Practice Pages: Yoga Therapy
Oh, Those Aching Joints! How Yoga Helps People With Arthritis Feel Young Again
“TODAY’S NOT SUCH A GREAT DAY.” That thought often resounds in the minds of people living with arthritis. Maybe the weather changed. Maybe they gardened a bit too much the day before. Regardless of the cause, participating in a Yoga class with painful joints might not seem like a great idea. After all, isn’t Yoga about standing on your head and arranging your legs to look like a pretzel?
Creak, Moan, Groan
More than seventy million (one in three) American adults live with arthritis, a word which literally translates to “joint inflammation.” It is the leading cause of disability in the US. In the words of Arthritis Foundation grant recipient, Staffany Haaz, MFA, RYT, “Arthritis is really a family of conditions.”Rheumatoid arthritis (RA) causes inflammation of the joints due to abnormalities in the body’s own defense system – the immune system (wherein the immune system attacks the joints themselves). The more common type of arthritis is Osteoarthritis (OA) which affects both men and women usually as they grow older, although it can also be the result of injury or trauma to the joints. Because the disease causes pain, swelling and stiffness as bones and cartilage progressively break down; osteoarthritis is sometimes called “degenerative arthritis.”
Arthritis affects the joints where two or more bones meet. Various parts of the joint may be affected, such as the bone, cartilage, synovium, tendons and muscles. Cartilage, a soft protective material, cushions the bones and keeps them from rubbing together. The joint capsule is lined with synovium that secretes a slippery fluid that lubricates the joints and helps them to move freely. Finally, tendons and muscles contribute strong support to the structure of the joint and are responsible for its movement. Each of these areas can be affected in some very specific ways, making living with arthritis painful, discouraging and often debilitating. When the relationship of these structures goes awry, it can causes the degradation of the cartilage and thereby the pain, swelling and inflammation of arthritis.
Yoga’s physical, mental, emotional and spiritual benefits are well-known. And people living with arthritis may experience even greater satisfaction from these benefits than the general Yoga population. Because arthritis limits flexibility, Yoga asana (postures) provide a way to gently expand the range of motion in the affected joints. Yoga also increases muscle strength, thus stabilizing the weakened joints. Because Yoga poses help create better balance, the likelihood of falls is decreased, and should a fall occur, the bones are more able to accommodate it.
In a source of practical information, the soon-to-be-classic book, Yoga for Arthritis by Dr. Loren Fishman and Ellen Saltonstall, tells us, “The very movement that serves the joint’s function also circulates the fluid that makes continued movement possible.” They go on to say, “One thing that Yoga does for sure is move the joints into extreme but safe positions, allowing the obscure corners and crevices of each joint to be awash with its lubricating, life-sustaining fluid.”
Dr. Fishman’s book is a priceless asset to anyone living with arthritis as it not only explains the condition, but provides practices and many modifications to suit the condition as well as specific contraindications. In the chapter called “All Stars,” the authors demonstrate twenty poses, each helpful to a number of joints. They go so far as to suggest these poses can be called sarva artha (all-purpose). “All-purpose poses can be done as a complete practice by those wanting a general arthritispreventing regime (author’s italics). Each pose, including standing, supine, twisting, seated and reclined poses, is explained thoroughly with many modifications. The succeeding chapters provide practices for specific areas of the body that may be affected by arthritis.
The practice is being put to the test, in one case at the Johns Hopkins School of Public Health, where Arthritis Foundation grant recipient Ms. Haaz is involved in a study that explores the effects of an eight-week Yoga program consisting of two classes (each sixty minutes) and one home practice every week. he classes include Yoga asana (poses), breathing practices and relaxation tech-iques. Ms. Haaz claims that Yoga is more comprehensive than other forms of “exercise” in that “it intentionally engages the self n all levels.” She continues,“Since there is o cure for arthritis, the frustration level of he students is often high. Yoga encourages hem to notice and accept their situation, and hen modify accordingly.”
The relief of physical symptoms is a remarkable enough benefit. But according to Ms. Haaz, where Yoga’s promise truly shines is in the spiritual experience of the students. While knowing there is no cure, and experiencing levels of pain and stiffness that can change daily, it is difficult to live with a constantly changing picture of one’s self. With Yoga’s focus in the moment, appreciation of what the body can do right now and the infinite modifications that are possible, each person learns to accept and adapt as needed. This makes life more open, more enjoyable and more serene.
In the Arthritis Foundation study there were “across the board improvements in every area of life” for the students – in their social, mental, emotional and physical health – as measured in the Quality of Life aspect of the study. There were also marked provements in the actual physical symptof pain, swelling and stiffness. Additidata from this study are still being analyzed,but so far they encourage the use of Yoga practice as a means of support and symptomrelief for those living with arthritis.
By the time a person living with arthritis comes to a Yoga class, the disease may have limited their mobility significantly. In this case, a chair Yoga practice might serve best. Gentle movements of the joints, coordinated with life-giving breathing, encourage the movement of the synovial fluid in the joint, which in turn, allows the cartilage to regenerate to some degree. When combined with relaxation practices, this form of modified Yoga can provide a safe, non-threatening program of relief. Living with a degenerative disease like arthritis creates a constant state of vulnerability in the person’s psyche. A person may often feel unable to take the risk in a common activity like walking outdoors because of uneven sidewalks or other hazards. Thus, a convivial Yoga class provides a social network of shared experiences that greatly enhances the student’s life.
With Yoga’s focus in the moment, appreciation of what the body can do right now and the infinite modifications that are possible, each person learns to accept and adapt as needed.
If the joints are not yet so debilitated, modified poses provide just the right amount of stimulation to prevent further degradation. Classic asana can be learned in stages so that, with increasing strength, flexibility and mobility, the tudent can increase their level of challenge.
As confidence grows, so too does the ability to listen to the body. For the person living with arthritis, honoring the condition of the moment includes the pleasure of stretching both body and mind in the poses as well as the fatigue and pain of the disease. Yoga students learn to distinguish the difference between the “good” and temporary discomfort of stretching a tight muscle or joint from the often dangerous pain of overdoing. Students discover the renewed energy that comes from moving, breathing and relaxing. Taking time after each pose to integrate its effects leads to a long-term commitment to the life-enhancing practice of Yoga – regardless of the condition of the body.
Felice Rhiannon, E-RYT, PYT is a registered Yoga teacher and professional Yoga therapist, author, educator and public speaker. Her passion is bringing the gifts of Yoga to people living with challenging conditions and to people in their middle years and beyond. After spending over two fruitful years living and teaching in Santa Monica, Felice is embarking on a new venture in London. She will be the yoga therapist at the Spiral Centre, a holistic healing center. Please visit her website for contact information after August 15:transformativeyoga.com.
By Felice Rhiannon, E-RYT, PYT
