Back pain is one of the major disabling health conditions among older adults aged 60 years and older. Many causes of lower back pain are age-related with physical and psychosocial changes. There is a distinct lack of awareness, especially in older adults to the causes and effects of back pain and pain management.

Existing evidence suggests that prevalence rates of severe and chronic low back pain increase with older age. As compared to working-age adults, older adults are more likely to develop lower back pain like osteoporotic vertebral fractures, tumors, spinal infection, and lumbar spinal stenosis

This twist and core sequence improves digestion and strengthens the abdomen, hip flexors and the spine.

This wonderful twist, Half Lord of the Fish (Ardha Matsyendrasana) stimulates the digestive fire in the belly and increases your appetite. The pose massages the liver and kidneys and stretches your shoulders, hips and neck, and energises the spine. It relieves menstrual discomfort, fatigue, sciatica and backache. It is also therapeutic for asthma and infertility.

Step-by-step technique


  • Sit on the floor with your legs straight out in front of you. Using a folded blanket or block under your buttocks is key, especially if you are a beginner or have tight hips.
  • Put your feet on the floor, then slide your left foot under your right leg to the outside of your right hip.
  • Lay the outside of your left leg on the floor.
  • Step your right foot over your left leg and stand it on the floor outside your left hip. Your right knee will point directly up at the ceiling.
  • Exhale and twist towards the inside of your right thigh.
  • Press your right hand against the floor just behind your right buttock and set your left upper arm on the outside of your right thigh near the knee.
  • Pull your front torso and inner right thigh together.
  • Press your right foot into the floor, release your right groin and lengthen your front torso. Lean your upper torso back slightly, against the shoulderblades, and continue to lengthen your tailbone into the floor.
  • With every inhalation, lift a little more through your sternum, pushing your fingers against the floor to help.
  • Twist a little more with every exhalation (a vertebrae or two).
  • Be sure to distribute the twist evenly throughout the entire length of your spine; don’t concentrate it in your lower back.
  • Stay in pose for 30 seconds to 1 minute, then release with an exhalation, return to the starting position and repeat to the left for the same length of time.


Contraindications and cautions


If you have suffered a back or spine injury, perform this pose only with the supervision of an experienced teacher.


Benefits of the twist and core sequence


  • Stimulates the digestive fire in the belly
  • Increases your appetite
  • Massages the liver and kidneys
  • Stretches the shoulders, hips and neck
  • Energises the spine
  • Relieves menstrual discomfort, fatigue, sciatica and backache
  • Therapeutic for asthma and infertility.


Modifications and props


At first it’s often difficult to get your torso to sit snugly against your inner thigh. Position yourself a foot or so away from a wall, with your back to it – the exact distance will depend on the length of your arms. Exhale into the twist and reach back for the wall. Your arm should be almost, but not quite, extended (make sure you aren’t sitting too close to the wall, otherwise it will jam your shoulder). Push the wall away and move your front torso against your thigh.

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