Yogic Cure For Arthrities

Yoga for Arthritis : An introduction booklet of Yoga practices for arthritis written by Dr. R. Nagarathna and Dr. H R Nagendra published by Swami Vivekananda Yoga Prakashana and printed by Sharadh Enterprises, Bangalore-560 003, pp 77+10, pb, 1/8th Demy

YOGA FOR

ARTHRITIS ©

Reserved

First eBook Edition : Sep 2006

Dr R NAGARATHNA,

M.D.,(Gen. Med.).,

F.R.C.P.(Edinburgh)

Dr H R NAGENDRA,

ME., Ph.D.,

ePublished by : www.HealthAndYoga.com for Swami Vivekananda Yoga Prakashana

''Vivek Kutir', # 9 Appajappa Agrahara Chamarajpet, Bangalore-560 018 Karnataka, INDIA Phone : (080) 661 2669 Tel Fax : 91-080-660 8645 Email : [email protected] Web site : www.vyasa.org

Published by : Swami Vivekananda Yoga Prakashana "Vivek Kuteer', # 9, Appajappa Agrahara Chamarajpet, Bangalore - 560 018, Karnataka, India

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FOREWORD It is a common experience of human beings that their minds and bodies are closely interlinked. Any disturbance in either of them is bound to affect the other. Mental worries do lead to physiological problems and bodily discomfort does impact on the mind. Yoga and Ayurveda, the ancient Indian sciences recognised this symbiotic relationship of body and mind long ago and postulated the concepts of Ádhi and Vyádhi.

to them for the great service they have rendered. I am confident that with the awareness of the benefits of yoga now increasing among people around the world, the discerning persons would make proper use of these booklets for the improvement and maintenance of their physical and mental health. Hariç Om Tatsat. Prof NVC Swamy Ex Director, IIT, Madras Chief Adviser sVYASA

Closely linked with Ayurveda is the science of Rája Yoga and its branch Hatha Yoga. Western philosophy and psychology even now lay great stress on the body and consider the mind to be its by-product. However the ancient Indian sciences have always considered mind as being supreme over matter and have based their practices on this idea. That yoga practices can help in the amelioration of certain types of psychosomatic diseases has been known for a long time. But no systematic investigation had been undertaken based on modern accepted norms of scientific research. It goes to the credit of Swami Vivekananda Yoga Anusandhana Samsthana (sVYASA) that over the last quarter of a century it has conducted systematic research in this field and has developed packages of physical and mental practices suitable for several psychosomatic diseases. There has been a need felt for some time to consolidate these results and to bring them out in the form of booklets, each one dedicated to a particular disease. I am glad that this need has now been amply met by this series of booklets, in which there is a methodical description of the Ásanas, Práïáyáma, Meditation and Kriya, in a simple and easily understandable language and profusely illustrated. The authors have to be congratulated for the pains they have taken in this venture. The general public indeed has to be grateful (ii)

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PREFACE It was 1977-78 when Eknathji Ranade, the founder of Vivekananda Kendra movement called us and asked "as medical professionals of this motherland, what is your dream?’’ We said that we could develop several hospitals giving high tech modern medical facilities to the needy brothers of this land. But he said that it is not enough if you just duplicate the hospitals in the existing style. Our mission should be to evolve techniques to unfold the inner potential divinity of man to heal and grow towards better and better positive health. And also establish the efficacy of our ancient science of yoga, which is no less than 5000 years old, in scientific terms as a socially relevant science. He also said that Bhárat should have several referal holistic healing centres where people from all over the world would come over and benefit from this unique knowledge of yoga therapy. He was the mastermind who encouraged us to go round the country, study at the feet of Yoga Gurus who had insights into this healing art. It was a great experience to go round several Yogashrams, talk to patients who had benefited from yoga therapy and record their progress. It was our main task to learn ‘what technique for what disease?’ from these masters. After obtaining convincing evidence of the healing potential of the practices that had helped these patients, we sat down to compile the data and prepare the list of practices for different conditions. To our surprise it was all a great mess. The patients had improved very well but it was dynamic asanas in one centre, slow pace of asanas in another, only Práïáyáma in yet another or only meditation in another. To add to our confusion one guru would use a posture or breathing to cure a condition whereas another guru would prohibit the same posture or breathing f or the same condition. For example, if Sarváñgásana was never to be practiced for hypertensive patients as per one centre, the same would be the recommended asana in another centre.

A little deeper thinking gave us the clue to decipher this riddle. All these patients using any of the practices had actually practiced ‘Yoga’ - the state of inner tranquility, mastery and freedom from fears and anxieties. And this was the common factor that helped all of them towards complete recovery. Now it became simple for us to understand Swami Vivekananda’s statement that the goal of healing is to unfold the potential divinity by one or more or all of the four aspects of yoga, namely Karma, Bhakti, Jnána or Rája yoga. Thus yoga therapy is not organ specific but it is a science that works holistically to strengthen the inner being. The next bigger challenge was to put together the concepts learnt from these Gurus, the knowledge base from traditional texts, the growing knowledge of pathophysiology of diseases from modern science and the feasibility of teaching them to our patients in an acceptable and enjoyable fashion. We started scanning through the traditional texts of yoga and spirituality. The concept of 5 layered existence of all of us as postulated and described in great detail in Taittireya Upaniúat as Panca Koùa was found to be the most holistic concept of human existence which is in no way contradicting the modern systematic approach to the understanding of human body. It is more generalised, holistic and hence can contain in it the physical body ~ [Annamaya Koùa] and the next three layers Práïamaya, Manomaya, and Vijnánamaya Koùás which are called the subtle bodies in Vedanta and spiritual lore. The fifth koùa the Ánandamaya Koùa is the causal body from where all other layers take birth. Thus we got a holistic and concrete perspective of human existence as the foundation for yoga therapy. Disease, in modern medical perspective is considered as dysfunctioning of organs and systems which may be due to congenital defects, external atmospheric agents like allergens, toxins, pollutants or infectious germs. Modern science does recognize that the other major cause for diseases could be the

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factor of internal imbalances like mental restlessness, emotional upsurges or intellectual conflicts that lead to stress reactions. The concept of disease according to yoga is found in the treatise called Yogavásiúûha. According to this text, the modern diseases such as asthma, diabetes, hypertension, and anxiety are called “Ádhija Vyádhi”(stress born diseases) originating in Manomaya Koùa- the astral layer of our existence. They arise from our actions that are governed by our emotions [strong likes and dislikes] rather than what is right or what is wrong. Often in this phase, we respond to our emotions - the pull of senses knowing fully well that we are going against what is right. This is called Prajnáparádha in Ayurveda-a mistake at the level of inner consciousness. It is this ‘going against what is right - the cosmic law ‘that causes an imbalance, a dis-ease at the Manomaya Koùa called Ádhi. The Adhi at the astral layer if not remedied will bring imbalances at the level of Práïamaya Koùa that shows up as breathing jerks, imbalances and speed. This in turn creates stress reactions causing autonomic and endocrine imbalances leading to diseases in the body called Vyádhi. Such diseases are called Ádhija Vyádhi i.e. Vyádhis created of Ádhis. The other category of diseases such as infections and injuries come under Anádhija Vyádhis which essentially are physical in nature and can be tackled by modern medical system effectively. Since the Ádhija Vyádhis are multi dimensional, we need to tackle them not merely with physical symptomatic treatment measures. The whole man has to be treated. And only then can there be lasting remedy to our problems of the modern era. The answer lies in the Integrated Approach of Yoga Therapy that provides techniques for correcting the problem at both the gross (physical) and subtle levels. Yoga practices help in bringing about balance at the level of all the five Koùas so that complete health can be restored. The practices at Annamaya Koùa include yogásanás, Ùithilèkaraïa vyáyáma [loosening practices], yoga diet and yoga kriyás, at

Práïámáya Koùa - breathing practices, breathing kriyás and Práïáyáma. At the Manomaya Koùa, the practices are meditation [Cyclic meditation and Om meditation], devotional sessions and happy assembly, where-as lectures, counseling and satsangs correct the notions about one’s life ambitions and goals that form the basic conceptual root for the life style of the individual. Karma yoga and tuning to nature are the practices that help one to get established in Ánandamaya Koùa bringing bliss in our lives. Based on all these information, we felt confident to start off our courses in yoga therapy with several workshops, camps, conferences, and seminars between 1980 to 85. Thousands of patients participated, learnt the techniques and started giving their feed -back. Based on the experiences of the patients we went on learning what, why and how of many of the techniques taught to them. A general set of integrated approach of yoga therapy which gave fascinating results in diseases like asthma, diabetes, hypertension, anxiety, etc. started evolving into more and more specific practices which could give quicker results, requiring lesser duration of practices. We also learnt from the feedback of patients how to give immediate relief for episodic conditions like asthma, migraine, panic disorders, etc. While treating these patients, we recorded data before and after 2 weeks of yoga therapy and followed them up to 10 years. The results were statistically analysed and published in indexed scientific medical journals. This series of booklets include step by step instructions for the set of practices, which could be practiced for an hour daily by patients with different ailments. These are safe practices. The practices that could be harmful for the conditions have been carefully avoided based on the knowledge of the physiological effects of these practices and its expected effects on the disease. However it is safe for you to ask your doctor or medical advisor before you start practising these techniques. The ideal way to use this booklet is to keep this as a reference book after you have (vi)

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learnt them under the guidance of a yoga teacher trained in our system of yoga therapy. The list of practices mentioned in the contents are all safe. If you have more than one illness, you need to select these common practices from the list for all those illnesses (see our other volumes). The complete list in the booklet would take more than one and half hour to practice. Start with a set of simple practices amongst these, and gradually go on to achieve the capacity to perform the entire set. The ideal way to plan your daily yoga practices is, 45 minutes of physical practices followed by Ùavásana in the morning, Práïáyáma and meditation for 45 minutes in the evening. Daily practice is mandatory. Physical practices have to be performed only in empty stomach or 4 hours after a major meal or 2 hours after a small meal. Do not practice yogásanas when you are very tired or during menstruation. Meditation and Nádánusandhána can be practised even after a meal or during menstruation in women. We are indebted to Smt. Subhadra Devi, Kum. Asha Didi, Sri Ganga Ningombam, Sri. Natesh and many other Yoga Therapists for their help in preparing this booklet.

Dr R Nagarathna Dr H R Nagendra

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CONTENTS

D Page Nos.

1

MODERN MEDICAL AND YOGA PERSPECTIVE OF ARTHRITIS

2

ÙITHILÈKARAÏA VYÁYÁMA AND YOGÁSANÁS.

31

A

Sthiti (initial) and Ùithila (relaxation) Postures for all Ùithilèkaraïa Vyáyáma and Ásanás.

31

B

Ùithilèkaraïa Vyáyáma (Loosening Exercises)

35

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

35 35 36 37 38 38 39 39 40 42 42 43 44 46

C

Passive rotation of toes Toe Bending Ankle Bending Ankle Rotation Knee Bending Knee Rotation Knee Cap tightening Half Butterfly Full Butterfly Waist Rotation Wrist Rotation Shoulder Rotation Neck Bending Neck Rotation

47

1. 2. 3. 4. 5. 6. 7. 8.

47 47 48 48 49 49 50 51

For Wrists - Mani Bandha Ùakti Vikásaka For Palms - Kara Tala Ùakti Vikásaka For Fingers - Anguli Ùakti Vikásaka For Elbows - Khaponi Ùakti Vikásaka For Arms - Bhuja Bandha Ùakti Vikásaka For Back - Kati Ùakti Vikásaka For Thighs - Jangha Ùakti Vikásaka For Calf Muscles - Pindali Ùakti Vikásaka

1. 2. 3. 4. 5. 6. 7. 8. 9.

1

Ùakti Vikásaka Süksma Vyáyáma

Yogásanás

3 A. B. C.

D.

Ardhakati Cakrásana Ardha Cakrásana Páda Hastásana Bhujañgásana Ùalabhásana Dhanurásana Sarváñgásana Matsyásana Viparèta karaïi

52 53 53 54 55 55 56 57 58

10 Halásana

58

11. Cakrásana

59

12. Ùaùáñkásana

60

13. Vakrásana

61

14. Ardha Matsyendrásana

61

15. Uútrásana

62

16. Instant Relaxation Technique (IRT)

63

17. Quick Relaxation Technique (QRT)

64

18. Deep Relaxation Technique (DRT)

64

PRÁÏÁYÁMA Postures for Práïáyáma and Meditation Mudrás for Práïáyáma and Meditation Preparatory Practices for Práïáyáma

67 69

1 Cleansing breath (Kapálabháti Kriya) 2. Vibhágèya Ùvasana (Sectional Breathing)

71 73

71

Práïáyáma 1. 2. 3. 4. 5.

Sürya Anuloma Viloma Práïáyáma Candra Anuloma Viloma Práïáyáma Náãè Ùuddhi Práïáyáma Cooling Práïáyáma Bhrámarè Práïáyáma

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77 77 79 80 82

4

5

MEDITATION

83

1. Nadánusandhána.

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2. OM Dhyána (Meditation)

85

KRIYAS (CLEANSING PRACTICES)

87

1. Jala Neti.

87

2. Sutra Neti.

88

3. Vamana Dhouti.

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6 INTEGRATED YOGA MODULE FOR ARTHRITIS

90

ONE HOUR SCHEDULES - Set-A

96

Set-B

98

INDEX

100

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MODERN MEDICAL & YOGA PERSPECTIVE OF ARTHRITIS

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Pain in the joints is a common problem which may vary from a minor discomfort to a disabling chronic problem affecting the quality of life to a great extent. The biomedical inventions have given great mobility and functional ability for damaged joints. It is not unusual to find persons with 10 to 20 joints (small and big) replaced as and when the joints get damaged, which has helped them to live their lives in comfort. Thanks to fascinating advances in medication too, which has definitely saved an arthritic from the devastating side effects of steroids. But, have we hit the nail on its head? Have we been able to cure or prevent joint diseases? The answer is a clear ‘No’. Increasing problems of aging changes in the joints, are expected even as our life expectancy and longevity have increased all round the globe. But what about the other types of arthritidis which are hitting younger persons? Rheumatoid arthritis, a disease of temperate climates, is still an enigma as we have not been able to remove the root cause of the disease. With the advances in technology as applied to the understanding of the disturbances at the molecular level we now have a huge fund of knowledge about the functional interrelationship between the brain, immune system, genes and all other organ systems of the body. This understanding has made us recognize the role of the mind over matter (the body) as well as the influence of cellular activities on the mind. There is an intricate feed back loop of connections that point out that many of these common disabling diseases of the joints can be traced to the life style, that triggers off the underlying family (genetic) tendencies. Yoga with its holistic understanding of the human body mind complex provides a well developed programme of practices to set right or correct these deep internal imbalances caused by the erratic life style. This booklet is a guide to Yoga therapists as well as patients

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suffering from arthritis.In the first part of the book an attempt has been made to give a brief understanding of the modern medical and yogic perspective of joint diseases. The second part of the book gives instructions to the daily practices of yoga to be performed by a patient with arthritis.

STRUCTURE AND FUNCTIONS OF JOINTS Types of Joints : 1. Immobile joints are seen in the skull bones. They hold the flat bones of the skull together and are simple. The irregularly sawed margins of one bone fits into the irregular crevices in the margin of the other bone. 2. Mobile joints are also called Synovial joints. These could be i. Hinge joints as in knees, elbows and fingers. ii. Ball and socket joints as in hips and shoulders. iii. Facet joints of the spine between vertebral bones. Amongst these two major types of joints, arthritis affects only the mobile joints as they are most vulnerable to injuries and inflammations.

What is Synovial joint ? In most of the mobile limb joints, the expanded ends of the two long bones come together to form the joint. The two bony surfaces that touch each other are lined by a thin pearly white, smooth, shiny, hard material called articular cartilage. The two Proximal phalanx

Synovial fluid

Metacarpal

Synovial membrane

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1 Dr. R Nagarathna

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Caritlage

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Dr. HR Nagendra

bone ends are enclosed inside a well protected space covered by a tough outer sheath called joint capsule. There are strong thick cord like structures (ropes) that hold the bones firmly together called ligaments. The free joint space is filled with a lubricating fluid called Synovial fluid. This fluid is slimy and is continuously replenished. Synovial membrane forms the velvety soft inner coating of the joint capsule. This is full of blood vessels and glands that secrete and reabsorb the lubricating fluid. Muscles are attached directly to the bones that go to form the joint. Contraction and relaxation of these muscles cause movement of the joints. As the muscle approaches the point of attachment to the bone it may change its texture into a tough non-contracting material called tendon. Tendons are strings that can manoeuvre the narrow passages to reach the bone across the joint in which the movement takes place. For e.g., the hands and feet are full of thin long tendons extending from bulky muscles of the forearm and calf, so that the fine movements of fingers and toes can be ensured.

What causes Arthritis? The word Arthritis means Arthra = Joint, itis = inflammation. Not all pains in joints can be called arthritis.When Pain in the joint and muscles occurs without any inflammation, it is called arthralgia and myalgia. According to yoga texts all types of pain

Causes Anadhija - non-stressborn Infections Acute Chronic Reactive

Adhijah - stress born Osteo arthritis Rheumatoid Arthritis Sero negative Sero positive

Injuries Acute phase Chronic phase With deformities

Connective tissue diseases Arthralgias Musculo Skeletal pain Fibromyalgia Osteoporosis

in the joints can be classified under two major headings. Adhija - stress born and Anádhija - non-stress born causes. Arthritis due to Anádhija causes (external causes) include those due to infections, injuries and toxins. Apart from direct invasion of joints by germs as in chronic TB, Leprosy etc, or pus producing acute arthritis, reactive arthritis is another condition wherein inflammation in the joints occurs as a response to infection anywhere else in the body (e.g., rheumatic fever, post dysentery arthritis etc.). The treatment of infections certainly requires antibiotics administered as medicines. Here the role of yoga is to strengthen the immune system to fight better; and also to prevent and correct deformities. The other common Anádhija causes of painful joints are due to injuries i.e., post-traumatic effects on joints. Here yoga practices have been used effectively to minimize pain and swelling, prevent or correct deformities. The other common causes of chronic arthritis fall under the category of “Adhija vyadhi” or stress related arthritis. Osteo arthritis and rheumatoid arthritis are two common conditions under this category. Fibromayalgia, autoimmune connective tissue disorders with musculo skeletal pains and non-specific arthralgias, are other Adhija causes of musculo-skeletal pains.

What is Osteo-arthrosis ? Osteo-arthrosis (OA) is a condition related to aging of the joints. The causes could be primary or secondary. The common joints ARTHRA - JOINT ITIS - FIGHTING (INFLAMMATION) COMMON - WEIGHT

BEARING JOINTS

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affected are the weight bearing joints. Hence it commonly affects the knees, hips, lumbar or cervical spine.

ii. Decreases in glycosaminoglycan concentration and

The secondary OA occurs in any joint that might have sustained injury due to trauma, or gout, or inflammation, some years ago, which goes on to produce wear and tear changes.

A dynamic balanced turnover of these substances helps the cartilage to function as an efficiant shock absorber. Once the balance is disturbed the cartilage starts wearing out which is a very slow process.

What happens in OA? The exact cause of OA is not yet known. The condition starts by wear and tear changes in the cartilage of the joint. Much research has gone on in the last ten years to understand the chemical changes that happen in the joint cartilage with aging. The cartilage is not a solid non-living material. There occurs a continuous WEAR & TEAR OF JOINTS SMOOTH LINING OF BONES - CARTILAGE BECOMES ROUGH & THIN

iii. Disruption of proteoglycan aggregation.

This wearing out starts as pitting on the surface which is initially more obvious on the margins of the ends of the long bones. When this process continues over a number of years the bone becomes exposed at the margins. To cover up the exposed points, extra bone gets deposited in place of healthy smooth cartilage. These bony deposits are called osteophytes. Thinning of the cartilage due to pits on the surfaces goes on and adds to reduction in the joint space. The joint starts creaking due to roughened surface and the extra bone (osteophyte) deposition at the margins. When the bone rubs against each other the pain sensitive nerve endings get stimulated and they send messages to the brain leading to pain. Now and then, there could be acute pain with much swelling requiring medicines and rest. During these episodes there is an active inflammation, an attempt of the body to remove the foreign body. The foreign body in the joint that causes acute arthritis could be the particles of bone or cartilage that may have been chipped off during periods of excessive strain on the already

programmed cell and fluid turn over in the cartilage to maintain a healthy balance. As the age advances, the rate of repair of the cartilage is not in proportion to the rate of wear and tear that goes on. The water content in the cartilage increases and becomes vulnerable to rapid wear and tear changes leading to formation of pits on the smooth surface. There are other biochemical changes in the cartilage which include i. Alteration in ratio of chemicals called Chondroitin and Keratin.

aging joint.

Is OA related to Stress? Osteo arthrosis, we have seen, is a natural aging process just like the skin becoming wrinkly, hair turning grey, teeth becoming loose, or the arteries becoming hard. In the modern life style we see many of these aging processes hastening up leading to early greying or baldness or early atherosclerosis with coronary artery disease leading to heart attacks in very young persons etc. Similarly the joints also show early aging changes. 6

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According to yoga we are born with a stock of Práïa programmed to last for a full life span of one hundred years. We go on spending a small part of it for all our day to day activities. Emotions demand larger amount of energy (Práïa) expenditure than physical activities. With the fast life style of modern living studded with hypersensitized emotional surges, and suppressions, the rate at which we burn out the práïa is much faster. The Práïa stock that had to last for a hundred years is being used up and hence the problems of aging show up at an earlier age. The joints also being a part of the whole system would obviously reflect the changes of early aging in the form of chemical changes in its cartilage followed by all the after effects of osteophyte formation and deformities. This concept is being understood today as genetic programming of cell turn over. The rate of cell destruction and regeneration is programmed in our genes. As the age advances the rate of cell regeneration falls short of the rate at which the cell destruction takes place. The pace at which this disparity happens is also programmed. It is as if we have a soft ware that has a programme of aging which goes on automatically for a century if a person leads a disciplined life in tune with nature and his own natural programmed biorhythm. A stressful life style alters the internal environment for gene expression and the program in the gene that decides the rate of aging gets disturbed. Hence a rapid aging process due to stress is due to altered rate of cell destruction and regeneration. Locally, the health of the cartilage requires moderate degree of movement. Just like the muscles would become weak when not used, the joints when not moved enough become unhealthy and vulnerable to injuries.

Today life can be managed most effectively with minimum (almost nil) physical movements, and hence OA is becoming a common problem of the sedentary life habits of modern life of computers and cars. Obesity is another factor that hastons up the rate of joint damage. The other end of the spectrum that could cause early aging changes in weight bearing joints is excessive injuries during physical sports. Repeated injuries obviously (small and big) could cause early aging as the repair rate of cartilage is very slow leading to osteophyte formation and OA. Thus, the spine and the weight bearing joints (hips and knees) are most vulnerable to OA in the modern age because of a combination of these extremes i.e., too little activity due to sedentary life and injuries due to heavy sports.

What is Rheumatoid Arthritis? Rheumatoid Arthritis (RA) is a disease of joints characterized by inflammation in many joints, that occurs at an younger age than OA. It generally starts off with pain in small joints of fingers and toes, in cold season after an episode of infection or delivery or around menopause. Pain and swelling affects middle and ring fingers, wrists, and toes; lasts for about 3 to 4 weeks and goes away with medicines; may be associated with fever, and general

RHEUMATOID ARTHRITIS LIFE STYLE - FAST LIFE SEDENTARY LIFE

STRESS

YOUNG PERSONS 20 - 50 YRS (OA > 60 YRS) MORE IN WOMEN F : M RATIO 5 : 1

OR VIOLENT SPORTS LEADS TO EARLY AGING

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weakness if it is a bad flare up. The pains may recur a few months later, again triggered by a physical or emotional stress, lasting for long durations, affecting more and more joints; when healing occurs it may lead to stiffness and deformities which is the most worrying aspect of this chronic disease. Although RA is found in all parts of the world , it is more common as severe in cold countries. There are different variations of RA; it may affect joints without swelling ; may be associated with problems in other organs. when it occurs in men, it affects bigger joints like hips, shoulders and spine.

What causes RA? No single cause has been established. But there are many things that we know about it. One of the major factors known in the cause of RA is autoimmunity.

What is autoimmunity? The immune system is our defence system equipped with different types of white blood cells to fight any dangerous invasion by enemy bacteria, viruses, foreign bodies or even a transplant tissue. This defence is just like the border security force of a country. The radors sense the enemy movements; the information reaches the chief vigilance officer who is put on the alert. After several meetings and discussions the war is declared; suitable type of army is recruited and the war begins.;continuous moment to moment monitoring goes on until the war is over;the entire country is put on vigilance and co-operation;all other activities and celebrations are deferred except the basic needs. A very similar phenomenon happens within our body. The white blood cells (WBCs )sense the invader, messages are sent to the camp site - the lymph nodes and thymus, where the decision is made to trigger off the fight. Intricate details are noted about the type, quantity, quality and severity of the invasion before decisions are made about what type of army (cells- lymphocytes, eosinophils, monocytes or chemicals- antibodies, compliments, local hormones) that has to be recruited to the site. Once the

decision is taken, the primed fighters are brought through the blood stream to the site and actual warfare (inflammation) takes place. The WBCs and the chemical fighters surround the invader, break the bacterial cell wall and dissolve the cell material. In the process the WBCs are themselves destroyed. After all the germs or the foreign material is destroyed the debris liquifies (pus), is thrown out and healing begins by filling up the damaged area by the surrounding healthy tissues or scar tissue. Of all these steps involved in this complex immune processes, the most important and sensitive component is the capacity of the WBCs to sense danger by differen tiating foreign cells from self cells. This is the most highly evolved faculty that is unique to a race or an individual. WBCs do this by identifying the differences in the structure of the proteins contained in different cells. In auto -immunity this capacity to differentiate ‘self from nonself’ is disturbed. The WBCs think that the self protein itself is foreign and send RH EU M ATO I D ARTH RI TI S messages to recruit fighter cells to that CAUSE particular area and AUTO IMMUNITY inflammation begins. In FIGHTING AGAINST SELF rheumatoid arthritis the body thinks that the cells JOINT LINING CELLS in the synovial lining of CONSIDERED NON-SELF BY the joints are foreign and DEFENCE CELLS the inflammations triggered off. This inflammation leads to swelling(tumor), pain(dolor), redness(rubor) and local heat (calor). After the acute phase is over when the healing takes place by scar tissue the joint gets fixed in odd positions and this leads to stiffness and deformities. Due to immobility and damage to the joint structure, the muscles around the joints become wasted(weakened).

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What triggers autoimmunity in rheumatoid arthritis? One of the well known factors is the cold weather. In RA we know that there occurs a typical seasonal aggravation of the disease. The other factor that is known to trigger off RH EU M ATOI D ARTH RI TI S autoimmunity is stress. It is WHY ? AUTO IMMUNITY observed that RA starts off • HEREDITY or flares up in most women • TRIGGERS after some form of stress. Stresses could be physical STRESS PHYSICAL STRESSES like an infection, post COLD CLIMATE POST DELIVERY delivery, or menopause. Or MENOPAUSE it may be an emotional trigger. Generally, it has been observed that you are sensitive by nature and trying to cope up with too many emotionally demanding situations in your life over a number of years. Also, there is usually an immediate trigger in the form of an acute emotionally demanding situation.

The Central Nervous System (CNS) is disturbed if your mind is disturbed. Long standing persistent emotional surges and suppressions trigger off the loop of persistent excitement starts off chronic imbalance in their chemical regulation mechanism. Several chemicals have been identified (ACTH, cartisones, cytokines etc.) that are released in large quantities from different parts of this psycho- neuro-immune pathway that affect the immune system functions. One way you could understand this is, when there is a danger we fight to survive; if there is a long PSYCHO NEURO IMMUNOLOGY STRESS & AUTO IMMUNITY

B THYMUS

LYMPHOCYTES

T

RH EU MATOI D ARTH RI TI S

• EMOTIONAL STRESS MODERN LIFE STYLE NI C

There seems to be a strong family tendency for rheumatoid disease at the background, which has made you vulnerable to autoimmune arthritis, and the stresses of life either physical or emotional have triggered off the actual disease process.

immunology is the science that has understood these connections vividly both through animal and human experiments.

N IO T A ON TR SSI S U E FR E PR D G IN K C S O T SH VEN E

Today modern science has understood the mechanisms of how this stress can trigger off the autoimmune process. Psycho-neuro-

Mrs. Jayanthi a 35 year old house wife come with typical rheumatoid arthritis of about 3 years duration. After she came

CH RO

Psyche, central nervous system and immune system.

standing danger we become more and more violent; we lose our discrimination, and start getting muddled; turn into a brute; forget the soft human qualities and get lost in acts of destroying the fellow human beings who may not be our enemies; this is what happens to your immune system. The most highly developed faculty of differentiating self from non-self is the first function to be knocked off, when you are chronically stressed. The killer instinct takes the upper hand and produces an autoimmune inflammation in the joints.

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out of her problem through yoga therapy she became confident to express her stress problems. She analysed herself and said that the cause of her RA was her sensitive nature, and suppression of her emotions. Coming from a rural background, and being married to a joint family (5 members) in the city, she had too many things to adapt in her new life. The emotional adjustment to accept the ways of the new house, husband, and the neighborhood, was quite demanding. Her biggest problem which caused the major emotional suppression was her interaction with the mother-inlaw. Mother-in-law being a meticulous obstinate personality would go on pointing out the mistakes several times in the day. This left her in a state of constant fear throughout the day. This unexpressed fears ended up with joint pains, with active symmetrical arthritis (RA). The pains were suppressed by long term suppressant medication and she was managing to do her routine duties. But because of repeated flare ups, increasing doses of medication and the mounting fears of long term crippling, her illness only went on persisting for about 3 years before she came for Yoga therapy. This is how the problem that starts in the mind brings about the stress induced autoimmune problems.

What are the other stress related rheumatic problems? Ankylosing spondylitis is a (Bamboo spine disease) is a form of auto-immune arthritis with a strong genetic back ground, that occurs more commonly in males affecting mainly the spine, pelvis and hip. The healing stage is characterised by bony fusion of the joint and hence the joints become fixed. Fibromyalgia is a type of rheumatic disease without active arthritis. This condition is characterized by complaints of generalised muscular pains, shifting from one place to another, with several tender spots in the painful muscles, that comes and goes episodically. This is also a life style related disease with inflammation in fibrous tissue and a general internal imbalance of psycho-neuro-muscular pathways.

Other conditions which do not clearly fall under any one specific pattern of a definable disease or syndrome would include arthralgias, myalgias, episodes of myositis and generalised body aches of unexplained etiology. Another major category of autoimmune disorders that includes connective tissue disorders like lupus, polyarteritis, scleroderma, etc., affect many organs including joints, kidneys, skin, muscles, eyes etc., are also adhija vyadhis with a strong family tendency. Stressful life events trigger off the actual imbalance that manifests around middle age as a specific ailment through damage to connective tissues by autoimmunity. Chronic fatigue syndrome(CFS) is another common disease of the muscular system, about which much research is going on. In this condition the fatigue is so severe that even to lift the hand from thebed could be a Herculian task. Research is continuing in order to understand the cause of CFS. It is believed to be a virus infection with an autoimmune process related to stressful life style.

Management of Arthritis Modern medicine has recognized the role of helping a patient with arthritis by a multidisciplinary approach, involving several experts including a physician, rheumatologist, orthopedic surgeon , physiotherapist, nurse, occupational therapist, psychologist and yoga therapist.

How do modern medicines work in Rheumatoid Arthritis? The Objective of drug therapy in RA has three goals. i. Symptom relief ii. Suppress inflammation, and iii. Prevent joint destruction. The first level is symptom relief by painkiller tablets (Analgesics) which benumb the nerves from sending off the messages of pain to the brain. 14

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The second level drugs include non-steroidal anti inflammatory drugs (NSAID) and steroids.

large number of patients with RA from the devastating crippling problems.

Steroids (Carticosteroids) which was the only miracle drug that was available a few decades ago, has been replaced by NSAIDS because of the large number of serious side effects. Obesity, hypertension, diabetes, thinning away of bones with proneness to multiple fractures, skin problems and vulnerability to chronic dangerous infections are known to occur with long term usage of any of the categories of steroids. Hence today steroids are prescribed for short periods of not more than 4 to 6 weeks in rare situations of severe and dangerous flare up of RA, when it affects heart, eyes etc. It is also established that steroids do not have a disease modifying potency. Local steroid injections into the joints,

What are the drugs available for management of OA?

eyes etc, are still used as it has no major side effects.

Physical therapies in the management of Arthritis

The NSAIDs are the commonly used agents as the first line of medication in all forms of rheumatic pains. Research over the years has been directed towards evolving potent and safe NSAIDs with less and less side effects. We can say that we have a succeded in the discovery of NSAIDs with almost no side effects even when consumed over years. A minor degree of stomach upset is probably the only minor side effect with the latest drugs of this category. Steroids and NSAIDs work at the level of the white blood cellsthe soldiers are blocked from attacking the cells in the lining of the joints by preventing the expression of the inflammatory processes.

Advances in technology has given many aids and gadgets for physiotherapy and occupational therapy. Local heat, wax bath,

The third category of medicines which are to be used for a long period of time in RA are called disease modifying anti rheumatic drugs (DMARD). These are Gold, D Penicillamine, anti-malarials like chloroquin and Immuno Suppressant drug Methotroxate. DMARDs are used for long term suppression of the basic immune disturbances. All these drugs are associated with many minor and major side effects requiring very close monitoring and careful look out for side effects that may affect the kidneys, eyes, blood etc. A judicial use of a combination of all these drugs has saved

Pain killers and Anti-inflammatory agents (NSAIDs) and local injection of steroids into joints form the first line of relief in OA. But none of these are curative. Many new drugs are now available that are known to have protective and preventive role in OA. These are Chondro-protective drugs (protect the cartilage), Prevent proteoglycan loss from cartilage as the age advances or stimulate cartilage synthesis or inhibit phagolytic enzymes that are responsible for rapid destruction of the cartilage. Glucosamine, Arteparan and Rumalon are the drugs in this category.

Anti inflammatory drugs Steroids, NSAID

Joint Inflammation Annamaya kosa

Auto Immunity Pranamaya kosa

STRESS

Manomaya kosa

Immuno- suppresants methotrexate Psycho therapy,

Yoga

medicated oil massage, ultra sound vibration therapy are all used for pain relief. Several gadgets are designed to rehabilitate and improve the quality of life of patients with already damaged joints. Replacement of joints that are damaged that may not be tackled by all the available medicines is now available. We can see that although there has been enormous amount of knowledge and therapeutic help that is available in modern medicine, none of these really tackle the problem at its root

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cause.Hence research continues. Let us see how yogis under stood this problem of psychoso- matic ailments and offered remedies.

Integrated approach of Yoga Therapy for Arthritis The integrated approach of yoga therapy provides techniques to address the problems of all aspects of the stressed fast life style of the individual. According to yoga we all FI VE FACETS OF PERSONALI TY have five bodies. The solid physical body ANNAMAYA visible to our eyes made PRÁNAMAYA of a permutation and combination of hydroMANÔMAYA gen, oxygen, carbon, VIJÒÁNAMAYA nitrogen, calcium, and ÁNANDAMAYA potassium etc. is called PANCA KÔÙA Annamaya koùa (physical body). The life energy (práïa) that makes each and every cell carry on its functions is práïamaya koùa (vital energy body). Right dose of práïa is supplied to all cells to maintain health. The mind which carries on the functions of perception, memory and emotions is called manomaya koùa (mind body or astral body). The inner mind that controls and guides the manomaya koùa is called vijnánamaya koùa (knowledge body). This is the judge who decides what is right and wrong based on life’s experiences so that we can live a life of contentment, bliss and happiness. In the fifth which is the subtlest body called ánandamaya koùa(bliss body), the person is in perfect health at physical, mental, emotional, social and spiritual level because of total inner mastery over the functioning of each one of the other four koùas. Ill health results if there is lack of mastery. According to yoga psychosomatic problems begin in Manômaya Koùa (mind layer of our existence) as an Ádhija vyádhi. Ádhi is stress. Stress begins in the mind (Manas) as

uncontrolled surge of emotions (Bhávana). These emotions such as anxiety, worry or depression, tension etc., are psychological responses to deman-ding situations either real or imagined. Stress is defined as Jes i e ( Vega) -excessive speed. Stresses are our emotional reactions( GÜsie - Udvega) described as the six enemies

of man namely, keÀece (intense desire) ¬eÀesOe (anger), ueesYe (miserliness)

ceesn (infatuation) ceo (arrogance) and ceelme-e&

(jelousy). In all these

emotions there is one common factor namely the excessive speed of the rate of flow of our thoughts. This is described as “ keÀece

¬eÀesOesodYeJeb Jesieb

“ (Kama Krodhodbhavam vegam in Bhagavad gita -

intense desire and anger lead to excessive speed.) These stresses carry enormous power (energy) by gathering momentum by the recycling of thoughts unceasingly in the Manômaya koùa. This speeded up loop goes out of control and we get lost in the speed. This speed when suppressed over a long period of time starts clouding the faculties and disturbs the balance of the 5 koùas. The ánanda or Jnána- the right knowledge, is clouded by the emotions. We get completely lost when worrying becomes a full time occupation. We start feeling tensedup all day, worried all night and depressed for days. Sleep gets disturbed. As the energy is drained out in this speeded up loop of worry, the other soft faculties of the mind like cheerfulness, patience, and contentment get replaced by violent emotions of reactivity, restlessness, depression, unfounded apprehesion, lack of drive, indecisiveness, irritability and forgetfulness etc. These are the manifestations of the uncontrolled stress reactions i.e., speed of the mind. When this goes on for some time it percolates into the Práïamaya koùa and disturbs the Práïa balance; excessive erratic surges of Práïa manifests initially as functional disturbances like excessive generalised tiredness, bodyaches, feverishness, exhaustion and immune disturbances . At this phase the most commonly noticeable imbalance is in the form of irregular breathing pattern - disturbed rate, rhythm, and depth of breathing followed by irregularities in digestion with disturbed appetite and

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bowel habits. When the suppressed stresses continue for some more months or years, it settles down in the joints as excessive Práïa that gets locked up in Nadis around joints. The inflammation that shows up in the joints is the excessive speed that has percolated from Manômaya to annamaya via Práïamaya Koùa. Inflammation, a war against the synovial membrane -an auto immune fight- a civil war. The speed is grossified into visible structural damage. Yoga says that you had the full freedom to react or not to react or react other wise in the Manômaya Koùa initially when there was a demanding situation. But when you amplified the reactions, you started losing the freedom. Once you lost the freedom, the chain of reactions went on gathering momentum and it settled down in the joints as inflammation. Yoga texts also explain this phenomenon as a process of constriction, as in the example of formation of Ice. The molecules that had complete freedom to diffuse into a wide space in the gaseous state, became confined to the boundaries of a container in the liquid state which later became constricted with very minimal freedom in the solid state of ice. Similarly when the stress reactions are in the state of ‘thought’ in Manomaya Koùa there is full freedom. Then it recycles and gets bound into the Práïa (liquid state) with less freedom. As it constricts further it solidifies into annamaya Koùa as joint problem with least freedom. This understanding is useful to you because it is a reversible process. Just like the ice can melt into water and vapour, you can reverse this whole process of constriction (in the form of arthritis) towards expansion or complete freedom from disease. This process is called ÒeefleÒemeJe (Pratiprasava-retracing). You can start reversing the whole process of inflammation by using three tools namely ‘internal awareness’ , ‘slowing down’ and ‘expansion’. You need to work with enormous confidence and fearlessness to acheive complete cure from this autoimmune arthritis or the aging arthritis. The IAYT provides techniques to change the imbalances at all the five Koùas.

IAYT for Rheumatoid Arthritis - Annamaya Koùa practices. All annamaya Koùa practices are meant to ‘reduce the speed’ at the physical level, i.e., give very deep relaxation and rest to the entire body in general and to the painful muscles and joints in TECHNICS OF YOGA

TECHNICS OF YOGA

ANNAMAYA KÔÙA

ANNAMAYA KÔÙA

JOINT LOOSENING EXERCISES REDUCES STIFFNESS OF JOINTS

SAKTI VIKÁSAKA SÜKÚMA VYÁYÁMA STRENGTHENS MUSCLES

IMPROVES FLEXIBILITY

AROUND JOINT

particular. Pain in the joint is seen as “speeded up activity” i.e., too many of the pain sensors are being triggered off to send electrical impulses to the brain. When there is a joint inflammation the surrounding muscles get tensed i.e., too many of the muscle fibers get activated in order to prevent joint movement. This muscle spasm is also speed. When you follow the special technique practices designed for arthritis, you must develop the deep internal awareness to consciously slow down the activity in the stretched part which is experienced as a feeling of rest, relaxation, ease, freedom, let go, and expansion. When you go through the full list of the practices you will be working with the whole body part by part to give a stretch followed by deep rest and relaxation. Patanajali gives the hints for achieving these two goals of “slowing down” and “expansion” when he talks about

Òe-elve MewefLeu-e ( Prayatna ùaithilya), trick to let go of all effort toslow down, and “ DevevlemeceeHeeflle “ (Anantasamápatti), the trick to expand and merge your awareness in the imagery of vast endless sky or ocean. When you practice the physical practices, your mind should focus intensely(OeejCe - Dharana) on the point of pain or stretch. Stretch up to a point where your pain is tolerable or enjoyable. Bring your full concentration on to the point of pain. 20

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As soon as you release ANNAMAYA KÔÙA the position (in repeating type of movements) feel YOGASANAS the let go, freedom,ease SLOWNESS & BREATHING and expansion at the spot • DEEP REST TO JOINTS where you had the stretch • RED U CES I NFLAM M ATI ON or the pain. Develop a • D ECREASES PAI N & SWELLI NG deep internal awareness of • IMPROVES FLEXIBILITY this alternate stretch and let go, which can be looked upon as speed and slowing down, or pain and no pain, or effort and effortlessness, or constriction and expansion, or focussing and defocussing. When you move on to yoga ásanas where you do not repeat the practices you have to maintain in the final posture of the ásana for some time. When you have moved into an ásana come to the point of tolerable degree of pain. Maintain with ease. Relax all other parts of the body which you had contracted unnecessarily (prayatna ùaithilya). Continue to maintain in the final posture of the ásana; focus your attention on the painful part. Now move on to the next phase (Ananta samápatti ) and start slowly diffusing the impulses from the point of pain, by merging your mind in the visualization of the vast blue sky for a few seconds. Enjoy the beautiful sky umbrella above your head. Bring your awareness back to the point of pain. By this time your pain would have started diffusing. Thus patanjali’s suggestions help you to get freedom from pain even while maintaining in the final posture of an ásana.Thus you start unwinding the constriction and speed in the joint (annamaya Koùa level) to expansion and slowness by using the tool of deep internal awareness, confidence and fearlessness; you need the courage and steadfastness to go through the practices regularly to reap the positive results of these practices. Kriyas are techniques that help to cleanse the system from deep within so that the internal organs get revitalized to function normally. The kriyas provide the strong stimulus followed by

very deep rest to the organs that are being cleansed. A systematic graded gradually increasing stimulus followed by very deep rest improves the stamina of the organ to function more efficiently. Pure sátvic diet is a pre-requisite to yoga. It helps you to cleanse the bowel, improve digestion and clear the mind. A sátvic diet, as the word indicates, makes your mind clear, gentle and soft so that you could have the necessary steadfastness, calmness and confidence to work with yourself.

Práïamaya Koùa practices. The Práïa imbalance is the bridge between the stressed mind and the sick body. This shows up as irregular breathing. Slow down the breathing. When you slow down the breathing rate, the mind slows down. As we know there is a direct YOGA TECHNIQUES - PRÁNAMAYA AKÔÙA . connection between our 10 YRS PRÁNÁYÁMA . mind and the breath. BREATHING RATE Whenever you are FAST - SHORT LIFE anxious, depressed or SLOW - LONGER LIFE angry (an emotional PRÁNÁYÁMA . speed), your breathing DELAYS AGING - OA 300YRS rate speeds up and vice REDUCES STRESS - RA versa. i.e., whenever you are calm, relaxed, sleeping comfortably or meditating,your breathing becomes slow. Sages picked up this connection and used breathing as a tool to slow down the mind. All breathing practices help you to balance the Práïa. Reducing the speed at the Práïamaya Koùa conserves the unnecessary wastage of vital life energy.It trains you to draw only the required quantum of energy and use it in the most economical way. Whenever you start doing the Práïayama and other breathing practices remember a few points ♦ Never overstrain the respiratory muscles. ♦ Do not overdo the rapid breathing or breath holding practices. ♦ Exhalation must be longer than inhalation during all Práïayamas. 22

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After you have become adept in the basic set of Práïamaya, you will go on to the subtle technique of Pranic Energization Technique (PET) which is a very deeply relaxing and balancing practice for the Práïamaya Koùa. This is the stage in which you can perceive the points where there is excessive Práïa may have been blocked within the nádis. You will start mobilizing and harmonizing the subtle energy in different channels (Nádis). You will start experiencing the meaning of constriction Vs expansion in the joints, slow Práïa Vs speeded up Práïa in the pain zone etc.

Manômaya Koùa practices Mr Jayaram, a 28 year-old unmarried young man was admitted to Praùanti Kuteeram with marked pain and inflammation in multiple joints. A typical symmetrical distribution of small followed by bigger joints, exhaustion, general debility and weight loss was the picture of his Rheumatoid Arthritis. Blood tests showed a positive rheumatoid factor with high ESR of greater than 100mm in the first hour. He was brought in a wheelchair into his bed in our árogya dháma which he occupied for the next few weeks. We had to initially give him significant doses of painkillers and non steroidal antinflammatory medicines to help him out of extreme pain and immobility. We had to work with very few physical practices, a lot of relaxation and Nádánusandhána. After the first week he started moving around in the wheel chair with an attendant. It took almost ABHIMANYU 6 weeks for him to build up his stamina, loosen the joints, reduce the inflammLEARN TO COME OUT OF THE ation and reduce his medication. He was LOOP OF STRESS

now fully ambulant and felt confident to go back to his duties. He went home with great joy only to come back after 4 weeks with a bad recurrence. His joints were again inflamed with much pain and stiffness. Mr. Jayaram said that “Dr. I have come back; but, I am now very clear in my mind as to how and why my joints flare up. This time I have come to work at my Manômaya Koùa. I improved last time under your guidance. But I was not convinced that it is all the correction at the mind level that works. I thought it was the sukshma Vyáyáma, Práïayama, good diet, and the kriyas that I practiced regularly that helped me. But when I went back home all my problems converged on me and the disease came back. I could literally feel how my mind would get lost in my fears, then disturb my breathing; I lost my confidence and the mastery over my mind; ended up in this flare up of my arthritis. I have to now listen to yoga concepts more carefully, culture my mind, work at the vijnánamaya and ánandamaya Koùa; I shall do it”; And he did it. His story was that he was the second son of a poor family of 5 children with a small family business. The elder brother had already left the family with his own family and business. The father passed away and this young man felt the whole burden come on to him. The shock of the bereavement and the unexpected load of responsibility of having to manage the business, looking after the mother, getting sisters married were all too much. Being a sensitive responsible youth, he started building up the fears and that was the back ground which had MANOMAYA KÔÙA 23 made him develop joint pains and left him crippled and bed ridden within about a year after • CM - DEEP CALMNESS the demise of the father. His medical - MEDITATION expenses added to DIVINE MOOD - CALM - REST his financial problems

C

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caused by inability to carry on with the business . The first time he came to Prashanti, as he came away from the problem situation and was given the techniques of IAYT, he improved very well. When he went back and had to actually face the situation, although he thought he had strengthened his will power to cope up with the demands, it was too much. He got lost in the whirlpool of his own fears, and came back. This time, he studied the concepts of Karma yoga and Bhakti yoga with keen interest. He practiced dháraïa, dhyána, cyclic meditation, MSRT and PET regularly. After 6 weeks he was confident, completely free from his arthritis, felt physically and mentally strong to face the situation better. He went back home, took up the business and picked up gradually and steadily with hard work . With a cheerful approach he managed to encourage the family members to become confident and stable. The inter-personal relationships improved. He could now carry on as a yoga teacher in the town, too. It is now 10 years since Mr. Jayaram had this episode in his life. He is a happy healthy human being, free from arthritis; no deformities; a great source of strength not only to all his family members but also to many suffering persons in his village. He got his sisters married. He now has his own family with a beautiful child. Even today he continues with his regular practices, now not for the treatment of his illness but to grow as a better and better human being to lead a useful spiritual life of joy, peace and harmony. MANOMAYA KÔÙA

DEVOTION - BHAKTI - SURRENDER

OF

BEING IN THE PRESENCE OF YOUR BELOVED

REDUCES STRESS & MAKES YOU YOUNG

Manômaya Koùa pracitces of dháraïa, dhyána and devotional sessions help you to work directly on the mind. It is here that the stresses begin. The trick of dhyána helps you to learn the art of slowing down the speeded loop of

thoughts; a training to unwind the loop of worry, depression etc. “Manah praùamana upáyah,” the trick to slow down the mind has to be practiced regularly after the physical and breathing practices every day. The cyclic meditation is a useful tool for the agitated mind to be brought under control through the principle laid down in Máïdükya kárika, a yogic text, that helps even a sick and suffering person to get the feel of these deep states of inner quietitude, calmness, ease, relaxation and deep inner rest- the state of alertful rest described in meditative states. Devotional sessions help you to culture the emotions. All stresses are nothing but violent emotions expressed or suppressed, that need to be replaced by soft emotions. Bhakti yoga uses the tool of “Pure love”. This path of surrender, sacrifice, joy in the joy of others, giving instead of asking, accepting instead of complaining, and nurturing motherly feelings of giving without expectations etc.; all these help you to mature as a human being from the lower instinctual demanding nature to a more humane accepting nature.

Vijnánamaya Koùa Practices Working at the Vijnánamaya Koùa, you become an observer(Sákúi) of your own mind. You are able to ask more basic questions about the purpose and meaning of your own life. Understand that the only purpose of VIGÒANAMAYA KÔÙA any pursuit is to get the contentment or NOTIONAL CORRECTIONS fulfilment; that this  SILENCE IS HAPPINESS state of joy is an inner state of bliss  REDUCE RUSH AND SPEED FOR and harmony and MATERIAL JOY quietitude; to achieve  BE CHEERFUL AT ALL TIMES and retain this state  BE YOUNG ALL THE TIME is whole of the purpose of this life;

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with this inner steady state of mind if you can see your own life you will drop off most of the reactions, fears, anxieties and depressions.

were compared with ten who did not practice yoga. All these were N 34 AGE: 46+12 chronic patients on long term disease modifying medication from the Rheumatology depart % improvement after 2 weeks of IAYT ment of South Cleveland Hospital, SS: symptoms score; PAS:pain analogue scale;PPC: physiological checklist; SRAS: self rating anxiety Middlesbrough, England. The psycho scale; BRS:Bortner’s rating scale (type A personality) yoga group showed significant improvement in hand grip strength and disability index as per Stanford health assessment questionnaire after three weeks. They all reported much better quality of life.They felt confident , sronger, less tired, and could manage their daily chores with much greater free- dom and ease. In another study on 34 rheu% improvement after 2 weeks of IAYT AM: Angle of movement; JS: Joint swelling; matoids in india we noticed HGS: Hand grip strength significant improvement in symptom scores (52%), pain analogue scores(50%), ESR (11%), and joints swelling (10%), after two weeks of IAYT. (STRESS PROJECT) 1996-98 CCRYN

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50

40

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2 0 .8

Ánandamaya Koùa Practices

20

1 6 .6

10

0

SS

Karmayoga is the trick to remain in Ánandamaya Koùa. The art of working in relaxation, work with an attitude of yajna (offering to Divine), working without ÁNANDAMAYA KÔÙA worrying about the results of action, working with a sense of duty, living in the present, working in tune with the universal principle ; recognizing that you are basically made of the universal stuff called Ánanda from which the entire universe has emerged; that all pain and suffering, losses, and gains in business, name, fame and money including this physical body are all ephemeral; that they all come and go and ‘you’ are the ever lasting, unchanging, ever blissful, imperishable entity. Scriptures proclaim thus

De®ísoîeess -eceoeÔîeess -ecekeÌuesoîeess Mees<-e SJe ®e~ efvel-eë meJe&ieleë mLeeCegë De®eueess-eb meveeleve:~~

Acchedyoyámadahyoyam akledyo’ùoúya eva ca', Nityaç sarvagataç stháïuç acaloyam sanátanaç.

I am that imperishable entity which cannot be cut by a knife, burnt by fire, wet by water, dried by wind; I am that eternal immovable all pervasive reality. This gives you fearlessness; complete freedom from the fear of death is the hallmark of perfect health.

Is there any scientific proof ? IAYT was used (Haslock et at. B.J. Rheum. 1999; 33(8): 788). as an adjunct in the management of ten patients with RA. They

PAS

PPC

S R AS

BRS

12

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(S T R E S S P R O JE C T ) 19 96-98 C C R Y N 10

10

8

6

5

4

3.2

2

0

ES R

HG S

JS

AM

IAYT for Osteo-arthrosis In this degenerative or aging arthritis yoga has been used effectively, both for prevention and treatment.

Prevention is better than cure Ásanas practiced regularly starting from young age offers smooth continuous healthy movement to the joints. Most ásanas are designed to keep the hips and spine flexible. This provides the necessary degree of balanced movements without jerks or bangs on the cartilage, thus preventing their early wear out. Relaxation in the final position of the posture emphasized by Patanjali when he talks about prayatna ùaithilya and Ananta samápatti (relax in the final posture and tune your mind to infinity) to maintain the posture with ease and comfort, is a subtle tool that promotes a very healthy blood flow to the cartilage.

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How does Yoga help OA? The physical yoga practices provide a systematically graded training in gradually increasing the range of movements when practiced with deep internal awareness. This not only helps to mobilize the stiff joints but can prevent further aging process. Although the damaged cartilage may not get replaced, further deterioration and wearing out can be arrested. In chronically damaged joints with pain and deformities, the surrounding muscles would be very weak because of long standing inactivity. Similar to physiotherapy many yoga practices when practiced with deep internal awareness and repeated, can help you to strengthen the muscles around. Ùakti vikásaka Sükúma vyáyámas are specific practices that provide the non-weight bearing isometric as well as isotonic exercises that strengthen the muscles that provide the weight bearing support to the damaged joints. The additional contribution of yogic sukúma Vyáyáma is the deep relaxation, which takes away the muscle fatigue.

Can yoga reverse OA changes? Working with the Práïamaya and Manômaya Koùa level practices of Práïayama and dháraïa and dhyána, helps you to move towards a more balanced functioning of all organs of the body including the joints. Stress reduction that emerges out of the notional correction at the Vijnánámaya Koùa reduces the basic fears of life that is responsible for the rapid process of aging. You continue to perform in the same set up with efficiency. The inner equipoise, contentment, absolute fearlessness and confidence to accept all ups and downs of life would almost arrest the process of further aging. It would give you a rechanged refreshed life with a total change in your world view, moving towards positive outlook. Stress reduction at this deep level of notional correction is the one that can revert the programmed gene function to a normal rate of cell repair in the cartilage. The further chapters in this booklet gives you step by step instruction for the regular daily practices that would help you to work at all 5 Koùas inorder to improve your health and move towards complete freedom from illness.

PRAYER

Namaskára Mudrá Sit in any comfortable meditative posture and adopt Namaskára Mudrá. Close the eyes. Observe your whole body and breathing. Turn your mind inwards. Begin your yoga session with chanting the following verse from Upaniúads praying for the welfare of the teacher and the student:

C menveeJeJeleg menveew YegvekeÌleg menJeer³e¥ keÀjJeeJenw~

lespeeqmJeveeJeOeerlecemleg cee efJeefÜ<eeJenw~ C Meeefvleë Meeefvleë Meeefvleë ~~ Om sahanávavatu, Sahanou bhunaktu, Saha vèryam karavávahai , Tejasvinávadhètamastu, má vidviúávahai Om Ùántiç, Ùántiç, Ùántiç. May he protect us both (i.e., the teacher and the student). May he nourish us both. May we both work together with great energy. May our study be enlightening and fruitful. May we not hate each other. Om Peace, Peace, Peace.

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2 ÙITHILÈKARAÏA VYÁYÁMA AND YOGÁSANÁS A.

STHITI (initial) and ÙITHILA (relaxation) postures for all Ùithilèkaraïa Vyáyáma and Yogásanás.

Sthiti (Initial) for Sitting Posture -Daïãásana



Sit with both legs stretched with heels together. Place the palms on the floor by the side of the buttocks.



Keep the spine, neck and head erect.



Close the eyes.

Sthiti: Initial standing posture - Táãásana





Stand erect with feet close together. Place the hands along the thighs with fingers stretched out.

Ùithila (Relaxation) for Sitting Posture - Daïãásana

The legs, trunk and the head are aligned in a straight line.



Close the eyes and observe the balance.





Sit with legs stretched apart and relax. Slightly incline the trunk backwards, supporting the body by placing the hands behind. Fingers point backwards. Let the head hang freely behind or rest on either side of the shoulder. Gently close the eyes.

Standing Relaxation Posture -

Ùithila Táãásana





Stand erect with legs about six to twelve inches apart, hands hanging freely by the side of the body with the shoulders collapsed. Make sure that the body is completely relaxed. Gently close the eyes. 31

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Sthiti (Initial) for Prone Posture

Sthiti (Initial) for Supine Posture

Lie down on the abdomen with legs together toes pointing outwards, the soles of the feet facing up and chin touching the ground.









Lie down on the back with legs together. Stretch the hands straight above the head, biceps touching the ears and the palms facing the ceiling. Close the eyes.

Stretch the hands straight above the head, biceps touching the ears and palms resting on the ground. Close the eyes.

Ùithila (Relaxation) for Supine Posture - Ùavásana Ùithila (Relaxation) for Prone Posture - Makarásana.





Lie down on the abdomen with feet wide apart, heels touching the ground and facing each other.







Bend both the elbows and place the right palm on the left shoulder and the left palm on the right shoulder. Rest the chin at the point where the forearms cross each other. Gently close the eyes.



Lie supine on the ground with hands and feet apart. Slightly stretch the body and allow the whole body to relax completely with eyes gently closed.

Become aware of different parts of the body starting from toes to head.Feel the spread of relaxation in all parts of the body progressively. With regular long practice, the relaxation will become deeper, natural and spontaneous. Then the whole body is relaxed to the extent that one forgets the body. The mind experiences alertful rest.

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B ÙITHILÈKARAÏA VYÁYÁMA 1. PASSIVE ROTATION OF TOES Sthiti: Daïãásana or sitting in a chair.

PRACTICE •

Bend the right leg at the knee, place the right foot on the left thigh.

•

Move the individual toes with the left hand (i.e., passive movement) bending them forward & backward, right & left followed by clockwise and anti- clock wise rotation five times each.

•

Then hold all the toes with the left-hand, rotate and bend them forward and backward 5 to 10 rounds.

•

Repeat the same practice with the left foot.

Note

• •

While practicing with individual toes, pull them outwards with the hand before moving them. If necessary, the instructor does the passive movement for the patient.

2. TOE BENDING Sthiti: Daïãásana

PRACTICE •

Sit with the legs outstretched and the feet together.

•

Place the hands beside the buttocks fingers pointing forwards.

•

Keep the spine erect.

•

Bring the awareness to the toes.

•

Bend the toes backward.

•

Keep the feet upright and the ankles motionless during the practice.

•

Hold each position (forward and backward) for a few seconds.

•

Practice with normal breathing.

•

Repeat ten times.

slowly forward and

Note

• •

This practice can also be done while sitting in a chair. If necessary, do this practice with each foot separately.

3. ANKLE BENDING Sthiti: Daïãásana

PRACTICE •

Sit with the legs outstretched and the feet apart (about 6 inches).

• •

Bring the hands near the buttocks finger pointing backwards.

•

Keep the spine and neck erect.

•

Bring the awareness to the feet.

•

Move both feet slowly forwards and backwards, bending them at the ankle joints.

•

Try to stretch the feet forward to touch the floor, and then pull them up towards the knees.

Slightly lean backwards shifting the body weight on to the arms.

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•

Hold each position (forward and backward) for a few seconds.

5. KNEE BENDING

•

Practice with normal breathing.

Sthiti: Daïãásana

•

Repeat ten times.

PRACTICE

Note

• •

•

Bend the right knee and clasp the right thigh with the hands under them.

•

Now straighten the right leg by pulling up the knee cap so that the right heel is off the floor.

•

Keep the arms straight.

•

Now, bend the right leg at the knee so that the thigh comes close to the chest and the heel near the buttocks.

•

Then straighten the right leg with heel off the floor.

•

Practice with normal breathing.

•

This is one round. Practice ten rounds.

•

Repeat the same practice ten rounds with the left leg.

This can also be practiced sitting in a chair. If necessary, practice each foot separately.

4. ANKLE ROTATION Sthiti: Daïãásana

PRACTICE •

Separate the legs by about a foot.

•

Bring the awareness to both feet.

•

Slowly rotate both feet from the ankles together in opposite directions.

Note

•

The big toes touch each other on the inward stroke of each foot.

• •

Repeat 10 rounds.

•

Practice with normal breathing.

•

Bring the awareness to the knee joint during the practice.

6. KNEE ROTATION Sthiti: Daïãásana

Change directions and repeat 10 rounds.

PRACTICE • Lift up the right thigh.

Note

•

Bring the right knee to 90o.

• • •

•

Support the thigh with interlocked hands.

•

Keep the right leg parallel to the ground.

•

Now, rotate the right lower leg around the knee joint five times clockwise and five times anti-clockwise. 38

Keep the heels in contact with the ground throughout the practice. Do not allow the knees to bend. This can also be done sitting in a chair or cot keeping the knees straight.

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• • •

Practice with normal breathing. Bring back the right leg down on the floor. Now repeat the same with the left leg. Note

• • •

While rotating allow the leg below the knee to hang freely You can do this, even sitting in a chair or at the edge of a cot. With this practice of Knee rotation, there is no risk of injuring the knee joint.

•

Stablize the position of the right foot throughout the practice with the help of the left hand.

•

Gently move the right knee up towards the chest and then gently push it down and try to touch the ground with the knee.

•

Repeat this up and down movement of the right knee 10

7. KNEE CAP TIGHTENING Sthiti: Daïãásana

times.

PRACTICE • Close your eyes and bring your awareness to the knees.

• Slowly pull the knee caps upwards and then release them. • Repeat this practice 20 times with normal breathing.

Note •

Do not practice mechanically. Practice with full awareness.

8. HALF BUTTERFLY

•

Inhale while the knee goes up and exhale while the knee comes down.

•

Repeat the same with the left leg.

Note

• • • •

9. FULL BUTTERFLY Sthiti: Daïãásana

PRACTICE •

Bend both the knees, draw the legs along the ground, to bring the soles of the feet to press each other and the heels touch the perineum.

•

Completely relax the inner thigh muscles.

Sthiti: Daïãásana

PRACTICE •

Bend the right leg and place the right foot as far up on the left thigh as possible with right heel touching the groin.

•

Place the right hand on top of the right knee.

Keep the leg muscles as relaxed as possible. The leg muscles should be passive, the movement being achieved by the use of the arm only. Do not force this movement . The trunk should not move.

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Stage - I (Clasping the feet with the hands)

10.

• •

Sthiti: Táãásana

Clasp the feet with the fingers. Now gently bounce the knees up and down.

•

Try to touch the knees to the ground on the downward stroke with normal breathing. Practice thirty to fifty up and down movements.

• •

Stage - I I (Hands on the knees) • • • • •

Place the hands on the knees. Using the palms, gently push the knees down towards the ground, allowing them to spring up again. Normal breathing. Repeat twenty to thirty times. Straighten the legs and relax.

•

>

PRACTICE • Spread the legs apart by about two feet • Place the hands on the waist. • First push your hips forward. • Rotate the waist by moving to the right, •

•

WAIST ROTATION

then to the back and to the left. Ultimately bring it back to the front where you started. This completes one round. Inhale during forward movement. Exhale during backward movement. Practice ten rounds in clockwise and ten rounds in anticlockwise direction. Come back to normal standing position, drop down the hands and relax in Táãásana

Note

• • • •

Maintain good balance all through the practice. Stand firm on the ground. Try to make the circles bigger and bigger. You may also allow the breathing tobe natural without trying to synchronise with rotation.

11. WRIST ROTATION Sthiti: Táãásana

PRACTICE • Extend both arms forward with the

Note

• • •

Do not force the movements. Try to keep the back, neck and head straight. Also keep the trunk steady during the practice.

>

• • •

fists clenched. Rotate both the fists in opposite directions. Practice ten times with normal breathing. Repeat the same practice in reverse direction.

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12. SHOULDER ROTATION

• • •

Stage - 1 Sthiti: Táãásana

PRACTICE • Rotate the shoulder girdles in a • • •

circular movement. First bring the shoulders forwards, then upwards, backwards and downwards ( i.e., back to Táãásana). This is one round. Practice 5 rounds slowly. Repeat 5 rounds slowly in the opposite direction i.e., forwards - downwards backwards - upwards .

Practice five rounds. Repeat the same practice 5 rounds in the opposite direction. Stand in Táãásana and relax. Note

• • • • • •

13.

Keep the fingers always in contact with the shoulders. Rotate the elbows in bigger and bigger circles gradually. Don’t strain yourself at any point of time. Always try and let the elbows touch each other when they are in front of the chest. You can practice this sitting in a chair if you cannot do it in Táãásana. Keep the body firm and the steady and face relaxed.

NECK BENDING

Sthiti: Daïãásana

PRACTICE Stage - I (Forward - Backward)

Stage - I I (Fingers on the shoulders) Sthiti: Táãásana

PRACTICE • Bend the arms at the elbows and place

•

Slowly move the head forward while exhaling and try to touch the chin to chest.

•

Then move the head as far back as comfortable with inhalation.

•

Feel the stretch of the muscles in front and back of the neck during the extreme position of bending.

•

Repeat 10 rounds.

the tips of the fingers on top of the shoulders.

•

Bring the elbows forwards and if possible let them touch each other.

•

Now, start rotating the elbows (and thereby the shoulders) upwards, then backwards and downwards.

• • • •

Inhale during backward movement of the shoulders and elbows. Exhale during forward movement of the shoulders and elbows. Synchronize the movements with breathing. This is one round. 43

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• •

Stage - I I (Right and Left bend) •

• • • •

Exhaling, slowly bend the head to the right, bring the ear as close as possible to the shoulder without turning the head or lifting the shoulder. Inhaling, bring the head back to normal position. Then exhale and bend it to the left side in the same fashion. Inhale and come back to normal position. This is one round, repeat 10 rounds.

•

14. NECK ROTATION Sthiti: Daïãásana

PRACTICE • •

Stage - I I I (Right and Left) • Keep the head upright with eyes

•

closed.

• Gently turn the head to the right

•

• Then slowly inhale and come back

• •

• Slowly exhale and turn the head to the left in the same fashion.

•

• Come back to normal position. •

This is one round, Repeat 10 rounds.

Note (For all the three Stages)

• • • •

•

Move the head as far as possible. Do not over strain. Keep the shoulders relaxed and steady. Feel the release of tension in the neck muscles and the shoulder muscles. Elderly people should not go to extreme positions.

>

Bend the head forward trying to touch the chin to the chest. Slowly rotate the head clock wise in as big a circle as possible. Practice ten rounds clockwise and ten rounds anti-clockwise whith normal breathing.

Note

while exhaling so that the chin is in line with the shoulder. to normal position.

•

Person with cervical spondylosis should avoid during acute pain. If you have pain at any stage, stop in that position for a while. As you bring your complete awareness to the area of pain, start breathing consciously and deeply and then continue the movement. It can be practiced standing in Táãásana or sitting in a chair, or in Vajrásana.

Allow normal breathing without trying to synchronize the breath and neck movements. Try to keep the eyes closed throughout the practice. Feel the shifting stretch around the neck and loosening up of the joints and muscles of the neck. If there is pain in any position, hold the head in that position. Become aware of the point or area of pain and start breathing consciously and deeply. This will relieve the pain and then you can continue. Can be practiced in cross-legged sitting position, sitting in a chair or in Táãásana. Elderly person and persons with cervical spondylosis may avoid this during acute pain.

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C SAKTI VIKASAKA SÜKÚMA VYÁYÁMA 1. MANIBANDHA ÙAKTI VIKASAKA (Wrists) Sthiti: Táãásana

PRACTICE •

• • •

Stretch your arms straight in front of the chest at shoulder level, keeping them parallel to the ground. Make tight fists of your hands (palms facing down). Now, move the fists up and down vigorously from the wrists. Repeat 10 rounds.

3. ANGULI ÙAKTI VIKÁSAKA (Fingers) Sthiti: Táãásana

PRACTICE • Throw out your arms in front, keeping them parallel to the ground at shoulder level. • Simultaneously give the fingers of both arms the shape of the hood of a cobra. • Now, stiffen the entire length of the arms from the shoulder joints to the finger tips as much as you can so that they start trembling. • Maintain this for about a minute. Note

• •

Tighten the arms until they start trembling. If you can not hold the arms trembling for a minute, hold it as long you can. Repeat it a few rounds.

2. KARA TALA ÙAKTI VIKÁSAKA ( Palms)

•

Sthiti: Táãásana

4. KAPHONI ÙAKTI VIKÁSAKA (Elbows)

PRACTICE

Sthiti: Táãásana

•

Stretch the arms sideways at shoulder level with palms facing downwards

PRACTICE • Stretch the arms straight down beside the

•

Bend the elbows and spread out and stretch all the fingures.

•

•

Bring the palms near the chest.

•

Now, move the palms up and down vigorously from the wrist.

•

Feel the strong tightness and stretch in the fingures and palms.

•

Normal breathing

• •

body, palms facing forward and make tight fists. Bend the arms at the elbows and raise your clenched fists forward to the level of the shoulders with a jerk. Then stretch them downwards again with a jerk. Repeat twenty times.

Note

• • •

The upper arms should remain stationary. The fists must come up to the level of the shoulders but should not touch the shoulders and then down straight. The fists must, not touch the thighs when they come down.

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7. BHUJA BHANDA ÙAKTI VIKÁSAKA (Arms) Sthiti: Táãásana PRACTICE



Make fists of your hands with the thumbs tucked in. Bend the elbows and raise the forearms till they are parallel to the ground (forming 90o with the upper arm), and the fists facing each other. Now, push both the arms forwards forcefully and vigorously to the level of the shoulder.





Then while exhaling bend forward trying to touch the head to the ground without bending the knees. Repeat this 10 rounds.

Note

Then, pull them back to the starting position. Repeat twenty times. Normal breathing.

7. JANGHA ÙAKTI VIKÁSAKA (THIGHS) Sthiti: Táãásana

Note



When pushed forward, the arms should be parallel to the ground and palms facing up. When pulled back, the elbows must not go back beyond the body (i.e., the starting position).

6. KATI ÙAKTI VIKÁSAKA (BACK)

PRACTICE



Sthiti: Táãásana

PRACTICE



Hands continue to be on the hips all through. Do not bend the knees any time during the practice. Make the movements within your capacity.



Spread your legs apart as far as possible. Place your hands on the hips with the thumbs pointing forward and the fingers pointing backward. While inhaling bend backward from the waist as far as you can. Maintain this posture for sometime.



Stretch out the arms straight in front at shoulder height, palms facing downwards. While inhaling bend your knees gradually till your thighs come parallel to the ground. Hold the breath and maintain this position. Come up while exhaling. Repeat 5 times.

Note

The knees must be together throughout the practice.

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You must not raise the heels or toes from the ground at any time during the practice. If you find it difficult to hold the breath, you can do it with normal breathing initially for a few days. Keep the arms parallel to the ground all through. Keep the back, neck and head as erect as possible.

PRACTICE:









1. ARDHAKATI CAKRÁSANA Sthiti: Táãásana



Sthiti: Táãásana





Clench the fists and stretch your arms forward at shoulder height.



While inhaling, squat and go down as far as you can. Holding your breath, stand up while your arms describe one full circle in the style of rowing a boat. On completion of the circle, the arms should be held before the chest, fists touching each other. Then exhale sharply while pulling the arms slightly backward and expanding the chest.

YOGÁSANAS (Yoga Postures)

PRACTICE

8. PIÏDALI ÙAKTIVIKÁSAKA (CALVES)



D





While inhaling, slowly raise the right arm side ways up. At the horizontal level turn the palm upwards. Continue to raise the arm with deep inhalation vertically until the biceps touches the right ear, palm facing the left side. Stretch the right arm upwards. While exhaling bend the trunk slowly to the left. The left palm slides down along the left thigh as far as possible.



Do not bend the right elbow or the knees.



Maintain for about a minute with normal breathing.



Repeat ten times.

Slowly while coming back to vertical position inhale and stretch the right arm up.Feel the pull along a straight line from the waist upto the fingers.

Note



Bring the right arm down as you exhale to Sthiti position.

• • •



Come back to Tadasana Sthiti.



Repeat on the left side, by bending towards the right side.

Maintain balance of the body throughout the practice. The knees should remain close to each other all through. The feet should remain on the ground all through.

Note

Bend laterally. Do not bend either forwards or backwards.

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2. ARDHA CAKRÁSANA



Sthiti: Táãásana



PRACTICE





Support the back at the waist by the palms, fingers pointing forwards. Inhale and bend backwards from the lumbar region. Drop the head backwards, stretching the muscles of the neck. Maintain for a minute with normal breathing.



Return to Sthiti.



Relax in Táãásana.







Exhale while going down further until the entire palm rests on the ground and chin touches the knees. Maintain in this final posture for about 2 - 3 minutes without bending the knees. Inhale, come up slowly to the vertical position and stretch the arms above the head. Exhale, drop down the arms, turn the palms downwards at the horizontal position. Continue to exhale and return to Sthiti. Relax in Táãásana.

Note



Never bend the knees. Keep the neck up until the forward bending at the hip and the waist is completed and then drop the neck freely down to touch the chin to knees.

3. PÁDA HASTÁSANA

4. BHUJAÑGÁSANA Sthiti: Prone Posture

Sthiti: Táãásana

PRACTICE

PRACTICE









Stand erect with legs together. Inhale slowly and raise the arms sideways.



At this horizontal level, turn the palms upward.



Continue to inhale and move the arms upwards until the biceps touches the ears. Turn the palms forward.



Stretch up the body from the waist.



Keeping the lower back concave, exhale and bend forward untill the trunk is parallel to the ground. Stretch out the shoulders at horizontal plane and inhale.



Bend the arms at the elbows and place the palms beside the lower chest at the level of the last rib exerting least pressure on the palms. Keep the elbows close to each other and let them not spread out. Inhale and come up. Arch the dorsal spine and neck backwards as far as you can. Keep the body below the naval in touch with the ground Maintain the final position with normal breathing for one minute with least pressure on the palms. While exhaling come back to sthiti position. Relax in Makarásana.

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5. ÙALABHÁSANA





Keep the legs together.



Maintain for about half a minute with normal breathing.



Slowly come back to Sthiti while exhaling.



Relax in Makarásana.



Sthiti: Prone Posture PRACTICE



Stabilize (rest) on the abdomen. Do not bend the elbows. Look up.



Make fists of your palms with the thumbs tucked in and place them under the thighs, with back of the hands towards the ground. While inhaling raise both the legs up as far as comfortable without bending the knees.

Note

Initially the knees will spread out, but with practice they can be brought very near, almost touching each other.

7. SARVÁÑGÁSANA Sthiti: Supine Posture



Maintain this position for about one minute with normal breathing. Come back to Sthiti position while exhaling. Relax in Makarásana.

PRACTICE

Note

Pull up the knee caps and squeeze the buttocks to improve the posture.



6. DHANURÁSANA Sthiti: Prone Posture



PRACTICE



Bend the knees and hold the ankles by the palms. As you inhale, raise the head and the.chest upwards.Pull the legs outwards and backwards so that the spine is arched back like a bow.





Inhale, raise the legs together slowly and gracefully (without bending the knees) till it forms about 450 to the ground. Continue to inhale and raise the legs further to 90 0 position and bring the arms downwards placing them next to the buttocks. Exhale raise the buttocks and the trunk , taking support of the arms and elbows, without lifting the head. Rest the elbows on the ground firmly and support the back with both palms. Retaining the legs parallel to the ground, straighten the trunk by pushing it with the hands untill the chin is well set in the suprasternal hollow. Inhale and raise the legs vertically keeping the body erect and come to the final shoulder stand position.

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Maintain effortlessly with normal breathing for about 2 to 3 minutes. Carefully avoid all jerks.



Slowly come back to Sthiti step by step and relax in Ùavásana



8. MATSYÁSANA

9. VIPARÈTA KARAÏI WITH WALL SUPPORT Sthiti: Supine Posture PRACTICE

Sthiti: Supine Posture PRACTICE



Take the right leg and place it on the left thigh. Place the left leg on the right thigh as in Padmásana.





Place the palms on either side of the head with fingers pointing towards the shoulders. Taking the weight on the palms, lift the head and the back, off the ground as you inhale. Bring the center of the crown of the head to the ground by bending the dorsal and cervical spine backwards. Exhale and release the hands after the weight is well balanced on the head and catch hold of the big toes hooking the index fingers around them. Press the elbows on the ground to bear the weight of the upper half of the body. Maintain this position for one minute with normal breathing. As you exhale come back slowly step by step to supine sthiti. Relax in Ùavásana.

















Note



Raise both legs to 900, slide them on to the wall, keeping the knees straight. Raise the buttocks and the trunk off the ground, rotate the trunk to make it perpendicular to the wall, support the body with the hands at the waist allowing the legs to rest on the wall. In this final position, the legs are completely on the wall. The trunk is inclined at about 450 to the ground. Maintain this position with normal breathing. In this position, consciously try to relax the back. Then slowly lower the buttocks to the ground, rotate the legs back to the floor, and relax.

Note

Make sure that you have achieved perfect balance before you release the hands supporting the trunk.

10. HALÁSANA Sthiti: Supine Posture PRACTICE



People with neck pain low back pain and hyper tension should avoid this posture.

Lie down on the back beside the wall, placing the body parallel to the wall.

Inhale raise the legs together slowly and gracefully (without bending the knees) till it forms about 450 to the ground. Continue to inhale and raise the legs further to 900 position and simultaneously bring the arms down placing them next to the buttocks.

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Exhale, raise the buttocks and the trunk without lifting the head. Support the back by the palms. Rest the elbows on the ground firmly to get better support to the back.









Exhale bring down the toes further to touch the ground. Release both hands and rest the arms straight on the ground parallel to each other with palms facing the ground. Maintain this position for one minute with normal breathing. Inhale come back slowly step by step to rest the trunk on the floor. Now exhale and bring down the legs to the ground. Relax in Ùavásana.

11. CAKRÁSANA



With palms and soles of the feet as four points of support, raise the trunk with an inhalation arching the entire body convex upwards to look like a wheel. Maintain the position for about half a minute with normal breathing. As you exhale come back slowly step by step to supine sthiti.

Note

Come down with control by placing the back of the head to the ground followed by the neck and the back. Do not collapse the buttocks first.

12. ÙAÙÁÑKÁSANA Sthiti: Daïãasana



Fold the right leg at the knees and then the left leg and sit on the heels in vajrásana resting the palms on thighs. Take the hands back, make a fist of the right palm and hold the right wrist with the left palm. Relax the ùhoulders.

PRACTICE

PRACTICE







Sthiti: Supine Posture



Maintaining the legs parallel to the ground straighten the trunk by pushing it up with the hands till the chin is well set in the suprasternal hollow. Inhale in this position.





Take the hands up and place the palms on either side of the head on the ground under the shoulders with fingers pointing towards the back. Bend the knees and fold the legs, and place the heels on the outer side of the buttocks.







While inhaling lean backwards a little from the waist opening up the chest. While exhaling slowly bend forwards from the waist bringing the forehead on to the ground in front of the knees. Collapse the shoulders. Maintain this position for about one minute with normal breathing. While inhaling slowly come up to the vertical position. Release your hands and come back to sthiti. Relax in Ùithila Daïãásana.

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13. VAKRÁSANA



Sthiti: Daïãasana.



PRACTICE





Bend the right leg at the knee and place it beside the left knee. Straighten and twist the waist towards the right as you exhale. Bring the left arm around the right knee and catch the right big toe. Take the right arm back and keep the palm on the ground in such a way that the trunk is kept erect with a proper twist. After maintaining for about a minute with normal breathing return to sthiti and relax for a while in Ùithila Daïãásana. Repeat the same on the other side.

Sthiti: Daïãásana. PRACTICE







Bend the right leg at the knee by drawing it along the ground. Place the sole of the right foot against the inner side of the left thigh. Keep the right heel about 4 to 5 inches away from the perineum. Bend the left knee and place the

left foot on the outer side of the right thigh near the right knee.

Look back over the left shoulder keeping the trunk erect.



Maintain for about a minute with normal breathing.



Come back to Sthiti.



Relax for a while in Ùithila Daïãásana.



Repeat the same, on the other side.

15. UÚTRÁSANA



Sit in Vajrásana.



Stand on the knees.





Place the palms on the waist with fingers pointing forwards. Inhale and bend the trunk backwards and place the palms on the heels. Maintain for about a minute with normal breathing.



Exhale while coming back to Sthiti.



Relax in Ùithila Danãásana.

Note

Do not sit on the heels.

Now take the left hand behind the back and try to touch the right thigh.





Exhale, twist the waist to the left and bring the right arm around the outer side of the left knee. The left knee acts as a fulcrum for getting maximum twist of the spine. Catch the left big toe with the right hand. The right triceps rests on the outer side of the left knee.

Sthiti: Daïãásana. PRACTICE

14. ARDHA MATSYENDRÁSANA





While inhaling raise the right arm up vertically and stretch up the shoulder.

The thighs should be perpendicular to the ground.

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Relaxation Techniques

17. QUICK RELAXATION TECHNIQUE (QRT)

16. INSTANT RELAXATION TECHNIQUE (IRT)

Sthiti: Ùavásana.

Sthiti: Ùavásana

PRACTICE Phase I

Feel the abdominal movements.Observe the movements of abdominal muscles going up and down as you breathe in and out normally. Observe 5 cycles.

PRACTICE









Bring your legs together; join the heels and toes together and place the palms by the side of the thighs. Keep the face relaxed with a smile all through the practice. Start tightening from the toes. Tighten the ankle joints, and calf muscles. Pull up the kneecaps. Tighten the thigh muscles. Compress and squeeze the buttocks. Breathe out and suck the abdomen in. Make fists and tighten the arms. Inhale and expand the chest. Tighten the shoulders, neck muscles and compress the face. Tighten the whole body from the toes to the head. Tighten…tighten…tighten… Release and let go the whole body instantaneously. Legs and arms go apart with the open palms facing the roof. Collapse the whole body. Enjoy the instant relaxation.

Phase II

Synchronize the abdominal movements with deep breathing.The abdomen bulges up with inhalation and sinks down with exhalation. Observe 5 cycles.

Phase III





As you inhale deeply and slowly, energize the body and feel the lightness. As you exhale completely collapse all the muscles, release the tension and enjoy the relaxation. Observe 5 cycles. Chant ‘AAA’ in a low pitch while exhaling. Feel the vibrations in the lower parts of the body. Slowly come up from either the right or the left side of the body.

18. DEEP RELAXATION TECHNIQUE (DRT) Sthiti: Ùavásana. PRACTICE

Gently move your whole body, make yourself comfortable and relax completely.

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Phase-I Bring your awareness to the tip of the toes, gently move your toes and relax. Sensitize the soles of your feet; loosen the ankle joints; relax the calf muscles; gently pull up the knee caps release and relax; relax your thigh muscles, buttock muscles; loosen the hip joints, relax the pelvic region and the waist region. Totally relax your lower part of the body. R..e..l..a..x .. . Chant A-kára and feel the vibration in your lower parts of the body.

Phase-II Gently bring your awareness to the abdominal region and observe the abdominal movement for a while, relax your abdominal muscles and relax the chest muscles. Gently bring your awareness to your lower back, relax your lower back, loosen all the vertebral joints one by one. Relax the muscles and nerves around the back bones. Relax your middle back, shoulder blades and upper back muscles, totally relax. Shift your awareness to the tip of the fingers, gently move them a little and sensitize. Relax your fingers one by one. Relax your palms, loosen the wrist joints, relax the forearms, loosen the elbow joints, relax the hind arms-triceps, biceps and relax your shoulders. Shift your awareness to your neck, slowly turn your head to the right and left, again bring back to the center. Relax the muscles and nerves of the neck. Relax your middle part of the body, totally relax. R..e..l..a..x .. . Chant U-kára and feel the vibration in the middle part of your body. Phase-III

Gently bring your awareness to your head region. Relax your chin, lower jaw and upper jaw, lower and upper gums, lower and upper teeth and relax your tongue. Relax your palateshard and soft, relax your throat and vocal chords. Gently shift your awareness to your lips, relax your lower and upper lips.

Shift your awareness to your nose, observe your nostrils, and feel the warm air touching the walls of the nostrils as you exhale and feel the cool air touching the walls of the nostrils as you inhale. Observe for a few seconds and relax your nostrils. Relax your cheek muscles, feel the heaviness of the cheeks and have a beautiful smile on your cheeks. Relax your eye balls muscles, feel the heaviness of eye balls, relax your eye lids, eye brows and in between the eye brows. Relax your forehead, temple muscles, ears, the sides of the head, back of the head and crown of the head. Relax your head region, totally relax. R..e..l..a..x ... and chant M-kára feel the vibration in your head region. Phase-IV

Observe your whole body from toes to head and relax, chant an AUM in a single breath. Feel the resonance throughout the body.

Phase-V Slowly come out of the body consciousness and visualize your body lying on the ground completely collapsed. Phase-VI Imagine the vast beautiful blue sky. The limitless blue sky. Expand your awareness as vast as the blue sky. Merge yourself into the blue sky. You are becoming the blue sky. You are the blue sky. Enjoy the infinite bliss. E..N..J..O..Y.. the blissful state of silence and all pervasive awareness. Phase-VII Slowly come back to body consciousness. Inhale deeply. Chant an “AUM-kára”. Feel the resonance throughout the body. The soothing and massaging effect from toes to head. Phase-VIII Gently move your whole body a little. Feel the lightness, alertness and movement of energy throughout the body. Slowly bring your legs together and the hands by the side of the body. Turn over to the left or the right side and come up when you are ready.

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Tuck the toe of the left foot into the fold of the right knee.



3 PRÁÏÁYÁMA

Push the right hand into the fold of the left knee and pullup the right big toe to ensure that it is kept pressed against the left inner thigh.



A. POSTURES FOR PRÁÏÁYÁMA & MEDITATION 1. VAJRÁSANA

Make sure that both the knees are resting on the ground.



Sthiti: Daïãásana PRACTICE







Fold the right leg and bring the right heel under the right buttock. Sitting on the right heel, fold the left leg and bring the left heel under the left buttock.

Note Although the posture is exactly the same, it gets the name Siddhayoni Ásana in women and Siddhásana in men.

Sit erect comfortably with the buttocks resting on both the heels and palms resting on the thighs.

Note

In the final posture the soles of the feet face upwards, heels are kept together and the entire weight of the body is felt on the back of the feet.

2. SIDDHÁSANA (For men) SIDDHAYONI ÁSANA(For women)

3. SUKHÁSANA Sthiti: Sit in Daïãásana PRACTICE

Sthiti: Daïãásana



PRACTICE



Sit erect with hands resting on the thighs in Cin mudrá with elbows bent.

Bend the right leg completely at the knees and place the foot under the left thigh with the heels pressed against the perineum. Bend the left leg at the knee and place the left heel on the right heel.

Fold the legs and cross them to place the feet under opposite legs. Sit comfortably with spine erect. The hands rest on the thighs in Cin Mudrá with the elbows bent.

Note

Here the knees do not touch the ground.

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B. MUDRÁS FOR PRÁÏÁYÁMA AND MEDITATION

3. ÁDI MUDRÁ

1. CIN MUDRÁ



Touch the tips of the thumbs with the tips of the forefingers. Keep the other fingers striaght.



Rest the palms on the middle of the thighs.





Make fists of both hands with the thumbs tucked in.



Rest the fists on the thighs.

4. BRAHMA MUDRÁ



2. CINMAYA MUDRÁ



The tips of the forefingers touch the tips of the thumbs and all other fingers are folded in to the hollow of the palms. Rest them on the thighs.

Make fists of both palms with the thumb tucked in and place them on either side of the navel with the palms facing upwards and the knuckles touching each other.

Note

Keep the elbows bent to ensure relaxed arm position in all the above mudras

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5. NÁSIKA MUDRÁ





Fold the index and middle fingers of the right hand into the centre of the palm.





Use the thumb to gently close the right nostril.Use the ring and the little finger combination to close the left nostril.



Note



This mudra is used during different types of uninostril práïáyámas. During alternate nostril breathing when you need to change the fingers to close the alternate nostrils, make sure that the pressure exerted on the nostril is very gentle. While changing the nostrils, the movement of the hand should be a gentle rotation. action at the wrist and not at the arms or the elbows.





Note



C. PREPARATORY PRACTICES FOR PRÁÏÁYÁMA



1. CLEANSING BREATH (KAPÁLABHÁTI KRIYA) Sthiti: Daïãásana







Sit in any meditative posture. Keep your spine and neck erect perfectly vertical to the ground.



Close the eyes and collapse the shoulders. Relax the whole body completely.

Throughout the entire practice the spine must be kept erect without any movement of the trunk, neck or the face. It is important to learn to allow the inhalation to happen automatically by relaxing the abdominal muscles at the end of each quick exhalation. Kapalabhati can be practiced through alternate nostrils by alternately closing the right and left nostrils in Násika mudrá. In the beginning it may not be possible to practice continuously at the rate of 60 strokes per minute. Therefore, one can start at the rate of 10 to 20 strokes per minute and repeat it 2 to 3 rounds with normal breathing intervals of a few seconds. With regular daily practice you can increase the speed to 60-120 strokes per minute. Persons with high BP, heart problems, vertigo, epilepsy, hernia, slip disc and spondylosis should avoid this practice. Women during menses and later months of pregnancy should also avoid this practice.

Benefits Physical:

PRACTICE

During each exhalation, blast out the air by vigorous flapping movements of the abdomen in quick succession. Inhale passively by relaxing the abdominal muscles at the end of each exhalation. Repeat the exhalation as quickly as possible at the rate of 60 strokes per minute. At the end of one minute, stop the practice. Now observe an automatic suspension of breath. In fact, there will be no urge for breathing for a few seconds. Simultaneously the mind may experience a deep state of silence. Enjoy this state of deep rest and freshness. Wait until the breathing comes back to normal .

Practice rapid breathing with active and forceful exhalation and passive inhalation.

Brain cells are envigorated. It brings brightness to the face with regular practice . It balances and strengthens the nervous system. It removes the drowsiness from the body. 72

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Therapeutic : It provides a nice massage to all the abdominal organs. People with digestive problems are highly benefited. It cleanses the lungs and also the entire respiratory tract. It is good for asthmatics and for other respiratory disorders. Spiritual: It removes the distractions of the mind and prepares it for meditation. The practitioner achieves a state of Kevala Kumbhaka, i.e. automatic cessation of breath. Limitations: Practice of Kapalabhati is to be avoided in case of moderate and severe High Blood Pressure Ischemic Heart Disease, Vertigo, Epilepsy, Hernia, Gastric Ulcer, Slip Disc and Spondylosis. Women during menses and advanced stage of pregnancy should avoid.



Before the breath is reversed, stop the breath for a second.



Repeat this breathing cycle five times.

There should be no jerks in the whole process. It should be smooth, continuous and relaxing. Note





II. THORACIC (INTERCOSTAL) BREATHING (MADHYAMA)

Sthiti: Vajrásana PRACTICE



2. VIBHÁGÈYA ÙVASANA (SECTIONAL BREATHING)



This is a preparatory breathing practice for Práïáyáma. It corrects the wrong breathing pattern and increases the vital capacity of the lungs. It has three sections:

I. ABDOMINAL (DIAPHRAGMATIC) BREATHING (ADHAMA)

Sthiti: Vajrásana PRACTICE







Place the hands resting on the thighs in Cin Mudrá. Inhale, (püraka) deeply, slowly and continuously, the abdomen bulges out. Before exhaling stop the breath for a few seconds effortlessly. Exhale, (recaka) the abdomen is drawn inwards continuously and slowly.

In abdominal breathing the air fills the lower lobes of the lungs. Avoid movement of the chest.



Place the hands resting on the thighs in Cinmaya Mudrá. While inhaling, expand the chest cage forwards, outwards and upwards. While exhaling relax the chest wall and return to resting position. Repeat this breathing cycle five times.

Note

Avoid movements of abdomen.

III. UPPER LOBAR (CLAVICULAR) BREATHING (ÁDYA)

Sthiti: Vajrásana PRACTICE



Sit in any meditative posture. Place the hands resting on thighs in ÁdiMudrá. While inhaling raise the collar bones and shoulders upwards and backwards.

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While exhaling drop down the shoulders to the resting position. Repeat this breathing cycle five times.

Try and avoid movements of the abdomen and chest .

IV. FULL YOGIC BREATHING

Full yogic breathing is a combination of all the three sections of sectional breathing.

Sthiti: Vajrásana PRACTICE







As you increase the number of rounds of Full Yogic Breathing day after day, you will come to develop this practice as an automatic and normal function of the body.

Benefits

Note



Place the hands resting on the abdomen at the navel in Brahma Mudrá.

The purpose of this practice is to make the practitioner aware of the three different components of respiration (Abdominal, Thoracic and Clavicular) and incorporate them into Full Yogic Breathing. Even 10 minutes of Full Yogic Breathing daily can work wonders. - You acquire more power and vitality, - Calmness in daily activities, - Thinking and clarity of thought improve, - When you feel tired or angry practice of full yogic breathing will help in calming down your mind and revitalising it. Limitations It has no limitations.

During inhalation, the Adhama, Madhyama and Ádya práïáyáma occur sequentially. Now exhale in the same sequence (abdominal, chest and clavicular). Repeat this breathing cycle five times.

Note







The whole process should be relaxing and comfortable, without any tension in the face. Roughly gauge the time of your inhalation and exhalation. Take one third of your inhalation time for adhama ,one third for madhyama and one third for ádya. Follow the same sequence and timing for exhalation. This exercise can be performed - lying down in ùavásana or sitting in a cross-legged position with head, neck and spine erect. All breathings should be performed through the nose and not through the mouth.

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One cycle of inhalation and exhalation forms one round. Practice nine rounds. Note

D. PRÁÏÁYÁMA



1. SÜRYA ANULOMA VILOMA PRÁÏÁYÁMA



Sthiti: Vajrásana



PRACTICE

Time taken for exhalation should be longer than inhalation. Anxiety patients may practice this Práïáyáma 27 rounds before breakfast, lunch, dinner and before sleep (4 times a day).

Benefits

Adopt Násika mudrá with your right hand.

(For Süryanuloma-Viloma Práïáyáma)

Close the left nostril with the little and ring fingers of Násika Mudrá.

and

Candranuloma-Viloma

Physical :

Inhale and exhale slowly through the right nostril (Sürya Nádi) only.



Keep the left nostril closed all the time during the practice.

These Práïáyámas help in clearing of the nasal passages. With regular and long practice, flow of breath through each of the nostrils becomes smooth and slow.



One cycle of inhalation and exhalation forms one round.

Therapeutic :



Practice nine rounds.

It is Very useful for nasal allergy and Deviated Nasal Spectrum (DNS). Suryanuloma-Viloma helps in reducing the obesity effectively and Candranuyloma-Viloma help in increasing weight.



Note

Time taken for exhalation should be longer than inhalation. Depression patients may practice this Práïáyáma 27 rounds before breakfast, lunch, dinner and before sleep (4 times a day).

2. CANDRA ANULOMA VILOMA PRÁÏÁYÁMA Sthiti: Vajrásana PRACTICE







Adopt Násika Mudrá with your right hand. Close the right nostril with the tip of the thumb. Inhale and exhale slowly through the left nostril (Candra Nádi) only. Keep the right nostril closed all the time during the practice.

For specific significant imaprovement, the recommended schedule is to have twenty-seven rounds of this Pranayamas four times a day (before breakfast, lunch, clinner and before going to bed). Systematic practices have benefited large number of obese and under weight persons to achieve normal weight. Spiritual : Cleaning of Surya and Candra Nadis is the first step to bring the balance between the two Nadis. They aid in unbfolding of the inner layers of consciousness. Limitations For Süryanuloma-Viloma Práïáyáma , people suffering from hibloodprusser, any heart disease and underweight problem should a avoid this practice. For Candranuloma-Viloma Práïáyáma, people suffering from obesity and any type of allergic should avoid it.

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3. NÁDIÙUDDHI PRÁÏÁYÁMA

Therapeutic :

Sthiti: Vajrásana

It lowers the levels of stress and anxiety by harmonising the práïas. It is beneficial in respiratory disorders such as Bronchial asthma, Nasal allergy, Bronchitis etc.

PRACTICE

Sit in any meditative posture.

Spiritual :



Adopt Násika Mudrá.

It induces tranquility, clarity of thought and concentration. It clears pranic blockages and balances Ida and Pingala nádis,causing Shuúumna nádi to flow which leads to deep states of meditation and spiritual awakening. It helps to maintain Brahmacharya which is a pre-requisite for spiritual progress.









Close the right nostril with the right thumb and exhale completely through the (left) nostril. Then inhale deeply through the same left nostril.

Limitations:

Close the left nostril with your ring and little finger of the Násiká Mudrá, release the right nostril. Now exhale slowly and completely through the right nostril.

No Limitations.

4. COOLING PRÁÏÁYÁMAS I. ÙÈTALÈ PRÁÏÁYÁMA

Inhale deeply through the same (right) nostril. Then close the right nostril and exhale through the left nostril. This is one round of Nádiùuddhi práïáyáma. Repeat nine rounds.





PRACTICE

Note

Sthiti: Vajrásana



This practice helps to maintain balance between Nádis. If you feel headache, heaviness of the head, giddiness, uneasiness etc.,. it means you are exerting much pressure on the lungs. The first symptoms of correct practice is the feeling of freshness, energy and lightness of the body and mind.



Benefits Physical :



It promotes balance between the two nostrils apart from cleansing the nasal tract. It increases the vitality. Metabolic rate decreases as in case of all other Práïáyáma prctices. It increases the digestive fire and appetite.

Place the palms resting on the thighs. Stretchthe tongue forward partly out of the mouth and fold it so as to resemble the beak of a crow. Slowly suck in the air through the beak and feel the jet of cool air passing down the throat into the lungs. Slowly exhale through the nostrils, feeling the movement of warm air all the way up from the lungs through the throat and the nasal passages.



This completes one round of Ùètali Práïáyáma.



Repeat nine rounds. 80

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II. SÈTKÁRI PRÁÏÁYÁMA



Sthiti: Vajrásana PRACTICE









Place the palms resting on the thighs. Fold the tip of the tongue inwards horizontally.The folded tongue slightly comes out between the two rows of teeth and provides a narrow opening on both sides. Slowly suck the air in through the two sides of the tongue. Feel

the cool stream of air diffusing throughout the mouth and throat into the lungs.

Exhale slowly through both nostrils. Feel the warmth of the exhaled air.



The warm air is exhaled out slowly through both the nostrils. Feel the warmth of exhaled air. This completes one round of Sadanta. Repeat nine rounds.

5. BHRÁMARÈ PRÁÏÁYÁMA Sthiti: Vajrásana PRACTICE



Assume Cinmudrá. Inhale deeply. Exhaling, produce a low pitched sound resembling the humming of a female bee. Feel the vibrations in the entire head. This is one round. Repeat nine rounds.



This completes one round of Sètkári.

Note



Repeat nine rounds.



During the practice of Bhrámarè use ‘N-kára’ and not ‘M-kára’.



Touch the tongue to upper (hard) palate.



Initially the sound vibration is felt more at the throat region only.

III. SADANTA PRÁÏÁYÁMA

Sthiti: Vajrásana



PRACTICE









Place the palms resting on the thighs.



With long practices try to feel the strong vibrations in the entire head region along with its resonating effect through out the body. In the beginning, 5 to 10 rounds of Bhramari is sufficient. Slowly increase to 10 to 15 minutes. It can be practised at any time to relieve mental tension.

Let the upper set of teeth touch the lower set of teeth. Keep the tip of the tongue just behind the teeth. Inhale through the crevices of the teeth and feel the cool air moving slowly and continuously into the mouth and passing down the throat into the lungs. 82

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4 MEDITATION

3. M-KÁRA CHANTING Sthiti: Vajrásana PRACTICE

A. NÁDÁNUSÁNDHÁNA



(A-kára , U-kára, M-kára, A-U-M)



1. A- KÁRA CHANTING



Sthiti: Vajrásana



PRACTICE









Sit in any meditative posture and adopt cin-mudrá. Feel completely relaxed and close your eyes. Inhale slowly and completely. While exhaling chant ‘AAA’ in a low pitch. Feel the sound resonance in the abdomen and the lower parts of the body. Repeat nine times.



Sit in any meditative posture. Adopt Ádi Mudrá. Inhale slowly and completely. while exhaling chant ‘MMM’ in a low pitch. Feel the sound resonance in the entire head region. Repeat nine times.

4. A-U-M CHANTING Sthiti: Vajrásana PRACTICE



2. U- KÁRA CHANTING



Sthiti: Vajrásana

PRACTICE





Sit in any meditative posture. Adopt Cinmaya Mudrá. Inhale slowly and completely. While exhaling chant 'UUU' in a low pitch. Feel the sound resonance in the chest and the middle part of the body. Repeat nine times.

Sit in any meditative posture Adopt Brahma Mudrá. Inhale slowly and completely fill the lungs. While exhaling chant ‘A-U-M ’ in a low pitch. Feel the sound resonance throughout the body. Repeat nine times.

Note





Different sounds like A, U, M & AUM are produced loudly so that they generate a fine resonance all over the body. (Resonance will occur only when the frequency of the generated sound matches with the natural frequency of the body). These resonant sounds act as stimulations and the post-resonance silence deepens the awareness and releases even very subtle tensions. Therefore, while producing different sounds (A, U, M, & AUM) try to adjust the pitch in such a way that a fine resonance is achieved.

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B. OM- Dhyána (MEDITATION)

awareness(beyond the limits of the body). The bed of silence becomes deeper and more expansive. Visualise and feel anocean of silence with gentle soft waves of OM on it. Now merge into complete silence and reach the stage of Ajapa(no repetition). This silence is the source of Creativity, Power, Knowledge and Bliss. Remain in this state for a while.

Sthiti: Any Meditative Posture PRACTICE Sit in any comfortable meditative posture feeling completely relaxed.



Phase I Close your eyes and start chanting OM mentally. Allow the mind to repeat OM continuously without any break. If there are destractions, chant OM faster, not giving a chance for distractions. After a while the chanting slows down. Consciously slow it down further. If the mind jumps to distractions, increase the speed of japa of OM kara. Thus, by increasing and decreasing the speed of chanting, allow the japa to settle down to a slow pace with an unbroken stream of effortless flow of OM japa in your mind. Phase II Make the chanting softer and softer, gentler and gentler, and more and more effortless. As you progress on the path of meditation, you will reach the second phase of japa in which you start feeling the vibrations of the japa in some part of the body and later throughout the body (three dimensional(3D) awareness). Phase III As you slow down the japa of OM, observe the gap between two OMs. As you slowdown further, the gap goes on becoming wider and wider to diffuse into silence.

Phase V



From this deep ocean of silence in the heart region, let one OM emerge as an audible sound which diffuses into the entire body and the space all around. Enjoy the beautiful vibrations. Blink the eyes slowly, gently open the eyes and come out of meditation.

Note

Try to touch this state of deep rest and inner silence several times in the day whenever you have some free time.

Phase IV The experience of inner silence helps to expand from the three dimensional awareness of the body to all pervasive 86

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5 KRIYÁS

2. SÜTRA NETI OR RUBBER CATHETER NETI Sthiti: Táãásana PRACTICE

NETI



1. JALA NETI (Cleaning the nasal passage) Sthiti: Táãásana



PRACTICE







Add about half a teaspoon of salt to a neti pot full of sterile lukewarm water.



Stand with the legs apart



Hold the neti pot in your right hand.



Insert the nozzle of the Neti pot into the right nostril. Keep the mouth open and breathe freely through the mouth.

Tilt the head first slightly backwards, then forwards and sidewards to the left so that the water from the pot enters the right nostril and comes out through the left by gravity. Allow the flow till the pot is empty.



Note





Repeat the same on the left side. To clear the nasal passages of the remaining water, blow out the water by active exhalation through alternate nostrils as in Kapálabháti.

Insert the blunt end of a thin soft rubber catheter horizontally into the right nostril. Gently push it along the floor of the nose until the tip is felt in the back of the throat. Insert the right index and the middle finger through the mouth and catch the tip of the catheter at the back of the throat. Pull it out through the mouth and gently massage the nasal passage by catching the two ends of the tube. Remove the catheter through the nose. Repeat on the left side.

Take care not to push the catheter vertically into the nostril. Before you start this practice, cut and trim the nails of the fingers to be used for inserting in the mouth, as it may injure the throat when you are trying to grasp the tip of catheter in the throat.

DHOUTI 3. VAMANA DHOUTI Sthiti: Táãásana PRACTICE



Drink about one and a half liters of lukewarm saline water (about 1% saline) as quickly as you can until you feel like vomiting it out. Churn the stomach by twisting exercises. 88

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Now, spread the legs about two feet and bend the trunk forward forming an angle of about 90 degrees to the ground.







Now with the help of the middle three fingers of the right hand, tickle the back of the throat to vomit out (vaman) all the water. Repeat the process of tickling the throat until no more water comes out which may mean that all water has been vomited . With continued practice one can stimulate the vomiting sensation and vomit out the water without using the fingers at the throat.





INTEGRATED YOGA MODULE FOR ARTHRITIS (IYMA) Having learnt the special practices elaborated in previous chapters, the Yoga Therapy Participants (patients) would like to have a module of daily practice and contemplation. It is with this in view that this IYMA (Integrated Yoga Module for Arthritis) has been specially tailor made to cater to the needs of yoga therapy participants, with different types of arthritis

What is IYMA ?

A bland breakfast could preferably consist of Indian kichadi . (rice and lentil-dhal, cooked with or without salt), along with a tea spoon ful of pure ghee. Avoid coffee or tea for breakfast.

The IYMA or Integrated Yoga Module for Arthritis is a combination of various yoga practices so arranged to work at all levels of human existence – Physical, práïic, mental, emotional and intellectual levels. As described in chapter 1, the root cause for these diseases (RA and OA) is Ádhi in Manomaya koùa which percolates down to Annamaya koùa (Physical body) via the Práïámaya koùa. Unless the root cause is eradicated, we cannot affect a complete normalisation. Hence, IAYT uses all the techniques needed to set right the imbalances at these three levels. The Integrated Yoga Module I and II recommended as an hour practice that can be practiced on alternate days consists of specially chosen yoga practices at all these three levels.

With long practice one can learn to vomit all the water as if it is a continuous jet. This is called Gajakaraïi.

What is the basis for IYMA ?

Relax completely in DRT for about 15 to 20 minutes. Have a bland breakfast after about half an hour.

Note

6

This is to be done early in the morning on an empty stomach.

There are two aspects of the disease : One: Tightness, inability to move, reduced flexibility of the joints; Two: Pain and inflammation at physical level and speeded up emotional upsurges at mental level that shows up as increased respiratory rate and imbalance of flow of breath between the two nostrils at the práïa level. These two aspects are called Tamas and Rajas.

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What is the solution? Both these aspects have to be handled intelligently at subtle levels, says the commentary on Máïãükya Upaniúat Máïãükya Karika). The wisdom from this traditional text says

ue³es mebyeesOe³esled ef®eÊeb efJeef#eHleb Mece³esled Hegveë mekeÀ<ee³eb efJepeeveer³eeled meceÒeeHleb ve ®eeue³esled ~ Laye sambodhayet cittam vikúiptam ùamayet punaç Sakaúáyam vijánèyát samapráptam na cálayet. (Máïãükya Kárèká 3 - 44) When the mind gets to a state of drowsiness, stimulate and awaken it; as it starts speeding up and distractions set in, calm it down. Do this again and again. Recognize the deep rooted blocks (knots, obsessions, phobias in the form of imbalances) and reach the state of balance. Once you touch this balanced state do not disturb it (stay in that state as long as you can). Each stimulation helps to end the stagnation and open up the constrictions. Immediately following this stimulation when you let go consciously you go into deep relaxation. After the relaxation continues for a while, the system reaches a saturation point often leading to stagnation or drowsiness. It is then, that we need to stimulate again. Successive stimulations and relaxations one after the other thus help to release the stresses at deeper and deeper levels. In essence in the first phase, you shatter the Tamas through stimulation and then calm down the Rajas. Thus a combination of stimulation- relaxation is the key. A series of successive stimulations and relaxations help to go on clearing all the deep seated stresses (the adhis) in a systematically organized manner and this helps to fully normalise your system at all the five levels of existance.

stimulations, the stimulations in práïáyáma(step 6) and devotional sessions(step 8) at the mental level take you to the subtle levels of mind and emotions to provide very deep rest. The practice of complete silence in the end expands the mind to its source of all pervasive ocean of peace and bliss, which is the basis for removal of all imbalances. The IYMA uses this basis and sets itself the sequence as follows:

Steps 1 ¾ Stimulate 2 ¾ Relax

Ùithilèkaraïa Vyáyáma - 7 Mints QRT - 3 Mints

3 ¾ Stimulate Ùakti Vikásaka Sükúma Vyáyáma - 4 Mints 4 ¾ Relax 5 ¾ Stimulate 5a ¾ Relax 6 ¾ Stimulate 7 ¾ Relax 8 ¾ Stimulate

In this module the stimulations are provided by Sithilèkaraïa Vyáyáma (step 1), Sukúma Vyáyáma (step 3), Asanas (step 5), Praïáyama (step6) and devotional songs (step 8) where as IRT, QRT(step 8), DRT and meditation (step 7) provide the relaxation component. While step 1, 3 and 5 provide the physical

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IRT and QRT - 3 Mints Ásanas - Standing, Prone, Supine and Sitting postures) - 9 Min DRT - 7 Mints Práïáyáma - 12 Mints OM meditation + Nadanusandana Devotional Songs - 5 Min Silence - 2 Mints Resolve 92

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c. Expansion of Awareness

Dimensions of IYMA Having understood the basis for IYMA, we now proceed to understand the dimensions of IYMA, that help you to release subtle stagnations, tensions and stiffnesses at the physical level, imbalances at the práïa level, and eradicate Ádhi at Manomaya Koùa levels.

a. Recognition is half solution Closing the eyes throughout the practice helps in building an internal awareness which is the key to the release of innate tensions and pains.

b. Move deeper and deeper In phase one, we use stretch and relaxation of muscle fibres to make them more supple. Repetitions help to make them more and more relaxed. As you move on to next phase, perceive the blood flow changes in the limbs and joints; you can sensitize yourself to the perception of variations (decrease or increase) of blood flow to the limbs during and immedialtely after any movement in the joint. As you go deeper, you start feeling the nerve impulses. When you experience a mild pain during the stretch of a joint, concentrate on the intensity of pain and the array of large number of nerve impulses, followed by reduction of these impulses when you return to the original position. This is the stage when you can allow the relaxation to deepen further. In step 7 when you generate the sound vibrations you develop the awareness of the complete body with greater sensitivity, better harmonisation and relaxation. When the practices are repeated day after day, the joints become more and more flexible, muscles become stronger and softer, and the movements become easier. Loosening of joints and improved mobility obviously help to improve the quality of life.

Patience, pays. Slow and steady wins the race. Do not rush and push to the limits of elasticity. While a good stretch is recommended you must learn to work with awareness and gradually increase the stretch of muscles. And relax them deeply with awareness.

The mind becomes calm with practices such as Ásanas and Práïáyama as evidenced by lower breathing rate and reduced metabolic rates. This helps in expanding your awareness by meditation; devotional sessions harness your emotions. From focussed attention to linear, surface and three dimensional awareness, you expand. This helps in performing actions in our day to day activities with ease. Similarly you learn to move from violent to softer and more cultured emotions as you practice devotional sessions. Softening of emotions to gain mastery over them is a science by itself. ( see our book on “Bhakti Yoga” - the science of emotion ) . d. Working in groups To be together as we practice helps a great deal. A group size of 10 to 20 will be ideal. The advantages are as follows. Reduces the laziness and lethargy. Develops regularity. Helps in learning the techniques nicely. Subtle effects through unseen vibrations charging the place automatically bring wonderful feeling of wellness and positive health. V. Sounds produced in synchrony during the practices help in developing group awareness. VI. Painful agravations of the ailments also reduce as we work in group. VII. Higher emotions of sharing and caring for others help you to overcome the pain.

. I

II. III. IV.

e. Resolve At the end of this eight stepped practices a few minutes of silence would help a great deal in expanding your vision further and develop confidence to combat the disease fully. After this you allow a resolve to soak deep into your system. Resolve (Sankalpa) is a selected positive short sentence that you repeat at the end of each session before you chant the closing

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prayer. Repeat the same sentence slowly and clearly in your mind with full attention and a deep feeling of the meaning of the sentence . Select positive words and try to avoid words with negative adverbs. Selected sentences could vary from week to week. some examples could be I “ I am fearless and confident” II “My immune system is normal and healthy” II “I am as young and fresh as a twenty year old” Avoid sentences like I. I am not worried II. my immune system is not fighting against my own tissues.

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¾5

Integrated Yoga Module for ARTHRITIS Eight steps- one hour-Alternate Days Set - A Steps Pg.No. Practice

Standing Postures 52 53 53

Duration

54 55

(Loosening Exercises) 35 35 37 38 39 40 42 42 43 46 46

Passive rotation of toes Toe Bending Ankle Rotation Knee Rotation Knee Cap Tightening Full Butterfly Waist Rotation Wrist Rotation Shoulder Rotation Neck Bending Neck Rotation

64

Quick Relaxation Technique

¾ 3

10 10 10 10 25 10 10 10 10 10 10

2 min ½ min ½ min ½ min 1 min ½ min ½ min 40 sec 40 sec 1 min 40 sec

For Wrist - Mani Bandha Ùakti Vikásaka For Palms - Kara Tala Ùakti Vikásaka For Fingers - Anguli Ùakti Vikásaka For Elbows - Khaponi Ùakti Vikásaka For Arms - Bhuja Bandha Ùakti Vikásaka For Back - Kati Ùakti Vikásaka For Thighs - Jangha Ùakti Vikásaka For Calf Muscles - Pindali Ùakti Vikásaka

63

Instant and Relaxation Technique

½ + ½ min ½ min 1 min.

Bhujangásana Ùalabhásana

½ min ½ min.

Supine Postures 56 57 61 62

Sarvángásana Matsyásana Sitting Postures Vakrásana Uútrásana

1½ or 2 min 1 min 1+1 min. ½ min.

¾ 5a 64

Deep relaxation technique

¾6

PRÁÏÁYÁMA

7 min

Preparatory Practices for Práïáyáma 71 73

3 min

Sakti Vikasaka Sukúma Vyáyáma 47 47 48 48 49 49 50 51

Ardhakati Cakrásana Ardha Cakrásana Páda Hasthasana

Prone Postures

Ùitilèkaraïa Vyáyáma

¾ 1

¾ 2

Rounds

Yogásana

Cleansing breath (Kapálabháti Kriya) Vibhágèya Ùvasana (Sectional Breathing)

1 min 4min

Práïáyáma 10 10 10 20 20 10 5 5

½ min ½ min ½ min ½ min ½ min ½ min ½ min ½ min

77 79 81

Sürya Anuloma Viloma Práïáyáma Náãè Ùuddhi Práïáyáma (9RDS) Sitali/ Sitkari/ Sadanta Práïáyáma

83

Nadánusandhána

3 min

85

OM Dhyána (Meditation)

5 min

Devotional Song

5 min

¾7

2 min 3 min 2 min

MEDITATION

¾8

Silence

¾ 4

64

Quick Relaxation Technique

1 min

Total

60 min

3 min

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Integrated Yoga Module for ARTHRITIS Eight steps- one hour-Alternate Days Set - B Steps Pg.No. Practice

Rounds

53 53

35 37 38 39 40 42 42 43 46 46

(Loosening Exercises) Passive rotation of toes Ankle Rotation Knee Bending Knee Cap Tightening Full Butterfly Waist Rotation Wrist Rotation Shoulder Rotation Neck Bending Neck Rotation

¾ 2 64

Quick Relaxation Technique

¾ 3

Sakti Vikasaka Sukúma Vyáyáma

10 10 10 25 10 10 10 10 10 10

55

Dhanurásana

½ min

58 56 57

Supine Postures Viparèta karaïi Halásana Cakrásána

1½ min 1 min ½ min

60 61

Sitting Postures Ùáùánkásana Ardha matsyendrásana

1 min. 1 min.

¾ 5a 64

Deep relaxation technique

7 min

¾6

PRÁÏÁYÁMA Preparatory Practices for Práïáyáma

Duration

2 min ½ min 1 min 1 min ½ min ½ min 40 sec 40 sec 1 min 40 sec

For Wrist - Mani Bandha Ùakti Vikásaka

10

½ min

47 48 48 49 49 50 51

For Palms - Kara Tala Ùakti Vikásaka For Fingers - Anguli Ùakti Vikásaka For Elbows - Khaponi Ùakti Vikásaka For Arms - Bhuja Bandha Ùakti Vikásaka For Back - Kati Ùakti Vikásaka For Thighs - Jangha Ùakti Vikásaka For Calf Muscles - Pindali Ùakti Vikásaka

10 10 20 20 10 5 5

½ min ½ min ½ min ½ min ½ min ½ min ½ min

64

Instant Relaxation Technique Quick Relaxation Technique

71 73

1 min 3 min

77 Candra Anuloma Viloma Práïáyáma (21 RDS) 79 Náãè Ùuddhi Práïáyáma (9RDS) 81 Sadanta Práïyáma

¾7

52



Ardhakati Cakrásana

½ + ½ min

2 min 3 min 2 min

83

Nadánusandhána

3 min

85

OM Dhyána (Meditation)

5 min

Devotional Song

5 min

Total

60 min

Other practices for both the sets

Standing Postures

1min 4 min

MEDITATION

¾8

Yogásana

¾ 5

Cleansing breath (Kapálabháti Kriya) Vibhágèya Ùvasana (Sectional Breathing)

Práïáyáma

3 min

47

¾ 4 63

½ min 1½ min

Prone Postures

Ùitilèkaraïa Vyáyáma

¾ 1

Ardha Cakrásana Páda Hasthasana

Kriyas - Jalaneti, Sutraneti and Vamana Dhouti, week

once a

MSRT (30 min) or PET (30 min) daily (Audio cassettes of sVYASA)

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INDEX

For Wrists - Mani Bandha Pg 47, 10 Rds, ½ min Ùakti Vikásaka For Palms - Kara Tala Ùakti Pg 47, 10 Rds, ½ min Vikásaka

Passive rotation of toes Pg 35, 10 Rds, 2 min

Toe Bending Pg 35, 10 Rds, ½ min

For Fingers - Anguli Ùakti Vikásaka Pg 48, 10 Rds, ½ min

Ankle bending

Pg 36, 10 Rds ½ min

Ankle Rotation

For Elbows - Khaponi Ùakti Vikásaka Pg 48, 20 Rds, ½ min

Pg 37, 10 Rds, ½ min

Knee Bending

For Arms - Bhuja Bandha Ùakti Vikásaka Pg 49, 20 Rds, ½ min For Back - Kati Ùakti Vikásaka

Pg 38, 10Rds, 1 min

Pg 49, 10 Rds, ½ min

Knee Rotation

Pg 38, 10 Rds, ½ min

For Thighs - Jangha Ùakti Vikásaka Pg 50, 5 Rds, ½ min

Knee Cap Tightening

For Calf Muscles - Pindali Ùakti Vikásaka Pg 51, 5 Rds, ½ min

Pg 39, 25 Rds, 1 min

Half Butterfly Pg 39, 10 Rds, ½ min

Ardhakati Cakrásana Pg 52, ½ + ½ min

Full Butterfly

Pg 40, 10Rds, ½ min

>

Waist Rotation

>

Ardha Cakrásana

Pg 53, ½ min

Pg 42, 10 Rds, ½ min

Páda Hasthasana

Wrist Rotation Pg 42, 10 Rds, 40 sec

Pg 53, 1 ½ min

Bhujangasana Pg 54, ½ min

Shoulder Rotation Pg 43, 10 Rds,40 sec

Salabhasana

Pg 55, ½ min

Neck Bending Pg 44, 10 Rds, 1 Min

Dhanurásana

Pg 55, 30 sec

Neck Rotation Pg 46, 10 Rds, 40 sec

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Sarvángásana Matsyásána

Candra Anuloma Viloma Pg 77, 21 Rds, 2 Min Práïáyáma Náãè Ùuddhi Práïáyáma

Pg 56, 2 Min

Pg 79, 9Rds, 3 Min

Pg 57, 1 min

Viparèta karaïi

Nadánusandhána Pg 58, 1½ min

Pg 83, 3 min

OM Dhyána (Meditation)

Halásana

Pg 85, 5 min

Pg 58, 1 min

Ùitali Práïyáma

Cakrásana

Pg 59, ½ min

Ùáùánkásana Vakrásana

Sètkári Práïyáma

Uútrásana

Pg 81, 2 min

Pg 60, 1 min

Sadanta Práïyáma

Pg 61, 1+1 min

Ardha Matsyendrásana

Pg 80, 2 min

Pg 81, 2 min

Pg 61, 1 min

Pg 62, ½ min

Instant Relaxation Technique

Pg 63, 1 min

Quick Relaxation Technique

Pg 64, 3min

Deep Relaxation Technique Pg 64, 3min

Cleansing breath (Kapálabháti Kriya) Pg71, 1min

Vibhágèya Ùvasana (Sectional Breathing) Pg 73, 4Min

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