Matsyasana (Fish Pose) - Issues and solutions

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

            Pregnancy





In the full version of this pose, the neck is in full extension. This can cause problems for those with an already vulnerable or damaged neck (which is very common). Whether a neck problem is an issue for this pose depends on the type of neck problem. For example, those with osteoporosis in the neck or thoracic spine need to take a lot of care. Whereas, those with disc protrusions (i.e. slipped disc) in the backwards direction may well find that the neck position of this pose is actively helpful.

In the full version of the pose (where the legs are in lotus position and hands rest on feet), the head rests on the floor and, via the neck, supports much of the weight of the body. Anyone with even a slight neck issue would be sensible to avoid this version as it puts the neck into a compression while in extreme position. In practice, very few are able to achieve this version of the pose.

Another version of the pose is to practise it with hands placed under buttocks, and then the chest is lifted via bending the elbows. Here, given enough spinal flexibility, one has a choice as to how high to lift the chest. Those who need to be careful with neck extension, should take care to only lift the chest to a point that still feels comfortable for the neck. Whereas those with disc protrusion type problems might well wish to lift the chest so far that that head is off the floor, with the neck in an extreme extension position. In this position, the combination of the weight of the head putting the neck into mild traction and the extension aspect of the neck position can help the disc to return to its natural, healthy shape.

In another version, which is gentler with regard to the neck (but which, in other ways, is harder work), one places the elbows beside the trunk, with forearms vertical and palms facing upwards. In this version, the elbows and shoulders are pressed downwards to cause the chest to lift upwards. Because the chest lifts by a relatively small amount, the neck is only slightly moved into extension. Hence, this is a fairly safe option for most necks.

Those with really delicate necks can still practise a version of the pose – to experience the wonderful feeling of openness in the chest. One can roll up a towel and lie on it so that one’s head and thoracic spine rest on the rolled-up towel – the neck is not in extension at all, but the chest is still being encouraged to be expanded.

The other issue to consider is the possibility that the thyroid gland will be “stimulated” by stretching in the front of the neck (especially if practised preceding or after a pose that squeezes the front of the neck). I am not sure that such “stimulation” actually occurs and for most students it would be desirable, but, for some thyroid disorders (over-active thyroids), stimulating the thyroid gland is not a good idea.



The arm position for fish pose varies greatly in different versions – as can be seen from the previous section. In all versions of the pose, there is an encouragement of the shoulders to be in retraction – it is common for muscles which pull in the other direction (pectoralis minor, serratus anterior and subclavius) to limit this movement. But while this might limit how far one moves into the pose, it does not generally cause other problems. In most active versions, the shoulder joint are also pulled into extension – here one might be limited by weakness in the muscles that cause this movement (latissimus dorsi, terres major and the back part of deltoid). This is because, in some active versions of the pose (e.g. ones where the elbows / arms are being pressed against the floor without the elbow flexors being engaged), these muscles are the key ones that need to work to cause the lifting of the chest. However, the solution is to simply practise and these muscles will naturally strengthen. Tightness in the muscles that take the shoulder joints into flexion (mainly pectoralis major and front part of the deltoid) may also be limiting – again simply practise and these muscles will lengthen.

The elbows and wrists are sometimes significantly involved. In particular, the muscles which flex the elbows often assist the extensors of the shoulder joints in drawing the arms backwards (relative to the trunk). For example, this happens when the hands are placed under (and are anchored by) the buttocks –it is then the flexing of the elbows that primarily causes the lifting of the chest. But it is unlikely that weakness in these muscles (as opposed to stiffness in the spine) that is limiting. Those with elbow problems may find pulls across the elbow joints uncomfortable in this version of the pose – in which case, they may do better with versions that don’t engage the flexors of the elbows.

Those with frozen shoulder type problems may find some versions of the pose either uncomfortable or impossible. This very much depends on how “frozen” the shoulder is with regard to extension – and those with this sort of problem vary greatly in this respect. To find out, one can explore moving the arm backwards from beside the trunk while sitting or standing – if discomfort is found while doing such an exploration, then one needs to avoid taking the arms to the same degree backwards while in fish pose. The passive versions where the support is placed under the thoracic spine will probably be accessible if the support is not too high. And, in these versions, the arms do not have to be left beside the trunk – if comfortable, they can be resting on the floor with elbows at shoulder level and forearms pointing away from feet, or in the over-head position resting on the floor.



Stiffness in and around the thoracic spine will limit the extent to which you can move into the fish pose. Those who are generally stiff in the spine will simply not be able to lift the chest far. However, those who are quite mobile in the lower back will need to take care not to compensate for thoracic stiffness by putting the lumbar spine into excessive extension (there may also be a similar need to take extra care of the neck). Improving one’s ability to lift up into the pose is generally helped by working on mobilizing and strengthening the upper back. The passive versions of the pose (i.e. thoracic spine resting on a support) will be accessible to those with stiff thoracic spines, provided the support used is not too high, and will help with getting used to the feeling of having the chest open and expanded. Active versions of the pose, where the lift of the chest is caused by shoulder extension (i.e. with the elbows flexors not helping), will be great for helping to develop appropriate strength. But they might feel unsatisfying (and very hard work), as the lift of the chest will be slight until the thoracic spine develops flexibility with regard to extension.

Breathing. When holding this pose, the breath is restricted. It is restricted in the upper and middle part of the lungs since the ribs are held in an extreme expanded position. It is also restricted somewhat in the lower part of the lungs due to the abdomen being pulled taut, so that the diaphragm has to work harder when it contracts. This is generally beneficial due to the muscles of respiration either being stretched (which helps to improve their elasticity) or having to work hard against resistance (which strengthens them). However, some people may find this uncomfortable at first and feel that they can’t breathe (cf. asthma) – such people need not hold the pose, but can move in and out of it until they feel comfortable holding it. Alternatively, they can practise the passive versions of the pose where the breath can be quite gentle because the body is not working hard. They can then practise gradually adding in pressing of the arms downwards to develop comfort in the position when needing to breathe a lot to supply working muscles with the oxygen that they need.

Heart. The active versions of this pose encourage the heart to beat harder and faster. This is generally beneficial for the heart as it gives it a bit of a “work-out” – helping it to stay fit and strong. However, for those with an already compromised heart, there is some danger that the heart will be asked to do more than it can cope with. Such people should listen/feel to how their hearts are responding and should only hold active versions of the pose for short periods (if at all) until the heart has built up its strength and stamina again. Those with heart problems may well (at least initially) find the passive versions of the pose (where the lift of the chest is supplied by a support such as a rolled-up towel) more helpful. In the passive versions, muscles are relaxed and so need little blood supply and are not squeezing on blood vessels – both factors help to keep the work load on the heart fairly low and so there is little risk of raising the blood pressure too much or of the heart being asked to work too hard.



Generally, this pose is thought to be good for those with back problems. This would be true for the sort of problems caused by straining (e.g. via lifting heavy loads) while the lumbar spine is flexed. However, for those with lumbar lordosis (excessive inward curving in the lower back), or for those with a highly mobile lower back, an issue to watch for is over-arching of the lower back. This need not be a problem as long as one practises the pose so as to keep the lower back long. Consciously attempting to point the lower tail bone towards one’s feet (or pressing the lower back towards the floor), and / or keeping the abdomen squeezed inwards, helps keep the lower back long, as does consciously directing the back-bend into the upper back (rather than the lower back).

I like to practise the pose with the legs in the semi-supine position (soles of feet on floor and knees bent and pointing upwards). In this position, I can press the feet somewhat downwards - and this encourages the lower back to flatten towards the floor. The resultant pose looks less impressive – but the lumbar spine is protected from over-arching, and the pose is actually much harder work and more strengthening.



In the full version of the pose, the legs are placed in a lotus type position – this requires one to be already comfortable sitting in the lotus position (which requires a lot of hip flexibility). More typically, the legs are in a fairly neutral position either with legs straight along the floor (most common) or with legs bent, soles of feet on floor and knees pointing upwards. In both these two positions, it is rare for anything about the hips, legs or feet to be limiting or aggravated. Those with joint replacements may not be able to be in one or other of these two leg positions – but they can usually find a leg position that is possible to practise the pose in.


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.

In the later stages of pregnancy, when lying on one’s back, the weight of the fetus presses on the inferior vena cava in the abdomen. This might be OK for very short periods, but it is generally something to avoid since it tends to restrict the return flow of blood to the heart from the legs and abdomen (encouraging problems like varicose veins and oedema in the legs). Hence, the supine versions of the pose are best avoided during pregnancy. Usual alternatives offered are sitting fish pose (from sitting, lean backwards and place hands on floor and then lift chest) or standing cobra (from standing, clasp hands behind back, draw hands downwards while rolling shoulders backwards and then lifting arms away from back, thus encouraging chest to expand forwards). Other options to consider would be things like cat breathing (from all fours or standing cat) and sitting with a chair in front and resting hands and head on the chair in such a way that encourages back bending of the upper back.

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