Yoga Therapy for Parkinson's Disease and Multiple Sclerosis. Jean Danford
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focus
•Encourage the students to hold the balance. This challenges balance, strength and core strength.
Side bends
Instruction
1.Walk your hands around to the right and then to the left, as if you are looking at your ‘tail’.
2.Stretch along the sides of the body and open up the ribs.
3.Hold and breathe into the stretch.
4.Repeat a few times.
Knee circles
Instruction
1.Stabilise over three points and lift one bent knee out to the side.
2.Lift the knee up out and around, moving the hip joint.
3.Repeat on the other leg.
CAT POSE ADAPTATIONS
These can be used if the student is unable to kneel.
Instruction
1.Using a chair, stand facing the chair and bend to rest the hands on the chair (blocks can be used to adjust height). Legs should be parallel. The spinal movement can be done from this position, but the legs may need to be slightly bent, if the hamstrings are tight. If the chair option is not suitable, a standing Cat Pose could be an alternative – that is, with knees slightly bent, bend forward a little to rest the hands on the thighs, just above the knees.
2.From this position start the spinal ‘cat’ movements.
Cat Pose is a wonderfully useful posture as it can be done by almost everyone and has the benefit of working the spine, easing back pain and improving coordination.
Hip sway in Cat Pose
Instruction
1.With the knees together and arms apart, swing the hips over towards the floor to the right, and then to the left. This creates a ‘slalom’-type action, and is helpful in the ability to transfer to and from the floor.
LYING WARM-UPS
Starting the session in a lying-down position is always a popular option. It gives the student time to arrive, to put the journey aside and to steady the breathing. It allows the teacher time to observe the group and to judge their state of being. During this time students can be guided in bringing their energy into focus for the session. This is a good time to do ‘body scan’ awareness, and for the student to tune in and acknowledge what is happening for them physically, any aches and pains, tensions, trouble spots, their energy and emotional state. It is an opportunity for a snapshot of how things are now in the moment, and for them to feel that they can carry that awareness through into the whole practice.
Neck releases in a lying position
Alignment is still important even in the lying position, and the floor can offer a good guide for the spine, head and neck. Starting in semi-supine with the knees bent gives a comfortable way of working with the neck releasing, but brings different things into focus. The head needs to be supported until the neck is long and not over-arched, supported by one or more blocks if necessary. A head roll can be guided with awareness of the rotation on the axis of the spine, and having the head supported in this way can help with the release, as there is little effort in the action.
Contraindication: In elderly students there is often much rigidity in the neck – there may be arthritis or spondylitis, conditions that may be painful and restrictive, so it is important to work within a pain-free range and to allow the student to work within comfortable parameters, guiding gently to gain further movement. If the upper spine has kyphosis, it may be impossible to work this safely from a lying position, and sitting would be better.
Teaching focus
•When working with limitations in the neck, it is helpful to use visualisation. Offer the idea that each rotation moves a little more, and that with each turn of the head there is a freeing of the cervical vertebrae; add visualisation, such as imagining the muscles are like elastic.
•Ask the students to breathe into the stretch, to imagine it opening, softening and lengthening.
Hip releasing
A good place to start is the familiar Pawanmuktasana, circling the knees by guiding with the hands. There are many common variations and progressions to this releasing movement that a yoga teacher will be familiar with:
1.Circle the knees outwards and inwards, separately, and then together.
2.Keep one knee pulled in an out-breath, lifting the head to the knee, and repeat with each breath. Repeat on the other side.
3.With the knee pulled in, slide the other leg along the mat, and extend through the back of the leg, pushing the heel away.
4.Pull both knees in, curling into a ball to extend the spine.
All of this can be worked with breath coordination.
Parkinson’s/MS note: It is sometimes helpful to assist with this, as there is often one-sided action. With permission, you can gently take the knee and move it in the correct way, until the student is ready to take over.
Rock the baby
This movement helps to work into the hips and sciatic area.
Instruction
1.In a sitting position either on the floor or on a chair, sit up tall.
2.Bring the right foot onto the left knee, and let the right knee fall out to the side, by allowing rotation in the hip. Do not force the knee into position.
3.Hold the knee in the right hand and the foot in the left, and lift the leg as far as is comfortable, as if you are cradling a baby. Be gentle.
4.Rock gently from side to side.
5.Repeat with the other leg.
More flexible people will be able to draw the leg up closer to the body.
WARM-UPS FOR COLD DAYS
Unless you have a beautifully heated room, there are sometimes cold winter days when being on the floor is just too cold. These days are when we practise standing dynamic warm-ups. These are good to get the circulation going and warm up hands and feet.
Swing arms
Instruction
1.Swing the arms, backwards and forwards, keeping the arms loose in the shoulder joints and moving freely. Coordinate with the breath – in with a forward and backward swing, and then out with another forward and backward swing.
Parkinson’s/MS note: In Parkinson’s the loss of arm swing is characteristic of the disease, but can be improved. Observe the group, to see where people cannot loosen or let go. Encourage that swingy puppet-arms feel. This can be worked into a forwards and backwards step. Step forwards as the arms swing up, and then shift the weight onto the back foot and let the arms naturally drop. Repeat with the other foot forward.
Swing twist
With a loose turn of the shoulders and upper body, allow the arms to hang loosely and to ‘hit’ the body where they land.
DYNAMIC BREATH WARM-UPS
These are done breathing in through the nose and out through the mouth.
Instruction
1.With an ‘easy step’ forward (see page 80), turn the shoulders and hips to the front.
2.Bring the arms up and hold the hands in fists in front of the chest, knuckles together, elbows lifted out to the sides.
3.Breathe in, and sharply pull the fists apart. Breathe out, snapping the fists back together.
4.Repeat five times. Bring the feet back together.
5.Step forward onto the other foot and repeat.
6.With the feet in the same position as before, arms straight out in front at shoulder