Arthritis & Yoga

Previously people with joint pain and swelling were advised by doctors not to move! The thinking was “If it hurts, don’t move it.” We now know that inactivity is one of the worst responses for someone with arthritis. Arthritis restricts movement. Yoga-Meditation increases the range of motion. Drugs, surgeries, and steroids can alleviate some of the discomforts, but study after study 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 often debilitating condition caused by years of wear and tear on the joints, is often wrongly considered to be a normal part of aging, just a side effect of living longer. Arthritis makes normal activities increasingly painful and difficult and diminishes or destroys the quality of life.

The word arthritis means “joint inflammation.” Modern medicine recognizes many  varieties of conditions that produce deterioration in joint structures. Arthritis-related joint problems may include pain, stiffness, inflammation and damage to joints. Joint weakness, instability and visible deformities may occur, depending on the location of the joint involved.

Arthritis is classified into two main types. Rheumatoid arthritis is a chronic inflammatory disorder, 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 whose joints are painful from extreme overuse.

Arthritis and Exercise

To remain healthy, muscles and joints must move and bear weight or they will lose strength. This weakness, coupled with joint swelling, will make the joints unstable. Joints in this condition are vulnerable to dislocation, increased injury and pain. Thus, regular gentle movement helps to reduce pain and to maintain mobility.

Physical movement promotes health in many systems of the body. It increases circulation, which in turn reduces swelling and promotes delivery of oxygen and nutrients to the tissues. With immobilization, a cycle of deterioration begins.

Because movement is crucial to so many physiological processes, the arthritic person’s overall health tends to deteriorate without it. The normal functioning of the immune system declines, infections and illnesses occur, and the person often becomes frustrated and depressed. This cycle is self-perpetuating.

Physicians are increasingly advising regular gentle exercise for people with arthritis because it tones muscles and reduces stiffness in joints. Yoga is an ideal form of exercise for this because its movements are fluid and adaptable. Yoga loosens muscles that have been tightened by inactivity, stress and tension. In yoga we progress gradually, beginning with simple stretches and strengthening poses and advancing to more difficult postures only as we become stronger and more flexible.

If necessary, you can begin with gentle movements while sitting in a chair or lying on the floor. You can gradually add weight-bearing standing postures, with the support of a wall, counter or table, wall ropes, chairs, blocks, and other props.

It’s important to note that weak muscles are considered a risk factor for osteoarthritis. Be especially aware of weakness in the quadriceps, the large frontal thigh muscles: The weaker the quadriceps, the higher the risk of developing osteoarthritis in the knee. Yoga standing poses are valuable for strengthening the quadriceps without wear and tear on the hip and knee joints.

Practicing Pranayama or  breathing exercise, which is a crucial part of yoga practice, can help improve respiration markedly. Calm, slow, rhythmic breathing helps to release both physical and emotional tension by flooding the body and brain with oxygen. The regular, daily practice of deep relaxation is restorative to every cell of the body.

The positive effects yoga can have on mood and overall outlook are especially important to someone with arthritis. A yoga class offers positive support and the opportunity to connect with people who are health-minded and have experienced the benefits of yoga. Numerous studies emphasize the value of group support in coping with health challenges such as arthritis.

With arthritis, as with any injury or disease, listen to your body with focused attention to avoid injury and determine which movements are most healing.

Guidelines for Practicing Yoga

1. Respect pain. All yoga students, especially those with arthritis, must learn the difference between the beneficial feeling of muscles stretching and the pain that signals harm. Learn to distinguish between the normal discomfort of moving stiff joints through range of motion, and the pain caused by a destructive movement or an excessive demand on a joint. Sudden or severe pain is a warning. Continuing an activity after such a warning may cause joint damage. In general, if pain and discomfort persists more than two hours after a yoga session, ask a knowledgeable person to check your alignment and help you modify the pose. Try moving more slowly, practicing more regularly and experiment 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 so that a healthy change has been made but not so long that your body stiffens from staying in a position too long.

2. 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, fatigued muscles set the stage for joint instability and injury. Balance your active yoga session with yoga’s deeply relaxing restorative poses, like Shabasana or Corpse Pose. Restorative poses are passive poses that help your internal healing processes to work. If you are fatigued, practice restorative poses first. You will benefit more from active, more challenging poses, if you are well rested.

3. Practice with focus and awareness (pay attention to how you feel) and breathe properly.  Watch the flow of your breath and your body’s response to a particular pose or exercise. Without fully expanding your lungs, the muscles you are exercising cannot be adequately supplied with oxygen. Holding your breath while stretching inhibits relaxation. Smooth, peaceful, rhythmic breathing through the nose reduces pain and tension and increases the feeling of deep 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 and 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 themselves.

Yoga for Arthritic Hips and Knees

The areas most commonly affected by arthritis are the hips, knees and hands. With decreased movement, the muscles and soft tissues around the hip shorten, putting additional wear and tear on the gliding surfaces. If 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 stability and support for the knee. When the soft tissues of the joint swell, this causes compression and reduces space in the joint even further.

Standing poses are crucial for stretching and building supportive strength in the hips, buttocks and thighs. Moving the head of the femur in the hip socket helps distribute synovial fluid, thus lubricating the joint and all points of contact.

The same standing poses recommended for hips are also critical for knee rehabilitation. They create more space in the knee joint for synovial fluid circulation and develop the strength of the thigh and calf muscles for better support. Sit on the Floor Every Day!

The positive effects yoga can have on mood and overall outlook are especially important to someone with arthritis.