):54-62. doi:10.1016/j.apmr.2006.10.014.
    9. Vera-Garcia FJ, Elvira JLL, Brown SHM, McGill SM. Effects of abdominal stabilization maneuvers on the control of spine motion and stability against sudden trunk perturbations. J Electromyogr Kinesiol. 2007;17(5):556-567. doi:10.1016/j.jelekin.2006.07.004.
    10. Koumantakis GA, Watson PJ, Oldham JA. Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther. 2005;85(3):209-225. http://www.ncbi.nlm.nih.gov/pubmed/15733046. Accessed August 8, 2018.
    11. Kim D-W, Kim T-H. Effects of abdominal hollowing and abdominal bracing during side-lying hip abduction on the lateral rotation and muscle activity of the pelvis. J Exerc Rehabil. 2018;14(2):226-230. doi:10.12965/jer.1836102.051.

    Illustration by Ksenia Sapunkova

    Edited by Jaimee Hoefert, the Scientist Yogini

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    Kerry McInnes

    Kerry is a Canadian yoga teacher and student of Physiotherapy. She completed her Master’s of Science in physiotherapy research (rehabilitation research) at Dalhousie University in 2016 and learned to value an evidence-based approach to understanding human movement. She loves to read about the mind and body and translate what she learns into writing. Kerry strongly believes in the inseparability of mind and body, otherwise known as the mind-body connection. To her, a movement practice is a beautiful place to explore this fascinating connection. Kerry also sees movement as a powerful tool for injury prevention, rehabilitation, and overall wellness. When Kerry is not learning about the body or teaching yoga, she spends her time cooking, knitting socks, and walking everywhere in barefoot shoes with her husband and two greyhounds. Kerry lives in beautiful Halifax, Nova Scotia on Canada’s east coast.

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    13 Responses

    1. Hi Kerry, I appreciate your evidence-based approach to these topics. My physical therapist son led me toward an evidence-based approach to my yoga some years ago. I’m definitely on board.

      You’re post raised a couple of questions for me that I would be interested in hearing your perspective on. I’ve done a couple of yoga workshops with a pelvic floor physical therapist and often bring attention to the pelvic floor tied to breathing in my classes. My PT son once told me that you can’t strengthen a muscle until you can consciously both relax and contract it. My focus with the pelvic floor is to help my clients find the ability to relax it with the inhale and stretch it (ok, it’s really an eccentric contraction, but my students don’t know that) in positions like a bent knee downdog or a bent knee wide forward fold. Thoughts on this?

      The other question I have relates to the abdominal issue. I live in an aging body and most of my students do, as well. Unfortunately, I find that my body doesn’t always know what to do in that abdominal area! I’m not sure if it’s smudged brain maps or simply the loss of strength that can come with aging. In the healthy, strong yoga bodies in most yoga classes these days, I’d say you are absolutely right. But for aging abs (or postpartum baby-stretched or caesarean severed abs), I’m not sure the body does always know what to do. While I don’t take issue with your thought at all, I do have some concern that if we take this idea across the board, are we allowing the pendulum to swing too far to the other side? I don’t mean to encourage engaging the abs (whatever cue you use) in order to protect the lumbar. There is too much evidence out there to contradict that idea. But I do think reminding students to be aware of the engagement of the core (and I mean 360 degrees), perhaps aware of filling with the inhale and aware of drawing the full core in toward center on the exhale is a helpful cue for those of us whose bodies do need the reminder. I’d love to hear your thoughts.

      Reply

      1. Hi Doraine,

        Thanks for your thoughtful reply and engagement with my article!

        In response to your first question — it would be out of my scope of practice and knowledge to address your question. I am not an expert in the topic and would want to be much more educated in the topic to be able to cue pelvic floor functioning. I do love that you are incorporating a cue to relax — I think it is a good idea to teach students (and ourselves) to notice any holding patterns in our body and learn to relax them.

        As for your second question, you bring up an excellent point. The body doesn’t always know what to do! If it did, we wouldn’t need movement educators and teachers. That being said, I do believe that some cues we use override our brains natural ability to control a movement and can potentially interfere with natural movement patterns. If the issue comes down to a lack of strength, then maybe the better idea is to regress the movement to a level where the client can feel strong. Work from a place where they do feel strong. Build from there. The other thing I want to clarify is that I don’t think its wrong to cue muscle engagement. For example, in bridge pose I cue abdominal engagement by saying something like “curl tailbone towards knees”. I also cue glute engagement because glutes can become lazy (I have written a blog post about glute activation in my personal blog). What I do see an unecessary is the belly to spine cue NOT because it is cueing muscular engagement but because there doesn’t appear to be any benefit to the movement and it is not a natural movement pattern. I definitely agree that there are many great ways to cue core engagement — and students definitely need this. I just don’t see any benefit of pulling the belly into the spine (aka abdominal hollowing) — and the scientific research would have to agree. Hope this clarified all your questions.

        Cheers,
        Kerry

        Reply

      1. Hi Cheryl,

        I am not sure what you mean — what kind of alignment cues are you looking for? Any specific poses? If you could be more specific I would be happy to share any knowledge I might have.

        Cheers,
        Kerry

        Reply

    4. I think it’s great for students to develop critical thinking as part of advancing their practice. I also think it can be dangerous for teachers to advise students on what to contract and not contract as universal, blanket statement type cues. That dichotomy of thinking can leave a whole bunch of people behind. I believe in students understanding why they may do one thing over another and make the decision for themselves. And many body workers still believe in slight pelvic floor activation matched with some core support throughout movement. Because of our cultural sedentary lifestyle these muscle groups often need a reminder to do their jobs.

      Reply

      1. Hi Shawna, Thanks for engaging with the article! I agree with you that it is great for students to develop critical thinking during their practice and moreover, for teachers to develop critical thinking about their own cueing. I also agree that it is dangerous for teachers to use many universal blanket type cues that really only apply to some (or none!) students in the room. I think you are only referring to the pelvic floor cue from my article in your comment so I will address that. I agree that there may be instances where conscious activation of the pelvic floor may be beneficial to some students. Unfortunately, I only ever hear this cue used to address a whole room of students and the sentiment of the cue is “squeeze your whole pelvic region throughout any strength-based pose”. And for the reasons I discussed in the article, I think this might not only be unnecessary but might actually be injurious to some students. I also know that the entire pelvic region and its associated disorders are quite complex. This is why some professionals (i.e., physios) can specialize in pelvic health and become informed about the region from an evidence-based perspective. Then, maybe they would prescribe some activation of the area. I am not a pelvic health expert nor are most yoga teachers. For these reasons, I think the habit of cueing pelvic floor activation should be re-thought. Hope this addresses your comment.

        Reply
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    8. I just met your blog, I love rethinking about the “universal truths of yoga”. I understand then, according to your article, that most of the reminders in practice about mula bandha and uddiyana bandha could be totally ignored ?. Sorry for my English, it’s not my language.

      Reply

      1. Hi Ana, thanks for your comment and engaging with our articles! This is a challenging question to answer because the bandhas are not simply physical cues. Those who practice bandhas profess that they are engaging in an energetic practice. This, however, is not something that I can speak to on an experiential level as energetics are not part of the language I speak or world that I understand. What I CAN speak to is the physical body and the effect of embodying certain movement cues. For the reasons I discuss in my article, from a purely physical standpoint, I do not feel that it is necessary to lift the pelvic floor throughout a movement practice nor do I feel it is necessary to draw the navel in towards the spine. I hope this clarifies your question!

        Reply
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