Move Through Arthritis

Recover your full range of motion with yoga.
By Jennifer Lang

Every morning, Angie steps onto her yoga mat and struggles to push herself into Downward-Facing Dog. Three breaths later—on a good day—she comes down and rests in Child’s Pose, rolling her wrists and flexing her fingers. Angie, at 32 years old, has osteoarthritis in her hands and her hips. But in spite of the pain, she says yoga actually makes her feel better.

Arthritis. The very word conjures up images of Grandma’s gnarled knuckles and stiff fingers. Serious joint pain reserved for little old ladies and retired professional athletes. But osteoarthritis (OA) can appear at any age. Genetics definitely play a role (they did for Angie), but if you have a history of being overweight, inactive, overactive, or injury prone, your odds increase dramatically. In fact, Patience H. White, MD, chief public health officer for the Arthritis Foundation in Washington, DC, believes arthritis will begin to affect a much younger generation in the coming years. “As much as 65 percent of the population is already overweight or obese—a big risk factor,” she says. “Every pound you gain is like four extra pounds bearing down on your knees.” If you lose 10 to 15 pounds, according to White, the pain of OA can be reduced by 50 percent. Sure, losing weight is hard, but if shedding a few pounds can help alleviate the pain without the side effects of painkillers, why not give it a try? “Plus, achieving a healthy weight can help prevent the progression of the disease,” says White.

The truth about OA
Osteoarthritis, classified as a rheumatic disease, joins more than 100 other conditions under the umbrella term arthritis, and they all affect the joints, muscles, tendons, ligaments, and cartilage. The two other common forms include rheumatoid arthritis, an autoimmune disease associated with inflammation, and gout, which stems from metabolic abnormalities. Researchers used to describe OA as a wear-and-tear condition in which the cartilage around the joint begins to break down from mechanical stress. But, says White, “we now know that low-grade inflammation accompanies the wearing away of the cartilage, which is further hastened by risk factors like weight and lifestyle.”

What does this mean exactly? When you have arthritis, the cartilage that cushions the ends of the bones has deteriorated and lost elasticity. Because cartilage doesn’t have its own blood supply, it feeds off the joints’ natural lubricant, called synovial fluid, which carries nutrients and waste into and out of the area. The more the joints move, the more fluid flows through them, making movement easier; the less the joints move for whatever reason (age, inactivity, or injury), the less fluid flows and the more the cartilage deteriorates, causing the bones to rub against one another, says White. The end result can be stiffness, pain, loss of joint mobility, and eventual disability.

Get moving
When you feel tired and achy, working out is probably not high on your to-do list, but experts agree it’s exactly what you need. Just 30 minutes of exercise a day can help maintain mobility, strengthen the muscles that support weak or damaged joints, and even help you shed those extra 10 or 20 pounds. “Most people with arthritis think that they can’t be physically active—that it will make things worse,” says White, “yet nothing could be further from the truth. No matter what type of arthritis you have, physical activity can help you avoid becoming a disability statistic.”

But don’t overdo it. “The adage of ‘no pain, no gain’ doesn’t apply to arthritis,” says Steffany Haaz, a Baltimore yoga teacher who conducted research on yoga for arthritis at Johns Hopkins School of Public Health. Anytime you begin a new exercise program, your muscles will feel sore, but sharp pain in the joints is a red flag, says Haaz. Do not push through that pain.

Healing with yoga
“Yoga can be particularly good for people with OA because it takes the joints through a healthy range of motion,” says Roger Cole, a certified Iyengar yoga teacher in Del Mar, California. And that’s a good thing. When the surfaces of a joint are used in their full range of motion, Cole explains, they remain healthy; but when not used, they’re more likely to get arthritic. In fact, a recent study in International Quarterly of Community Health Education showed that after six weeks of yoga therapy, the quality of life for patients with osteoarthritis of the knee had noticeably improved.

A consistent yoga practice will do more than keep you limber. “Yoga includes deep relaxation, breath-control techniques, and self-awareness,” says Haaz, “all of which can lessen the effects of living with chronic pain.”

Choosing a class
Gentle or restorative classes work best if you have stiff joints and sore muscles. Make sure, of course, you let the teacher know your challenges, so she can help you modify the poses. Consider working one-on-one with someone who has studied yoga therapy, which usually involves some combination of customized postures, restorative yoga, props, breath work, and meditation. Be aware that there are a lot of different styles of yoga, says Cole, and some pay less attention to alignment. For example, Iyengar yoga highlights precise alignment to achieve maximum effect and tends to move slowly. Anusara yoga, while also alignment driven, puts more emphasis on the emotional effect of the poses. Power, Ashtanga, and Bikram yoga styles all build body heat by moving quickly. Cole doesn’t recommend any of these hot and fast practices because they don’t focus enough on proper alignment and “there’s a greater chance of going outside your healthy range of motion [when the body is very warm],” he says. This overextension can cause damage “if the joint goes too far or has to work too hard.”

Angie discovered that doing yoga—even just a few poses—every day helps manage her pain and keep her joints lubricated. She prefers to practice in the late afternoon when she’s a little more limber, but no matter when she steps onto her mat, she knows she’s found her solution.

Jennifer Lang is a freelance writer and certified yoga instructor in White Plains, New York .


Namaste (Prayer Position)
Benefits: Maintains strength and flexibility in hands and wrists
How to: Start with a few hand clenches: Draw your fingers in tightly toward the center of the palms to make fists, then release and spread them like starfish. Bring palms together at your breastbone, fingers pointing down. Draw your hands up (palms do not lose contact) along your torso until you feel a stretch in your wrists and fingers. Stay here for five breaths. Then, keeping your palms together, rotate hands up so that fingers point toward the ceiling. Draw hands down the torso until you feel a stretch. Hold for five more breaths and release.

Utkatasana (Chair Pose)
Benefits: Stabilizes and strengthens the knee joint
How to: Stand with your legs and feet hip-distance apart. Bend at your hips and knees—as though you were about to sit down on a chair—and send the tailbone down toward the floor behind you and your arms up along your ears. (If lifting your arms overhead feels uncomfortable, then reach them straight out in front of you.) Keep your shoulders relaxed and away from your ears, and check to see that your knees are tracking over your toes. Hold for a few breaths. The deeper you bend, the more challenging the pose.

Baddha Konasana (Cobbler Pose)
Benefits: Opens hips with outward rotation to increase and maintain range of motion in the hip joint
Props: Two blocks, a blanket, and a strap
How to: Sit on the floor (use a chair to get on the floor if necessary) and draw the soles of your feet together, knees opening out to the sides. Put blocks under both knees and sit on a thick, folded blanket to help elongate your spine and lessen any intensity in the hips. Hold your ankles or put a strap underneath the feet and hold it in your hands. Lengthen your spine, look out in front of you a few feet, and pull your chest forward slightly, trying not to round your back. Work toward five deep breaths.

Shalabhasana (Locust Pose)
Benefits: Strengthens the erector spinae (muscles alongside the spine) as well as the lower back, buttocks, and hamstrings, while stretching and opening the chest and shoulders to give more mobility to the whole torso
How to: Lie on your belly, forehead resting on the floor, arms by your sides, palms facing up. Turn your big toes toward each other slightly to activate your inner thighs. Tuck your pelvis so that your pubic bone presses into the floor (this protects the lower back). On an inhale lift your head, upper torso, arms, and legs off the floor so that you’re resting on your pubic bone, belly, and lower rib cage. Keep your collarbones wide and neck straight (don’t look up). Stay here for five breaths (or as long as you can hold it) and come down on an exhale.


Do's and Don'ts of Practicing Yoga with OA
* Do practice with a teacher who tells you how to do a pose, not just the name of the pose. * Do easier poses before harder ones. * Do practice with a teacher who will work with your abilities and can recommend modifications. * Don’t force yourself into a pose.