Science-Based Benefits of Backbends

If you try googling “benefits of backbends” you will come up with hundreds of vague claims about how back-bending can nourish the spine, open the heart, energize the body, teach life skills. These are nice ideas, but they seem almost to undermine the multitude of science-backed benefits of spinal extension.

I wanted to write this article because in my experience most people are unaware, or at least unconvinced, that backbends are necessary. Spinal extension isn’t just a party trick or circus art, it’s essential to the health and longevity of the body. This is not meant to be an exhaustive literature review, but rather a brief summary of measurable benefits that are backed by peer-reviewed studies.

Before I begin, I want to first clarify that back-bending (aka spinal extension) is back strengthening. I’m often shocked by how many people – advanced practitioners included – think about back-bending as “stretching the back.” Back-bending is the opposite of stretching your back – it’s stretching the front of the body, and contracting the back body. I bring this up only because I have found it to be a much more useful way to think of backbends in practice. Backbends require a lot of muscular engagement, and are not easily accessed via passive movement. If you approach your “flexibility” in backbends as back-body strengthening and front-body opening, they will make a lot more sense.

In this article, I’ll summarize 4 research-backed benefits of backbends, which are all related to the prevention and, in some cases, reversal of widespread adverse health conditions.

1. Prevents kyphosis (forward rounding of the spine)

Think about what happens to the posture of the spine as people age: it curls forward. We become hunched over in an almost defeated stance. Excessive forward rounding of the spine, called hyperkyphosis, is associated with aging, and is accelerated by habitual forward flexion prevalent in our culture. In fact, even the sight of young person with excellent posture can be somewhat striking. We often think, “He/she must be a dancer/athlete/confident/powerful.”

Hyperkyphosis is independently associated with decreased pulmonary function, decreased motor function, increased fracture risk, and lower quality of life. Beyond the physical effects, this posture can also have a negative psychological effect. It is even a strong predictor of overall mortality.

Backbends bend your spine back the other way, so it shouldn’t come as a surprise that back strengthening exercises have been shown to halt or even reverse the progression of kyphosis. Spine extensor strength has a causal inverse relationship with kyphosis. In other words, backbends can literally stop and rewind the age-related forward hunching of the spine, to maintain the posture (and attitude) of your youth.

2. Prevents disc degeneration

As a bit of background (particularly if you are someone who has a lot of fear centered around back-bending), it can be useful to examine the anatomy of the vertebrae – specifically, to dispel the belief that back-bending is inherently “bad” for the spine. If you look at the anatomical structure of the vertebrae and the intervertebral discs, spinal flexion is by far the riskier position for the spine. This is confirmed by a whole body of literature demonstrating that repeated forward bending is what can cause disc prolapse and herniation.

Spinal extension is used as physical therapy in cases of prolapsed or herniated (also called “slipped”) spinal disc. Some studies show that it can actually reverse prolapse by helping the disc nucleus to migrate back into the center of the disc, as in healthy spines. If you practice backbends proactively, you can help to prevent disc prolapse before it occurs.

3. Prevents loss of bone mass and osteoporosis

Osteoporosis is an advanced stage of bone density loss, resulting in increased risk for bone fracture. Low bone mass affects nearly half of the 50-and-older population in the United States. While there are genetic and nutrition-related risk factors, it is preventable and treatable via mechanical stimulation of the bone.

Let’s not forget that back-bending is not just about strengthening the muscles around the spine, but moving the spine itself. Through our movements, we can affect not only the muscles and the connective tissue, but the bones as well. Bones are living tissue, and they will respond and adapt to the demands that are placed on them.

Muscle activation and mechanical loading actually stimulate bone formation. There is a positive causal relationship between back extensor strength and bone mineral density. Doing backbends can literally prevent one of the most “inevitable” and dangerous diseases of old age.

4. Prevents and corrects back pain

From a broad perspective, structural damage and injuries often result from atrophy or muscular imbalance. If you are repeatedly bending forward over your laptop, phone, or book, without also bending the other way, you create a muscular imbalance. The body is extremely adaptable and efficient, and will therefore “forget” the movements that you stop using. Back-bending is a way to eliminate pain related to a common imbalance in the body.

Moreover, while pain can be associated with structure, often times it is related to the beliefs we have about our bodies. Proprioception and body awareness are negatively correlated with pain. In most cases, the more you know and understand your body, the less pain you will have. If you have pain in your back, what is your relationship with the muscles there? Do you understand their actions, how to activate them, and how to relax them? Backbends can teach you that.

The problem with backbends is that once you have an established practice, you will understand that they are amazing, that they are life-changing, and essential – but you won’t be able to prove it. Many of the benefits of backbends cannot be quantified or studied, only experienced. My intention with this article is to motivate you to establish your backbend practice, so that you can experience all of these science-based benefits, as well as all the benefits I cannot begin to describe.

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References
Kyphosis
Ball, J.M., Cagle, P., Johnson, B.E. et al. Spinal extension exercises prevent natural progression of kyphosis. Osteoporos Int 20, 481–489 (2009). https://doi.org/10.1007/s00198-008-0690-3
Kado DM, Prenovost K, Crandall C. Narrative review: hyperkyphosis in older persons. Ann Intern Med. 2007 Sep 4;147(5):330-8. doi: 10.7326/0003-4819-147-5-200709040-00008. PMID: 17785488.
Kasukawa, Y., Miyakoshi, N., Hongo, M. et al. Relationships between falls, spinal curvature, spinal mobility and back extensor strength in elderly people. J Bone Miner Metab 28, 82 (2010).

Disc prolapse
Stokes IA, Iatridis JC. Mechanical conditions that accelerate intervertebral disc degeneration: overload versus immobilization. Spine (Phila Pa 1976). 2004 Dec 1;29(23):2724-32. doi: 10.1097/01.brs.0000146049.52152.da. PMID: 15564921; PMCID: PMC7173624.
Scannell, Joan P. PhD; McGill, Stuart M. PhD. Disc Prolapse: Evidence of Reversal With Repeated Extension. Spine: February 15, 2009 – Volume 34 – Issue 4 – p 344-350 doi: 10.1097/BRS.0b013e31819712a6

Osteoporosis
Mehrsheed Sinaki, Malcolm C. McPhee, Stephen F. Hodgson, Jogn M. Merritt, Kenneth P. Offord. Relationship Between Bone Mineral Density of Spine and Strength of Back Extensors in Healthy Postmenopausal Women, Mayo Clinic Proceedings, 61:2, 1986, p 116-122, ISSN 0025-6196
Sinaki, M. Critical appraisal of physical rehabilitation measures after osteoporotic vertebral fracture. Osteoporos Int 14, 773–779 (2003). https://doi.org/10.1007/s00198-003-1446-8
Sinaki, M., Pfeifer, M., Preisinger, E. et al. The Role of Exercise in the Treatment of Osteoporosis. Curr Osteoporos Rep 8, 138–144 (2010). https://doi.org/10.1007/s11914-010-0019-y
Hongo, M., Itoi, E., Sinaki, M. et al. Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomized controlled trial. Osteoporos Int 18, 1389–1395 (2007). https://doi.org/10.1007/s00198-007-0398-9

Back pain
Shinde, S. B., Manpreet, B., & Bhore, P. R. (2022). Effect of spinal extension exercises on mechanical low back pain in work from home IT professionals in India. International Journal of Occupational Safety and Health, 12(2), 75–80. https://doi.org/10.3126/ijosh.v12i2.39022
David A Browder, John D Childs, Joshua A Cleland, Julie M Fritz, Effectiveness of an Extension-Oriented Treatment Approach in a Subgroup of Subjects With Low Back Pain: A Randomized Clinical Trial, Physical Therapy, 87:12, 2007, p 1608–1618, https://doi.org/10.2522/ptj.20060297
Gill, K. P., & Callaghan, M. J. (1998). The measurement of lumbar proprioception in individuals with and without low back pain. Spine, 23(3), 371-377.
Matthew Hoyan Tong, Seyed Javad Mousavi, Henri Kiers, Paulo Ferreira, Kathryn Refshauge, Jaap van Dieën, Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis, Archives of Physical Medicine and Rehabilitation, 98:1, 2017, p 120-136.e2, ISSN 0003-9993, https://doi.org/10.1016/j.apmr.2016.05.016.

By Jillian Jastrzembski

Jillian is a yoga teacher with over 500 hours of teacher trainings and hundreds of hours of teaching experience. A PhD scientist and a student of Chinese Medicine, she draws on her knowledge of Western and Eastern anatomy, and loves to find the intersection between the two schools of thought. Jillian also trains hand-balance, and has previous experience as a competitive figure skater. ig: @jillianjastrz

This blog article was previously published on her website, moreblissplz.com.