Muscular Dystrophy

Has anyone worked with yoga students who have muscular dystrophy? I am working with a woman privately who is 45 and has severe curvature of the spine. If so, will you please share your experience and suggestions? Thank you.

BACKGROUND:

From Gyandev:

In case you're wondering about muscular dystrophy vs. multiple sclerosis (MS), the two disorders have some important differences. Following is some background material on both disorders from National Institutes of Health (http://www.ninds.nih.gov/health_and_medical/disorders). After that come the replies.

What is Muscular Dystrophy (MD)?

Muscular dystrophy (MD) refers to a group of genetic diseases characterized by progressive weakness and degeneration of the skeletal or voluntary muscles which control movement. The muscles of the heart and some other involuntary muscles are also affected in some forms of MD, and a few forms involve other organs as well. The major forms of MD include myotonic, Duchenne, Becker, limb-girdle, facioscapulohumeral, congenital, oculopharyngeal, distal and Emery-Dreifuss. Duchenne is the most common form of MD affecting children, and myotonic MD is the most common form affecting adults. MD can affect people of all ages. Although some forms first become apparent in infancy or childhood, others may not appear until middle age or later.

Is there any treatment?

There is no specific treatment for any of the forms of MD. Physical therapy to prevent contractures (a condition in which shortened muscles around joints cause abnormal and sometimes painful positioning of the joints), orthoses (orthopedic appliances used for support) and corrective orthopedic surgery may be needed to improve the quality of life in some cases. The cardiac problems that occur with Emery-Dreifuss MD and myotonic MD may require a pacemaker. The myotonia (delayed relaxation of a muscle after a strong contraction) occurring in myotonic MD may be treated with medications such as phenytoin or quinine.

What is the prognosis?

The prognosis of MD varies according to the type of MD and the progression of the disorder. Some cases may be mild and very slowly progressive, with normal lifespan, while other cases may have more marked progression of muscle weakness, functional disability and loss of ambulation. Life expectancy may depend on the degree of progression and late respiratory deficit. In Duchenne MD, death usually occurs in the late teens to early 20s.

What is Multiple Sclerosis?

Multiple sclerosis (MS) is a life-long chronic disease diagnosed primarily in young adults. During an MS attack, inflammation occurs in areas of the white matter of the central nervous system (nerve fibers that are the site of MS lesions) in random patches called plaques. This process is followed by destruction of myelin, which insulates nerve cell fibers in the brain and spinal cord. Myelin facilitates the smooth, high-speed transmission of electrochemical messages between the brain, the spinal cord, and the rest of the body. Symptoms of MS may be mild or severe and of long duration or short and appear in various combinations. The initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance. Most people with MS also exhibit paresthesias, transitory abnormal sensory feeling such as numbness or "pins and needles." Some may experience pain or loss of feeling. About half of people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and judgment. Such impairments are usually mild, rarely disabling, and intellectual and language abilities are generally spared. Heat may cause temporary worsening of many MS symptoms. Physicians use a neurological examination and take a medical history when they suspect MS. Imaging technologies such as MRI, which provides an anatomical picture of lesions, and MRS (magnetic resonance spectroscopy), which yields information about the biochemistry of the brain. Physicians also may study patients' cerebrospinal fluid and an antibody called immunoglobulin G. No single test unequivocally detects MS. A number of other diseases produce symptoms similar to those seen in MS.

Is there any treatment?

There is as yet no cure for MS. Until recently, steroids were the principal medications for MS. While steroids cannot affect the course of MS over time, they can reduce the duration and severity of attacks in some patients. The FDA has recently approved new drugs to treat MS. The goals of therapy are threefold: to improve recovery from attacks, to prevent or lessen the number of relapses, and to halt disease progression.

What is the prognosis?

The cause of MS remains elusive, but most people with MS have a normal life expectancy. The vast majority of MS patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk.

ANSWERS:

From Karen Barbarick

Re MS:

There is a teacher trainer named Eric Small who will be in Sacramento Feb 8 and 9. The program is $75.00 and you get a certification put out by the MS Society and can even get funding through the MS Society as a MS trained Yoga Teacher. You can call 800fightms and get details.

Good Luck & Namaste'

Karen

From Mary Yost:

When I worked at the Recreation Center for the Handicapped in SF CA 1985-1991 I created a water yoga class in warm water and a chair yoga class at RCH in 1986 then both were copyrighted in 1999,,,,,,people with all types of physical problems work better....in warm water...........

If you need to stay on land ....Use a chair to assist or sit in it depending on the day for your student.......Also, I generally start with a long modified Shoulder Stand created by Nischala Devi in Yoga of the Heart.....below is a copy of her pose......

Namaste,

Mary

Material from Nischala Devi (Nischala teaches her Level 2 AYTT program -- Yoga of the Heart: Cardiac Teacher Training -- March 6-16, 2003 at The Expanding Light. See also her book, The Healing Path of Yoga.)

Inverted Poses

Inverted poses have many benefits, both physically and emotionally. If ever you are upset or disillusioned with the world, turn upside down and look at the world from a different angle. Everything looks different and, perhaps, a little less threatening upside down.

Shoulder Stand

When I first started doing Shoulder Stand with heart patients there was a concern about their ability to do the pose because of the heart¹s lack of ability to pump enough blood to the legs. The inversion of the legs actually allowed the heart to rest, and the poor circulation in their legs was greatly improved. The reverse pose also brought about a sense of well-being. The smiles and their reluctance to come out of the pose was all the affirmation we needed that it was bringing benefit.

The heart pumps the blood into the arteries, which nourish the entire body. The muscular arteries, with the help of gravity, deliver the blood to the fingers and toes. Getting the blood back up from the feet to the lungs is a greater challenge. The blood returns to the heart via the lungs by veins, which do not have muscles of their own. The blood is pumped upward through the veins by the contraction of the external muscles in the leg. Stop valves at regular intervals

Keep the blood from draining back down the leg, under the force of gravity. Normal daily walking and exercise assist the return flow of blood.

Many of us sit or stand for hours with our feet down. The pull of gravity and lack of muscle movement encourages the blood to pool in our feet and legs. Sometimes swelling occurs and even varicose veins (the breakdown of the valves in the veins). Varicose veins also occur in areas other than the legs such as in the rectum in the form of hemorrhoids, which are aggravated by constant sitting. All these problems can be helped by good venous return to the lungs and heart.

Shoulder Stand aids the return of the blood to the lungs for oxygenation, by raising the feet and legs and pelvis higher than the head.

The lymphatic system is part of the immune system and plays a major role in the body¹s defense against infection and cancer. Since the lymph system has no central pump, lymph is circulated by movement of the muscular-skeletal sys-tem, similar to the venous system. Healthy lymphatic vessels equipped with one way valves‹ensure an upward movement of lymph through the body. The shoulder stand and body inversion encourage the return of lymph from the lower extremities. This enhances a healthy immune function.

Shoulder Stand also brings great benefit to the thyroid gland, at the base of the throat. It is a butterfly-shaped gland that controls the body's metabolism. While the body is inverted, the throat is gently pressed to the chest. The spongy thyroid gland is squeezed and‹when it¹s released new fresh blood rushes in and revitalizes it, helping to balance its function.

If you have known uncontrolled high blood pressure, diabetes retinopathy, carotid artery disease, or neck problems please check with a health practitioner before doing this practice. Many times Stage I can be comfortably done with minor adjustments.

Adjust your clothing to loosen any tightness especially at the neck and throat. Be aware of any dizziness, light-headedness, or discomfort. At the first sign of any of these, come out of the pose immediately and rest in the Relaxation Pose.

Ideally, we hold this pose for at least three minutes, as this is approximately how long it takes the blood to make one trip through the entire body. The important part is to only hold it as long as it is comfortable for you.

From "Yoga of the Heart," by Nischala Joy Devi Copyrighted 1998

As you feel more comfortable in the pose, allow your eyes to close for more internal benefit. The awareness is on the inversion of the body and at the thyroid gland.

Stage I: Shoulder Stand Modified with a Chair

Lie on your back and rest your feet and legs on a sturdy, straight chair that is braced against the wall. Allow the legs‹up to the back of the knees‹to be resting on the chair, not dangling off. You may need to turn the chair to the side or place a pillow on the edge of the chair to have the legs fully on the chair. If the edge of the chair cuts your Legs, it can inhibit circulation.

Place a pillow or blanket under your head and neck, with the folded side supporting the neck. This allows the chin to come forward, putting gentle pressure on the base of the throat and thyroid gland.

Place a second pillow under the buttocks folded side in elevating the buttocks and tipping them slightly forward, This allows the blood and energy to flow back from the legs to the upper body.

Keep the breath normal. Hold the pose for one minute. As you feel more comfortable, the holding time can be gradually increased.

Feel the relaxing and beneficial effects, slowly bend the knees and place the feet back on the floor, Remove the pillows, stretch out the legs, and relax on your back..