Arthritis affects your body in many ways. In this blog, I’ll discuss the physical repercussions of arthritis, healing arthritis, and how to support physical wellbeing through yoga. There is a remarkable relationship exists between arthritis and body weight throughout body structure. Your mood, hormones and digestion etc. are affected by both arthritis as well as yoga. Earlier prime focus of medical field was on biological aspects, but now it’s moving towards whole-person approach like Yoga Therapy. Anyone can practice Yoga, which includes its movements, yoga postures and breathing practice, as long as he can do, individually.
Misconception about Arthritis and Physical Movement.
Previously it was common believe that exercise enhance inflammation and worsen arthritis pain, however such conviction has been changed. Now, regular physical movement is recommended as essential element of arthritis treatment. While hard exercise is sometimes unbearable and not recommended for many arthritis patients, yet some exercises are vital for health-maintenance. This approach has been endorsed by OARSI (Osteoarthritis Research Society International), ACR (American College of Rheumatology) and Ottawa panel. It is recommended that stretching exercises like practiced in yoga, can progress stamina and helps to preserve physical capacity. Such movements help to fight pain and fatigue in arthritis. Appropriate yoga practice is an excellent healthy physical activity for arthritis patients.
It’s best for arthritis patients, who are suffering from pain and unfamiliar with yoga, to practice under supervision of yoga-teacher. If no teacher is available, no worries, you can start with gentle and beginner class. Avoid practicing yoga in large class or with inexperienced instructor or with DVD which is incapable to give individual guide. It’s better if yoga teacher is aware of your condition and provide you individualized attention. Once you’ve got familiarity and confidence with respect to modification and safe practice, you can practice it in various postures.
Yoga helps in different ways.
Yoga helps in reducing arthritis symptoms, defending mobility, prevention and addressing common comorbidity like hypertension, cardiovascular disease and obesity. Poses which includes holding your body, strengthen muscles. Exercise includes moving joints, enhances flexibility. Similarly, standing postures support balance by stabilizing your muscles and reduce falls. Overall, yoga includes many exercising aspects that are beneficial in arthritis disease.
Stress management tips are advised to deal with chronic illness challenges and prevent the cycle of inflammation, psychological-stress and immune dysregulation. Further yoga’s non-competitive and slow nature is right for such disease which, over time, potentially enhance in physical limitations. Yoga also teaches self-acceptance and non-harming approach towards movement choices. In this way arthritis patient feels trouble-free and remains healthy and active for many years.
Obesity, Arthritis and Yoga.
Life with less movement ends with obesity which plays vital role in arthritis. There is a relationship between inactive lifestyle and overweight, and this makes arthritis worse. Due to arthritis disease, immobility and fatigue further contribute to this cycle. It is said:
If you don’t use it, you lose it.
Actually, with the progress of muscle wasting, alongside continual loss of body function and strength, it also increases inflammation. There is less probability of arthritis in adults with lower BMI (body mass index), than overweight adults. Increased BMI means more friction and pressure on hips and legs joints (common effected sites for OA).
Poor physical activity.
Although, less physical activity and inactive lifestyle are risk factors for arthritis progression, but arthritis is associated with limited movements. As of 2017, approximately 24 Million US adults have both arthritis-attributable activity limitations and doctor-diagnosed arthritis. Potential joint destruction and pain associated with arthritis further translate into difficulty with a range of activities. Such troubles affect quality of life, thereby limiting the independent life, ability to work and even participating leisure activities. Due to swelling and pain, reduced activity level further causes loss to functional ability. That’s why arthritis patients are susceptible to comorbidities. As per CDC (Centers for Disease Control and Prevention) around 1/3rd of obese adults also have arthritis. Over, 54 Million of adults in USA (approximately 23% of population) are suffering from arthritis.
Arthritis and obesity aggravates each other.
Arthritis and obesity worsen each-other. More patient is overweight, there’ll be more stress on his joints and painful the activity. Therefore, arthritis patient should avoid hard exercise and more weight as it worsens the arthritis. Each pond of excess weight wields four pounds of pressure on the knees. Obesity is a significant risk factor for Osteoarthritis.
Yoga Therapy for arthritis.
You may have been advised by some health professional to avoid from yoga, but such advice is based on misinformation. It is the responsibility of yoga practitioners and professionals to inform medical community about therapeutic role of yoga. As per dignity of yoga practice, yoga therapists must comply with HIPPA laws and standard procedures of healthcare professionals.
Arthritis patients should also consult their healthcare in order to understand as what should be adapted or avoided, in yoga. On the other hand yoga professional should also reach-out to medical providers for collaborative care and better communication.
Ethical Approach of Yoga postures.
Each principle of yoga can be applied to yoga postures as they applied to everyday life. These ten principles are:
- Non-harm to your body.
- Be truthful about the limits of your body.
- Don’t steal health by being pushing too hard or self-critical.
- Don’t grab for skills that are not present at the moment.
- Accept the things as they are, and preserve your energy for healing.
- Don’t strive for something that is not available rather its struggle would create harm.
- Purpose of yoga should be to maintain health.
- Be satisfied during practice.
- Balance it with controlled and disciplined effort to keep yoga practice a daily routine.
- Study different philosophical aspects of yoga and observe how instructions relate to your body, emotions, energy, mind and spiritual-life.
If you are aware of these guiding ethics, complete yoga practice will gain richness, depth and safety.
Joints adjustment and adaptations.
One should have to follow guidelines to keep joints protected during posture practice. Best measurement is message from your own body. If someone is doubtful as to how extreme to go into a position, he may do this gradually. If, God forbid, you have arthritis here are things to consider.
Just make sure that you don’t flex or hyperextend the neck. Don’t fall the head backward. Make sure, while tilting the head back you have muscular control. Instead of looking straight up your head, you may support head with hands and looking little upward.
It is practical to keep arms lower than the height of shoulders. Even you are comfortable with raising arms overhead just make sure to keep shoulders movable. While arms coming up, shoulder should not be tense or compressed. Arms may be in shape of wide “V” or with bent elbows. With the passage of time, biceps would come closer to ears while keeping shoulder blades comfortable down the back.
It is very much important to preserve natural curvatures and length of spine. In seated poses, it is best if person sit on a cushion or block on the points of sitz bones. Make sure that in both, extension and flexion, spine is not twisting, rather the curve is even beside the spine’s length. Just imagine you are forming the back over a ball, instead of creating break at specific location in the back. A supple bend in knees, further decreases the burden upon the back. Don’t use arms to compel a twist in back or to press into a backbend. Rather allow the movement and strength to come from torso and use your arms and hands just for support.
Make sure in an unstable position don’t lock the elbows. Just make a slight bend and perceive the strength in muscles through your arms. Be aware of elbows, particularly with postures which require weight-bearing though your arms. Instead of doing practice on the floor, at first it is best you consider using chair or wall for support.
Just like wrists, hands are also very much sensitive for weight-bearing yoga poses. You can place your forearms on a slab and lose your hands over the border. Try different ways of holding your hands. Some prefer to press palms, interlock fingers however, some prefer to hold the writs in hand and then alter sides. Relax sitting pose (Mudra posture) can be difficult, therefore be aware and familiarize yourself as per need. Make sure that, to mobilize your hands to avoid hardness.
People with arthritis are more sensitive in their wrists. There are plentiful variations and alterations to maintain safety of your wrist joint and keep it comfortable. Instead of pulling the palms down on the floor, try to come onto forearms placed on chair or fists. As palm pose can be an extreme direction for the wrist. In order to make the twist more comfortable and accessible, a folded towel can be placed underneath your palms.
In many yoga poses, hips are involved. It is best to control the pressure on hips in stretching shape, by changing orientation of pose. For example you can change posture from seated, legs on the mate, to lie down, with legs in the air. External rotation of hips and Reduction of flexion can create more easiness. Similarly instead of practicing on the floor, sitting on a chair may be preferable.
Beware, and don’t twist or hyperextend knee with arthritis disease. Just keep knees straight with ankles or hips. If knees come out of your toes, change the pose in a way that feet are underneath your knees. Just like elbows, it is good to have little bend in knee so that leg muscles may support the posture. In all poses where knee is holding weight, you must have a well cushion underneath your joint e.g. folded blankets.
Methods which you used for wrists can also beneficial for ankles. Putting a folded blanket under the heels facilitates to reduce the pressure on lower joints and provide immense support. Some postures require the ankles to be at positions which you never use in daily life. In such case, you may choose different direction for ankles.
Conventionally yoga is performed barefoot. However, some students might observe this as easy, however others need facility of athletic footwear. In order to enhance awareness of movement and position of your body, it is beneficial to exercise often bare feet. This will also limit the risks of fall as feet grow more sensitive with the ground.
Ahead of Posture adjustments.
In arthritis disease, no posture is definite. You may modify postures as affordable to you. To modify, you may curtail the movement or adaptations as mentioned above. It is much important to experiment with wide of range of postures alteration, because symptoms of arthritis may vary.
The important thing is to recognize the spirit of each yoga posture. Synchronize your yoga posture with your mind. Before practicing each step you should ask yourself that why are you practicing this pose? It may be some physical feeling, like creating calm sense or mental calm. There is no particular exact answer of any pose and each posture provides numerous options. Two different adaptations of a posture may look different but reach the same purpose. Similarly two similar postures might be different regarding their purpose, energy and physical effects. Irrespective of abilities and limitations, anybody having mind and body can practice yoga.
Notice the feelings and respond to your Pain.
During yoga practice, try to listen to your body signals and feelings. Arthritis patient, often lives with constant pain, therefore it is important to ignore so that you can perform daily life. However, you must be conscious to avoid any harm. Any posture which enhances pain must be avoid or at least limit.
For arthritis patient, it is natural to observe uneasiness and commotion in any new activity. Strengthening of muscles may feel burning, stretching muscles may tingle. But these feelings are not as arthritic joint pain.
Observe and perceive the amount of commotion, either it is dull or sharp ache or killing pain. If it is dull or sharp ache, it may be natural due to increasing physical fitness. However, if you are feeling severe pain, then it is a warning sign that your posture requires alteration or should be stopped. There are multiple options for any posture and none is better than other. With the passage of time you may develop skill of mindfulness, and will be able to distinguish between commotion and pain.
- Guidelines for the Management of Rheumatoid Arthritis (2002).
- “Yoga in the Management of Overweight and Obesity.” Published in American Journal of Lifestyle Medicine by Bernstein, A.M. et al. (2014).
- Gut Microbiota-Host Interactions and Juvenile Idiopathic Arthritis, by Arvonen, M et al. (2016).
- “Decreased Bacterial Diversity Characterizes and Altered Gut Microbiota in Patients with Psoriatic Arthritis, Resembling Dysbiosis in Inflammatory Bowel disease” by Scher, J.U, et al. (2015).
- Ingestion of Lactobacillus Strain Regulates Emotional Behavior and Central GABA Receptor Expression in a Mouse via the Vagus Nerve. By Bravo, J.A. et al. (2011).