Sometimes our community members and website visitors write to us with specific questions about their medical condition and their yoga practice. We'll work to answer these questions on the blog as they come in.
"I have a condition not covered by the Index and need guidance. I have RA and it has destroyed my shoulder joints. I would love to do yoga again, but not sure what poses I can do that does not require use of arms. I can raise them no higher than chest level and have no strength for support. Any ideas would be greatly appreciated."
Yoga is wonderful therapy for rheumatoid arthritis (RA), so taking up Yoga again is a great idea. At least three studies exist in the medical literature looking specifically at the effects of Yoga for RA. A small pilot trial at the University of California at Los Angeles revealed reduced pain, improved functional ability, and better mental health in RA patients after a few weeks of practice. The two other studies revealed similar results. No studies on record offer a dissenting view.
For readers who are unfamiliar with RA, it is an autoimmune disease that leads to inflammation of the joints and surrounding tissues. In the long term, it can lead to severe joint pain and stiffness, and sometimes joint deformities. Since RA leads to varying patterns and degrees of disability, an individual assessment and plan is required at the outset for optimal effects and safety. If you can, work closely with a qualified Yoga therapist or Yoga teacher who understands your physical limitations. They'll be able to assess your capabilities and design a Yoga asana session around them, one that will enliven the body while building strength and balance.
Regarding the asanas, or poses, there are many that are accommodating for those with shoulder issues. Two of the four reported to be the most important in the Hatha Yoga Pradipika, bhadrasana (bound angle pose) and simhasana (lion pose), require no work of the arms. Other postures, like vrksasana (tree pose) and utkatasana (chair pose), can be slightly modified to fit your needs. For example, rather than holding the arms overhead, place the palms at the chest in prayer position in the former or straight in front of the torso at a comfortable level in the latter.
Asanas are only a small part of Yoga, just one of the eight limbs of Patanjali. Incorporating other limbs into your day will lead to additional benefits. A regular practice of pranayama (breathing exercises) and meditation balances the immune system. It's the immune system that's out of whack in rheumatoid arthritis, turning on itself to destroy the body it was designed to protect.
Reconnecting the mind and breath through practices like nadi shodhana pranayama, or alternate nostril breathing, will initiate healing. Nadi shodhana pranayama has been shown to have calming and relaxing effects on the physical body and mind in a way that relieves signs of stress and helps the body to cope with high levels of it over the long haul. We know from multiple studies that stress hampers the ability of the immune system to function properly.
Daily meditation is an important part of any serious Yoga practice. Its physical benefits have been proven in a number of studies over the past 45 years, and it's an amazing tool to ease the psychological challenge of living with a chronic and painful condition. A few minutes spent in meditation every morning can do wonders for those who suffer from any autoimmune condition, about 10 million individuals in the United States.
Adopting a regular Yoga practice, one that is suited to your particular physical condition and limitations, is one of the most important things you can do for yourself from a holistic perspective. It's a valuable path to self-healing.
During her frequent travels to India, Dr. Summers researches Yoga and its therapies. She enjoys uniting her two passions, Yoga and medicine, and is continually exploring Yoga's healing concepts and integrating them with modern, evidence-based care. Her primary Yoga influences have been the tantric styles of Sivananda and Agama. She holds a 500-hr Yoga teacher training certification. You can follow Dr. Summers on Facebook and Twitter.
Kathleen Summers, MD, PhD, is a contributor to Prevent Yoga Injury. She is a board-certified internist specializing in natural, Yoga-based care. Dr. Summers is a graduate of Northwestern University Medical School in Chicago and holds a second doctorate in neuro-pharmacology from Southern Illinois University. Currently, she is an Adjunct Clinical Instructor at Southern Illinois University School of Medicine, and she is a member of the American College of Physicians, the American Society of Nutrition, and the International Association of Yoga Therapists.