Adaptive Yoga:Fibromyalgia

NUTSHELL: Gentle sustained, supported stretching in conjunction with anxiety relieving pranyama and visualization. 

• external force
• you assisting
• sandbag
• no head back

In 1990, the American College of Rheumatology created a map of 18 “tender points,” or places on the body that are most often tender to the touch in people with fibromyalgia. A person who feels pain in 11 of the 18 tender points probably has it.

• While the exact cause of fibromyalgia is still a mystery, science is beginning to shed light on the disease. “There are genetic risk factors that make it more likely that you will, under certain circumstances, develop a chronic pain disorder like fibromyalgia,” says Leslie Crofford, an expert in the disorder and chief of rheumatology at the University of Kentucky in Lexington. A person may be born with a risk factor, but it will remain dormant until it’s activated by something like a car accident, a repetitive-motion injury, or osteoarthritis, Crofford says.
• Stress is also a trigger. Yovanovich suspects that stress ignited her own fibromyalgia. When she first fell ill, she was struggling in a bad marriage, working at a challenging job, and finishing an advanced degree, all at once. “I was surrounded by stress at work, home, and school,” she says. “There was no escape.”
• People with fibromyalgia process pain differently from those without it, due to a kind of hypersensitivity of the nervous system. For instance, pressure that feels mildly uncomfortable to the average person often feels painful to someone with fibromyalgia. “Basically, the volume control on pain is turned up as high as it will go,” Crofford says.
• Yoga’s ability to shift the nervous system out of the stress response and into the relaxation response is vital to people whose central nervous systems are sensitive and naturally hyped way up, says Crofford. It also acts directly on the very muscles where fibromyalgia pain occurs. “Think of it like having a writer’s cramp in all of your muscles at once,” says Jacob Teitelbaum, medical director of the National Fibromyalgia and Fatigue Centers. First the muscles shorten, then they get stuck in the shortened position, and eventually they hurt. (The tender points are often located where cramps commonly occur.) “One of the beauties of yoga for people with fibromyalgia is that it returns muscles to their normal length,” he says.

http://www.webmd.com/fibromyalgia/news/20101014/yoga-eases-fibromyalgia-pain#1

One of the few certainties about fibromyalgia is that it affects everyone differently, and a yoga practice should reflect that. Some people may want to follow Yovanovich’s path, bringing awareness back into the body with meditation and pranayama before starting an asana practice. Others may benefit from going to a restorative yoga class. 

• Shoosh Lettick Crotzer, the author of Yoga for Fibromyalgia, recommends that beginners do a gentle practice that enhances relaxation and that they avoid strenuous poses until they know they can move into them without triggering a pain reaction. 
• Crotzer suggests yoga styles that focus on alignment, relaxation, or therapeutics, such as Iyengar, or Viniyoga. She also advises working with instructors who have at least 10 years of teaching experience and letting them know before class about your condition, so they can be ready with appropriate modifications.

Easing the Pain

• People with fibro-myalgia often have chronic tension in the upper back, shoulders, and neck—places where 10 of the 18 tender points are located. All three areas are easily targeted with a few simple yoga poses. 
• Garudasana (Eagle Pose), because it stretches the muscles around the shoulder blades in the upper back,
• Bhujangasana (Cobra Pose) extends the back while opening the chest as well as gentle head rotations to relieve tension in the large muscles on the sides of the neck.
• Stay warm, because cold can tighten muscles; move slowly; breathe into painful areas; and work both sides of the body evenly to maintain balance, even if the pain is only on one side.

Healing Breath

• People in chronic pain often default to short, shallow breathing, which can set off the body’s fight-or-flight response and trigger the release of stress hormones like cortisol.
• Breathing deeply counters stress by stimulating the vagus nerve. Running from the brain to the diaphragm, the vagus nerve activates the parasympathetic nervous system. That’s why breathwork is crucial for people with fibromyalgia

If you are like me and many others in this fibro journey, mornings can be the worst part of the day because of morning stiffness. If you do desire to integrate yoga into your early morning routine, there are a few things you can do to prepare for a pleasant experience.

Take a warm bath, put on warm exercise clothing, and layer clothing to adjust with varying temperatures. Anything you can do to make your environment and experience more balanced is of benefit.

You may find productive for fibromyalgia and yoga is right before your evening meal, around four or five o’clock. Or, to really help you achieve a deeper sleep, practice right before bedtime. Just be gentle as too much activity at night can hinder sleep.

Develop a consistent yoga workout. Five or 10 minutes a day will be more beneficial for you than doing 20 minutes every other day, or 60 minutes once a week. Make it a part of your daily routine and don’t allow anything to deter that.

Consider it part of your morning ritual even if you vary in the degree of impact based on your level of pain. Increase yoga practice time as you are able.

Find something pleasant to focus on while you’re practicing yoga: a favorite picture on the wall, a decorative focal point or a window — anything that invokes positive thoughts.

Don’t practice yoga in your normal “work” environment where you might be looking into your kitchen thinking about cooking breakfast, or near your laundry area where there are clothes to be folded. Your place should be a quiet peaceful place with no distractions. Yoga’s full benefit is the ability to concentrate on what you are experiencing in your body as well as your mind.

Your thoughts need to be clear during yoga practice. Below are some of the things you should be concentrating on:

• Your breathing. Take long, deep complete breaths through your nose.
• Focusing on one spot. Stare at a spot directly in front of you, or whichever direction your head is pointing for the posture.
• Your body’s alignment. Be aware of what your body is doing. Is it balanced, equal on each side? Are you using the proper form for the pose?
• Sensations in your body. Are your muscles tighter on one side than the other? Are you feeling a good, comfortable stretch or are you pulling on your muscles too much?
• Tightened stomach and Kegel muscles. This is a little harder to accomplish but well worth the effort. You may only be able to hold these for a second of each pose at the beginning but keep trying to hold them longer.

Begin your yoga practice with warm-ups and end with relaxation for best results.

Safety Measures

• Don’t compress either the lower back or the neck into a backward bending position. If you have neck or back problems this will help avoid injury.
• Don’t lock your knees when bending forward in either a standing or sitting position. This will help prevent pulling on your lower back.
• Cushion your knees with a pillow under them if kneeling on them hurts. You can also put a pillow under your bottom, and over or between your feet when kneeling to take some stress off the knees.
• Be aware of poses and your health. If you have high blood pressure, sinus problems or are menstruating, do not practice upside-down postures.
• Never force anything or push until you feel discomfort. If a posture is hurting you, ease up or stop. The one exception to this may be foot pain as the feet are often weak and tight. Keep trying to work them if possible.
• Listen to your body and go with what it will be able to do — it will let you know what you can and can’t do from day to day. If you have a day where you are unable to do any of the yoga exercises due to pain or a flare-up, it would be of benefit to still find a quiet place to sit and clear your thoughts and exercise your mind as you prepare for your day.

Fibromyalgia and Yoga

Introduction to Yoga

Get your body moving again. Fibromyalgia and yoga are a great combination for easy stretches, careful strengthening,plus relaxation techniques. Improve your mind, body, sleep, and more.

Be sure to check with your doctor about starting any exercise program. Things like high blood pressure and back, neck, and knee problems can be adverse conditions for certain yoga exercises. I'll do my best to let you know which exercises can be harmful for which conditions.

One of the oldest forms of organized exercise, yoga dates back over 5000 years.

A terrific aspect about fibromyalgia and yoga is that there are hundreds, maybe thousands of different poses, called postures, which provide variety. It's pretty difficult to stick with an exercise routine if you're bored.

Yoga also helps integrate your mind and body, creating a healthier you.

It is important to perform yoga postures for the whole body, not just postures that target a certain area or problem. Everythings connected.

The form you use during a posture is more important than how far you can go into a posture. Yoga is not a competition with others. It is for you to discover yourself and your abilities.

Practice yoga on an empty stomach at least 2 hours after eating. Popular times to practice yoga are at sunrise or sunset and before bedtime.

For those of us with fibromyalga, mornings can be very stiff. You may find that taking a warm bath, then putting on warm sweats (even double layers in cooler tempuratures) will make it easier to practice in the morning.

The other time you may find productive for fibromyalgia and yoga is right before your evening meal, around 4 or 5 o'clock.

The last time that can really help you achieve a deeper sleep is right before bedtime. But, be careful. Too strenuous of an activity at this time of night can ward off sleep for hours. Just gentle, slow yoga at this time of day is best for fibromyalgia and anyone.

Next is,

How Long Do I Practice Yoga for Fibromyalgia?

I can tell you from experience that just 5 or 10 minutes a day will be more beneficial for you than doing 20 minutes every other day or 60 minutes, once a week. 

It's making the commitment that you are going to make it a priority for yourself. Make it part of your routine and don't let anything throw you off of your routine. Tell yourself that you can't get dressed or you can't eat breakfast until you exercise. This starts the day off right.

As you start to feel the benefits of yoga (possible after only one session!) you will naturally want to add a little more time to your yoga practice, working up to 15, 20, or 30 minutes a day. An hour would be great, but I try to be realistic.

How Do You Get Real Benefits  for Fibromyalgia from Yoga
in Just 5 or 10 minutes a Day?

First, try to find a quiet place where you will not be interrupted. I realize this can be difficult with kids, I have two boys. If you can wake up a little earlier, before the kids, you will find that the loss of a little sleep will not bother you as you gain the benefits of yoga. And I know this is hard to believe since you're already sleep deprived, but it will get better.

You may like to have something nice to focus on while you're practicing yoga. A favorite picture on the wall or a pretty towel or quilt thrown over a door will do just fine. Just don't try doing yoga while you are staring at the basket full of clothes to fold or a pile of clutter you've been meaning to take care of.

It will make concentration that much harder and not being distracted is a big key to yoga and it's mind/body benefits. You need to concentrate on so many things going on with your body, that your mind is able to clear.

The constant chatter that goes on in your brain has to stop in order to concentrate on these aspects:

1) Your Breathing - Take long, deep complete breaths that first fill the bottom of your lungs, then the middle, then the top. In exhaling, this is reversed - empty the top of the lungs first, then middle, then the bottom of your lungs.Breathe through your nose, it's a natural filter. In an advanced breathing technique, you partially close off the throat so that there is a breathing noise as you inhale and exhale. This strengthens the diaphram, which pulls air into your lungs.

2) Your Eyes Focusing on One Spot - Stare at a spot directly in front of you (or whichever direction your head is pointing for the posture).

3) The Alignment of Your Body - Be aware of what your body is doing. Is it balanced, equal on each side? Are you using the proper form for the pose?

4) The Sensations in Your Body - Are your muscles tighter on one side than the other? Are you feeling a good, comfortable stretch or are you pulling on your muscles too much? During a balancing pose, feel the body sway slightly and how you and your body correct the balance. Feel your blood give energy to your body as you move.

5) Tightened Stomach and Kegel Muscles (the muscles on your pelvic floor that you use to stop urinating) - These are a little harder to accomplish but are well worth the effort. You may only be able to hold these for a second of each pose at the beginning but keep trying to hold them longer. Start by tightening the stomach muscles on your exhale to push out the used air and allow more fresh air in. Then as this becomes easier, try holding your stomach and kegel muscles in while inhaling. This will work your lungs more as the diaphram cannot expand downward with your stomach muscles tightened. Your rib cage will expand on each breath. When you hold your kegel and stomach muscles while performing yoga postures, you will feel a warmth come over your body due to the increased effort. When you get warmer, your body becomes more able to stretch and change it's shape.

Begin your yoga practice with warm-ups and end with relaxation, for best results.

If You have Neck or Back Problems, Yoga can help

(And who doesn't, right?) Don't compress either the lower back or the neck into a backward bending position, in order to avoid injury.

Don't lock your knees (holding them rigidly tight so they cannot bend) when bending forward in either a standing or sitting position. This will help prevent pulling on your lower back.

Cushion your knees with a pillow under them if kneeling on them hurts. You can also put a pillow under your bottom, over or between your feet, when kneeling to take some stress off the knees.

If you have high blood pressure, sinus problems, or are menstruating, do not practice upside-down postures in yoga.

If a posture is hurting you, ease back on it a little, or stop it altogether. With fibromyalgia and yoga you should only move into a posture until you feel a mild sensation. Never force anything or push until you feel discomfort. The one exception to this may be foot pain as the feet are often weak and tight. Keep trying to work them in the future if you are unable to exercise them at this time.

If you have increased shooting pain the next day, you know you did too much and must take it easier the next time you are able to practice yoga. This is common when starting yoga with fibromyalgia. Do not feel like you have to make progress every day. Some days will be tighter that other days (like when those cold weather fronts are coming through).

Listen to your body and go with what it will be able to do that day. This is very important for people with myofascial pain or fms. If you don't follow your body's signals, you may end up with a lot of pain for a couple weeks.

If you are in a lot of pain and unable to do even the simplest yoga stretches, visualize yourself doing the exercises. It's amazing how this works! You will still feel some benefits and be able to get back to actually exercising sooner.

Practice your yoga for fibromyalgia barefoot on a thin carpet or hard floor with a mat. A carpet that is too thick will make it difficult to balance and be grounded.

I've made these Fibromyalgia and Yoga Lessons with only Standing Yoga Postures. This way, you do not need a mat. Also, when I started yoga, it was too painful for me to lie down on my back since pressure on the trigger points, especially at the back of my pelvis, created too much pain.

You can also find cotton mats. There's new mat that has a microfiber side that wicks away moisture while the other side sticks to the floor.

Find 5 minutes a day and check out the Fibromyalgia Yoga Lessons here: Standing Yoga Posture Lessons