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Yoga for ms: Yoga and MS | National Multiple Sclerosis Society

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Yoga and MS | National Multiple Sclerosis Society







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In this article

    Overview

    “Yoga teaches us to cure what need not be endured and endure what cannot be cured.” – B.K.S. Iyengar

    Yoga is an ongoing practice rather than an end in itself. The practice of yoga was written down thousands of years ago as a system to live a healthy, happy life. The word ‘yoga’ means to yoke or join together—uniting the mind, body and spirit. Joining physical poses with the breath, action with thought, and awareness with intention can bring peace to body, mind and spirit.

     

    The simple practice of breathing, something all of us do every day without thought, becomes a powerful tool when you can become aware of how your breathing affects every part of your body. As you learn how to focus awareness on your breathing, you can observe how your mind can feel calmer and your body more relaxed.

     

    Each pose is designed to support the body’s joints, muscles, structure and function. Every pose can be modified to its simplest form and can be practiced in a variety of positions. You can be standing, sitting in a chair or wheelchair, or even lying on the floor or in bed –- wherever you are most comfortable at that point in time. Visualization, which involves combining a breathing practice while imagining performing the poses, may also be beneficial for people with MS, including those with reduced mobility.

     

    Before you begin to practice yoga, speak with your healthcare provider(s) and discuss any questions or concerns that you or they may have. Be aware that any exercise can elevate the body’s core temperature and temporarily aggravate MS symptoms.

     

    The benefits of yoga can be experienced in just a few minutes of practice. You should always feel better after practicing yoga than when you started!

    A simple breathing practice

    Get comfortable—sitting or lying down; Breathe in slowly through your nose and then breathe out slowly through your nose. Cool air in/warm air out. Close your eyes and continue to breathe in this way for a few moments. Concentrate on your breath. If your focus drifts, bring your concentration back to your breath.

    Who can practice yoga?

         * If you have ever wondered whether yoga is something you can do, it is.

         * If you have ever wondered whether yoga is too difficult, it’s not.

     

    Each body is different – in its shape, strength, flexibility, mobility, height, weight, tension, energy level and ability – at any given time. Yoga is a flexible practice that can be modified to accommodate all of these variables.

     

    Support partners can also benefit greatly from practicing yoga. Taking the time to care for their own bodies and practicing strategies to reduce stress and relax are all very important for support partners as well. Strengthening and learning proper alignment can help when providing assistance to someone with MS, whether the assistance involves hands-on caregiving activities or household chores.

     

    Practicing together can be fun and gives you and your support partner better awareness of each other’s needs and abilities. In addition, more poses may be accessible to you with the assistance of your support partner. 

    Adaptive Yoga

    Adaptive Yoga adapts the instruction and practice of yoga to each body in a safe, comfortable, ‘makes sense’ way. Yoga can be accessible to everyone no matter how your body is at any moment.

    All the different styles of yoga ask you to ‘start where you are’. Only you know how it feels to be in your body. Adaptive Yoga helps you identify where that starting point is without making any judgment about it. For example, if you can’t lift your toes or your arm right now, you can adapt the pose to accommodate your body’s needs and abilities. Your abilities may be different from day to day, even hour to hour. Awareness of the changes always allows you to adapt the poses to “where you are.”

     

    The aim of practicing yoga is not to merely assume specific postures, but rather to combine breathing, posture, movement and awareness to achieve relaxation, body awareness and possibly other benefits.

    How can yoga help manage multiple sclerosis?

    Practicing yoga can give you tools to help manage everyday tasks that include balancing to stand or walk, strengthening and alignment for standing up and sitting down on a chair, toilet or bed, and core strength for everything you do. The relaxing benefits of yoga may also help manage the unique challenges of MS, such as lying in an MRI machine for extended periods of time, receiving injections or infusions, staying calm during an exacerbation and focusing when meeting with your health care professionals.

     

    Dr. Allen Bowling, in Optimal Health with Multiple Sclerosis, 2014 summarizes the existing research on yoga and concludes:

     

    “Yoga is relatively inexpensive, generally safe, and may potentially improve multiple sclerosis symptoms. One rigorous MS clinical trial found that yoga decreased fatigue. Other studies in MS and various other medical conditions have reported improvement in anxiety, depression, fatigue, bladder function, pain, spasticity, weakness and walking. There are anecdotal reports but minimal research on yoga and sexual function. For general health, yoga may improve arthritis pain, reduce blood pressure, and promote weight loss. The effects of yoga on these conditions may secondarily benefit those with MS because these conditions may worsen disability and lower quality of life in those with MS.”

    A simple posture practice

    Feel where your shoulder blades are on your back. Now, ‘slide’ the bottom points of your shoulder blades downwards toward your waist. Feel your shoulders lower and your chest open

    Meditation


    Meditation is stilling your mind and quieting your thoughts – taking notice of them without being distracted by them.

     

    Many people incorporate meditation into their practice of yoga. The physical poses of yoga prepare your body to sit in stillness for meditation. Sitting isn’t necessary, though. You can also meditate lying down.

     

    There is no single, correct way to meditate. You may already do it, but without calling it meditation. Walking can be a meditation practice. Knitting, gardening, observing the birds out your window or any other activity that causes you to narrow your focus can be meditative.

     

    Guided meditations can help you to focus your concentration and relax your body. Repeating a phrase or sound, focusing your gaze on one object–like a candle–or breathing slowly and intentionally are all different ways to focus concentration during meditation.

     

    The benefits of meditation address many of the issues faced by people diagnosed with MS. A research study published in 2011 that examined the effects of meditation on pain and quality of life in MS found that participants in the meditation group showed a significant improvement in pain scores and scores for overall physical health, mental health, vitality, and physical role.  

    Most studies tend to be small, however, and while they suggest a positive impact, the evidence is not always clear. More research is needed.    

    Dr. Alan Bowling’s review of the research on meditation and MS (Optimal Health with Multiple Sclerosis, 2014) concludes that:  

    “Meditation is a well-tolerated, low-cost therapy that may provide medical benefits without the use of medication. Limited studies indicate that meditation may be helpful for relieving stress, anxiety, depression, fatigue, insomnia, pain and cognitive problems. It also may improve self-esteem and feelings of control. For general health, meditation may reduce blood pressure and improve blood glucose control.”

    Finding a qualified yoga instructor


    There are many styles of yoga. Most yoga studios offer different styles and levels of classes. Finding the ‘right’ class for you is very important.

     

    Certified yoga instructors teach yoga classes in yoga studios, in private homes, and even in introductory workshops. Some people with MS who have found yoga to be beneficial have taken Accessible Yoga Training to become certified to teach others. To locate yoga classes and registered yoga instructors in your area, see the Additional Resources.

     

    It is beneficial to work with a qualified instructor when you begin to practice yoga to learn the proper alignments, adaptations specifically developed for your body and how to use props (blocks, straps, chairs, etc.) to assist you gently into the poses. Always ask the instructor you will be working with:

    • what their qualifications are,

    • how long they’ve been teaching,

    • what style of yoga they teach, and

    • if they have worked with people with special needs.


     The National MS Society offers an online course for wellness and fitness instructors, including yoga teachers, entitled Introduction to MS that provides important information about working with people with MS. (And is approved for continuing education credits through the American Council on Exercise. )

     

    Explain to your instructor how your body is feeling and what your individual needs are. Always stop any part of the practice that doesn’t feel right to you. Again, you should always feel better after a yoga practice than when you started!

     

    Even if you are not able to leave your home, there are books, videos and Internet streaming yoga resources available.

    Additional resources

    • Namaste – Momentum article

    • Therapeutic Yoga for MS Videos – a series of videos about yoga specifically for people with MS

    • Your Own Gentle Yoga Approach – free instructional Adaptive Yoga videos by Cherie Hotchkiss, E-RYT 200, Yoga Alliance Continuing Education Provider (YACEP), CMT. Cherie has been managing her own MS dx since 1999 and is an accessible yoga ambassador.

    • Yoga and Multiple Sclerosis: A Journey to Health and Healing – written by Loren Fishman and Eric Small

    Find Yoga Referrals

    • International Association of Yoga Therapists – IAYT is a professional organization for yoga teachers and yoga therapists worldwide. Visit the site to find yoga therapists and practitioners throughout the world (more than 3,500 listings)

    • Yoga Alliance – Yoga Alliance® is the largest nonprofit association representing the yoga community. Yoga Alliance provides an online search tool to locate Registered Yoga Teachers (RYTs) and Experienced Registered Yoga Teachers (E-RYTs). Search from more than 69,000 listings by location, yoga style or teacher’s name.

    • Yoga Finder – Visit the site to locate yoga classes and events throughout the world

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    5 Yoga Poses for People with Multiple Sclerosis | Yoga for MS

    Heading out the door? Read this article on the new Outside+ app available now on iOS devices for members!
    Download the app.

    A recent Rutgers University study found that women with moderate symptoms of multiple sclerosis experienced improvements in balance, walking, coordination, and quality of life after eight weeks of practicing yoga. If you have MS, these five poses from the research team are a great way to start a home practice or contact the National Multiple Sclerosis Society to find a class, teacher, or video based on your location and symptoms.

    Consult your doctor before starting a yoga practice, and begin with the easiest version of a pose before working toward the more challenging options. Seated versions can be done in a wheelchair or firm chair with a solid back, such as a folding chair, placed near a wall, on a yoga mat. If it is a metal or unpadded chair, you might want a firm folded blanket over the seat and through the back of the chair so it doesn’t slide. If at any time you are not able to physically perform a posture, you can picture yourself doing it, or if someone is available, have them help move you through it safely.

    Mountain Pose with overhead stretch

    Tadasana, variation 1

    Easiest
    Seated in a chair, root into your sit bones and feet. Extend up through your spine. Feel your spine lifting from your waist, heart lifted and open, shoulders soft, wide and released down from ears, and crown of head lifting with neck long. Place hands on thighs or on seat sides to support spinal lift if needed. Pause, breathe, and observe. With an inhale, gently, slowly, with awareness, raise your left arm overhead, or as high as you are able, reaching through your fingertips. Use your right arm to support your left arm if needed. Maintain your left arm up while exhaling and extend upward while inhaling. Lower your arm slowly with an exhale. Repeat the sequence, raising the right arm. Repeat, raising both arms. Pause, breathe and observe. Repeat if desired.

    See also8 Steps to Master and Refine Tree Pose

    Mountain Pose with overhead stretch

    Tadasana, variation 2

    More challenging
    Stand behind a chair with your back near or against the wall, hands resting on or holding onto the back of the chair. Root into your feet, rise up through your center. Feel your spine lifting from your waist, heart lifted and open, shoulders soft, wide and released from ears, and crown of head lifting with neck long. Pause, breathe, and observe. With an inhale, gently, slowly, with awareness, raise your left arm overhead, or as high as you are able, reaching through the fingertips. Hold onto or rest the right hand on the back of the chair. Maintain your left arm up while exhaling and extend upward while inhaling. Lower your arm gently with an exhale. Repeat the sequence, raising your right arm. Repeat, raising both arms if comfortable. Alternatively, if it feels comfortable and safe, face the wall and walk your hands up the wall to obtain the stretch. Breathe at the top of the stretch, and walk your hands back down while exhaling. Before you start, turn the chair so the seat is facing the wall and is directly behind you, in case you want to sit. Pause, breathe and observe. Repeat if desired.

    See also3 Ways to Safely Modify Tree Pose

    Mountain Pose with overhead stretch

    Tadasana, variation 3

    Most challenging
    Stand between the wall and the chair, facing the back of the chair. Root into your feet, rise up through your center. Feel your spine lifting out of your waist, heart lifted and open, shoulders soft, wide and released from ears, crown of head lifting with neck long. Rest your arms at the sides of your body. Pause, breathe, and observe. With an inhale, gently, slowly, with awareness, raise your left arm overhead, or as high as you are able, reaching through the fingertips. Maintain your left arm up while exhaling and extend upward while inhaling. Lower arm gently with exhale. Repeat the sequence, raising the right arm. Repeat raising both arms if comfortable. Pause, breathe and observe. Repeat if desired.

    See alsoSpring Forward Flow: Two Fit Moms’ Tree + Sun Salutations

    Forward Bend to waist height

    Uttanasana, variation 1

    Easiest
    From seated Tadasana, hands holding onto the sides of a chair, take a deep inhale and extend your spine upward. As you slowly exhale, bend forward toward your thighs, extending from the hips with a long spine. Stay here and inhale extending and exhale relaxing. On an inhale, with spine straight, return to sitting up, using your arms to help if needed. If comfortable, bring both arms overhead on an inhale and bend forward on the exhale, bringing your hands onto your knees, a chair seat, or to a wall in front of you. Inhaling with your arms raised, come back to sitting up straight. Lower your arms slowly with awareness, while exhaling. Pause, breathe, and observe. Repeat if desired.

    See also5 Steps to Master Standing Forward Bend

    Forward Bend to waist height

    Uttanasana, variation 2

    More challenging
    Stand behind a chair in Tadasana with your back near a wall, hands resting on or holding onto the back of the chair. Take a deep inhale and extend your spine upward. As you slowly exhale, take small steps backward so that you can bend your torso forward, keeping your head and shoulders at hip height or higher. Inhaling, stretch gently from your hands to your hips. If it feels appropriate and helpful, you can have your hips and heels against the wall. Inhaling, walk forward up to standing. Pause, breathe and observe. Repeat if desired.

    See alsoVIDEO: Standing Forward Bend

    Forward Bend to waist height

    Uttanasana, variation 3

    Most challenging
    Stand between a wall and a chair, facing the back of the chair. Root into your feet. With a deep diaphragmatic inhale, extend upward through your spine and raise both arms slowly with awareness. Exhaling slowly, with arms alongside your head, bend forward, extending from the hips with a long spine. Bring hands to the back of the chair. Inhaling, stretch gently from your hands to your hips and exhale relaxing into the stretch. On an inhale, with spine straight, and arms alongside your head, return to standing up. Exhale, lower arms to your sides. Pause, breathe and observe. Repeat if desired.

    See alsoStanding Forward Bend (Uttanasana) with Yoga Blocks

    Warrior Pose II

    Virabhadrasana II, variation 1

    Easiest
    Seated in a chair without sides, hold onto the right side of chair seat with right hand and slide to the left of the chair seat. Hold onto front of chair with your left hand just to the left of your right leg. Inhaling, extend your left leg back with your toes bent forward and grounding through the ball of your foot. Ground through your right foot in front of the chair. Rotate your torso to the left. Switch your left hand to holding the side or back of the chair and right hand to the front of the chair. Inhaling, extend up through your spine. Breathing diaphragmatically, get quiet in the pose. Inhale, rotate your torso front and bring your hands to the sides of the chair. Exhale, bring your left leg back to the front and move to the center of the chair. Pause, breathe, and observe. Repeat on the other side.

    See also Watch + Learn: Warrior II Pose

    Warrior Pose II

    Virabhadrasana II, variation 2

    More challenging
    Stand behind a chair in Tadasana with your back near the wall, hands resting on or holding onto the back of the chair. On an exhale, step your left leg out to the side toward the wall with your foot at about a 45-degree angle, with your heel into the wall. Leaving your right hand on the chair back, reach back with your left hand and place your palm on the wall with fingers pointing up. Place your forward (right) leg so it’s facing the chair and bend your knee at a 45-90 degree angle. Make sure your knee is over your ankle, not your foot. Tuck your tailbone slightly, let your shoulders be over your hips, and look out over your front arm. Breathing diaphragmatically, get quiet in the pose. Inhaling, straighten your front leg. Exhaling, bring your back leg to center under your torso. Exhaling bring your front leg back under you. Remove the left hand from the wall and bring it to the chair. Return to Tadasana with hands on the chair. Pause, breathe, and observe. Repeat with the right leg back at the wall.

    See also Work It: Chair Warrior

    Warrior Pose II

    Virabhadrasana II, variation 3

    Most challenging
    Stand between a chair and a wall in Tadasana. On an exhale, step your left leg out to the side toward the wall with your foot at about a 45-degree angle with your heel into the wall. Place your forward (right) leg so it’s facing the chair and bend your knee at a 45-90 degree angle. Make sure your knee is over your ankle, not your foot. Inhaling, raise both arms to horizontal, over your legs, reaching through your fingertips. Tuck your tailbone slightly, let your shoulders be over your hips, and look out over your front arm. Breathing diaphragmatically, get quiet in the pose. Inhaling, straighten your front leg. Exhaling, lower your arms and return to Tadasana. Pause, breathe and observe. Repeat with the right leg back at the wall.

    See alsoKathryn Budig’s Dancing Warrior Moving Meditation

    Cobra Pose

    Bhujangasana, variation 1

    Easiest
    Seated in a chair with your legs together, reach your arms back to hold your hands or wrists or elbows behind your back, or on sides of chair, or interlace fingers behind your head. Inhaling, lengthen up through your spine, arch from your heart area, pull your shoulder blades together and lengthen your neck. Breathe and get quiet in the posture. Exhaling, return to sitting up straight.

    See also Watch + Learn: Cobra Pose

    Cobra Pose

    Bhujangasana, variation 2

    More challenging
    Lying on your belly on a yoga mat on the floor, place small folded blanket under your chest across breast line. Place hands palms down on the blanket. Inhaling, gently push the torso up slightly, extending through the spine. Breathe and get quiet in the posture. Exhale and rest on the blanket. Pause, breathe and observe. Repeat.

    See alsoPractice Safe Stretch in Cobra

    Cobra Pose

    Bhujangasana, variation 3

    Most challenging
    Lying on your belly on a yoga mat on the floor, place hands palms down on the floor next to chest. Legs are together, muscles gently activated. Inhaling, gently push the torso up to the degree that is comfortable, extending through the spine. Breathe and get quiet in the posture. Exhaling, release gently back to floor. Pause, breathe and observe. Repeat.

    See also Bend Back Into Your Body: Cobra

    Twist

    Supta Matsyendrasana, variation 1

    Easiest
    Seated in a chair, on an inhale, lengthen your spine. On the exhale, gently revolve your torso to one side using the chair seat and back for support with your hands. Breathe and get quiet in the posture. Pause, breathe, and observe. Repeat, turning the opposite way.

    See also Ask the Expert: Do Twists Really Wring Out Toxins?

    Twist

    Supta Matsyendrasana, variation 2

    More challenging
    Lie on your back with both knees bent and feet on the floor. Place rolled blankets on either side from your hip past knee height. Stretch your arms out to the sides at shoulder height with palms down. Tucking and grounding your shoulder blades, inhaling, lengthen your spine. Exhaling, release knees to the left onto the blanket, look right. Breathe and get quiet in the posture. Inhaling, bring head and knees back to center. Exhaling, drop, knees to the right and look left. Breathe and get quiet in the posture. Pause, breathe, and observe.

    See also Try Jason Crandell’s New Twist on Twists

    Twist

    Supta Matsyendrasana, variation 3

    Most challenging
    Lie on your back with your left leg straight and your right knee bent. Extend your arms out at shoulder height, palms down, grounding through your shoulder blades. Inhaling, lengthen your spine. Exhaling, release your right knee to the left, look right. Place your left hand on your right thigh. Breathe and get quiet in the posture. Inhaling, bring your head and knee back to the center. Straighten your right leg and bend your left leg. Exhaling, release left knee to the right and look left. Breathe and get quiet in the posture. Pause, breathe, and observe.

    See alsoSpinal Tap: Incorporate Yoga Twists for Increased Energy

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