Yoga for MS

The practice of yoga has been researched extensively in multiple sclerosis and upsides abound, from physical benefits—in balance, strength and fatigue—to mental and quality of life improvements. Even better, gentle chair yoga can be beneficial, boosting strength and confidence, meaning MSers at higher levels of disability can also participate. Here is an overview.

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Yoga has long been touted for both its physical and mental benefits for those with multiple sclerosis. Indeed, a randomized controlled trial of yoga found that those with MS who completed a 6-month yoga class (or exercise class) “showed significant improvement in measures of fatigue” compared to a waiting-list control group. But yoga, particularly in a studio setting, also conjures fear in us MSers who’ve never done the ancient Indian discipline.

There are lots of strange poses—downward facing dog, upward facing dog, slightly menacing sideways-glancing dog—not to mention strange breathing practices and odd “om” new-agey noises. And then if one can wrap his or her head around that, there are myriad subsets of yoga to choose from: Hatha, Vinyasa, Iyengar, Ashtanga, Bikram, Viniyoga, Anasura, Jivamukti, Forrest, Kripalu, Integral, Restorative, Moksha, Sivananda, Kundalini, and many other styles that may or may not sound like types of Italian pasta. Scared yet? Don’t be.

Types of Yoga

“Yoga can be practiced in several different ways,” explains Sarah Humphries, a yoga instructor who was diagnosed with MS in the early 1990s. “The poses that can be experienced standing or sitting on the floor can also be modified to be performed in a chair. In addition, an option exists to modify the poses for those who need to remain in a wheelchair. Yoga is popular with MSers because it is slow and with props—blankets, blocks, straps, bolsters, etc.—can be made available to anyone.”

So regardless of your level of disability, you can do this. I’ve done everything from hardcore power yoga (with challenging standing poses that require significant strength and stamina) to gentle chair yoga to DVD mat yoga to even laughter yoga. As Sarah says, yoga can be adapted specifically to your needs. If you can get around pretty well and your balance is solidish, experiment with any style except perhaps Bikram or Hot yoga, which is practiced in a room that is 105 degrees (icky hot for us MSers). The more disability you have, though, the more particular you’ll want to be.

One extra benefit of laughter yoga is that you will laugh. I was “rather hesitant” to try, and rather hesitant is in quotes because at the time I was insistent that no amount of cajoling could get me to go to such a class and potentially make a goof out of myself. Then a good friend made a poignant observation. “Dave, you already are a world-class goof.” Point taken. So I went and had fun. The fake laughter eventually turned to real laughter and I made some new friends.

Choosing Your Class

“It’s best to find a small class,” says Sarah. “Yoga classes for MSers may require lots of hands-on adjustments and that is easier to accommodate in a small class. Also, be honest about your MS. All yoga instructors are trained to offer alternative poses for the individual yogi. If a certain pose is uncomfortable, stop; yoga should never be painful. Ask your instructor for a way to adapt the pose.”

Another twist on yoga classes is the “woo-woo” factor, as one instructor I had calls it. Yoga can be an entire mind/body practice, so if a studio emphasizes too much of one and not enough of the other for you, try another studio. I’m a down-to-earth guy and prefer instructors who focus more on the “asanas” (poses) than the meditative aspects. That said, both are important factors in practicing yoga, so don’t discount the mental side.

“Proper breathing is one of the first things taught in a beginner yoga class,” says Sarah. “Integrating this nasal breath with the slow movements helps to relieve stress and calms and quiets the mind. A quiet, calm mind leads to less stress, and we all know how stress affects MS.”

When I started doing chair yoga at my local MS Society, it was jarringly different from mat yoga. It took me some time to get used to the slower pace since my daily workouts were usually far more vigorous. But I discovered that’s okay. I learned to focus on my breaths and where my body is in space, and to be a bit more in the flow. The biggest surprise from the class, though, was the camaraderie of the group, which ranged from those MSers fully capable to those in wheelchairs. Our gang—our “kula”—was refreshing to hang out with each week, all of us working for a common goal: to stay active.

ActiveMSers Recommendations

Talk to your doc. I know, I know, you hear this all the time, but it’s smart to first talk to your primary care physician and/or your neurologist.

Find your jam. Try out a class at your local gym or yoga studio. Experiment with different styles, different instructors, different “woo-woo.” It might take a moment to find the sweet spot, but when you find it, you find it. ActiveMSers also recommends checking our Connect forum for potentially free or discounted classes for people with disabilities in your area.

Timing matters. Pay attention to your workout room and class times. If heat gives you problems, choose a gym that keeps their rooms on the cool side and aim for morning sessions when these areas tend be cooler. Additionally, classes during off times are less crowded meaning fewer bodies to generate heat.

Pace yourself. Go at your own pace. If a certain exercise bothers you—your Lhermittes gets fired up, you get too hot, whatever—take a break. Your yoga instructor can likely suggest alternative positions that would work better for you. By the same token, if you feel you are not challenged enough, ask the instructor to show you a more difficult technique.

Home advice. For those on tight budgets, limited free time, or with transportation issues, you can practice yoga at home once you are comfortable with traditional yoga movements learned at your classes. We recommend getting a few lessons under your belt to ensure proper form. It also helps to have a yoga mat (we like this one and this one) and we’d advise a DVD or book to help you remember and perfect the positions and moves. One popular book is Yoga and Multiple Sclerosis, coauthored by Dr. Loren Martin Fishman and Eric Small. Small is a yoga teacher who has used the practice (specifically Iyengar yoga) to manage his disease.

Since most yoga is slow, emphasizing proper positioning of the body along with a compatible breath, it’s an ideal exercise for those with multiple sclerosis, especially those who are particularly heat sensitive. Yoga has the potential to help in many common problem areas: balance, stress, gait, spasticity, strength … and confidence. You’d be hard pressed to find a better relaxing mind/body program. Repeat with me: Ommm…