INTEGRATED APPROACH OF YOGA THERAPY FOR ARTHRITIS
The integrated approach of Yoga therapy provides techniques to address the problems of all the aspects of the stressful life style of the individual. According to yoga there are five facets of personality namely Annamaya Kosa, Pranamaya Kosa, Manomaya Kosa, Vijnanamaya Kosa, Anandamaya Kosa. The solid physical body visible to our eyes is called Annamaya Kosa (Physical body). The life energy (Prana) that makes each and every cell carry on its functions is Pranamaya Kosa (Vital energy body). Right proportion of Prana is supplied to every cell to help it perform its functions and thereby maintain optimum health. The mind that carries on the functions of perception, memory and emotions is called Manomaya Kosa (Mind body or astral body). The inner mind that controls and guides the Manomaya Kosa is called Vijnanamaya Kosa (Knowledge body). This makes the judgment that decides what is right and wrong based on life’s experiences so that a life of contentment, bliss and happiness can be lead.
The fifth level which is the subtlest body called Anandamaya Kosa (Bliss body), the person is in perfect health at physical, mental, emotional, social and spiritual level because of total inner mastery over the functioning of each one of the other four Kosas.
According to Yoga psychosomatic problems begin in Manomaya Kosa (mind layer of our existence) as an Adhij Vyadhi. Adhi is stress. Stress begins in the mind (Manas) as uncontrolled surge of emotions (Bhavana). These emotions such as anxiety, worry or depression, tension etc. are psychological responses to demanding situations either real or imagined. These stresses carry enormous power (energy) by gathering momentum by the recycling of thoughts increasingly in the Manomaya Kosa.
This speeded up loop goes out of control and we get lost in the speed. This speed when suppressed over a long period of time starts clouding the faculties and disturbs the balance of the five Kosas. The Ananda or Jnana-the right knowledge, is clouded by the emotions. Worrying becomes a full time occupation. Tension, worries and depression prevails. Sleep gets disturbed. Energy is drained out in this speeded up loop of worry and the other faculties of the mind like cheerfulness, patience and contentment get replaced by violent emotions of reactivity, indecisiveness, irritability and forgetfulness etc. These are the manifestations of uncontrolled stress reactions i.e., speed of the mind.
When this carries on for long time it percolates into the Pranamaya Kosa and disturbs the Prana balance; it is manifested initially as functional disturbances like excessive generalized tenderness, body aches, exhaustion and immune disturbances. At this phase the most commonly noticeable imbalance is in the form of irregular breathing pattern- disturbed rate, rhythm and depth of breathing followed by irregularities in digestion with disturbed appetite and bowel habits.
When the suppressed stress continue for months or years, it settles down in the joints as excessive Prana that gets locked up in Nadis around joints. The inflammation that shows in the joints is excessive speed that has percolated from Manomaya to Annamaya via Pranamaya Kosa. According to Yoga, one has full freedom to react or not to react otherwise in Manomaya Kosa initially when there was a demanding situation. But when you amplified the reactions, you started losing the freedom. Once you lost the freedom, the chain of reactions went on gathering momentum and it settled down in the joints as inflammation.
Yoga texts also explain this phenomenon as a process of constriction, as in the example of formation of ice. The molecules that had complete freedom to diffuse into a wide space in the gaseous state, became confined to the boundaries of a container in liquid state which later became constricted with very minimal freedom in the solid state of ice. Similarly when the stress reactions are in the state of “thought” in “Manomaya Kosa” there is full freedom. Then it recycles and gets bound into the Prana (liquid state) with less freedom. As it constricts further it solidifies into Annamaya Kosa as joint problem with least freedom.
It is a reversible process. Just like the ice can melt into water and vapour, you can reverse this whole process of constriction (in the form of arthritis) towards expansion or complete freedom from disease.
The integrated approach of Yoga therapy provides techniques to change the imbalances at all the five Kosas.
All Annamaya Kosa practices like Sakti vikasaka Sukshma Vyayama (Strengthening exercises) and joint loosening exercises are meant to reduce the speed at the physical level, i.e., give deep relaxation and rest to the entire body in general and to the painful muscles and joints thereby reducing stiffness of joints and improves flexibility.
Kriyas are techniques that help to cleanse the system from deep within so that the internal organs get revitalized to function normally. The Kriyas provide the strong stimulus followed by very deep rest to the organs that are being cleansed thereby improves the stamina of the organ to function more efficiently. Pure satvic diet is a pre requisite to Yoga. It cleanses the bowel, improves digestion and clears the mind.
Pranamaya Kosa practices
The Prana imbalance is the bridge between the stressed and the sick body. This shows up as the irregular breathing. Slow down the breathing. When you slow down the breathing rate, the mind slows down. There is a direct relationship between the mind and the breath. Whenever you are anxious, depressed or angry, your breathing rate speeds up and vice versa i.e., whenever you are calm, relaxed, sleeping comfortably, your breathing becomes slow. All breathing practices help you to balance the Prana. Reducing the speed at the Pranamaya Kosa conserves the unnecessary wastage of vital energy. It trains you to draw only the required amount of energy and use it in the best way. While doing Pranayama, following things should be borne in mind viz.
- Never overstrain the respiratory muscles.
- Never overdo the rapid breathing or breath holding practice.
- Exhalation must be longer than inhalation during all Pranayamas.
Manomaya Kosa practices of Dharana, Dhyana and devotional sessions help to work directly on the mind. Dhyana helps to learn the art of slowing down the speeded loop of thoughts; it has to be practised daily after the physical and breathing practices. Cyclic meditation is a useful tool for the agitated mind to be brought under control. Devotional sessions help you to culture the emotions. All stresses are nothing but violent emotions expressed or suppressed, that need to be replaced by soft emotions. Bhakti Yoga uses the tool of “Pure love”. This path of surrender, sacrifice, joy in the joy of others, giving instead of asking, accepting instead of complaining and nurturing motherly feelings of giving without expectations etc.; all these helps you to mature as a human being from the lower instinctual demanding nature to a more humane accepting nature.
Vijnanamaya Kosa Practices
Certain notional corrections are to be made in order to work at the Vijnanamaya Kosa level like Silence is happiness; Be cheerful at all times; Be young at all times and reduce rush for material joy.
Anandamaya Kosa Practices
Karmayoga is the trick to remain in Anandamaya Kosa. The art of working in relaxation, work with an attitude of Yajna (Offering to divine), working without worrying about the results of action, working with a sense of duty, living in the present, working in tune with the universal principle; recognizing that you are basically made up of the Universal stuff called Ananda from which the entire universe has emerged.; that all pain and suffering, losses and gains in business, name, fame, money including this physical body last for a short time; you are the ever lasting, unchanging, ever blissful, imperishable entity.
Scientific studies have been conducted; IAYT was used (Haslock et at. B.J. Rheum.1999;33(8):788). as an adjunct in the management of ten patients with Rheumatoid Arthritis. They were compared with ten who did not practise yoga. All these were chronic patients on long term disease modifying medication from the Rheumatology dept. of the South Cleveland Hospital, England. The Yoga group showed significant improvement in hand grip strength and disability index as per Stanford health assessment questionnaire after three weeks. They all reported much better quality of life. In another study on 34 rheumatoid patients in India significant improvement was noticed in symptom scores(52%), pain analogue scores (50%), ESR (11%), and joint swelling (10%), after two weeks of IAYT.
IAYT for OA
Prevention is better than cure.
Asanas practised regularly starting from young age offers smooth continuous healthy movement to the joints. This provides the necessary degree of balanced movements without jerks or bangs on the cartilage, thus preventing their early wear out.
Role of IAYT in OA
The physical yoga practices gradually increases the range of movements when practised with deep internal awareness. This not only helps to mobilize the stiff joints but can prevent further ageing process. Although the damaged cartilage can not be replaced, further deterioration and wearing out can be arrested.
In chronically damaged joints with pain and deformities, the surrounding muscles would be very weak because of long standing inactivity. Similar to physiotherapy many yoga practices when practised with deep internal and repeated, can help to strengthen the muscles around. Sakti Vikasaka Suksma Vyayamas are specific practices that provide the non weight bearing isometric as well as isotonic exercises that strengthen the muscles that provide the weight bearing support to the damaged joints. The additional contribution of Yogic suksma Vyayama is the deep relaxation, that takes away the muscle fatigue