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

an inhale breath, lift the arms up towards the ceiling, and lift and lengthen through the front of the body as well as the back.

      5.Exhaling, bend from the hip joint, keeping the spine long and allowing the knees to bend.

      6.Reach forward and then down. Let the hands and arms rest wherever is comfortable.

      7.Come out on an in-breath and stretch the arms forward, and then bring the spine up.

      8.Alternatively, from the folded position, come up by uncurling the spine.

      9.Walk the hands up the legs to come out of the posture if the back needs support.

      Teaching focus

      •Keep the knees released unless the hamstrings are able to allow the legs to be straight.

      •Check that the knees don’t roll inwards.

      •Be aware of the muscles that are used in completing this movement.

      •Let each student work within their own limits.

      •Don’t hold for too long at first; work with going into the posture and coming out of it.

       Using the wall or a chair

      This forward-bending action can be offered from seated position or using the wall or a chair (Paschimottanasana, Seated Forward Bend) for support.

       Wall- or chair-supported bend

      Whether you use a wall or a chair depends on the height of the student. The wall is usually better for taller people.

      Instruction

      1.Stand about 1 metre away from the wall, and place your hands on the wall at shoulder height. Adjust the position of your feet to get the best alignment for the spine – they can be a little wider than your hips. Explore what is comfortable.

      2.Keep your knees bent if the hamstrings are tight.

      3.Walk the hands up or down the wall until there is a feeling of comfortable supported stretch.

      Teaching focus

      •Allow each student to explore their own limits.

      •Explore the distance, by moving further away from the wall.

      •Let the student begin with bent knees if necessary, and work towards straightening them gradually.

      •Look for body sagging, and encourage work into the abdominals, and check the shoulder position.

      •Check that the heels are down – a wedge-shaped block might help if there is strong shortening of the Achilles tendon.

      •Bring attention to the feet.

      MS note: For some people with MS, numbness is an issue. This affects balance and stability and therefore needs to be considered in the standing postures. Not being able to feel the feet will impact on how the other muscles are moved and used, so individual attention and adjustments to alignment are essential. Here you are playing the part of giving feedback that is lacking in the nervous system.

       Seated Forward Bend (Paschimottanasana), on a chair

      Instruction

      1.With the feet parallel and placed on blocks, if that helps the feet to feel grounded, lift the arms in parallel, lengthening the torso and spine.

      2.Forward bend from the hips on the exhale breath. Move into the bend slowly, going all the way down, hands to feet, or as far as they will go.

      3.To progress, this posture could be worked more slowly, stopping halfway with the spine and arms horizontal with the floor, inhaling and exhaling on bending further.

      4.To come out of the posture, lift and extend the arms up and forwards first, creating a horizontal line with the arms and the spine.

      5.Lift all the way up and then relax.

      6.If this is too strenuous, lift the spine with the arms in a soft relaxed position.

       Seated Forward Bend (Paschimottanasana), on the floor

      Props are helpful in this posture – a block to sit on to enable a better bend if the hip joints are tight, or a rolled blanket to support under the knees if the hamstrings are tight and the legs cannot be comfortably straight, or a strap to help facilitate alignment of the spine.

      Instruction

      1.Sit on the block. Feel for the ‘sit’ bones and connect into them.

      2.Take note of the knees and whether they want to bend; support underneath them with the rolled blanket if necessary.

      3.Place the strap around the soles of the feet and leave the ends loose beside the legs.

      4.Sit up tall and breathe in.

      5.Lift the arms up to lift up the ribs, and reach up.

      6.Hinge at the hip and bend forwards.

      7.Let the knees bend.

      8.Imagine you are going to lie along your legs. Go as far as you can and hold the ends of the strap, or hold your legs.

      9.Move a little further into the stretch.

      10.Come out by lifting the arms up again and sitting upright, or let the arms drop and return to upright in a softer way.

      This is contraindicated if there is osteoporosis, and hiatus hernia may also prove problematic if acute.

      Teaching focus

      •Go only as far as is comfortable.

      •Imagine a long line down the front of the body, and keep the line long.

      •Let the crown of the head move towards the feet, not the knees.

      •Swadistana chakra.

      •Breathe along the stretch, imagine light and space in the spine.

      •Avoid poking the chin forward, and keep the back of the neck long.

      Parkinson’s note: Those with severe kyphosis should focus on extending the upper back and avoid ‘crouching’ over. Give guidance for the position of the head and neck.

       Apanasana

      This easy flexion posture is a great way to begin to warm up and to release tension in the lower back.

      Instruction

      1.Lie flat on the floor. Support the head with a block to keep a length in the neck. This pose can also be started in a semi-supine position.

      2.Bend one knee, reach and clasp it in your hands, and fold it towards your body, as you exhale. Hug the knee and inhale, exhale again and lift your head up towards your knee.

      3.Inhale and put your head back on the block, exhale and lift it towards the knee.

      4.Repeat this action five times.

      5.Slide the leg away, and draw the other leg in.

      6.Repeat the movements and breathing.

      7.Draw both knees up together and hug them in on the exhale breath. Hold and inhale.

      8.Exhale and lift the head to both knees. Inhale and lower the head back to the floor.

      Teaching focus

      •Check for the head/neck position and support where needed.

      •Observe any difference in mobility in right and left.

      •Imagine breathing into the whole length of the spine.

      •Imagine the muscles lengthening and stretching like elastic.

      Rotation

      Twisting postures enable the small joints of the spine to be mobilised. Yoga offers standing, sitting and lying versions of this same action. Each offer something