| Forty years ago, when I first became interested in | | | | Practicing yoga can help improve respiration |
| yoga and therapeutic exercise, I was assisting an | | | | throughout the day. Calm, slow, rhythmic breathing |
| older woman who was immobilized in her wheelchair | | | | helps to release both physical and emotional tension |
| by arthritis. Long before I understood the degree to | | | | by flooding the body and brain with oxygen. The |
| which yoga can rehabilitate the body, I was helping | | | | regular, daily practice of deep relaxation is restorative |
| people who were unable to dress, bathe or feed | | | | to every cell of the body. |
| themselves independently due to the pain and | | | | I encourage those of you with arthritis to seek the |
| stiffness in their joints. This has helped me | | | | help of an experienced teacher who can help you |
| understand the extreme suffering that can be | | | | learn to distinguish between good pain and bad pain |
| inflicted by arthritis. | | | | and to make yoga part of your daily life. |
| Back then, people with joint pain and swelling were | | | | The positive effects yoga can have on mood and |
| advised by doctors not to move! The thinking was | | | | overall outlook are especially important to someone |
| "If it hurts, don't move it." We now know that | | | | with arthritis. A yoga class offers positive support |
| inactivity is one of the worst responses for someone | | | | and the opportunity to connect with people who are |
| with arthritis. | | | | health-minded and have experienced the benefits of |
| As Loren Fishman, MD, points out in his book, Yoga | | | | yoga. Numerous studies emphasize the value of |
| for Arthritis, "Arthritis restricts movement, yoga | | | | group support in coping with health challenges such as |
| increases range of motion-these two were made for | | | | arthritis. |
| each other." | | | | With arthritis, as with any injury or disease, listen to |
| Arthritis is the leading cause of disability in this | | | | your body with focused attention to avoid injury and |
| country, limiting everyday activities for millions of | | | | determine which movements are most healing. Take |
| people. Drugs, surgeries, and steroids can alleviate | | | | classes with a teacher who is knowledgeable about |
| some of the discomforts, but study after study has | | | | arthritis. If you are new to yoga, I recommend a |
| shown that exercise is most beneficial to most forms | | | | few private lessons, if possible, or start in a small |
| of arthritis, specifically low-impact, flexibility-enhancing | | | | group class with individualized instruction, where you |
| exercises such as yoga. | | | | can practice at your own pace. |
| Osteoarthritis, a painful and often debilitating condition | | | | Guidelines for Practicing Yoga in Class and at Home |
| caused by decades of wear and tear on the joints, is | | | | 1. Respect pain. All yoga students, but especially |
| considered to be one the side effects of living longer. | | | | those with arthritis, must learn the difference |
| By the time we reach age sixty-five, X-rays for at | | | | between the beneficial feeling of muscles stretching |
| last a third of us will show some signs of | | | | and the pain that signals harm. Learn to distinguish |
| osteoarthritis, the most common of a group of | | | | between the normal discomfort of moving stiff joints |
| diseases collectively referred to as arthritis. | | | | through range of motion, and the pain caused by a |
| Arthritis in its many forms affects more than | | | | destructive movement or an excessive demand on a |
| seventy million (or one in three) American adults, | | | | joint. Sudden or severe pain is a warning. Continuing |
| according to estimates by the Center for Disease | | | | an activity after such a warning may cause joint |
| Control and Prevention. | | | | damage. |
| Arthritis is so common in our culture that most | | | | In general, if pain and discomfort persists more than |
| people consider the pain and discomfort it brings to | | | | two hours after a yoga session, ask a knowledgeable |
| be a normal part of aging. Arthritis makes normal | | | | teacher to check your alignment and help you modify |
| activities increasingly painful and difficult and diminishes | | | | the pose. Try moving more slowly, practicing more |
| or destroys the quality of life. | | | | regularly and experiment with how long to stay in a |
| An Overview of Arthritis | | | | pose. There is no set answer to the perennial |
| The word arthritis means "joint inflammation." Modern | | | | question "How long should I stay in the pose?" Stay |
| medicine recognizes more than a hundred varieties of | | | | long enough so that a healthy change has been made |
| conditions that produce deterioration in joint | | | | but not so long that your body stiffens from staying |
| structures. The common thread among these | | | | in a position too long. |
| conditions is that they all affect the joints-those | | | | 2. Balance work and rest. Balancing activity and rest |
| nearly 150 ingeniously designed structures located | | | | applies to yoga as well as to other daily activities. Do |
| where two or more bones come together. | | | | not exercise to the point of fatigue. Stop before you |
| Arthritis-related joint problems may include pain, | | | | are exhausted! Weakened, fatigued muscles set the |
| stiffness, inflammation and damage to joints. Joint | | | | stage for joint instability and injury. Balance your |
| weakness, instability and visible deformities may | | | | active yoga session with yoga's deeply relaxing |
| occur, depending on the location of the joint involved. | | | | restorative poses. Restorative poses are passive |
| Arthritis is classified into two main types. Rheumatoid | | | | poses that help your internal healing processes to |
| arthritis is a chronic inflammatory disorder, resulting in | | | | work. If you are fatigued, practice restorative poses |
| stiffness in the joints and muscles, joint erosion and | | | | first. You will benefit more from active, more |
| pain. Osteoarthritis is a degenerative disorder that | | | | challenging poses, if you are well rested. |
| erodes the cartilage in joints, which leads to bones | | | | 3. Practice with focus and awareness (pay attention |
| rubbing together. Osteoarthritis frequently occurs in | | | | to how you feel) and breathe properly. Avoid |
| people who are overweight or whose joints are | | | | mechanical repetitions and counting while exercising. |
| painful from extreme overuse. | | | | Watch the flow of your breath and your body's |
| In spite of the prevalence of arthritis, be careful not | | | | response to a particular pose or exercise. Without |
| to jump to the conclusion that your achy joints are | | | | fully expanding your lungs, the muscles you are |
| necessarily due to it. Overuse and injuries can also | | | | exercising cannot be adequately supplied with |
| result in tendonitis, bursitis, carpal tunnel syndrome | | | | oxygen. Holding your breath while stretching inhibits |
| and other fairly common conditions that are unrelated | | | | relaxation. Smooth, peaceful, rhythmic breathing |
| to arthritis. | | | | through the nose reduces pain and tension and |
| Arthritis and Exercise | | | | increases the feeling of deep relaxation that follows a |
| To remain healthy, muscles and joints must move | | | | yoga session. Learn to tune into what your body is |
| and bear weight or they will lose strength. This | | | | telling you. |
| weakness, coupled with joint swelling, will make the | | | | 4. Learn to use yoga props. People with arthritis may |
| joints unstable. Joints in this condition are vulnerable | | | | already be quite stiff by the time they start yoga. |
| to dislocation, increased injury and pain. Thus, regular | | | | The use of props helps improve blood circulation and |
| gentle movement helps to reduce pain and to | | | | breathing capacity. By supporting the body in a yoga |
| maintain mobility. | | | | posture, props allow the muscles to lengthen in a |
| Physical movement promotes health in many | | | | passive, non-strenuous way. Props help conserve |
| systems of the body. It increases circulation, which in | | | | energy and allow people to practice more strenuous |
| turn reduces swelling and promotes delivery of | | | | poses without hurting or over exerting themselves. |
| oxygen and nutrients to the tissues. With | | | | Yoga for Arthritic Hips and Knees |
| immobilization, a cycle of deterioration begins. | | | | The areas most commonly affected by arthritis are |
| Because movement is crucial to so many physiological | | | | the hips, knees and hands. With decreased |
| processes, the arthritic person's overall health tends | | | | movement, the muscles and soft tissues around the |
| to deteriorate without it. The normal functioning of | | | | hip shorten, putting additional wear and tear on the |
| the immune system declines, infections and illnesses | | | | gliding surfaces. If a person becomes more sedentary |
| occur, and the person often becomes frustrated and | | | | in an effort to minimize pain, bones and cartilage |
| depressed. This cycle is self-perpetuating. | | | | receive less weight-bearing stimulation. Bone spurs |
| When someone comes to me with arthritis, I teach | | | | may even develop to further limit movement. |
| them how to practice yoga safely with the support | | | | Lack of exercise also weakens the thigh and calf |
| of yoga props. For those who are new to yoga, the | | | | muscles. Their strength provides stability and support |
| term "yoga props," simply refers to any object, such | | | | for the knee. When the soft tissues of the joint |
| as a wall, a sturdy table or a chair, a folded blanket, a | | | | swell, this causes compression and reduces space in |
| firm pillow, a strap or other item that makes | | | | the joint even further. |
| practicing yoga safer and easier. Yoga props are | | | | Standing poses are crucial for stretching and building |
| especially helpful for older beginners who may have | | | | supportive strength in the hips, buttocks and thighs. |
| balance problems and are coping with common health | | | | Moving the head of the femur in the hip socket helps |
| issues such as arthritis and osteoporosis. In addition | | | | distribute synovial fluid, thus lubricating the joint and |
| to common household objects that can be used as | | | | all points of contact. |
| yoga props, there are professional yoga props such | | | | The same standing poses recommended for hips are |
| as a sturdy wooden bar known as the "yoga horse," | | | | also critical for knee rehabilitation. They create more |
| yoga wall ropes, yoga bolsters in many shapes and | | | | space in the knee joint for synovial fluid circulation |
| sizes, yoga straps, special yoga chairs, yoga blocks, | | | | and develop the strength of the thigh and calf |
| firm yoga blankets and more elaborate props like | | | | muscles for better support. |
| yoga backbenders that give people with arthritis and | | | | Sit on the Floor Every Day! |
| other common health conditions new hope and | | | | I encourage all my students, especially those with |
| confidence. | | | | osteoarthritis of the knees, to sit on the floor every |
| Physicians are increasingly advising regular gentle | | | | day, in various cross-legged and other bent knee |
| exercise for people with arthritis because it tones | | | | positions, as part of their daily life routine. This helps |
| muscles and reduces stiffness in joints. Yoga is an | | | | assure that you do not lose the ability to sit |
| ideal form of exercise for this because its | | | | comfortably on the floor. Sitting with the legs |
| movements are fluid and adaptable. Yoga loosens | | | | crossed loosely is a simple, natural position that helps |
| muscles that have been tightened by inactivity, | | | | remove stiffness in the hips and knees. To help you |
| stress and tension. In yoga we progress gradually, | | | | sit comfortably on the floor with your back straight, |
| beginning with simple stretches and strengthening | | | | sit on one or more folded blankets, a firm bolster, |
| poses and advancing to more difficult postures only | | | | large dictionary or other height. Avoiding sitting on |
| as we become stronger and more flexible. | | | | the floor will only make your hips and knees stiffer |
| If necessary, you can begin with gentle movements | | | | with the passage of time. |
| while sitting in a chair or lying on the floor. You can | | | | Hint: If there is pain in the knees, try increasing the |
| gradually add weight-bearing standing postures, with | | | | height under the buttock so that your pelvis is higher |
| the support of a wall, counter or table, wall ropes, | | | | than the knees, and place folded blankets or yoga |
| chairs, blocks, and other props. | | | | blocks under the knees. A knowledgeable yoga |
| The weight-bearing yoga standing poses are among | | | | teacher can help you adjust your props so that |
| the key poses for safely increasing range of motion | | | | sitting on the floor becomes easy and comfortable. |
| in all the joints as well as increasing strength and | | | | Increase the length of time you sit gradually, and be |
| flexibility. | | | | sure to cross your legs the opposite way (opposite |
| It's important to note that weak muscles are | | | | leg in front). |
| considered a risk factor for osteoarthritis. Be | | | | Caution: Do not strain your knees by attempting to |
| especially aware of weakness in the quadriceps, the | | | | sit prematurely in more advanced, bent-knee |
| large frontal thigh muscles: The weaker the | | | | positions such as the classic Lotus Pose. Forcing your |
| quadriceps, the higher the risk of developing | | | | body into any position can result in serious injury. |
| osteoarthritis in the knee. Yoga standing poses are | | | | STOP if you feel pain, and consult a knowledgeable |
| valuable for strengthening the quadriceps without | | | | teacher. |
| wear and tear on the hip and knee joints. | | | | |