Yoga for Arthritis: The science of Yoga

Take a deep breath and get started - Yoga for Arthritis could be your key to reduce pain

Yoga is a mind and body practice with its historical origins in ancient Indian philosophy. Like other meditative movement practices used for health purposes, various styles of yoga can combine physical postures with breathing exercises and meditation. The word ‘yoga’ means union. It unites the mind, body and spirit. Those who get into a regular schedule of yoga invariably experience many health benefits. Studies have shown the intrinsic value of dynamic exercise programs - with yoga and Tai Chi in particular helping to ease the symptoms of rheumatoid arthritis. These same studies also suggest that practising yoga regularly might have other health benefits - like reducing heart rate and blood pressure as well as in the relief of anxiety and depression.

The evidence is clear

The evidence is clear that, when combined with a program of good medical care, yoga may provide important additional physical and psychological health benefits for people with arthritis. Many RA sufferers who have taken it up and stuck with it - maybe for years - consider it to be an important part of their lifestyle and disease management. Yoga can be a safe and effective form of physical activity, but as with any new activity, it is important to take proper precautions. Talk with your doctor first and ask specifically if there should be any limitations or restrictions he thinks you should observe. For arthritis patients it is important to discuss your wish to take up yoga with your rheumatologist or orthopaedist. You’ll want to find a yoga instructor with a lot of experience, ideally one who has worked with people with RA. The most committed instructors are registered with the Yoga Alliance, based in the US, in which teachers bear the designations E-RYT 200 (completing a training regimen and teaching for a minimum of two years) and E-RYT 500 (even more qualified and four years plus of teaching). An experienced yoga teacher will know how to help you modify poses and, as important, won’t hold you back from doing what you are able to do. The experts suggest starting off with a private session or two with a yoga therapist, so you can learn adjustments to poses that work for you before you enter a main class.

Approved yoga styles for RA

People with certain types of arthritis are advised to look for these schools of yoga:

• Iyengar Yoga - This method emphasizes precision and alignment in each posture, along with correct breathing techniques. A Iyengar instructor might suddenly shift your foot half an inch to put your hips in the proper place, which prevents you from putting excess pressure on the joints. Poses are typically held for a few minutes. The classes themselves include props which are particularly helpful for people with limited mobility.
• Hatha Yoga - Technically refers to all forms of yoga involving postures. The term has however come to mean slower-moving classes - each pose is held for at least a few breaths. Separate breathing practices, known as pranayama, and a brief period of meditation are also typically included. With Hatha it’s easier to figure out how to modify poses that affect your joints. A deep relaxation period ends each session.
• Restorative Yoga - An adaptation of Iyengar yoga, this practice is all about relaxation. Poses are held for five minutes or more with bolsters and blankets used to ensure each pose is comfortable. It allows you to get into a mental and physical state of deep rest. But don’t confuse restorative yoga with yin yoga, another practice that holds poses for a long time and aims to push the joints to their limit to improve flexibility. These stretches that can be too severe for people with RA.

Styles to avoid

On the subject of yoga styles RA suffers should avoid, there’s Bikram. Indian guru Bikram Choudhury developed this precise style, in which 26 specific yoga postures are done in a room kept at 105 degrees Fahrenheit and with 40 percent humidity! Its totally fatiguing, something people with RA don’t need more of, and the Bikram poses doesn't allow for much adaptation. In fact, some of the poses particularly stress the joints. Exercise enthusiasts are often drawn to vinyasa classes which encompass poses linked in a dynamic, flowing practice that is more aerobic than other yoga types. Instead of a hold you might immediately move into a twist, then a different stretch, then another - and so it goes on. Also, unlike the relaxing music you’ll find in most yoga classes, music here is often fast and furious to accompany the quick-paced movements. While in theory a class of flowing movements can be fine for someone with RA, the face pace just doesn’t allow much time to alter poses that put pressure on the wrists or ankles. There are a small number of specialty vinyasa classes available that are geared for people with joint pain and in these classes participants are often able to use chairs.

Weight loss, diabetes and yoga

A person can burn anywhere between 200-500 calories during an hour of yoga but other forms of exercise may help to more efficiently burn calories. However, the secret to weight loss and regulation of sugar with yoga may come from a different mechanism. Studies have shown the benefits of yoga in decreasing blood sugar levels in patients with diabetes. These yoga-based exercises are not based on aerobic activities but mostly on postures which are designed for spinal twisting and increasing intra-abdominal pressure. New hormones produced by the intestine have been discovered only recently – namely, incretin hormones. These stimulate insulin secretion in response to meals. The two most important incretin hormones are called glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The increase in intra-abdominal pressure from various yoga poses and the response from the intestinal nervous system may promote a rise in these hormones, subsequently promoting weight loss and regulating diabetes.

Hypoxia for better health

Pranayama is an ancient Indian yogic technique of regulation of breath included in the daily routine of the yogis. It involves gradual training of the respiratory apparatus for prolonging the time of being able to hold the breath. In the yogic practice there are more than eight types of Pranayama, which involve breathing through one or the other nostril, or through the rolled tongue made like a tube. The breath is held after inhaling, let out in expiration, or somewhere between the two in rhythmic sequencing. Medical research shows that there are benefits of induced hypoxia and hyperventilation for short periods of time. It’s also well documented that these breathing techniques can reduce anxiety and improve the mood. Many studies have demonstrated that yoga reduces the disease activity scores in RA patients as well as improving spine flexibility, range of motion and provides for the actual strengthening of joints.