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