All Fours Pose - Issues and solutions

List of some of the issues that can be relevant for practising this pose:

            Pregnancy





There is relatively little strain in this pose on either the neck or upper back.

However, many find that there is not as much mobility in the neck or upper back in this position as is ideal – usually leading to the spine of the upper back being overly raised or humped. Where this is the case, it is usually helpful to imagine the shoulders broadening (moving away from each other) – as this appears to create space in which the spine can lower. It can also be helpful to place the hands slightly wide of the shoulders (as opposed to directly under them), have the elbows slightly bent, point them sideways and then rotate the arms so as to make the elbows point backwards towards the feet. Another approach that can be helpful involves spreading the fingers wide with the two middle fingers parallel, then consciously pressing the forefingers down (especially the pad of the joint where the finger joins the rest of the hand) and maintaining this pressing down of the forefingers while deliberately pressing down the outside edge of the hands.



In this pose the wrists are for most people close to their most extreme position of extension and also take a lot of the body weight – so this pose is unusually demanding of the wrists. Even for those with usually healthy wrists this can feel uncomfortable (if held for long), particularly if the position is unfamiliar – practice usually making the position less uncomfortable. For those who already have wrist problems (usually of the arthritis type) there is a range of options to try.

One thing to try is actively pressing down through the hands (rather than slumping down through the arms / hands) – think in terms of trying actively to press the heels and the pad of the forefingers and little fingers into the ground. This feels as if it has the effect of encouraging space in the wrist, elbows and shoulder joints and thus the joints feel less compressed and more comfortable. (And indeed this approach is a good idea even for those with healthy wrist joints).

An adaptation that is usually helpful is to reduce the angle of the wrist – that is to make the degree of extension at the wrist less extreme. One approach is to put some padding (e.g. a yoga block or a couple of folds of a towel) under the heel of the hands but still have the whole of the fingers resting on the mat / floor – indeed if one’s finger joints are up to it the same position can be adopted without the use of padding. If that does not help sufficiently, try making a fist with one’s hands and then place the knuckles and the first part of ones fingers on the mat so that the wrist are close to straight in a neutral position for the wrist joints.

If these adaptations are not sufficient to make the position comfortable for one’s wrists then one can place one’s elbows on the floor where one’s hands would be and have the forearms pointing forwards away from the feet. This removes the load-bearing aspects of the pose for the wrists but in fact makes other aspects of the pose a little more challenging – for example, the mobility of the spine is usually reduced in this position, making “cat breath” feel less easy to do.



There is relatively little strain in this pose on the lumbar spine.

However, some will find they tend to overly allow their lumbar spine to slump or sag downwards. Usually this iseasily remedied by consciously increasing the tone of the abdominal muscles. (Note however that the transverse abdominis muscles, even when contracted, will have little to no effect on the shape of the lumbar spine – unlike the other abdominal muscles). Another approach that can be useful (especially where one wishes to keep the lumbar spine and pelvic girdle still and stable) is to press the lower legs and “tops” of the feet downwards – this engages leg muscles in a way that pulls on the pelvic girdle such that it encourages the lumbar spine to lift (obviously one should not take this too far or the lumbar spine will end up humped).



The knees take a lot of the body weight in this position – in a way that can be uncomfortable if one does not have sufficient padding under the knees. Some will find it is sufficient simply to have the usual degree of padding as supplied by a normal yoga mat. However, most people will find it necessary to rest the knees (and lower legs and ankles) on several folds of a blanket or towel to avoid causing discomfort in the knees.

If one already has knee problems, the use of plenty of padding is essential and some will find that it is best to avoid the all fours type position (except briefly as part of moving into or out of another position).



If one has limited flexibility in the ankles with regard to plantar flexion then the all fours pose can feel uncomfortable in either the “tops” of the feet or the “front” of the lower legs. The solution is to reduce the degree to which the ankles are placed in plantar flexion. Options include : placing padding under knees and lower legs that does not quite reach as far as the ankles; putting a thin rolled up towel under the ankles; curling the toes under so the ankles are in dorsi flexion.

Some find that, if they leave their feet in plantar flexion for a while, they tend to get cramp in their feet. So at the first signs of beginning to get cramp in the feet it is a good idea to curl the toes under to give the soles of one’s feet a bit of a stretch. A nice thing to do is to place one’s hands close to one’s knees and push with one’s hands so that one’s buttocks move over one’s heels and then release the push with one’s hands sufficiently for one’s knees to gently return to the floor – one can do this several times until the foot cramp has been released – and then return to the main exercise.


Pregnancy

Practising yoga in the first trimester is considered by most yoga teachers to be contra-indicated. The only explanation I have heard for this is that in the first trimester there is a fairly high tendency for spontaneous miscarriage and this could in principle be exacerbated by yoga (although, as far as I know, there is no evidence for this). Possibly a mid-wife or an expert pregnancy yoga teacher might be able to give a better explanation.

This is generally considered to be a good posture to practise when pregnant – the usual care should be taken to avoid holding it statically for too long. Also note that, in the later stages of pregnancy, one’s weight has increased meaning that there is greater weight having to be supported by the wrists (so one may wish to try resting elbows on floor) and knees (increasing the likely need for padding under knees).

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