Yoga - the antidote to arthritis and a key to healthy aging

Yoga - the antidote to arthritis and a key to healthy aging

When I first became interested in yoga and therapeutic exercise forty years ago, I was helping an elderly woman who was immobilized in her wheelchair by arthritis. Long before I understood the power of yoga to rehabilitate the body, I was helping people who couldn't dress, bathe, or feed themselves because of the pain and stiffness in their joints. This helped me understand the extreme suffering that arthritis can cause.

At that time, people with joint pain and swelling were advised by doctors not to move! The thought was, “If it hurts, don’t move it.” We now know that inactivity is one of the worst reactions for someone with arthritis.

Like Dr. Loren Fishman emphasizes in his book,Yoga for arthritis“Arthritis limits movement, yoga increases range of motion – these two were made for each other.”

Arthritis is the leading cause of disability in this country, limiting the everyday activities of millions of people. Medication, surgery, and steroids can relieve some of the discomfort, but study after study has shown that exercise is most beneficial for most forms of arthritis, especially low-impact, flexibility-improving exercises like yoga.

Osteoarthritis, a painful and often debilitating condition caused by decades of wear and tear on the joints, is considered one of the side effects of living longer. By the time we reach age sixty-five, for at least a third of us, X-rays will show some signs of osteoarthritis, the most common of a group of diseases collectively called arthritis.

The Center for Disease Control and Prevention estimates that arthritis in its many forms affects more than seventy million (or one in three) American adults.

Arthritis is so common in our culture that most people view the pain and discomfort it brings as a normal part of aging. Arthritis makes normal activities increasingly painful and difficult, impairing or destroying quality of life.

An Overview of Arthritis

The word arthritis means “joint inflammation”. Modern medicine recognizes more than a hundred different conditions that lead to deterioration of joint structures. The common thread among these conditions is that they all affect the joints—those nearly 150 intricately designed structures where two or more bones come together.

Joint problems related to arthritis can include pain, stiffness, inflammation, and joint damage. Joint weakness, instability, and visible deformities may occur depending on the location of the affected joint.

Arthritis is divided into two main types. Rheumatoid arthritis is a chronic inflammatory disease that causes joint and muscle stiffness, joint erosion, and pain. Osteoarthritis is a degenerative disease that erodes the cartilage in the joints and causes the bones to rub together. Osteoarthritis often occurs in people who are overweight or whose joints are painful due to extreme overuse.

Despite the prevalence of arthritis, be careful not to jump to the conclusion that your painful joints are necessarily due to it. Overuse and injury can also lead to tendonitis, bursitis, carpal tunnel syndrome, and other fairly common conditions not related to arthritis.

Arthritis and exercise

To stay healthy, muscles and joints must move and support weight, otherwise they lose strength. This weakness, combined with swelling of the joints, makes the joints unstable. Joints in this condition are prone to dislocation, increased injury and pain. Regular gentle movements help to relieve pain and maintain mobility.

Physical exercise promotes health in many body systems. It increases blood flow, which in turn reduces swelling and promotes the delivery of oxygen and nutrients to tissues. Immobilization begins a cycle of deterioration.

Because exercise is critical to so many physiological processes, the arthritic person's overall health deteriorates without it. The normal functioning of the immune system decreases, infections and illnesses occur, and the person often becomes frustrated and depressed. This cycle continues.

When someone comes to me with arthritis, I teach them how to practice yoga safely with the support of yoga props. For those new to yoga, the term “yoga props” simply refers to any object, such as a wall, a sturdy table or chair, a folded blanket, a firm pillow, a strap, or any other item that makes practicing yoga safer and easier. Yoga props are especially helpful for older beginners who may have balance issues and are dealing with common health issues like arthritis and osteoporosis. In addition to common household items that can be used as yoga props, there are professional yoga props such as a sturdy wooden pole known as a “yoga horse,” yoga wall ropes, yoga pads of many shapes and sizes, yoga straps, special yoga chairs, yoga blocks, solid yoga blankets, and more sophisticated props such as Yoga backbenders that give new hope and confidence to people with arthritis and other common health conditions.

Doctors are increasingly advising people with arthritis to engage in regular gentle exercise as it strengthens muscles and reduces joint stiffness. Yoga is an ideal form of exercise for this because its movements are fluid and adaptable. Yoga loosens muscles that have become tight due to inactivity, stress and tension. We progress gradually in yoga, starting with simple stretches and strengthening poses and moving on to more difficult poses as we become stronger and more flexible.

If necessary, you can start with gentle movements while sitting in a chair or lying on the floor. You can gradually add supporting stances by supporting a wall, counter or table, wall ropes, chairs, blocks, and other props.

The weight-bearing yoga standing poses are among the key poses for safely increasing range of motion in all joints as well as increasing strength and flexibility.

It is important to note that weak muscles are considered a risk factor for osteoarthritis. Pay particular attention to the weakness of the quadriceps, the large front thigh muscles: the weaker the quadriceps, the higher the risk of developing knee osteoarthritis. Yoga standing poses are valuable for strengthening the quadriceps without wearing out the hip and knee joints.

Practicing yoga can help improve breathing throughout the day. Calm, slow, and rhythmic breathing helps relieve both physical and emotional tension by flooding the body and brain with oxygen. The regular, daily practice of deep relaxation restores every cell in the body.

I encourage people with arthritis to seek out an experienced teacher who can help you differentiate between good and bad pain and make yoga a part of your daily life.

Yoga's positive effects on mood and overall outlook are particularly important for people with arthritis. A yoga class provides positive support and the opportunity to connect with people who are health conscious and have experienced the benefits of yoga. Numerous studies emphasize the value of group support in managing health problems such as arthritis.

With arthritis, as with any injury or illness, listen to your body with focused attention to prevent injury and determine which movements are most healing. Take lessons from a teacher who is knowledgeable about arthritis. If you're new to yoga, I recommend taking a few private lessons if possible, or starting in a small group class with individual instruction where you can practice at your own pace.

Guidelines for practicing yoga in the classroom and at home

1.Respect the pain. All yoga students, but especially those with arthritis, need to learn the difference between the soothing feeling of muscle stretching and the pain that signals harm. Learn to differentiate between the normal discomfort of moving stiff joints through range of motion and the pain caused by destructive movement or excessive strain on a joint. Sudden or severe pain is a warning. Continuing an activity after such a warning may result in joint damage.

In general, if pain and discomfort persist for more than two hours after a yoga session, ask a knowledgeable teacher to check your alignment and help you modify the pose. Try moving slower, practicing more regularly, and experimenting with how long to stay in a pose. There is no set answer to the perennial question, “How long should I stay in the pose?” Stay long enough for a healthy change to be made, but not so long that your body stiffens if you stay in one position for too long.

2. Balance work and rest. The balance between activity and rest applies to yoga as well as other daily activities. Do not train to exhaustion. Stop before you're exhausted! Weakened, tired muscles set the stage for joint instability and injury. Combine your active yoga session with the deeply relaxing poses of yoga. Restorative poses are passive poses that support your internal healing processes. If you are tired, practice restorative poses first. You'll benefit more from active, challenging poses when you're well-rested.

3. Practice with focus and awareness (pay attention to how you feel) and breathe properly.Avoid mechanical repetitions and counting during exercise. Observe the flow of your breath and your body's response to a particular pose or exercise. Without full expansion of your lungs, the muscles you are exercising cannot receive enough oxygen. Holding your breath while stretching inhibits relaxation. Gentle, peaceful, rhythmic breathing through the nose reduces pain and tension and increases the feeling of deep relaxation after a yoga session. Learn to tune into what your body is telling you.

4. Learn how to use yoga props.People with arthritis can be quite stiff even when starting yoga. The use of props helps improve blood circulation and breathing capacity. By supporting the body in a yoga posture, props allow muscles to lengthen in a passive, non-strenuous manner. Props help conserve energy and allow people to practice more strenuous poses without injuring or overexerting themselves.

Yoga for arthritic hips and knees

The areas most commonly affected by arthritis are the hips, knees and hands. When movement is reduced, the muscles and soft tissues around the hip shorten, causing additional wear and tear on the sliding surfaces. As a person becomes more sedentary to minimize pain, bone and cartilage receive less stressful stimulation. Bone spurs may even develop to further restrict movement.

Lack of exercise also weakens the thigh and calf muscles. Their strength provides stability and support to the knee. When the soft tissues of the joint swell, this causes compression and further reduces the space in the joint.

Standing poses are crucial for stretching and building supportive strength in the hips, glutes, and thighs. Moving the femoral head within the hip socket distributes synovial fluid, lubricating the joint and all contact points.

The same standing postures recommended for the hips are also crucial for knee rehabilitation. They create more space in the knee joint for the circulation of synovial fluid and develop the strength of the thigh and calf muscles for better support.

Sit on the floor every day!

I encourage all of my students, especially those with osteoarthritis of the knees, to sit on the floor in various positions with their legs crossed and other knees bent every day as part of their daily routine. This helps ensure that you don't lose the ability to sit comfortably on the floor. Sitting with your legs loosely crossed is a simple, natural position that helps eliminate stiffness in the hips and knees. Sit on one or more folded blankets, a firm cushion, a large dictionary, or a different height so that you can sit comfortably on the floor with your back straight. Avoiding sitting on the floor will only make your hips and knees stiffer over time.

A notice:If you have pain in your knees, increase the height under your buttocks so your pelvis is higher than your knees and place folded blankets or yoga blocks under your knees. A knowledgeable yoga instructor can help you adjust your props to make sitting on the floor easy and comfortable. Gradually increase the amount of time you sit and cross your legs in the opposite direction (opposite leg in front).

Caution:Don't put strain on your knees by trying to sit prematurely in more advanced, bent-knee positions like classic lotus pose. Forcing your body into any position can result in serious injury. If you experience pain, stop and consult a knowledgeable teacher.

Inspired by Suza Francina