Yoga for MS
What is multiple sclerosis (MS)?
MS is an autoimmune disease in which the body’s defence system attacks the myelin sheaths surrounding the nerves. In the same way that insulation covers an electrical wire, these sheaths cover our nerves. Without the sheaths, the nerves begin to short out. Consequently, the pathways between the brain and the body are interrupted. People with MS experience recurring episodes of inflammation and damage to the sheaths.
What are the symptoms?
MS has a wide range of symptoms. They are unpredictable and vary depending on the type of MS. They also vary from time to time in the same person. Symptoms may include fatigue, vertigo, clumsiness, muscle weakness, slurred speech, unsteady gait, blurred or double vision, numbness, weakness or pain in the face, tingling, temporary blindness, impaired sense of touch, incontinence, constipation and cognitive impairment. MS can affect any part of the body, though it usually starts with a single episode of nerve dysfunction, very often an inflammation of the optic nerve in one eye.
It is not uncommon too for MS patients to experience depression. And, as with so many things, good breathing techniques can make a difference here. Clinical trials at the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India, showed that regular practice of sudarshan kriya yogic (SKY) breathing reduces symptoms of depression and is as effective as the established anti-depressant drug, imipramine.
How many people have it?
MS is difficult to diagnose and symptoms can be completely invisible, but estimates suggest that about 18,000 Australians have this chronic disease and every year the number of people diagnosed increases by 7 per cent. Worldwide, MS affects about 2.5 million people.
Who does it affect?
Onset is usually between 20 and 40 years of age and it’s more common in women, with a ratio of two men to three women affected. MS more commonly affects people in temperate rather than tropical climates.
What causes it?
Not much research has been done on MS and the exact cause is not yet known. Doctors believe it’s caused by a combination of genetic and environmental factors. Although it isn’t primarily regarded as an inherited disorder, twin studies suggest the presence of certain genes can make one susceptible to it. Other factors, possibly a viral infection, may also play a part.
Yoga for MS
Yoga practices can vary from gentle and accommodating to strenuous and challenging. Hatha yoga is typically a gentler style of yoga, combining asanas (physical poses), pranayamas (breathing techniques), deep relaxation and meditation.
Practising yoga may not be able to cure MS, but it can certainly ease the crippling effects of it. Today, people with a wide range of medical problems use yoga as a way of managing their symptoms and coping more effectively.
“Yoga is beneficial for people with MS,” says Dr Maneesha Patel. “Yoga and breathing exercises help improve the muscular and skeletal systems, cultivating a positive state of mind … and that’s how they can get better.”
The effect of hatha yoga on MS patients was studied by the National Institute of Health in America. Results showed various areas of improvement, specifically in fatigue experienced by individuals with MS.
How yoga helped Eric
American yoga teacher, Eric Small, woke up one morning and couldn’t get out of bed. He was diagnosed with MS at age 21. His involuntary breathing stopped and he was put on a breathing machine.
Mesmerised by a man he saw doing yoga in a park, Small began studying it. His teacher gave him simple movements to do against a wall or on the floor. Although he still needed a cane to walk, he became stronger and more centred and the depression so often associated with MS lifted.
Small adopted a vegetarian diet and read extensively about hatha yoga and meditation. Later, he devised a system for doing yoga in the pool. Since people dealing with MS are warned not to get overheated, he believed yoga and swimming were a good combination — swimming cools the body and yoga calms the nervous system. When he was out of the water, he found that using props enabled him to hold the asanas (yoga poses) longer.
Small’s fatigue lessened, his digestion improved and he could walk farther. It’s been 25 years since he’s had a serious attack. Today, although he’s not cured or completely symptom free, he teaches and travels all over the world. He also supervises the Eric Small Yoga Program, providing free or inexpensive training to people coping with MS in southern California.
How sudarshan kriya yoga helped Gheeta
When Gheeta Pendharkar, 46, was diagnosed with multiple sclerosis she was absolutely shattered. “I didn’t know what MS was. My cousin knew someone with MS who was having herbal treatment in India, so I went there to do the same. I was crying day in and out, asking, ‘Why me, why me?’ My sister suggested I learn sudarshan kriya yoga (SKY). When I got back to Sydney, I turned on the radio and heard two men talking about it.
“Because of MS, my left eye had somehow become smaller than my right. It was like this for about 10 months. Then I learnt the sudarshan kriya. It’s a very beautiful and very effective breathing technique. The next morning, my daughter said, ‘Mum, what have you done? Your eyes are the same size now!’ I had double vision for about four or five months. I’ve been practising SKY for five years now. I don’t have much tingling, my eyes are normal and there’s no numbness in my body.”
In July 1998, a pilot study on the effectiveness of sudarshan kriya and its related yogic breathing practices in the treatment of multiple sclerosis was conducted at the Institute of Rehabilitation of the Republic of Slovenia. The study showed significant improvements in patients’ mobility, endurance levels and lung capacity as well as significant reductions in anxiety.
Anxiety and depression have been found to be co-factors in the progression of illnesses ranging from cancer to HIV to asthma and cardiovascular disease. The sudarshan kriya and related yogic breathing practices have been found to have remarkable therapeutic benefits.
One of the advantages of these simple yet powerful breathing techniques is they are free from negative side-effects, reduce the costs of health care and are easy to learn and practise in daily life.
“SKY is very helpful for fatigue related to multiple sclerosis” says Dr Richard Brown. “Although I still tire quickly,” says Gheeta, “I can use the breathing technique when I’m tired and feel revived quickly.”
SKY, a unique practice consisting of yogic breathing (ujjayi, pranayama, bhastrika and sudarshan kriya) together with yoga and meditation has been taught to over 6 million people. The positive attitude that often comes from practising SKY gives people tools for life. Committing to a regular program enables MS patients to feel they’re doing something positive and effective for their health and wellbeing.
It’s easy to notice Gheeta’s renewed enthusiasm. “I was a very negative person when I was diagnosed with MS,” she recalls. “I thought, ‘Nothing can be changed. It’s the end for me now.’ But SKY changed everything for me. I became much more positive. I am now happy with what I have. With MS you can get a bit jittery and stressed and really you cannot afford to get stressed when you have it. Doing the breathing for just 20 minutes every day helps me enormously.”
Yoga asanas for MS
The following sequence consists of classic asanas which Small adapted for people with disabilities caused by MS. Before you begin, here are a few guidelines to be aware of:
- It’s been observed that heat, stress and tension can cause temporary worsening of MS symptoms, so keep the pace of your yoga practice relaxed but focused — avoid going to the point where you’re sweating.
- Practise the poses at your own pace, never forcing or straining.
- Remember that the goal is to enjoy the practice, not to achieve a particular posture.
- Hold each pose for 10 to 20 long, deep breaths, then release and move with awareness to the next one.
- The ability to adapt the poses with props can be particularly beneficial with MS, since flare-ups can affect strength, balance, and co-ordination. Tailor your practice in accordance with your needs. If you’re in a period of remission and your balance is fine, you can do most of the poses practised in an ordinary class setting. During periods of relapse, modify your practice, utilising props, a chair and the wall wherever necessary.
Breathing
MS excites and fatigues the mind. Effortlessly keeping your awareness on your breath during your yoga practice allows your mind to relax and settle into the present moment.
Sit towards the front of your chair and place your feet firmly on the ground. If necessary, place a rolled-up blanket behind your back to support your spine. If your feet don’t comfortably touch the ground, place a blanket under your feet. If you’re tall, place a blanket on the chair seat to bring you into proper alignment. Be comfortable.
Sitting up straight, breathe evenly and effortlessly through the nose. Don’t force your breath. Keep observing your breath in a light manner for at least three minutes. Benefits: Relaxes the nervous system and prepares you for the asanas (yoga poses).
Downward-facing dog
Stand with your back to the wall and a chair in front of you, with the seat facing away from the wall. Fold a sticky mat into quarters and place it on the backrest of the chair. Cover it with one or two blankets. With your heels against the wall, bend from your hips and place your hands on the seat. Place the bottom of your pelvis, below the navel, on the back of the chair. Deepening the bend at your hips, rest your chest on the chair seat, hands on the floor. Your feet may go up the wall or be elevated on blocks, depending on your height and flexibility. Benefits: Relieves fatigue, improves circulation and brings fresh blood to the brain. This is a good posture to begin with for those who are mobile but have balance problems and for those who are weak in the arms or legs.
Wheelchair variation: Sitting six to nine inches away from the wall, lean forward and place your hands up on the wall, with your fingers spread. If possible, bend your legs. If you are short, you may be more comfortable with blocks under your feet.
Seated forward bend
Sit on one chair with another chair facing you. Pick up your legs with your hands and stretch your legs across the chair seats. Bend forward at the hips, resting your hands on top of the opposite chair back. Spread your fingers (don’t grip). Benefits: Releases tension in the lower back. Good for the bowels and digestive system.
Wheelchair variation: With the wheelchair locked and the safety belt fastened around the waist, place your hands firmly on the seat of a folding chair and push it away from you (if you are extremely stiff, place your hands on the chair back). Now push the chair diagonally, first away from the right knee, then away from the left. Benefits: Gives the body a cross stretch.
Cobbler pose
Place two chairs facing one another. Cover the seats with sticky mats. Sitting on one chair, draw your legs up and bring the soles of your feet together. Let your knees open away from each other. Hold onto the back of the chair facing you, keeping your spine erect. Benefits: Strengthens the urinary tract and relieves sciatic pain.
Warrior pose
Support your right buttock and most of your right thigh along the very edge of a chair or wheelchair. Place your right foot directly under your knee. Kneel with your left knee on the floor or supported by a block. If necessary, tall people can pad the seat with a blanket to get more height.
Make sure your left buttock is off the chair, inner thigh pressed into the edge of the seat. If necessary for balance, rest your hand on the back of a second chair. If possible, raise one arm, then the other. Repeat on the other side. Benefits: This pose opens the chest and builds strength and balance.
More mobile variation: Square the shoulders and hips as much as possible. Raise your hands over your head, keeping your biceps in line with your ears. Press your sitting bones firmly into the chair. Straighten the back leg so the knee comes off the ground.
Triangle pose
Stand with your feet about a leg’s length apart. Place your left heel, right buttock, both shoulders and head against the wall. Turn your right foot parallel to the wall as close as is comfortable. Stretch your arms straight out to the sides. Lift your left hip and bend from the right hip. If you can’t comfortably reach the floor, place your hand on a block or chair. Raise your left arm, balancing against the wall. Repeat on the other side. Benefits: Strengthens the legs, tones and cleanses the liver, kidney, heart and lungs.
Spinal twist
Sit sideways on the right side of a chair, feet directly under your knees. (If you are tall, you can put a blanket on the seat. If you are short, put one under your feet.) Raise both hands in the air, biceps close to your ears. On the exhalation, bring your arms parallel to the floor, shoulder height, and turn your torso to the right. Keeping your knees together, place your hands on top of the chair, elbows wide. Gently pulling with the left hand and pushing with the right, keep twisting a little more on each exhalation. Repeat on the other side. Benefits: Relieves backache.
Backbend
Place a sticky mat on the seat of your chair. Sit with your buttocks on the edge of the chair, shoulder blades resting on the back of your chair. Keeping your feet on the floor, extend your legs, lift your toes up and push your heels forward. (You might want to place a rolled-up sock between your shoulder blades to encourage the dorsal spine to move inward,) Clasp your hands behind your neck, pointing your elbows toward the ceiling. Benefits: Opens the chest, aids breathing and counteracts the tendency to roll the torso forward and down. Wheelchair variation: Sit with your buttocks toward the middle of the seat, keeping the knees bent. Stretch up and bring your elbows toward the ceiling. Benefits: This variation mostly stretches the upper back, while the previous variation stretches the entire length of the spine.
Legs up the wall
Place a bolster or several folded blankets four to six inches away from the wall. Sit sideways on the edge of the blankets, left hip touching the wall. Lie on the blankets with your neck and shoulders resting on the floor. Lift your legs one at a time so your buttocks and legs rest against the wall. Relax completely. Release your arms out to the side, palms facing up. Enjoy the pose. When ready to come out, bend your knees and count to 30. Roll off the blanket and count to 30 again. If it’s difficult to get to the floor, do the pose in bed, with your legs resting on the wall or headboard. Benefits: This restful asana relieves neck and back strain and improves circulation.