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Tuesday, October 4, 2011

Yoga and Parkinson's Disease, Part 1


by Richard Rosen, guest contributor
A Road Through the Woods by Brad Gibson
When we received a question last week about yoga and Parkinson’s Disease, we turned to our friend Richard Rosen. Richard Rosen is a senior yoga teacher, who has been practicing yoga for 31 years and who was diagnosed with Parkinson’s Disease about 9 years ago. Richard had so many interesting things to say in the response to the question that we decided to make it a separate post. —Nina
Q: Interested in suggestions for yoga for students with Parkinson's.

A: Parkinson’s Disease (I prefer Condition) is a progressive degenerative disorder of the central nervous system. Common symptoms include loss of muscular flexibility, balance, and strength. You may notice that these are the very physical qualities promoted by the physical practice of yoga postures and related exercises. To a certain undetermined extent then, yoga exercises help to not exactly counteract PD symptoms, but go a long way toward at least a temporary amelioration. These exercises (depending on the frequency and intensity of practice) also help cultivate and refine greater body awareness, which in turn (again to an undetermined extent) allows the individual to self-correct certain of the symptoms. I’m hedging everything I say here because, as in all of life, there are no guarantees. Some conditions progress very rapidly, others only gradually. But in any case the sooner a credible practice is established the better it will serve the individual. I can’t stress this enough: once the diagnosis of PD is confirmed, if you’re not already practicing some form of yoga exercise, get started immediately with a competent teacher.

This is a very difficult question to answer in 25 words or fewer as it’s stated here. I would ask first about the students’ condition: are they pretty much at the same level of development, or are some farther along? If the former, are they all still fairly mobile, is their balance still decent, their strength and flexibility? If the latter, how serious is the situation? Do some need canes or walkers? Is the shaking debilitating at times? Different strokes for different folks is the operative approach.


And then I’d need to know something about the teacher, if there is one. Training? Experience? Are there props like chairs and bolsters? What size is the class, if there is one? Are there assistants if there are more than, say, 6 to 8 students? Don’t mean to be evasive here but a PD class is definitely not like an average public class, these are students that need extra attention.

Or are you asking in general about individual students you might be working with in a private setting? Again it’s important to tailor the work to the student’s level of development. Without more detailed information I can only give general suggestions. 

Certainly one of the most useful exercises would be a passive backbend over a bolster or rolled blanket (see here for a photo). We PD people tend to slump after awhile and the backbend helps encourage a long (not "straight") front spine. The thickness of the support would depend on the student, both his/her level of development and previous experience with yoga-influenced exercises (I assume when you say “yoga” you’re talking about asana-like postures; please remember “yoga” is an umbrella term for a wide variety of schools and practices, and shouldn’t be equated solely with asana). Obviously the stiffer the student, the smaller the roll’s diameter should be, and stiffer students will likely need a blanket support under the back of their head to prevent jamming the neck, and should also keep knees bent and feet on the floor to avoid back strain. The roll should be positioned under the lower tips of the shoulder blades so that the arms can lay comfortably off to the sides, not higher than parallel to the line of the shoulders. Initially the student might stay for a couple of minutes, then slowly over time, depending on the student and the seriousness of his/her practice, increase the stay to 5-6 minutes. I should emphasize here that if the student isn’t ready or willing to practice regularly—every day would be ideal—then the exercises will have minimal impact if only practiced once weekly or less.

While in the pose it’s essential that some attention be paid to the breath. Have the student pretend he/she can channel the inhalations slowly and directly into the space behind the sternum (yes, I know that’s where the heart is, I said “pretend”), so that each intake creates more and more space in the upper chest. On the exhalations have the student imagine sinking down over the blanket, so that with each successive exhale, he/she seems to be releasing more and more over the roll.

I’m not, at this point, particularly comfortable going any farther until I learn something more about the teacher-student relationship, the former’s chops and the latter’s needs. Please write to this blog again with more information about yourself and the students, and of what you intend to do with this instruction. 

Richard Rosen is currently the director of Piedmont Yoga Studio in Oakland, CA. He is a contributing editor for Yoga Journal magazine, and is the author of three books, The Yoga of Breath (Shambhala 2002), Yoga for 50+ (Ulysses 2004), and Pranayama Beyond the Basics (Shambhala 2006). He’s also created a set of seven CDs titled The Practice of Pranayama, issued by Shambhala, and Shambhala will publish his Original Yoga, a book about traditional Hatha Yoga, in 2011. (To find out more about Richard and Piedmont Yoga Studio, see here.)

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