We all know - and have possibly heard it said multiple times (not just in this blog series) - that yoga is good for the body; that it can support myriad conditions and is even a type of preventive medicine. But what exactly are the benefits of yoga for arthritis? And - what exactly is arthritis?
Let me enlighten you.
There are various forms of arthritis, although the most common is osteoarthritis (OA). This is the wear-and-tear variety of arthritis that tends to affects the fingers joints, back, neck, knees and hips.
In an affected join, the protective, lubricating cartilage is worn down and damaged, causing pain and swelling as bone rubs on bone in movement. This damage occurs through bad posture, old sports injuries, repetitive work habits (such as holding a phone between ear and shoulder) and genetic factors. It affects men and women equally and tends to occur in later years.
Less common is rheumatoid arthritis (RA). This is an autoimmune inflammatory disease that leads to inflammation - swelling and redness of the joints. If left unchecked it can lead to joint deformities as the body continually builds bone in the affected area in response to the inflammation. According to the Iyengar specialist, researcher and author Marian Garfinkel, women are more likely to develop RA and it can come on at an early age.
What are the Benefits of Yoga for Arthritis?
From a yogic understanding wear and tear on the joints, the factors that cause damage to the joints, is caused by how the body moves, sits and stands.
Misaligned movement causes undue, uneven wear on the joints as a result of a misalignment of bones, poor posture, dysfunctional movement patterns and a lack of body awareness. All these factors overlap and combine to degrade the cartilage surrounding the bone joints. And all of these are issues that yoga can help to correct.
“Yoga is one of the most effective ways to improve posture ever invented.”
- Marian Garfinkel
In fact, the meditative, mindful practice of yoga-asana is particularly effective to help prevent or minimise the erosion of the cartilage in OA and reduce inflammation in RA. It increases an easier range of movement and decreases pain in the affected joints.
Increasing movement is a key factor in how yoga supports the arthritic body. It is tempting, when in pain, to avoid movement in the affected joints. However, it has been shown that a lack of activity weakens muscles and thus further exaggerates loss of joint movement. This vicious cycle is referred to as “decreased range of motion.” Gentle movements under the supervision of a qualified yoga practitioner can end this cycle.
Additionally, for those of you whose arthritis is severe, the practice of yoga (including breath work, meditation and mindfulness as well as asana) can teach you how better to cope with any pain that cannot be fully irradiated. Seasoned meditators seem equipped to regulate their reaction to pain - still feeling the pain yet being less affected by it.
Another benefit of yoga for arthritis is that regular asana practice can help you become aware of maladaptive patterns of movement and help to change them. Because of the nature of yogic movements it serves to build body awareness. Unless you have a background in dance, or similar discipline, you possibly have little idea of what your knees or hips are doing when you sit, stand or walk.
Do you notice how your kneecaps track when you bend your knee along a certain axis of movement for example?
Or do you notice your back, neck and shoulders as you sit at your laptop, or repeatedly look down at your device?
The good news is that yoga can get you out of any unhealthy grooves (known as samskaras in Sanskrit) both figuratively and literally.
Effectively, and even more beneficially, yoga works as a form of preventative medicine for arthritis by taking your joints through a wide range of motion, introducing new and healthier samskaras (grooves) in your body-mind. On a physiological level this movement spreads the lubricating synovial fluid which is continually secreted into the joint by the synovial lining, when in motion. This covers the surface of cartilage that overlays the bones. A well lubricated cartilage surface means that the joints glide over each other, reducing wear and tear.
“Asana is also great preventative medicine. Most people who aren’t actively working to maintain flexibility in their muscles and other tissues, and range of motion in their joints become more restricted as they age.”
- Marian Garfinkel
Moreover, joint movement brings a fresh supply of nutrients into the cartilage, which is not served by a direct blood supply. This works with what yogis call the “wring and soak” principle. Imagine the cartilage between your bones as a sponge that is squeezed by the movement of your joints. Spent synovial fluid that has been depleted of nutrients in wrung out of the joint as it moves. When it returns to a neutral position and the compression is released, the stale fluid leaves, bringing in a fresh supply of fluid to the area.
Any areas of the joint surface that area rarely used, being outside the habitual grooves of movements cease to get the nutrients they need. This means that over time they start to degenerate; hence the expression “use it or lose it.”
Stress and Arthritis
Arthritis isn’t simply a mechanical issue; it is also rooted in the mental grooves, patterns of thinking and the unconscious beliefs you hold. The effect of unhealthy or unsupportive beliefs and patterns is to cause dis-ease, and stress in the body. Stress contributes to a worsening of symptoms in OA and as it increases muscle tension, stress contributes to flare-ups in RA. Studies show that muscle tension is a major cause of pain in arthritis.
In fact, Dr Jon Kabat-Zinn, the founder of the Stress Reduction Clinic at the University of Massachusetts Medical Centre, appraised a ten week program teaching haha yoga and mindfulness meditation to fifty one people with chronic pain in the back neck and shoulders. The group’s pain had not improved with conventional medical care.
Half the participants had a fifty percent reduction in pain, and sixty five percent had a third reduction in their pain scores. There were also large improvements to mood and other symptoms. What is more, the participants who continued their practice following the program, demonstrating long-term improvements in function.
Practices To Support Arthritis
A holistic approach to arthritis includes bringing awareness and changes to diet and lifestyle to reduce inflammation and increase movement in the body. According to Timothy McCall MD in Yoga As Medicine, this includes:
Ginger and turmeric, used in cooking and as a tea, is a traditional Ayurvedic arthritis remedy, both have anti-inflammatory properties.
Drink plenty of water to keep your synovial fluid hydrated.
Eat a diet low in harmful fats and rich in whole foods such as nuts, grains, vegetables and fruits. Aim to eat a rainbow of whole foods; whole foods contain a wealth of vitamins and antioxidants that can reduce arthritic symptoms.
Include a natural source of omega-3 oil in your diet - they reduce inflammation. Good sources include, flaxseeds and flaxseed oil, and oily fish such as mackerel, salmon, tuna and herring.
Avoid fried food, trans-fats, refined sugar and red meat.
Some practitioners hold that the vegetables in the nightshade daily, namely potatoes, tomatoes, peppers and aubergine can exacerbate arthritic symptoms and and contribute to flare ups.
Cognitive Behavioural Therapy or Emotional Freedom Technique are both effective and gentle therapies to learn coping strategies, resolve stress, and process unhelpful or limiting beliefs.
Acupuncture is safe and offers effective pain relief.
Swimming, walking or another form of aerobic exercise is beneficial.
Yoga Poses To Support Arthritis
If you are managing arthritis it is advisable to move in and out of poses rather than hold them (it can place undue stress on the joints).
Keep your transitions slow, smooth, coordinated, and with your breath.
Don’t be tempted to jump into poses.
Come out of a pose if you experience muscle weakness of shakiness - tired muscles are not able to hold good alignment, so you risk further damage to the joint.
Where possible work with a fully qualified teacher who can guide you through modifications and alternatives to poses to support your body to build strength and length slowly and sustainably.
When deciding on a sequence of poses or an individual pose is appropriate for you take careful notice of how you feel both during and after. An increase to your usual level of stiffness a couple of hours afterwards can be a sign that you need to scale back your practice.
Build up slowly, eliminating poses and gradually incorporating them as your strength and suppleness increases.
Supported Savasana, Relaxation Pose
Benefits: This is an advanced pose owing to the still, meditative aspect that offers. It is very beneficial in gently opening the chest and encouraging the release of stress and tension.
How To: use folded blankets for both elevation and softness in this variation.
Fold a blanket and place it lengthways on your mat to support your torso and head. Sit in front of the blanket, but not on it, and lean backwards so as you lower on to your mat the blanket is contacting your body from the waist upwards.
Place a second folded blanket under your head to support your head and neck.
Roll a blanket or towel with a diameter to around 10cm and place under the backs of your knees to support your lower back and knee joints.
Close your eyes, breathe and relax for ten minutes, or longer should you wish.