12 Dec Yoga as Therapy: A Treatment Plan for Carpal Tunnel Syndrome and Osteoarthritis
Many yoga students have injuries and physical ailments.
Some are drawn to yoga as a form of therapy for their physical suffering, while others attend yoga despite their injuries, aches and pains. When I consider the curative effects of yoga, I’m reminded of Bikram Choudhury, world renowned master yogi, who at the age of 13, won the National India Yoga Championship and maintained the title for the three years following. At 17-years-old, he suffered a severe knee injury during weight lifting; European doctors said he would never walk again. Not accepting their prognosis, Bikram had his friends carry him back to his yoga school, believing that if anyone could help his knee it was his teacher. Six months later, his knee had healed. Bikram’s teacher, Bishnu Ghosh was the first to scientifically document yoga’s curative properties.
Several decades later, Marian Garfinkel, director of the B.K.S. Iyengar Yoga Studio of Philadelphia, and a team of researchers studied the benefits of yoga in treating two rheumatic diseases: Carpal Tunnel Syndrome and Osteoarthritis of the hands. The researchers determined that the yoga programs used in the studies were effective in relieving negative symptoms of both diseases. The Iyengar yoga approach was utilized in the studies, chosen for its emphasis on proper body alignment and focus on adjusting yoga postures to meet the physical conditions of the subjects.
In the first study, Evaluation of a yoga-based regimen for the treatment of Osteoarthritis of the hands (Garfinkel, M.S. et al., 1994), subjects were divided into a control group, and a group in which participants worked with a yoga instructor once a week for eight weeks. The yoga group focused on stretching, strengthening, alignment and extension. In addition to the physical poses, the yoga group included relaxation techniques, group discussions and supportive encouragement. At the end of the eight weeks, the yoga treated group reported significantly less pain and tenderness during activity and greater range of motion.
The second study, Yoga-based intervention for carpal tunnel syndrome, (Garfinkel, M.S. et al, 1998), a control group received a wrist splint, while the yoga treated group received a program based on upper body postures focused on improving flexibility, correcting the alignment of hands, wrists, arms and shoulders, and increasing the awareness of proper joint position during practice. The yoga group practiced twice a week for eight weeks. Eleven asanas were used, each designed to strengthen, stretch and balance each joint, utilizing full range of motion. Results of the study showed that the yoga group significantly improved grip strength and reported pain reduction compared to the control group. Researchers concluded that yoga was more effective than wrist splinting or no treatment in relieving carpal tunnel syndrome symptoms.
Here are the eleven asanas that Garfinkel and her researchers used to treat Carpal Tunnel Syndrome in the study:
- Sitting With Extension of the trunk (dandasana) –
Sit on a chair with the trunk upright. Press hands into the seat. Press shoulder blades into the back. Move shoulders down.
- Hands in prayer position (namaste) –
Press palms & fingers of each hand together, with fingers away from their position of ulnar deviation. Release and repeat, pressing palms together with fingers spread as wide as possible. Repeat by pressing metacarpals of each finger. Pull fingers back into hyper extension, increasing distance between fingers of each hand.
- Arms extended overhead with fingers interlocked (urdhva hasatasana) –
Stretch arms and fingers forward and up, with hands facing vertically. Open palms, keep fingers together and lock the elbows. Lift sides of the body. Keep arms straight.
- Arms extended overhead with fingers interlocked (parvatasana) –
Interlock fingers with the right thumb base over the left, wit the base of the fingers in contact. Turn palms out and stretch arms forward and up. Lock elbows and keep arms straight. Raise trunk by lifting the arms and pull arms further back. Lower arms. Repeat with left thumb over the right.
- Arms interlocked in front of body (garudasana) –
Bend elbows, crossing arms in front of the chest with the forearms stretching up and thumbs facing the head. Cross left elbow over the right. Move right hand toward the head and the left hand away; cross hands and place fingers of the right hand on the left palm. Stand and raise elbows to shoulder level and bend them. Stretch hands and fingers. Release arms and stand straight.
- Chair Twist (bharadvajasana) –
Sit sideways on a chair, with right hip and thigh against the back of the chair. Stretch the trunk up and pull shoulders back. Keep knees and feet together, turn toward the back of the chair. Place hands on back of chair. Pull left hand to bring left side toward back of chair and push with right hand to turn right side away. Turn Body then the head to look over the right shoulder.
- Standing, Mountain Pose (tadasana) –
Stand straight in bare feet, facing forward, feet together, toes and heels in line, with big toes and center of the inner ankles touching. Balance weight evenly on inner and outer edges of both feet , heels and soles. Lift knee caps in the goinits. Raise upper chest and collarbones.
- 90-degree forward bend to the wall (1/2 uttanasana) –
Stand with feet one foot apart. Stretch the arms over head. Bend from the hips, extending entire body toward the wall, hands touching the wall. Stretch forward.
- Arms extended overhead with palms together in prayer position (virabhadasana 1, arms only) –
Stand in tadasana. Stretch arms to sides at shoulder elvel keeping fingers together. Turn arms circularly in their sockets, palms facing the ceiling. Keeping arms straight, extend them over the head until they are parallel. While moving arms upward, stretch the sides of the chest and armpits. Take arms back, and bring them closer together; join palms, with the fingers stretching upward. Lock elbows.
- Dog pose with chair, with special emphasis on hand placement (urdhva mukha svanasana) –
Stand, feet hip width apart, facing the seat of a chair. Bend, placing palms on the seat, shoulder width apart. Straighten arms and lift waist, hips and knees a few inches above the chair. Turn arms out and curve trunk back between them. Bring coccyx, sacrum, and lumbar spine forward, keeping buttocks tight. Stretch front of the body from the pubis. Raise sternum and ribs. Hold shoulders back. Press shoulder blades and dorsal spine in.
- Hands joined in prayer position behind the back (namaste) –
Stand in tadasana. Join palms behind the back, fingers pointing down and in line. Turn hands toward the trunk and then up. Raise them as high as possible between the shoulder blades. Join heels of the hands and press little fingers into the dorsal spine. Stretch fingers up. Turn upper arms outward and press shoulders back and down.
- Relaxation –
Lie flat on the back. Keep arms slightly away from thighs, palms up, heels together, and toes apart. Close eyes. Breathe deeply. Concentrate on soft, slow exhalation. Relax lower jaw, tongue, and pupils of the eyes. Relax completely and exhale slowly. Remain in pose for 10 to 15 minutes.
Hold positions 1-11 for 30 seconds and breathe through the nose. Do not tense the throat and keep the shoulders away from the ears. Repeat each position. The lyengar system of hatha yoga emphasizes structural alignment. These postures are described in abbreviated form
Yoga therapy has not yet proven to be a replacement for traditional medical treatment of rheumatic diseases and repetitive strain injuries, but it has demonstrated an opportunity to reduce pain and improve symptoms. In order to receive the therapeutic effects of yoga, however, it is imperative to complete each asana with proper alignment, under the guidance and supervision of a registered yoga instructor.
Choudhury, Bikram. “About Bikram.” bikramyoga.com. Web. 15 Oct 2009.
Garfinkel, M., et al. (1994) “Evaluation of a yoga-based regimen for treatment of Osteoarthritis of the hands.” Journal of Rheumatology, 21, 2341-2343.
Garfinkel, M., et al. (1998) “Yoga-based intervention for carpal tunnel syndrome.” Journal of the American Medical Association, 280, 1601-1603.
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