Yoga Therapy for Parkinson's Disease and Multiple Sclerosis. Jean Danford

only as far as can be comfortably reached – no straining.

      3.Rotate the head to the right as if you are going to look over your shoulder.

      4.Find the end of the range of movement and breathe into the stretch; visualise moving a tiny bit more.

      5.Come back to the starting point with the spine upright and a feeling of a long neck.

      6.Rotate to the left.

      This rotation can also be done lying down, with the floor as a guide, and supported by a block or blanket that aligns the spine and keeps the neck long, to avoid over-arching.

      Teaching focus

      •Correct the line of the neck using gentle hand guidance, where needed.

      •Observe whether there is any one-sidedness, but do not push the limited side; notice and wait.

      •There should be no movement in the shoulders. Put your hands on the student’s shoulders to steady if needed, or encourage with words.

      •Visual imagery can help here. Ask the student to imagine that they can take their head all the way round like an owl, using their eyes as well.

      •The chin should be kept level.

       Side moves

      Instruction

      1.With an upright head, and neck and chin level, allow the head to move laterally, as if putting the right ear on the right shoulder. Avoid pressing down or straining, and let the neck travel within a pain-free range.

      2.Return and repeat on the other side, noticing any differences or limitations, but do not try to correct and over-stretch.

      Teaching focus

      •There should be no movement in the shoulders or upper back. Put your hands on the student’s shoulders to steady if needed, or encourage with words.

      •If it is comfortable to do so, allow the student to stay in this position and breathe. Ask them to direct the breath into the stretch on the opposite side, to imagine the muscle lengthening, creating a space between the tip of the shoulder and the ear on the other side, and to then breathe into this space.

      This whole exercise can be offered with an arm extended over and across the head so that a hand can be placed over the ear; in this way the movement has an added weight.

       Root of the neck

      Instruction

      1.Push the chin forward, like a tortoise coming out of its shell.

      2.Draw the head back, creating a double chin.

      3.Repeat forwards and backwards.

      This move mobilises the vertebrae and works the capitis muscles.

       Occipital ridge

      Instruction

      1.Begin by folding the arms to anchor the shoulders down.

      2.Draw tiny circles with the tip of your nose and gradually spiral outwards so the movement increases.

      3.Spiral back in again.

      Teaching focus

      •This should not result in throwing the head back or forward; the movement should be kept subtle.

      EASING OUT THE SHOULDERS

       Simple shoulder rolls

      These are a good starting point as shoulders are often rigid and tight.

      Parkinson’s note: Directing the students to simply shrug the shoulders around in a circle often results in them only moving their arms rather than their shoulders. This is where it is helpful to demonstrate clearly what you want the class to do, and do it with them. Walk around, and stand in front so that they can easily copy you. Sometimes you will find that people need you to show them by hands-on guiding, moving the shoulders gently in a circling action. The finger tips to shoulders version with elbow circling is easier to handle.

       Lift and drop

      This offers a good opportunity for release, using breath to facilitate the ‘let go’.

      Instruction

      1.Lift the shoulders up around the ears with an in-breath.

      2.Drop down with a sigh.

       Hugs

      Instruction

      1.Start with arms outstretched and then cross them over, bringing them in, to hold the opposite shoulder.

      2.Creep your hands around and feel for your shoulder blades, giving yourself a big hug. This stretches the teres major, minor and infraspinatus. Note which arm is on top.

      3.Take the arms out wide again and repeat, bringing the other arm on top.

       Joint Freeing Pose (Pawanmuktasana)

      All of the familiar Pawanmuktasana can be offered, and are particularly helpful in keeping the joints in action. They do often pose a problem with coordination, as the student may move joints other than those directed, which is due to faulty ‘messaging’. Guide with demonstration and light-touch hands-on to show how the joint should move.

       Arm twists

      Instruction

      1.With arms outstretched at shoulder height, release the shoulders downwards, with palms facing down.

      2.On an in-breath rotate them, to palms facing up. Move between one position and the other with coordinated breathing, exhaling as the palms turn down.

      Teaching focus

      •Some students find it hard to maintain this position for more than one or two breaths, so allow rest time when needed.

       Swimming

      Instruction

      1.Breathe in, with hands together and elbows bent.

      2.Push both arms forward on breathing out, as if swimming breaststroke.

      3.Turn the palms up and open the arms wide, as you breathe in.

      4.Repeat four times.

      These are good general warm-ups in any class, and are essential before working more specifically into the shoulder and upper back area. See the postures in the shoulder and upper back section on page 97.

      Further shoulder mobility and strength is gained in other classical postures, where movement and alignment work with the function of the whole body.

      HANDS AND FINGERS

      It is worth spending a little more time than usual to check out how each individual can manage wrist rotation, hand and finger exercises, as these areas are particularly affected by spasm, and where motor control is lost.

       Spread and clench

      Instruction

      1.Separate and spread the fingers wide; feel the stretch across the palm and between the fingers.

      2.Make tight, tight fists or ‘claws’.

      3.Flick the fingers away sharply.

      4.Repeat a few times for each hand.

       Shake

      Loosely shake the hands as if you are shaking water off. This is good to do on a cold morning, to get the hands a little warmer.

      Parkinson’s note: Some students with Parkinson’s have real problems with this and cannot loosen up enough to do the flicking. The same will apply if you offer foot loosening. Keep going and allow them to explore it anyway, and with practice, a