​​PRAY FOR A BETTER BACK

You are as young as your spine feels so keeping it mobile is key to keeping you feeling young and staying agile. Lack of movement not only leads to weight gain and neuromuscular degeneration, it can esoterically stop the whole essence of life as it encourages the development of restrictions in the spine, which is the highway for neurological signals from the body to the brain and back again, so has the potential to influence all body systems and processes. 

In his wisdom, God has prescribed prayer in the form of a series of physically enhancing movements that in essence is moving our spine, joints, muscles and fascia in a way that helps to maintain them. Even those who we consider to be inactive, still have to physically get up and move as Salah (or the muslim prayer) is the minimal level of physical movement prescribed for all of mankind.

 In an age of bad backs, neck pain and poor hip mobility, Salah is designed to create a consistent movement routine in our daily lives, that forces us to activate our musculoskeletal and nervous system and at least offer some movement for those who live lives completely void of it.  Various forms of movement systems such as Thai Chi, Yoga and Pilates are being used as health maintenance routines to promote wellbeing and to combat disease. Schools teach these systems and mainstream healthcare is also recommending them to the masses as therapeutic aids for both physical and psychological ailments. 

The system of Salah itself is unique in that it condenses into just five simple prayer positions the most effective and efficient benefits. These positions, which have their corresponding yoga alternatives, are also considered within ayurvedic traditions to collectively “activate” all seven “chakras” (energy fields) in the body. If analyzed and studied in detail the physiological benefits to these movements are vast but unfortunately very few of us benefit from them, as their correct and conscious implementation is rare. This is due to both our over adaptation to a lifestyle of limited movement and our unconscious disregard to the physical components of our prayer. 

According to Imam Shafi it is strongly encouraged (Wajib) to ensure that all bones in the body are in their correct place when performing the prayer. When I think of this in the context of musculoskeletal medicine and my experiences in the field of chiropractic spinal corrective care, it makes me question how this advice fits today’s norms in which the majority of us are hunched over in a forward posture due to our adaptations to desk work, TV screens and mobile phones.  Is it reasonable for us to carry over our improper postures and spinal alignments into our prayer positions, or should we be aiming to improve our alignment during our prayers? The irony is that the majority of us can improve our alignments though simple improvements in our spatial awareness and the hunchbacks and vulcher necks that we develop are merely a result of habitual practices. The truth is that if we were to implement correct prayer postures as a habitual practice it would automatically play a part in corrective adaptations.

STANDING 

An interesting point to note is that when standing in salah we are instructed to focus our gaze towards the site on the floor in front of us, in which our heads will prostrate in the position of Sujood. When doing this in what is biomechanically  considered to be a neutral spine,  our chins will tuck back as our eyes gaze downwards in their sockets towards the floor, creating what is known in spinal mechanics as a “chin tuck” position or “cervical retraction” move. This position, which is often prescribed as an exercise by chiropractors and physical therapists helps engage muscles that encourage proper cervical alignment and muscular stability.   The alternate way of directing your eyes towards the sujood site would be to flex the neck forward leaning the head down towards the floor which from a medical science perspective is not considered to be its natural or correct place or positioning and this posture is also discouraged from a religious standpoint too. In actuality a forward leaning head posture is associated with degenerative disc disease, nerve entrapment and overloading of the posterior elements of the spine. 

In this position the same comments can be made regarding shoulder alignment and positioning. Raised, rounded and forward leaning shoulders are not considered to be the natural or correct resting place of the shoulder blades and protracted scapula positioning is associated with shoulder impingement syndromes, tendonitis and compromised shoulder mechanics. Simply standing with the spine in a straighter position and gently allowing the shoulder blades to sit back and down into the mid back can drastically improve spinal alignment, removing compression and alleviating pressure on the ribcage consequently allowing more breathing space, oxygenation and even improved Qirrah (Quran recitation).      

(side note/ tip: to appreciate the physical effects rounded shoulders and forward leaning posture can have on your health try hunching forward in an exaggerated slouching position and then try raising your arms up to the sky, at the same time as trying to take a deep breath in. Now contrast this to a upright position with an open posture)

RUKOOH

Watching people continuously make rukooh with compromised spinal mechanics has to be one of the most agonizing sights for me as a chiropractic doctor when sitting in a mosque. Unknown to many, is the fact that Rukooh is not an action that involves bending the spine but actually requires the whole spine to remain straight throughout the movement. In an authentic narration that is in line with the teachings of all four schools of thought (Mathahibs) on the topic, it is mentioned that when the Prophet (pbuh) would make Rukooh his spine would be so flat that you could rest water on his back without it falling. This tells us that he (pbuh) was engaged in hip flexion and not spinal flexion meaning the movement was coming from his hips and not from his spine. 

From a spinal biomechanics perspective this detail is huge as it tells us that the loads of the movement were not pressing into the small joints and discs of the spine but rather they were being distributed into the large ball and socket joints of the hip, which has a large surface area and is surrounded by large supportive musculature including the gluteus muscles and the hamstrings that are specifically designed to deal with such loads. Unfortunately due to our adaptations to desks and office chairs our bodies are malnourished from inactivity which results in restricted hips and tight hamstrings that cause us to disproportionately load our lumbar spines causing gradual degenerative changes to the bones, discs and eventually nerves of the spine in a process of spinal degeneration, which orthopedic surgeons often call wear and tare. The reality is that the so called wear and tear or degenerative disc disease as it is also known as is not a natural process occurring due to type of work, nature or old age but rather, it is often a result of imbalances and poor maintenance of the body.  The body can wear out in focal places due to poor loading and movement imbalances just in the same way that one side of a car’s tyre gets worn out due to improper tracking and alignment. It would be foolish to say it was the result of regular wear and tare unless it was evenly distributed degeneration but surgeons and orthopedists are often guilty of this act and their diagnosis often contain statements such as “stage 2 degenerative changes at the level of L4-5” without a care, thought or consideration as to why it’s all happening in one place.  Thus is the state of symptom based medicine, chasing the problem while forgetting the cause.

Correct and regular implementation of Rukooh encourages positive adaptations to spinal mechanics and chiropractors and spinal specialists often prescribe a similar practice called nerve flossing which aims to do the same. The floss is performed by taking the correct position of Rukooh and the body weight is slightly lent forward to encourage the sensation of load bearing into the toes providing a progressive stretch to the posterior chain fascia, nerve endings and musculature. This not only improves musculoskeletal health but also aids circulation, lymphatic flow and balanced mechanics.  

Avoiding rounding of the shoulders by gently squeezing the shoulders back and downwards in this position while maintaining a chin tuck to make sure that the neck is not kinking up and that the entire spine is straight will ensure a flat spine throughout and not just in the lower back.  Keeping the knees straight and locked out at the same time as locking the elbows out when pressing on the knees will also ensure that a true stretch is occurring in the legs without cheating by bending them. Collectively the movement should create a 90-degree angle between the line of the legs and the full length of the spine including the neck, with the hips as the fulcrum. This means that the chin should be well tucked, avoiding the kinking of the neck or extending the head up higher than the position of the rest of the spine.    

SUJOOD

Sujood or prostration is one of the most spiritually elevated positions of the prayer. Likened to a fetal pose it is considered one of the most natural and peaceful positions one can be in. Its transition from seated or standing position is interestingly very specific. The hands are to be placed on the floor followed by the nose and then the forehead. When performed correctly the angle between the thigh bone (femur) and lower back (lumbar spine) at the pelvis should be a 90 degree angle. This ensures that the weight of the body is not sat back onto the legs but rather lent forward into the upper body and loaded onto the arms. To perform this mini push up of a movement correctly with the control and coordination needed to prevent squashing the nose or slamming the forehead, requires a great degree of strength and stability from the shoulders as well as their respective stabilizing musculature (scapular stabilizers). Doing this in the correct way encourages an opening of the chest and straightening of the spine, which is quite different from the round back, hunched forward position often witnessed when seeing people pray.  

The sujood position holds many other benefits from increased venous return, facilitated blood flow to the brain, lymphatic drainage, mobilization of cerebral spinal fluid, improved digestive function and waste elimination and more. 

TASHOOD

Sitting in the Tashood position can be a big challenge for those unconditioned to it but its benefits are great. Full flexion of the knees creates a deep stretch in the quadriceps and end ranges of the knee joints creating a heightened negative state within the synovial capsule. This negative pressure encourages synovial fluid secretion and fluid filtration which rheumatologically speaking is essential to aiding the nourishment of the joint and preventing arthritic degeneration. Elongation of the quadriceps in Tashood in combination with elongation of the hamstrings in Rukooh collectively play an important part in helping to balance the pelvis into a neutral tilt which is significant in spinal mechanics, balance and posture.    

When performed in the correct manner with a neutral spine, without an over leaning forward head position or rounded shoulders the Tashod position encourages space for appropriate opening of the lungs and deep breathing.    

SALAAM

The final position of prayer known as the salaam is when the head is turned from right to left upon the shoulders to signify the end of the prayer state. This rotation of the neck can sometimes be seen to be conducted slowly and with full movement or fast with a short range. In some cases people can be seen twisting their shoulders and upper bodies towards their chins instead of rotating their heads and chins towards their bodies.  This type of movement is often associated with restrictions in neck (cervical) range of motion and can be accompanied by a whole array of nasty dysfunctions. The prophetic descriptions of the movement detail the messenger of Allah (may peace and blessings be upon him) turning his head so far to the right and to the left that the people in the row behind him could see his cheek and he could see them. This small but significant detail tells us not only that we should be perusing a full range movement with our necks during Salaam but also informs us of the desired posture when sitting in Tashood. If, as many people are today the prophet (may peace and blessings be upon him) was sat in a slouched position with a ‘C’ shaped curved spine, rounded shoulders and forward head he would have been unable to turn his head to see the row behind him as his shoulder would have got in the way. For the people to be able to see his (peace be upon him) cheek, his spinal posture and head positioning would have had to have been upright with shoulders pinned back as to not come in the way of the movement.

Regularly performing this degree of spinal rotation not only nourishes the joints of the spine and stretches the muscles and nerves that come from the neck but the action also encourages the maintenance of cervical mobility allowing free and unrestricted movement. Without the divine prescription of this and the other positions of prayer that regularly stretch and mobilize the bones, joints, muscles, nerves, fascia and lymph of the body, it could easily become neglected without proper maintenance through movement and mobilizations.  

The truth is that movement is medicine and we need it to maintain health just as we need nourishment to sustain life. The minimal doses we have been prescribed in the form of prayer positions are our essentials and by doing these regularly and doing them in the correct manner we can start to un-tap and revive the benefits that they have been encased with often to our betterment both physically and spiritually. 

By no means however should we consider the movements in prayer to be all that we require for health maintenance and optimization. All aspects of physical health including our mobility, balance, strength, flexibility and endurance require regular utilization for them to be maintained in the best way. The phrase use it or lose it could not be more applicable when it comes to our bodies and we need to learn what we as individuals are capable of achieving with our bodies through stretch, movement and play so that we can then work on, not only maintaining, but also expanding and increasing that range.  

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Prayer in its essence is physically healing and if we only knew how powerful it was, we would reach meditative states during our salah, incorporating the healing of the breath, mobility and Quranic recitation.. 

We could write a whole book on the physical benefits of salah and how it activates these chakras. The simple act of sujood activates the crown chakra, base chakra and sacral chakra all of which combine to balance and enhance ones spiritual capacity whilst enhancing the health of the lymph, skeletal systems, the prostate, bladder, and the adrenal glands, whilst Ruku stretches the muscles of the lower back, thighs, legs and calves, and allows blood to be pumped down into the upper torso. More reasons to prolog the prayer and become consciously connected to our lord through the ruku and sujood.  When it comes to yoga, breath, meditation, mobility and flexibility, salah combines all these elements and if done correctly, can be your gateway to optimal health this coming ramadan.

Alhamodulilah, we are blessed to have such comprehensive systems in our deen and the deeper we delve into it, the more we will be fascinated and convinced of its eternal truth.

Through reading this book, I am sure you  have become motivated enough to appreciate the delicate nature of health and why our creator has forced us to reset ourselves yearly. Because if we had the choice, truly and deeply, not one of us would ever sacrifice food and water if we had the complete free choice to do so. The divine sustainer blessed us with a powerful opportunity to heal and for that, we should be eternally grateful, for every second is sacred and every moment counts. Let’s make this Ramadan one where we remodel our lifestyles, emanating a reality that reflects the sunnah of the prototype being and his lifestyle, our Prophet Muhammad SAW.

 In a month where blessings are vast, and spiritual realities are generous, we have a beautiful opportunity to reconstitute, rebalance and rekindle our bodies and souls. Let it be the time you take control of your fasting experience and I pray Allah blesses us with strength, discipline and baraka. 

This year is your year. Consistently express gratitude for breath and whatever you do this Ramadan,  don’t medicate, meditate. 

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