According to the Center for Disease Control and Prevention, 50 million Americans suffer from arthritis, and many more live with chronic pain that limits their mobility. This inflammatory joint condition is the nation’s leading cause of disability according to the publication Yoga Therapy Today. The debilitating symptoms include pain, swelling, and joint stiffness – and yoga offers the promise of relief for many who suffer.
Therapeutic Yoga Instructor Nancy O’Brien and a rotating crew of specially trained teachers has taken it on as their specialty and offer a Yoga for Arthritis and Chronic Pain class at Integral Yoga Institute on Wednesdays from 4:00-5:30. As a yoga instructor who lives with this chronic pain myself, I was intrigued.
Nancy’s journey to yoga began with a serious “medical mis-adventure.” As she lay bed-ridden, therapeutic yoga teachers taught her breathing and meditation techniques, and coached her into reclining versions of poses like tree. “Yoga gave me such a sense of hope,” she recalled. “It totally transformed my recovery.”
“The deep relaxation is the most important part,” Nancy told me. “It allows people to become the ‘witness.’ They can breathe into the pain and recognize that maybe they need to rest, or that a little bit of stretching could help. It’s not that the pain goes away completely, but as they let go of the protective wall around it, they gradually are able to increase their range of motion, improve their circulation, and get more nutrients and minerals into the joints to relieve the inflammation.”
I entered Integral’s Gold Room primed to experience this relaxation response for myself. I joined a small group of women who were splayed blissfully over bolsters in goddess pose. Nancy and her assistant
Pamela Padmashri Young (who is also one of the rotating class teachers) were meticulously attentive to everyone’s needs, delivering abundant props to cushion us in each pose.
Nancy suggested that we choose one of two techniques to encourage slow mindful breathing: softly blow out as if through a straw; or make the sound of the ocean (ujjayi) on the exhale. Nancy had us emerge from the juicy restorative with gentle joint movement to lubricate the synovial fluid. “With yoga, we transform the synovial fluid from ‘hard-boiled egg’ stage – where the connective tissue is too dry and brittle – to a liquefied state where it can flow and allow for greater and less painful movement,” she said.
“Don’t move through pain,” Nancy frequently reminded us. “Respect the pain, and soften around the edges so the body feels safe to release.” She suggested that students practice some gentle motions if pain wakes them up in the night, or to alleviate morning stiffness: “Interlace your fingers and make figure 8’s with your elbows. When you lead with your elbows, your shoulders can relax and do less. The clasp of the hands allows movement in the finger joints that doesn’t require muscular effort.”
Many of Nancy’s techniques came from Steffany Haaz, RYT, and Research Coordinator with the Johns Hopkins Arthritis Center who conducted a seven-year study documenting improvements in joint health, mobility, and mental/emotional well being for arthritis patients. The International Association of Yoga Therapists provides links to numerous other studies that show yoga’s effectiveness.
As the poses gradually progressed in intensity Nancy made sure that no one was left behind. She demonstrated a traditional cat/cow, while Padmashri showed how to perform the same spinal movement sitting on a chair. Padmashri demonstrated sun salutations with chair support while Nancy talked us through the sequence. In our peak pose of ardha candrasana at the wall we used two chairs: one in front for the supporting arm and one behind for the lifted leg.
For savasana, a tower of bolsters supported us under our knees while Nancy talked us into a deeply restful state. We concluded class with alternate nostril breathing and meditation. The restorative benefits of this class were profound. I climbed slowly back into a semi-verbal state to talk with some of Nancy’s students about their experience.
Milta Torres, a consistent student for the past 5 months, described the sense of accomplishment yoga has given her. An a-ha moment was when she first achieved Dancer pose with her back leg supported on a chair, and her arms moving freely overhead. “I have more trust in my body now,” she said. “I’m not afraid to move. I can lift my arm forward and to the side. It’s healing.”
Nadine Hoffman recalled how she used to swim and take Pilates until arthritis pain in her shoulder forced her to stop. Yoga allowed her to get back into exercise again. “With yoga I can work the parts of my body that are not affected by the arthritis. My physical therapist measured increased strength in my arms, and I notice the improved flexibility in my entire body.”
“On my own I tend to work too hard,” said Rachel Wells, one of Nancy’s newest students. “Nancy’s emphasis on the concept of ‘ahimsa’ [non-harming] gave me permission to do less. I thought I was going to be crippled – now yoga is helping me to feel hopeful about my ability to keep moving.”
Nancy believes that with ObamaCare the “time has come” for integration of yoga in our health care system. She envisions a future where anyone with a doctor’s diagnosis is “given a prescription on a pad that says ‘yoga.’ ”
To increase the pool of yoga instructors qualified to teach arthritis patients, Nancy and Steffany offer a Yoga for Arthritis Teacher Training Intensive at Integral. The training will show certified yoga instructors how to tailor individual yoga programs to this receptive population. Topics include helping people safely up and down from the floor, guiding students into Yoga Nidra, and offering modifications for common poses with props like wedges, straps and the wall.
“Some people might consider this type of work to be ‘yoga light,’” Nancy reflected. “But I think of it as the deep heart of yoga. It brings optimism and a sense of calm that far surpasses what a doctor with a pill can provide.”
In Milta's words, “Yoga for arthritis is focused on the individual. It’s not about doing a perfect pose. It’s finding the pose that’s perfect for you.”
For more information about Arthritis-Friendly Yoga click this link to see DVD and other materials prepared by the Arthritis Foundation.