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YOGA AS A THERAPUTIC MODALITY
Yoga is a practical and powerful tool for the
prevention and treatment of chronic illness. The word “yoga” means “to unite” or ‘’to
yoke”. The practice of yoga unites the body and the mind by bringing
intelligence of the mind to improve the functioning of the body. Yoga
is a path to enlightenment that integrates mental and physical exercise
with nutritional and philosophical guidelines.
The basic principles taught in yoga are what
Dr. Kari Rollins refers to as the ‘Principles of Wellness’ these principles include
good posture, healthy breathing, and a ‘peasant’ diet:
Read on to see the benefits of these three principles.
Posture
Postural alignment must be understood as the
relationship the body has with gravity. Gravity is a very powerful
force that is rarely acknowledged as having any affect on the body.
It is a force that pulls the body toward the earth. The body can be
moved into an alignment that minimizes the work done to hold itself
in a “sea of gravity”. This alignment
will create less stress on joints and improve the functioning of internal
organs.
The philosophy of osteopathic medicine embraces
postural alignment as a key to the body being able to heal itself.
It is said, “structure
determines function”. This means that the health and functioning
of our internal organs is affected by the structure and alignment of
the musculoskeletal system. For example, if a patient has an exaggerated
kyphosis of the thoracic spine, this will affect the functioning of the
lungs. The kyphosis will interfere with movement of the diaphragm and
intercostals muscles will therefore limit lung capacity.
With perfect alignment, muscles have normal tone and are not required
to strain in order to support the body. On the other hand, without the
awareness of how to align our body, we tend to collapse. Fatigue, gravity,
stress, negative emotions, etc. cause us to slump. With poor postural
alignment certain muscles become increasingly tense as they overwork
to hold the body up. Opposing muscles grow weak. The imbalance of muscle
tension causes increase wear and tear on joints.
It is easy to understand postural alignment by looking at plum lines
drawn through silhouettes of the body. As an architect might look at
a building and say that it is structurally sound or not, physicians can
learn to screen for structural problems, and teach patients how to correct
them. Think of the body as being made up of a series of blocks stacked
one on top or the other. Structural health requires that the center of
gravity of each block representing the body (the head, chest, abdomen,
and legs) sit in a stable relationship with gravity. The center of the
head (which is usually the ear) should sit over the center of the shoulder.
The center of the shoulder should sit over the center of the hips. The
center of the hips should sit over the center of the feet. Structural
soundness also implies balance or symmetry between right and left sides
of the body.
The next important concept to understand about musculoskeletal alignment
is that the balance of muscles in our body determines structural alignment,
not our bones. Muscles move our bones and hold our body up. Bones create
length. Flexor muscles that pull the body forward must balance extensor
muscles that pull the body backward. Side bending and twisting muscles
must be balanced for symmetry right and left sides. This will prevent
the spine from twisting of pulling to the side.
With perfect alignment, muscles have normal
tone and are not required to strain in order to support the body. On
the other hand, without the awareness of how to align our body, we
tend to collapse. Fatigue, gravity, stress, negative emotions, etc.
cause us to slump. With poor postural alignment certain muscles become
increasingly tense as they overwork to hold the body up. Opposing muscles
grow weak. The imbalance of muscle tension causes increase wear and
tear on joints. I often use the analogy of having the front end of
a car out of alignment. Everyone knows that tires will wear unevenly
and wear out faster. The same physics apply to the joints in the body.
If you observe people in a shopping mall or grocery store, you’ll see that very few have a sense of how to
hold the body erect. It’s not difficult to see why most people
end up stooped over in their old age.
Postural alignment can be corrected by gradually strengthening weak
muscles and stretching contracted, shortened muscles to bring the body
back into balance. Centuries ago yoga was developed to address postural
health. Hatha yoga can be summarized as a highly sophisticated method
for aligning the spine. Working with gravity, the systematic stretching
and strengthening exercises begin to loosen tendons, muscles, and fascia
that have become contracted and tightened. As muscles regain their suppleness
and strength, the body regains freedom of movement. A more efficient
and comfortable posture becomes possible. What at first feels awkward
or difficult (standing up straight) becomes a habit, and the new posture
becomes the norm.
My training in osteopathic medicine emphasized
treating structural problems with manipulative techniques. Manipulative
therapy can be very helpful, but it means that you rely on someone
else to “fix” you.
Yoga gives you the tools to fix yourself. The practice of yoga produces
remarkable changes in the body because it becomes integrated into how
you sit, stand, breathe, and think all day long. Improved health comes
through not only better joint health, but improved circulation of blood
and lymph, better oxygenation, and optimal placement of internal organs.
The result is more efficient functioning of all systems on the body including
muscular, respiratory, circulatory, digestive, endocrine and nervous
systems.
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Breathing
Because breathing is a function that occurs without conscious thought,
we may easily take it for granted. Few people think of using breathing
as a tool for improving health. However, intelligent control of the breath
can improve the functioning of both body and mind. The breath is the
link between the body and the mind and therefore gives us conscious access
to unconscious processes in the body. It is the key to improving our
response to stress.
Breathing is both voluntary and involuntary, and it gives us conscious
access to our involuntary nervous system. For example, when you inhale,
heart rate increases, and when you exhale, heart rate decreases. This
occurs because the pericardial sac is attached to the diaphragm. When
inhaling there is a tug on the sinu-atrial node and the heart rate increases.
When you exhale and the diaphragm rises, the heart rate will decrease.
By consciously lengthening exhalation, you can learn to slow down heart
rate. Remember also that the involuntary nervous system is divided into
sympathetic and parasympathetic components. We know that under stress,
the sympathetic nervous system is aroused, and we breathe faster. The
simplest intervention to diminish the adverse affects of chronic stress
is to consciously calm the sympathetic nervous system by breathing slower
and deeper. The ability to consciously shift the functioning of the nervous
system is a powerful tool for treating and preventing many chronic illnesses.
There is no “right way’ to breathe. You can use the breath
to stimulate the body or calm the body. In order to learn to use the
breath, you must gain awareness of and strengthen the muscles of respiration.
The primary muscle of breathing is the diaphragm. Breathing with the
diaphragm requires the least effort and is the most calming. When you
inhale, the diaphragm contracts expanding the lower ribcage and upper
abdomen. When you exhale, the diaphragm relaxes and as it rises, air
moves out of the lungs. I tell my patients to watch a baby breathe. They
don’t move their chest, the move their belly. Breathing with the
diaphragm fills the lower portions of the lung. Intercostals and neck
strap muscles are accessory muscles of breathing and are used to fill
the upper portions of the lung. They are used to take a deep breath.
The muscles of respiration should be able to fill the lungs from top
to bottom, side-to-side, and front to back.
Healthy breathing requires strength in the
muscles of exhalation. If you don’t empty stale air, there’s
no room for fresh air. The most common lung ailments such as asthma
and emphysema are diseases where the lungs suffer from over-inflation.
The abdominal wall must be able to pull back toward the spine to effectively
empty the bottom of the lung. This movement of the abdominal wall also
gives stability and support to the low back. Intercostals and shoulder
girdle muscles assist in emptying the top portions of the lung. Strong
muscles of exhalation enable you to slow down breathing to calm the
body.
Pranayama is a highly sophisticated system for using the breath to optimize
health. The effects of changing and improving breathing can be applied
to multiple health problems including heart disease, hypertension, lung
disease, stress disorders, gastrointestinal disease, ADD, depression,
and musculoskeletal problems. The affects of breathing may be subtle
at first, but the effects are breathing are cumulative and profound.
It is said in yoga that you age as fast as you breathe. Learning to breathe
slowly and deeply quiets the mind and turns our attention inward to become
more conscious of inner processes. Healing from within only occurs when
we are quiet and listen to our bodies.
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Diet
If I had to consolidate my idea of a healthy
diet, it is to eat like a peasant. Recognizing that diet must be individualized
and that no diet is good for everyone, there are general concepts that
apply to everyone. If you look at the diet of healthy people cross-culturally
and throughout history, a consistent pattern of healthy eating can
be seen. It is a simple plant-based diet that consists of primarily
beans, grains, fruits, vegetables, nuts and seeds. Animal products
and sweets are used sparingly with the exception of special occasions.
For example, a Mediterranean peasant’s meal might include pasta,
lentils, and salads. An Indian peasant might eat curried vegetables,
rice, and dahl (lentils). A mainstay in the diet of the Chinese people
is tofu, rice, and vegetables. Each cultural group has a tradition
of beans and grains that they build their meals around using locally
grown fruits and vegetables as well as unique flavorings and spices.
In our culture, affluence allows us to indulge
in special occasion food on a daily basis. As we overindulge ourselves
by eating too much food and food that is too rich, we tax our bodies
and the planet. Remember that part of the moral and ethical codes taught
in yoga are about nonviolence and freedom from greed. Dietary principles
taught in yoga begin with embracing these principles. The peasants
of the world have no choice but to eat simply. For us it must be a
conscious choice. Yoga teaches you to refrain from eating more than
you need. Be conscious of where your food comes from and what affect
it has on you. Minimize the suffering of other living beings in the
process of sustaining your own life. We all kill things in order to
survive. As we breathe we kill microorganisms. But we can eat in such
a way that we minimize waste and suffering. It’s
no mistake that the simple foods that promote individual health allow
us to live lightly on the earth. The philosophy of yoga asks us to see
nutrition in this global sense and connect our individual self with our
universal self.
Without preaching, I tell my patients to think about eating low on the
food chain.
Energy From the Sun |
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Photosynthesis
Plants > CHO
Produce
Carbohydrates |
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Animals Consume Plants
(1% Consumer) |
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Animals Consume Animals
(2% Consumer) |
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V |
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Energy Loss |
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Energy Loss |
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Energy Loss |
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The food chain is a term used by biologists to describe how energy is
transferred from sunlight which strikes the earth, to the food nourishing
our bodies. Sunlight is transformed into plant starches by the process
of photosynthesis. These plant starches feed animals and humans. Energy
is lost at each stage in the food chain. For example, plants only use
30% of the sunlight that reaches the earth. Furthermore, it takes 16-20
pounds of grain to make one pound of meat. The production of one pound
of meat also requires 2,500-6,000 gallons of water, while one pound of
wheat requires only about 60 gallons. Vegetables will feed about 10-20
times more people than meat. Therefore, when we eat low on the food chain,
eating mostly plants, we are conserving energy. We also protect ourselves
from environmental pollutants through this discretion.
Concentration of pollutants and toxins increases at each step on the
food chain as energy decreases. For example, if it takes 16-20 pounds
of grain to produce one pound of meat, and the grain that was fed to
the cow was sprayed with pesticides, the body ingests a concentrated
residue from the entire 21 pounds of grain when one pound of meat is
consumed. One pound of wheat contains far less residue.
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Benefits
Benefits of eating low on the food chain include global and individual:
- Food that is environmentally cleaner and more efficient ecologically
- Optimal transit time
- Maintains stable blood sugar
- Good for the heart
- Low in saturated fats and cholesterol
Abstracts
Diabetes: A study of response pattern of non-insulin dependent diabetics
to yoga therapy.
Jain SC, Uppal A, Bhatnager SO, Talukdar B.
Laboratory Division, Central Research Institute for Yoga, Delhi, India.
Diabetes Res Clin Pract 1993 Jan; 19 (1):69-74
“Changes in blood glucose and glucose
tolerance by oral glucose tolerance test (OGTT) after 40 days of yoga
therapy in 149 non-insulin-dependent diabetics (NIDDM) were investigated.
The response to yoga in these subjects was categorized according to
a severity scale index (SSI) based on area index total (AIT) under
OGTT curve. One hundred and four patients showed a fair to good response
to the yoga therapy. There was a significant reduction in hyperglycemia
and AIT with decrease in oral hypoglycemia and AIT with decrease in
oral hypoglycemic drugs required for maintenance of normoglycemia.
It is concluded that yoga, a simple and economical therapy, may be
considered a beneficial adjuvant for NIDDM patients.”
Asthma: Study of pulmonary and autonomic functions of asthma patients
after yoga training.
A. A. Khanam, U. Sachdeva, R Guleria and K. K. Deepak
Department of Physiology, All India Institute of Medical Science, New
Delhi
Indian Journal of Physiology and Pharmacology, Oct 24, 1996
“The concept of yoga is helpful for the treatment of Bronchial
Asthma has created a great interest in the medical research field. In
order to investigate whether autonomic functions and pulmonary functions
are improved in asthma patients after short term yoga training, a study
was conducted with nine diagnosed bronchial asthma patients. Yoga training
was given for seven days in a camp in Adhyatma Sadhna Kendra, New Delhi.
The autonomic function tests to measure the parasympathetic reactivity
(Deep Breathing test, Valsalva Maneuver), Sympathetic reactivity (Hand
Grip test, Cold Pressure test), and pulmonary function tests FVC, FEV1,
PEFR, PIF, BHT and CE were recorded before and after yoga training. The
resting heart rate after yoga training (P<0.05) was significantly
decreased (89.55 +/- 18.46/min to 76.22 +/- 16.44/min). The sympathetic
reactivity was reduced following yoga training as indicated by significant
(P<0.01) reduction in DBP after HGT. There was no change in parasympathetic
reactivity. The FVC, FEV1, PEFR did not show any significant change.
The PIF (P<0.01), BHT (P<0.01) and CE (P<0.01) showed significant
improvement. The results closely indicated the reduction in sympathetic
reactivity and improvement in the pulmonary ventilation by way of relaxation
of voluntary inspiratory and expiratory muscles. The “comprehensive
yogic life style change programme for patients of Bronchial Asthma has
shown significant benefit even within a short period.”
Obsessive Compulsive Disorders: Clinical case report: efficacy of yogic
techniques in the treatment of obsessive compulsive disorders
D. S. Shannahoff-Khalsa and L. R. Beckett
Research Group for Mind-Body Dynamics, University of California, San
Diego, La Jolla Calif
International Journal of Neuroscience, March 1996
“The aim of this study was to investigate
the clinical efficacy of yogic techniques in the treatment of eight
adults with obsessive-compulsive disorder (OCD). A specific yogic breathing
pattern has been prescribed for the treatment of OCD, as well as others
for treating generalized anxiety. A one year course of therapy was
followed. Subjects improved on the Yale-Brown Obsessive-Compulsive
Scale (Y-BOCS) comparing baseline with three, six, nine and twelve
month results (one-way ANOVA for repeated measures, F(4, 12) = 3.343,
p, .001), anxiety (t = 3.167, p, .051), and global severity indexes
(t = 7.314, p = .005). Perceived Stress Scale scores showed significant
improvement for the five test periods (one-way ANOVA for repeated measures,
F(4,12) = 9.114, p.”
Epilepsy: Effect of Sahaja yoga practice on seizure control & EEG
changes in patients of epilepsy.
U. Panjwani, W. Selvamurthy, S. H. Singh, H. L. Gupta, L. Thakur and
U. C. Rai
Defence Institute of Physiology & Allied Sciences, New Delhi, India
Indian Journal of Medical Research, March
“The effect of Sahaja yoga meditation
on seizure control and electroencephalographic alterations was assessed
in 32 patients of idiopathic epilepsy. The subjects were randomly divided
into 3 groups. Group I (n = 10) practiced Sahaja yoga for 6 months,
Group II (n = 10) practiced exercises mimicking Sahaja yoga for 6 months
and Group III (n = 12) served as the epileptic control group. Group
I subjects reported a 62 per cent decrease in seizure frequency at
3 months and a further decrease of 86 per cent at 6 months intervention.
Power spectral analysis of EEG showed a shift in frequency from 0-8 Hz
towards 8-20 Hz. The ratios of EEG powers in delta (D), theta (T), alpha
(A), and beta (B) bands, i.e., A/D, A/D = T, A/T and A+ B/D + T were
increased. Per cent D power decreased and per cent A increased. No significant
changes in any of the parameters were found in Groups II and III, indicating
that Sahaja yoga practice brings about seizure reduction and EEG changes.
Sahaja yoga could prove to be beneficial in the management of patients
of epilepsy.”
Carpal Tunnel: Yoga-based intervention for Carpal Tunnel Syndrome: A
randomized trail.
M Garfindel, A Singhal, W. Katz, et al
The Journal of the American Medical Association, November 11, 1998
“A simple yoga program – no drugs, no expensive equipment,
and no surgery – was better than conventional treatment at reducing
pain and improving the hand strength of patients with Carpal Tunnel Syndrome,
according to a new study at the University of Pennsylvania Medical School.
The randomized, single blind, controlled study included a yoga group
and a group who only received wrist splints, the most common form of
treatment. The yoga group took a 1.5 hour class twice a week. They performed
simple postures designed to take each joint of the upper body through
its full range of motion, stretching, strengthening and aligning the
hands, wrists, arms and shoulders. After eight weeks, the yoga group
had significantly less pain and greater hand strength, whereas the control
group experienced no significant reduction in pain or increase in hand
strength.”
Heart Disease: Intensive Lifestyle Changes for Reversal of Coronary
Heart Disease
Dean Ornish, M.D., Larry W. Scherwitz, PhD, James H. Billings, PhD,
MPH, K Lance Gould, MD, et al
Journal of the American Medical Association, December 16, 1998
“The study was a follow-up to the groundbreaking Ornish’s
Lifestyle Heart Trial. The original trial found that after one year,
heart patients who made intensive lifestyle changes had a 37.2 percent
reduction in LDL cholesterol (“bad” cholesterol), less frequent
angina (chest pain), and a reduction in stenosis (narrowing of the blood
vessels). By contrast, patients who made moderate changes reduced LDL
cholesterol by only 6 percent, had more frequent angina, and greater
stenosis. Among the 48 patients from the original study, 35 agreed to
take part in the follow-up and continued through the entire five years.
An experimental group who made intensive changes in diet, exercise, stress
management and other lifestyle factors, including yoga, showed greater
reversal of coronary heart disease after five years than patients who
followed a program advocated by the American Heart Association.”
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