Yogic Cure for Arthrities

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YOGA

FOR

ARTHRITIS

Dr R NAGARATHNA, M.D.,(Gen. Med.).,

F.R.C.P.(Edinburgh)

Dr H R NAGENDRA, ME., Ph.D.,

Published by :

Swami Vivekananda Yoga Prakashana"Vivek Kuteer', # 9, Appajappa Agrahara

Chamarajpet, Bangalore - 560 018,

Karnataka, India

© Reserved

First eBook Edition : Sep 2006

ePublished by :www.HealthAndYoga.com

for Swami Vivekananda Yoga Prakashana

''Vivek Kutir', # 9 Appajappa Agrahara

Chamarajpet, Bangalore-560 018

Karnataka, INDIA

Pho ne : (080) 661 2669

Tel Fax : 91-080-660 8645

Email : [email protected]

Web site : www.vyasa.org

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

© Copyright, www.svyasa.org



FOREWORD

It is a common experience of human beings that their minds andbodies are closely interlinked. Any disturbance in either of themis bound to affect the other. Mental worries do lead tophysiological problems and bodily discomfort does impact onthe mind. Yoga and Ayurveda, the ancient Indian sciences

recognised this symbiotic relationship of body and mind longago and postulated the concepts of Ádhi and Vyádhi.

Closely linked with Ayurveda is the science of Rája Yoga andits branch Hatha Yoga. Western philosophy and psychology evennow lay great stress on the body and consider the mind to be itsby-product. However the ancient Indian sciences have alwaysconsidered mind as being supreme over matter and have basedtheir 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. Butno systematic investigation had been undertaken based onmodern accepted norms of scientific research. It goes to the creditof Swami V ivekananda Yoga Anusandhana Samsthana(sVYASA) that over the last quarter of a century it has conductedsystematic research in this field and has developed packages of physical and mental practices suitable for several psychosomaticdiseases.

There has been a need felt for some time to consolidate theseresults and to bring them out in the form of booklets, each one

dedicated to a particular disease. I am glad that this need hasnow been amply met by this series of booklets, in which there isa methodical description of the Ásanas, Práïáyáma, Meditationand Kriya, in a simple and easily understandable language andprofusely illustrated.

The authors have to be congratulated for the pains they havetaken in this venture. The general public indeed has to be grateful

to them for the great service they have rendered. I am confidentthat with the awareness of the benefits of yoga now increasingamong people around the world, the discerning persons wouldmake proper use of these booklets for the improvement andmaintenance of their physical and mental health.

Hariç Om Tatsat.

Prof NVC Swamy

Ex Director, IIT, Madras

Chief Adviser

sVYASA

(i ) (ii)




PREFACE

It was 1977-78 when Eknathji Ranade, the founder of Vivekananda Kendra movement called us and asked "as medicalprofessionals of this motherland, what is your dream?’’ We saidthat we could develop several hospitals giving high tech modernmedical facilities to the needy brothers of this land. But he said

that it is not enough if you just duplicate the hospitals in theexisting style. Our mission should be to evolve techniques tounfold the inner potential divinity of man to heal and growtowards better and better positive health. And also establish theefficacy of our ancient science of yoga, which is no less than5000 years old, in scientific terms as a socially relevant science.He also said that Bhárat should have several referal holistichealing centres where people from all over the world would comeover 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 intothis healing art. It was a great experience to go round several Yogashrams, talk to patients who had benefited from yogatherapy and record their progress.

It was our main task to learn ‘what technique for what disease?’from thesemasters. After obtaining convincing evidence of thehealing potential of the practices that had helped these patients,we sat down to compile the data and prepare the list of practicesfor 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 Práï áyámain yet another or only meditation in another. To add to ourconfusion one guru would use a posture or breathing to cure acondition whereas another guru would prohibit the same postureor breathing f or the same condition. For example, if Sarváñgásana was never to be practiced for hypertensive patientsas per one centre, the same would be the recommended asana inanother 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 fromfears and anxieties. And this was the common factor that helpedall of them towards complete recovery. Now it became simplefor us to understand Swami Vivekananda’s statement that thegoal of healing is to unfold the potential divinity by one or more

or all of the four aspects of yoga, namely Karma, Bhakti, Jnánaor Rája yoga. Thus yoga therapy is not organ specific but it is ascience that works holistically to strengthen the inner being.

The next bigger challenge was to put together the concepts learntfrom these Gurus, the knowledge base from traditional texts, thegrowing knowledge of pathophysiology of diseases from modernscience and the feasibility of teaching them to our patients in anacceptable and enjoyable fashion.

We started scanning through the traditional texts of yoga and

spirituality. The concept of 5 layered existence of all of us aspostulated and described in great detail in Taittireya Upaniúat asPanca Koùa was found to be the most holistic concept of humanexistence which is in no way contradicting the modern systematicapproach to the understanding of human body. It is moregeneralised, holistic and hence can contain in it the physical body[Annamaya Koùa] and the next three layers Práï amaya,Manomaya, and Vijnánamaya Koùás which are called the subtlebodies in Vedanta and spiritual lore. The fifth koùa theÁnandamaya 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 asdysfunctioning of organs and systems which may be due tocongenital defects, external atmospheric agents like allergens,toxins, pollutants or infectious germs. Modern science doesrecognize that the other major cause for diseases could be the

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factor of internal imbalances like mental restlessness, emotionalupsurges or intellectual conflicts that lead to stress reactions.

The concept of disease according to yoga is found in the treatisecalled Yogavásiúûha. According to this text, the modern diseasessuch as asthma, diabetes, hypertension, and anxiety are called“Ádhija Vyádhi”(stress born diseases) originating in ManomayaKoùa- the astral layer of our existence. They arise from our actionsthat 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 fullywell that we are going against what is right. This is calledPrajnáparádha in Ayurveda-a mistake at the level of innerconsciousness. It is this ‘going against what is right - the cosmiclaw ‘that causes an imbalance, a dis-ease at the Manomaya Koùacalled Ádhi.

The Adhi at the astral layer if not remedied will bring imbalances

at the level of Práï amaya Koùa that shows up as breathing jerks,imbalances and speed. This in turn creates stress reactions causingautonomic and endocrine imbalances leading to diseases in thebody called Vyádhi. Such diseases are called Ádhija Vyádhi i.e.Vyádhis created of Ádhis. The other category of diseases suchas infections and injuries come under Anádhija Vyádhis whichessentially are physical in nature and can be tackled by modernmedical system effectively. Since the Ádhija Vyádhis are multidimensional, we need to tackle them not merely with physicalsymptomatic treatment measures. The whole man has to betreated. And only then can there be lasting remedy to ourproblems of the modern era. The answer lies in the IntegratedApproach of Y oga Therapy that provides techniques forcorrecting the problem at both the gross (physical) and subtlelevels. Yoga practices help in bringing about balance at the levelof all the five Koùas so that complete health can be restored. Thepractices at Annamaya Koùa include yogásanás, Ùithilèkaraï avyáyáma [loosening practices], yoga diet and yoga kriyás, at

Práï ámáya Koùa - breathing practices, breathing kriyás andPráïáyáma. At the Manomaya Koùa, the practices are meditation[Cyclic meditation and Om meditation], devotional sessions andhappy assembly, where-as lectures, counseling and satsangscorrect the notions about one’s life ambitions and goals that formthe basic conceptual root for the life style of the individual. Karmayoga 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 ourcourses in yoga therapy with several workshops, camps,conferences, and seminars between 1980 to 85. Thousands of patients participated, learnt the techniques and started giving theirfeed -back. Based on the experiences of the patients we went onlearning what, why and how of many of the techniques taughtto them. A general set of integrated approach of yoga therapywhich gave fascinating results in diseases like asthma, diabetes,hypertension, anxiety, etc. started evolving into more and morespecific practices which could give quicker results, requiringlesser duration of practices. We also learnt from the feedback of patients how to give immediate relief for episodic conditions likeasthma, migraine, panic disorders, etc. While treating thesepatients, we recorded data before and after 2 weeks of yogatherapy and followed them up to 10 years. The results werestatistically analysed and published in indexed scientific medical

journals.

This series of booklets include step by step instructions for theset of practices, which could be practiced for an hour daily bypatients with different ailments. These are safe practices. Thepractices that could be harmful for the conditions have beencarefully avoided based on the knowledge of the physiologicaleffects of these practices and its expected effects on the disease.However it is safe for you to ask your doctor or medical advisorbefore you start practising these techniques. The ideal way touse this booklet is to keep this as a reference book after you have

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learnt them under the guidance of a yoga teacher trained in oursystem of yoga therapy.

The list of practices mentioned in the contents are all safe. If youhave more than one illness, you need to select these commonpractices from the list for all those illnesses (see our othervolumes).

The complete list in the booklet would take more than one andhalf hour to practice. Start with a set of simple practices amongstthese, and gradually go on to achieve the capacity to perform theentire set.

The ideal way to plan your daily yoga practices is, 45 minutes of physical practices followed by Ùavásana in the morning,Práï áyáma and meditation for 45 minutes in the evening. Dailypractice is mandatory. Physical practices have to be performedonly in empty stomach or 4 hours after a major meal or 2 hoursafter a small meal. Do not practice yogásanas when you are very

tired or during menstruation. Meditation and Nádánusandhánacan be practised even after a meal or during menstruation inwomen.

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 NagarathnaDr H R Nagendra

(vii)




D Yogásanás

1. Ardhakati Cakrásana 522. Ardha Cakrásana 53

3. Páda Hastásana 53

4. Bhujañgásana 54

5. Ùalabhásana 55

6. Dhanurásana 55

7. Sarváñgásana 56

8. Matsyásana 57

9. Viparèta karaï i 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) 6317. Quick Relaxation Technique (QRT) 64

18. Deep Relaxation Technique (DRT) 64

3 PRÁÏ ÁYÁMA

A. Postures for Práï áyáma and Meditation 67B. Mudrás for Práï áyáma and Meditation 69C. Preparatory Practices for Práï áyáma 71

1 Cleansing breath (Kapálabháti Kriya) 712. Vibhágèya Ùvasana (Sectional Breathing) 73

D. Práï áyáma1. Sürya Anuloma Viloma Práï áyáma 772. Candra Anuloma Viloma Práï áyáma 77

3. NáãèÙuddhi Práï áyáma 79

4. Cooling Práï áyáma 80

5. BhrámarèPráï áyáma 82

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CONTENTSPage Nos.

1 MODERN MEDICAL AND YOGA PERSPECTIVE 1OF ARTHRITIS

2 ÙITHILÈKARAÏ A VYÁYÁMA AND YOGÁSANÁS. 31

A Sthiti (initial) and Ùithila (relaxation) Postures for all 31

Ùithilèkaraï a Vyáyáma and Ásanás.

B Ùithilèkaraï a Vyáyáma (Loosening Exercises) 35

1. Passive rotation of toes 35

2. Toe Bending 35

3. Ankle Bending 36

4. Ankle Rotation 37

5. Knee Bending 38

6. Knee Rotation 38

7. Knee Cap tightening 39

8. Half Butterfly 399. Full Butterfly 40

10. Waist Rotation 42

11. Wrist Rotation 42

12. Shoulder Rotation 43

13. Neck Bending 44

14. Neck Rotation 46

C Ùakti Vikásaka Süksma Vyáyáma 47

1. For Wrists - Mani Bandha Ùakti V ikásaka 472. For Palms - Kara Tala Ùakti Vikásaka 47

3. For Fingers - Anguli Ùakti Vikásaka 484. For Elbows - Khaponi Ùakti Vikásaka 48

5. For Arms - Bhuja Bandha Ùakti Vikásaka 49

6. For Back - Kati Ùakti Vikásaka 497. For Thighs - Jangha Ùakti Vikásaka 50

8. For Calf Muscles - Pindali Ùakti Vikásaka 51




(x )

4 MEDITATION 83

1. Nadánusandhána. 83

2. OM Dhyána (Meditation) 85

5 KRIYAS (CLEANSING PRACTICES) 87

1. Jala Neti. 87

2. Sutra Neti. 883. Vamana Dhouti. 88

6 INTEGRATED YOGA MODULE FOR 90ARTHRITIS

ONE HOUR SCHEDULES - Set-A 96

Set-B 98

INDEX 100




1 2

MODERN MEDICAL & YOGAPERSPECTIVE OF ARTHRITIS

Pain in the joints is a common problem which may vary from aminor discomfort to a disabling chronic problem affecting the

quality of life to a great extent. The biomedical inventions havegiven great mobility and functional ability for damaged joints. Itis not unusual to find persons with 10 to 20 joints (small andbig) replaced as and when the joints get damaged, which hashelped them to live their lives in comfort. Thanks to fascinatingadvances in medication too, which has definitely saved anarthritic from the devastating side effects of steroids. But, havewe hit the nail on its head? Have we been able to cure or prevent

joint diseases? The answer is a clear ‘No’. Increasing problemsof aging changes in the joints, are expected even as our lifeexpectancy and longevity have increased all round the globe.But what about the other types of arthritidis which are hittingyounger persons? Rheumatoid arthritis, a disease of temperateclimates, 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 understandingof the disturbances at the molecular level we now have a hugefund of knowledge about the functional interrelationship betweenthe 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 cellularactivities on the mind. There is an intricate feed back loop of

connections that point out that many of these common disablingdiseases of the joints can be traced to the life style, that triggersoff the underlying family (genetic) tendencies.

Yoga with its holistic understanding of the human body mindcomplex provides a well developed programme of practices toset right or correct these deep internal imbalances caused by theerratic life style.

This booklet is a guide to Yoga therapists as well as patients

suffering from arthritis.In the first part of the book an attempthas been made to give a brief understanding of the modern medicaland yogic perspective of joint diseases. The second part of thebook gives instructions to the daily practices of yoga to beperformed by a patient with arthritis.

STRUCTURE AND FUNCTIONS OF JOINTS

Types of Joints :

1. Immobile joints are seen in the skull bones. They hold theflat bones of the skull together and are simple. The irregularlysawed margins of one bone fits into the irregular crevices inthe margin of the other bone.

2. Mobile joints are also called Synovial joints. These could bei. 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 onlythe 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 twolong bones come together to form the joint. The two bonysurfaces that touch each other are lined by a thin pearly white,smooth, shiny, hard material called articular cartilage. The two

Metacarpal

Synovial membrane

Synovial fluid

Caritlage

Proximal phalanx

1

Dr. R Nagarathna Dr. HR Nagendra




3 4

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 thosedue to infections, injuries and toxins. Apart from direct invasionof joints by germs as in chronic TB, Leprosy etc, or pusproducing acute arthritis, reactive arthritis is another conditionwherein inflammation in the joints occurs as a response to

infection anywhere else in the body (e.g., rheumatic fever, postdysentery arthritis etc.). The treatment of infections certainlyrequires antibiotics administered as medicines. Here the role of yoga is to strengthen the immune system to fight better; and alsoto prevent and correct deformities.

The other common Anádhija causes of painful joints are due toinjuries i.e., post-traumatic effects on joints. Here yoga practiceshave been used effectively to minimize pain and swelling, preventor correct deformities.

The other common causes of chronic arthritis fall under the

category of “Adhija vyadhi” or stress related arthritis. Osteoarthritis and rheumatoid arthritis are two common conditionsunder this category. Fibromayalgia, autoimmune connectivetissue disorders with musculo skeletal pains and non-specificarthralgias, 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

bone ends are enclosed inside a well protected space covered bya tough outer sheath called joint capsule. There are strong thickcord like structures (ropes) that hold the bones firmly togethercalled ligaments.

The free joint space is filled with a lubricating fluid called Synovialfluid. This fluid is slimy and is continuously replenished. Synovialmembrane forms the velvety soft inner coating of the joint capsule.

This is full of blood vessels and glands that secrete and reabsorbthe lubricating fluid.Muscles are attached directly to the bones that go to form the

joint. Contraction and relaxation of these muscles causemovement of the joints. As the muscle approaches the point of attachment to the bone it may change its texture into a toughnon-contracting material called tendon. Tendons are strings thatcan manoeuvre the narrow passages to reach the bone across the

joint in which the movement takes place. For e.g., the hands andfeet are full of thin long tendons extending from bulky musclesof 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 calledarthralgia andmyalgia. According to yoga texts all types of pain

Causes

Anadhija - non-stressborn Adhijah - stress born

Infections Osteo arthritis Acute Rheumato id Arthrit is -

Chronic Sero negative

Reactive Sero positive

Injuries Connective tissue diseases

Acu te p hase Arthralgias

Chronic phase Musculo Skeletal pain

With deformities Fibromyalgia

Osteoporosis

ARTHRA - JOINT

ITIS - FIGHTING (INFLAMMATION)

COMMON - WEIGHT

BEARING JOINTS






7 8

According to yoga we are born with a stock of Práï a programmedto last for a full life span of one hundred years. We go on spendinga small part of it for all our day to day activities. Emotions demandlarger amount of energy (Práï a) expenditure than physicalactivities. With the fast life style of modern living studded withhypersensitized emotional surges, and suppressions, the rate atwhich we burn out the práï a is much faster. The Práïa stock that

had to last for a hundred years is being used up and hence theproblems of aging show up at an earlier age. The joints alsobeing a part of the whole system would obviously reflect thechanges of early aging in the form of chemical changes in itscartilage followed by all the after effects of osteophyte formationand deformities.

This concept is being understood today as genetic programmingof cell turn over. The rate of cell destruction and regeneration isprogrammed in our genes. As the age advances the rate of cellregeneration falls short of the rate at which the cell destructiontakes place. The pace at which this disparity happens is also pro-grammed. 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 leadsa disciplined life in tune with nature and his own natural pro-grammed biorhythm.

A stressful life style alters the internal environment for geneexpression and the program in the gene that decides the rate of aging gets disturbed. Hence a rapid aging process due to stress isdue to altered rate of cell destruction and regeneration.

Locally, the health of thecartilage requires mode-rate degree of movement.

J ust like the muscleswould become weakwhen not used, the jointswhen not moved enoughbecome unhealthy andvulnerable to injuries.

SEDENTARY LIFE

LIFE STYLE - FAST LIFE

STRESS

OR VIOLENT SPORTS

LEADS TO EARLY AGING

The other end of the spectrum that could cause early agingchanges in weight bearing joints is excessive injuries during

physical sports. Repeated injuries obviously (small and big) couldcause early aging as the repair rate of cartilage is very slowleading 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 acombination of these extremes i.e., too little activity due tosedentary 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 agethan OA.

It generally starts off with pain in small joints of fingers andtoes, in cold season after an episode of infection or delivery oraround menopause. Pain and swelling affects middle and ringfingers, wrists, and toes; lasts for about 3 to 4 weeks and goesaway with medicines; may be associated with fever, and general

RHEUMATOID ARTHRITIS

YOUNG PERSONS20 - 50 YRS (OA > 60 YRS)

MORE IN WOMEN

F : M RATIO

5 : 1

Today li fe can be managed most effectively with minimum(almost nil) physical movements, and hence OA is becoming acommon problem of the sedentary life habits of modern life of computers and cars. Obesity is another factor that hastons upthe rate of joint damage.




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weakness if it is a bad flare up. The pains may recur a few monthslater, again triggered by a physical or emotional stress, lastingfor long durations, affecting more and more joints; when healingoccurs it may lead to stiffness and deformities which is the mostworrying aspect of this chronic disease. Although RA is foundin all parts of the world , it is more common as severe in coldcountries. There are different variations of RA; it may affect joints

without swelling ; may be associated with problems in otherorgans. 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 thingsthat 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 byenemy 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 reachesthe chief vigilance officer who is put on the alert. After severalmeetings and discussions the war is declared; suitable type of army is recruited and the war begins.;continuous moment tomoment monitoring goes on until the war is over;the entirecountry is put on vigilance and co-operation;all other activitiesand celebrations are deferred except the basic needs. A very

similar phenomenon happens within our body. The white bloodcells (WBCs )sense the invader, messages are sent to the campsite - the lymph nodes and thymus, where the decision is madeto trigger off the fight. Intricate details are noted about the type,quantity, quality and severity of the invasion before decisionsare 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 theblood stream to the site and actual warfare (inflammation) takesplace. The WBCs and the chemical fighters surround the invader,break the bacterial cell wall and dissolve the cell material. In theprocess the WBCs are themselves destroyed. After all the germsor the foreign material is destroyed the debris liquifies (pus), isthrown 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 fromself cells. This is the most highly evolved faculty that is uniqueto a race or an individual. WBCs do this by identifying thedifferences in the structure of the proteins contained in differentcells.

In auto -immunity this capacity to differentiate ‘self from non-self’ is disturbed. The WBCs think that the self protein itself is

foreign and sendmessages to recruitfighter cells to thatparticular area andinflammation begins. Inrheumatoid arthritis thebody thinks that the cellsin the synovial lining of the joints are foreign andthe inflammationstriggered 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 byscar tissue the joint gets fixed in odd positions and this leads tostiffness and deformities. Due to immobility and damage to the

joint structure, the muscles around the joints become

wasted(weakened).

CAUSE -

AUTO IMMUNITY

FIGHTING AGAINST

SELF

JOINT LINING CELLS

CONSIDERED

NON-SELF BY

DEFENCE CELLS

RHEUMATOID ARTHRITI S




11 12

What triggers autoimmunity in rheumatoidarthritis?

One of the well known factors is the cold weather. In RA weknow that there occurs a typical seasonal aggravation of the

disease. The other factor thatis known to trigger off

autoimmunity is stress. It isobserved that RA starts off or flares up in most womenafter some form of stress.Stresses could be physicallike an infection, postdelivery, or menopause. Orit may be an emotional

trigger. Generally, it has been observed that you are sensitiveby nature and trying to cope up with too many emotionallydemanding situations in your life over a number of years. Also,

there is usually an immediate trigger in the form of an acuteemotionally demanding situation.

There seems to be a strongfamily tendency forrheumatoid disease at thebackground, which hasmade you vulnerable toautoimmune arthritis, andthe stresses of life eitherphysical or emotional have

triggered off the actualdisease process.

Psyche, central nervous system and immunesystem.

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

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

The Central Nervous System (CNS) is disturbed if your mind isdisturbed. L ong standing persistent emotional surges andsuppressions trigger off the loop of persistent excitement startsoff chronic imbalance in their chemical regulation mechanism.Several chemicals have been identified (ACTH, cartisones,

cytokines etc.) that are released in large quantities from differentparts of this psycho- neuro-immune pathway that affect theimmune system functions. One way you could understand thisis, when there is a danger we fight to survive; if there is a long

WHY ?AUTO IMMUNITY

RHEUMATOID ARTHRITI S

• HEREDITY

• TRIGGERS

ST SS -

PHYSICAL STRESSES

COLD CLIMATE

POST DELIVERY

MENOPAUSE

• EMOTIONAL STRESS MODERN LIFE STYLE

RHEUMATOID ARTHRI TIS

A C U T

E S H

O C K I N

G

E V E N

T S

C H R O N I C

F R U S T R

A T I O N

D E P R E S

S I O N

PSYCHO NEURO IMMUNOLOGY

STRESS & AUTO IMMUNITY

THYMUS

B

T

LYMPHOCYTES

standing danger we become more and more violent; we lose ourdiscrimination, and start getting muddled; turn into a brute; forgetthe soft human qualities and get lost in acts of destroying thefellow human beings who may not be our enemies; this is what

happens to your immune system. The most highly developedfaculty of differentiating self from non-self is the first functionto be knocked off, when you are chronically stressed. The killerinstinct takes the upper hand and produces an autoimmuneinflammation in the joints.

Mrs. J ayanthi a 35 year old house wife come with typicalrheumatoid arthritis of about 3 years duration. After she came




13 14

out of her problem through yoga therapy she became confidentto express her stress problems. She analysed herself and said thatthe cause of her RA was her sensitive nature, and suppression of her emotions. Coming from a rural background, and being marriedto a joint family (5 members) in the city, she had too many things

to adapt in her new life. The emotional adjustment to accept theways of the new house, husband, and the neighborhood, was

quite demanding. Her biggest problem which caused the majoremotional suppression was her interaction with the mother-in-law. Mother-in-law being a meticulous obstinate personalitywould go on pointing out the mistakes several times in the day.

This left her in a state of constant fear throughout the day. Thisunexpressed fears ended up with joint pains, with activesymmetrical arthritis (RA). The pains were suppressed by longterm suppressant medication and she was managing to do herroutine duties. But because of repeated flare ups, increasing dosesof medication and the mounting fears of long term crippling, herillness only went on persisting for about 3 years before she camefor Yoga therapy. This is how the problem that starts in the mindbrings about the stress induced autoimmune problems.

What are the other stress related rheumaticproblems?

Ankylosing spondylitis is a (Bamboo spine disease) is a form of auto-immune arthritis with a strong genetic back ground, thatoccurs more commonly in males affecting mainly the spine, pelvisand 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 activearthritis. 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 andgoes episodically. This is also a life style related disease withinflammation in fibrous tissue and a general internal imbalanceof psycho-neuro-muscular pathways.

Other conditions which do not clearly fall under any one specificpattern of a definable disease or syndrome would includearthralgias, myalgias, episodes of myositis and generalised bodyaches of unexplained etiology.

Another major category of autoimmune disorders that includesconnective 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 manifestsaround middle age as a specific ailment through damage toconnective tissues by autoimmunity.

Chronic fatigue syndrome(CFS) is another common disease of the muscular system, about which much research is going on. Inthis condition the fatigue is so severe that even to lift the handfrom thebed could be a Herculian task. Research is continuingin order to understand the cause of CFS. I t is believed to be avirus infection with an autoimmune process related to stressfullife style.

Management of Arthritis

Modern medicine has recognized the role of helping a patientwith arthritis by a multidisciplinary approach, involving severalexperts including a physician, rheumatologist, orthopedicsurgeon , 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 painto the brain.




15 16

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

Steroids (Carticosteroids) which was the only miracle drug thatwas available a few decades ago, has been replaced by NSAIDSbecause of the large number of serious side effects. Obesity,hypertension, diabetes, thinning away of bones with pronenessto multiple fractures, skin problems and vulnerability to chronic

dangerous infections are known to occur with long term usageof any of the categories of steroids. Hence today steroids areprescribed for short periods of not more than 4 to 6 weeks in raresituations of severe and dangerous flare up of RA, when it affectsheart, eyes etc. It is also established that steroids do not have adisease modifying potency. Local steroid injections into the joints,

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

The NSAIDs are the commonly used agents as the first line of medication in all forms of rheumatic pains. Research over theyears has been directed towards evolving potent and safe NSAIDs

with less and less side effects. We can say that we have a succededin the discovery of NSAIDs with almost no side effects evenwhen consumed over years. A minor degree of stomach upset isprobably the only minor side effect with the latest drugs of thiscategory.

Steroids and NSAIDs work at the level of the white blood cells-the soldiers are blocked from attacking the cells in the lining of the joints by preventing the expression of the inflammatoryprocesses.

The third category of medicines which are to be used for a longperiod of time in RA are called disease modifying anti rheumaticdrugs (DMARD). These are Gold, D Penicillamine, anti-malarialslike chloroquin and Immuno Suppressant drug Methotroxate.DMARDs are used for long term suppression of the basic immunedisturbances. All these drugs are associated with many minorand major side effects requiring very close monitoring and carefullook out for side effects that may affect the kidneys, eyes, bloodetc. A judicial use of a combination of all these drugs has saved

STRESSManomaya kosa

Auto ImmunityPranamaya kosa

JointInflammationAnnamaya kosa

Anti inflammatory drugs

Steroids, NSAID

Immuno- suppresants

methotrexate

Psycho therapy, Yoga

large number of patients with RA from the devastating cripplingproblems.

What are the drugs available for management of OA?

Pain killers and Anti-inflammatory agents (NSAIDs) and localinjection 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 orstimulate cartilage synthesis or inhibit phagolytic enzymes thatare responsible for rapid destruction of the cartilage. Glucosamine,Arteparan and Rumalon are the drugs in this category.

Physical therapies in the management of Arthritis

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

medicated oil massage, ultra sound vibration therapy are all usedfor pain relief. Several gadgets are designed to rehabilitate andimprove the quality of life of patients with already damaged

joints. Replacement of joints that are damaged that may not betackled 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 modernmedicine, none of these really tackle the problem at its root




17 18

cause.Hence research continues. Let us see how yogis under stoodthis problem of psychosomatic ailments and offered remedies.

Integrated approach of Yoga Therapy for Arthritis

The integrated approach of yoga therapy provides techniques toaddress the problems of all aspects of the stressed fast life styleof the individual.

According to yoga we allhave five bodies. Thesolid physical bodyvisible to our eyes madeof a permutation andcombination of hydro-gen, oxygen, carbon,nitrogen, calcium, andpotassium etc. is calledAnnamaya koùa (physical

body). The life energy (práï a) that makes each and every cell

carry on its functions is práï amaya koùa (vital energy body).Right dose of práï a is supplied to all cells to maintain health. Themind which carries on the functions of perception, memory andemotions is called manomaya koùa (mind body or astral body).

The inner mind that controls and guides the manomaya koùa iscalled vijnánamaya koùa (knowledge body). This is the judgewho decides what is right and wrong based on life’s experiencesso that we can live a life of contentment, bliss and happiness. Inthe fifth which is the subtlest body called ánandamaya koùa(blissbody), 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 healthresults if there is lack of mastery.

According to yoga psychosomaticproblems begin in Manômaya Koùa(mind layer of our existence) as anÁdhija vyádhi. Ádhi is stress. Stressbegins in the mind (Manas) as

uncontrolled surge of emotions (Bhávana). These emotions suchas anxiety, worry or depression, tension etc., are psychologicalresponses to deman-ding situations either real or imagined. Stressis defined as Jesie( 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 theseemotions there is one common factor namely the excessive speed

of the rate of flow of our thoughts. This is described as “ keÀece¬eÀesOesodYeJebJesieb“ (Kama Krodhodbhavam vegam in Bhagavad gita -intense desire and anger lead to excessive speed.)

These stresses carry enormous power (energy) by gatheringmomentum by the recycling of thoughts unceasingly in theManômaya koùa. This speeded up loop goes out of control andwe get lost in the speed. This speed when suppressed over a longperiod of time starts clouding the faculties and disturbs the balance

of the 5 koùas. The ánanda or Jnána- the right knowledge, isclouded by the emotions. We get completely lost when worryingbecomes a full time occupation. We start feeling tensedup allday, 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 themanifestations of the uncontrolled stress reactions i.e., speed of

the mind. When this goes on for some time it percolates into the

Práï amaya koùa and disturbs the Práï a balance; excessive erraticsurges of Práï a manifests initially as functional disturbances likeexcessive generalised tiredness, bodyaches, feverishness,exhaustion and immune disturbances . At this phase the mostcommonly noticeable imbalance is in the form of irregularbreathing pattern - disturbed rate, rhythm, and depth of breathingfollowed by irregularities in digestion with disturbed appetite and

PA N CA K ÔÙA

ANNAMAYA

VIJ ÒÁNAMAYA

MANÔMAYA

PRÁNAMAYA

ÁNANDAMAYA

FI VE FACETS OF PERSONA LI TYFI VE FACETS OF PERSONALI TY




19 20

bowel habits. When the suppressed stresses continue for somemore months or years, it settles down in the joints as excessivePráï a that gets locked up in Nadis around joints. Theinflammation that shows up in the joints is the excessive speedthat has percolated from Manômaya to annamaya via Práï amayaKoùa. Inflammation, a war against the synovial membrane -anauto immune fight- a civil war. The speed is grossified into

visible structural damage. Yoga says that you had the full freedomto react or not to react or react other wise in the Manômaya Koùainitially when there was a demanding situation. But when youampli fied the reactions, you started losing the freedom. Onceyou lost the freedom, the chain of reactions went on gatheringmomentum and it settled down in the joints as inflammation.

Y oga texts also explain this phenomenon as a process of constriction, as in the example of formation of Ice. The moleculesthat had complete freedom to diffuse into a wide space in thegaseous state, became confined to the boundaries of a containerin the liquid state which later became constricted with very

minimal freedom in the solid state of ice. Similarly when thestress reactions are in the state of ‘thought’ in Manomaya Koùathere is full freedom. Then it recycles and gets bound into thePráï a (liquid state) with less freedom. As it constricts further itsolidif ies into annamaya Koùa as joint problem with leastfreedom.

This understanding is useful to you because it is a reversibleprocess. Just like the ice can melt into water and vapour, youcan reverse this whole process of constriction (in the form of arthritis) towards expansion or complete freedom from disease.

This process is called Òeefl eÒemeJe(Pratiprasava-retracing). You canstart reversing the whole process of inflammation by using threetools namely ‘internal awareness’ , ‘slowing down’ and‘expansion’. Y ou need to work with enormous confidence andfearlessness to acheive complete cure from this autoimmunearthritis or the aging arthritis. The IAYT provides techniques tochange the imbalances at all the five Koùas.

IAYT for Rheumatoid Arthritis - AnnamayaKoùa practices.

All annamaya Koùa practices are meant to ‘reduce the speed’ atthe physical level, i.e., give very deep relaxation and rest to theentire body in general and to the painful muscles and joints in

TECHNICS OF YOGA

ANNAMAYA KÔÙA

particular. Pain in the joint is seen as “speeded up activity” i.e.,too many of the pain sensors are being triggered off to sendelectrical impulses to the brain. When there is a joint inflammationthe surrounding muscles get tensed i.e., too many of the musclefibers get activated in order to prevent joint movement. Thismuscle spasm is also speed. When you follow the specialtechnique practices designed for arthritis, you must develop thedeep internal awareness to consciously slow down the activityin the stretched part which is experienced as a feeling of rest,relaxation, ease, freedom, let go, and expansion. When you gothrough the full list of the practices you will be working with thewhole body part by part to give a stretch followed by deep restand relaxation. Patanajali gives the hints for achieving these twogoals of “slowing down” and “expansion” when he talks about

Òe-elveMewef Leu-e( Prayatna ùaithilya), trick to let go of all effort toslowdown, and “ DevevlemeceeHeefl le“ (Anantasamápatti), the trick to expandand merge your awareness in the imagery of vast endless sky orocean. When you practice the physical practices, your mind

should focus intensely(OeejCe- Dharana) on the point of pain orstretch. Stretch up to a point where your pain is tolerable orenjoyable. Bring your full concentration on to the point of pain.

TECHNICS OF YOGA

ANNAMAYA KÔÙA

JOINT LOOSENING EXERCISES

REDUCES STIFFNESS OF J OINTS

IMPROVES FLEXIBILITY

SAKTI VIKÁSAKA SÜKÚMAVYÁYÁMA

STRENGTHENS MUSCLES

AROUND JOINT




21

As soon as you releasethe position (in repeatingtype of movements) feelthe let go, freedom,easeand expansion at the spotwhere you had the stretchor the pain. Develop a

deep internal awareness of this alternate stretch andlet go, which can be looked upon as speed and slowing down,or pain and no pain, or effort and effortlessness, or constrictionand expansion, or focussing and defocussing.

When you move on to yoga ásanas where you do not repeat thepractices you have to maintain in the final posture of the ásanafor some time. When you have moved into an ásana come to thepoint of tolerable degree of pain. Maintain with ease. Relax allother 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 moveon to the next phase (Ananta samápatti ) and start slowly diffusingthe impulses from the point of pain, by merging your mind inthe visualization of the vast blue sky for a few seconds. Enjoythe beautiful sky umbrella above your head. Bring yourawareness back to the point of pain. By this time your pain wouldhave started diffusing. Thus patanjali’s suggestions help you toget freedom from pain even while maintaining in the final postureof an ásana.Thus you start unwinding the constriction and speedin the joint (annamaya Koùa level) to expansion and slowness

by using the tool of deep internal awareness, confidence andfearlessness; you need the courage and steadfastness to gothrough the practices regularly to reap the positive results of thesepractices.

Kriyas are techniques that help to cleanse the system from deepwithin so that the internal organs get revitalized to functionnormally. The kriyas provide the strong stimulus followed by

very deep rest to the organs that are being cleansed. A systematicgraded gradually increasing stimulus followed by very deep restimproves the stamina of the organ to function more efficiently.

Pure sátvic diet is a pre-requisite to yoga. It helps you to cleansethe bowel, improve digestion and clear the mind. A sátvic diet,as the word indicates, makes your mind clear, gentle and soft sothat you could have the necessary steadfastness, calmness and

confidence to work with yourself.Práï amaya Koùa practices.

The Práï a imbalance is the bridge between the stressed mindand the sick body. This shows up as irregular breathing. Slowdown the breathing. When you slow down the breathing rate,the mind slows down. Aswe know there is a directconnection between ourmind and the breath.Whenever you are

anxious, depressed orangry (an emotionalspeed), your breathingrate speeds up and viceversa. i.e., whenever youare calm, relaxed, sleepingcomfortably or meditating,your breathing becomes slow. Sagespicked up this connection and used breathing as a tool to slowdown the mind. All breathing practices help you to balance thePráï a. Reducing the speed at the Práï amaya Koùa conserves theunnecessary wastage of vital life energy.It trains you to drawonly the required quantum of energy and use it in the mosteconomical way. Whenever you start doing the Práï ayama andother 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

Práï ayamas.

22

YOGASANAS

• REDUCES I NFLAMMATI ON

• DECREASES PAI N & SWELLIN G

SLOWNESS & BREATHING

• DEEP REST TO JOINTS

• IMPROVES FLEXIBILITY

ANNAMAYA KÔÙA

YOGA TECHNIQUES - PRÁNAMAYA

BREATHING RATE

FAST - SHORT LIFESLOW - LONGER LIFE

PRÁNÁYÁMA

DELAYS AGING - OA

REDUCES STRESS - RA

PRÁNÁYÁMA

300YRS

10 YRS

KÔÙA.

.

.






REDUCES STRESS & MAKES YOU YOUNG

DEVOTION - BHAKTI - SURRENDER

MANOMAYA KÔÙA

OF

BEING INTHE

PRESENCE

OF YOUR

BELOVED

BEING INTHE

PRESENCE

OF YOUR

BELOVED

caused by inability to carry on with the business . The first timehe came to Prashanti, as he came away from the problem situationand 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 copeup with the demands, it was too much. He got lost in the whirlpoolof his own fears, and came back. This time, he studied the

concepts of Karma yoga and Bhakti yoga with keen interest. Hepracticed dháraï a, dhyána, cyclic meditation, MSRT and PETregularly. After 6 weeks he was confident, completely free fromhis arthritis, felt physically and mentally strong to face the situationbetter. He went back home, took up the business and picked upgradually and steadily with hard work . With a cheerful approachhe managed to encourage the family members to becomeconfident 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. J ayaram 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 familymembers but also to many suffering persons in his village. Hegot his sisters married. He now has his own family with a beautifulchild. Even today he continues with his regular practices, nownot for the treatment of his illness but to grow as a better andbetter human being to lead a useful spiritual life of joy, peaceand harmony.

Manômaya Koùapracitces of dháraï a,dhyána and devotional

sessions help you to workdirectly on the mind. It ishere that the stressesbegin. The trick of dhyána helps you to learnthe art of slowing downthe speeded loop of

thoughts; a training to unwind the loop of worry, depression etc.“Manah praùamana upáyah,” the trick to slow down the mindhas to be practiced regularly after the physical and brea-thing practices every day. The cyclic meditation is a useful toolfor the agitated mind to be brought under control through theprinciple laid down in Máï dükyakárika, a yogic text, that helpseven a sick and suffering person to get the feel of these deep

states of inner quietitude, calmness, ease, relaxation and deepinner rest- the state of alertful rest described in meditative states.

Devotional sessions help you to culture the emotions. All stressesare nothing but violent emotions expressed or suppressed, thatneed to be replaced by soft emotions. Bhakti yoga uses the toolof “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 expectationsetc.; all these help you to mature as a human being from thelower instinctual demanding nature to a more humane acceptingnature.

Vijnánamaya Koùa Practices

Working at the Vijnánamaya Koùa, you become anobserver(Sákúi) of your own mind. Y ou are able to ask morebasic questions about the purpose and meaning of your own life.Understand that theonly purpose of any pursuit is to getthe contentment orfulfilment; that this

state of joy is aninner state of blissand harmony andquietitude;toachieveand retain this stateis whole of the pur-pose of this life;

26

VIGÒANAMAYA KÔÙA

NOTIONAL CORRECTIONS

SILENCE IS HAPPINESS

REDUCE RUSH AND SPEED FOR

MATERIAL JOY

BE CHEERFUL AT ALL TIMES

BE YOUNG ALL THE TIME

25




27 28

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

Ánandamaya Koùa PracticesKarmayoga is the trick to remain in Ánandamaya Koùa. The artof working in relaxation, work with an attitude of yajna (offering

to Divine), working withoutworrying about the results of action, working with a senseof duty, living in the present,working in tune with theuniversal principle ; recog-nizing that you are basicallymade of the universal stuff called Ánanda from whichthe entire universe has

emerged; that all pain and suffering, losses, and gains in business,

name, fame and money including this physical body are allephemeral; that they all come and go and ‘you’ are the everlasting, unchanging, ever blissful, imperishable entity. Scriptures

proclaim thus

De®í soîeess -eceoeÔîeess -ecekeÌuesoîeess Mees<-eSJe®e~efvel-eëmeJe&ieleëmLeeCegëDe®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

were compared with ten who didnot practice yoga. All these werechronic patients on long termdisease modifying medicationfrom the Rheumatology department of South Cleveland Hospital,Middlesbrough, England. The

yoga group showed significantimprovement in hand grip strength and disability index as perStanford health assessment questionnaire after three weeks.

They all reported much betterquality of life.They felt confident, sronger, less tired, and couldmanage their daily chores withmuch greater freedom and ease.In another study on 34 rheu-matoids in india we noticedsignificant improvement in

symptom scores (52%), pain analogue scores(50%), ESR (11%),and joints swelling (10%), after two weeks of IAYT.

IAYT for Osteo-arthrosisIn this degenerative or aging arthritis yoga has been used effectively,

both for prevention and treatment.

Prevention is better than cureÁsanas practiced regularly starting from young age offers smoothcontinuous healthy movement to the joints. Most ásanas aredesigned to keep the hips and spine flexible. This provides the

necessary degree of balanced movements without jerks or bangson the cartilage, thus preventing their early wear out.

Relaxation in the final position of the posture emphasized byPatanjali when he talks about prayatna ùaithilya and Anantasamápatti (relax in the final posture and tune your mind to infinity)to maintain the posture with ease and comfort, is a subtle toolthat promotes a very healthy blood flow to the cartilage.

ÁNANDAMAYA KÔÙA

5250

37

1 6 . 6

2 0 . 8

0

10

20

30

40

50

60

S S P AS P P C S R AS B R S

(STRESSPROJECT) 1996-98 CCRYN

% improvement after 2 weeks of IAYT

SS: symptoms score; PAS:pain analogue scale;PPC:psycho physiological checklist; SRAS: self rating anxiety

scale; BRS:Bortner’s rating scale (type A personality)

N 34 AGE: 46+12N 34 AGE: 46+12

11

10

3.2

5

0

2

4

6

8

10

12

ES R HG S J S A M

(S T R E S S P R OJE C T ) 1996 -98 C C R Y N

% improvement after 2 weeks of IAYTAM: Angle of movement; JS: Joint swelling;

HGS: Hand grip strength




29 30

PRAYER

Sit in any comfortable meditative posture and adopt NamaskáraMudrá. Close the eyes. Observe your whole body andbreathing. Turn your mind inwards. Begin your yoga sessionwith chanting the following verse from Upaniúads praying

for the welfare of the teacher and the student: menveeJeJelegmenveewYegvekeÌleg menJeer³e¥keÀjJeeJenw~

lespeeq mJeveeJeOeerlecemleg ceeefJeef Ü<eeJenw~

Meeefvleë MeeefvleëMeeef vleë~~

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). Mayhe nourish us both. May we both work together with greatenergy. May our study be enlightening and fruitful. May wenot hate each other. Om Peace, Peace, Peace.

Namaskára Mudrá

How does Yoga help OA? The physical yoga practices provide a systematically gradedtraining in gradually increasing the range of movements whenpracticed with deep internal awareness. This not only helps tomobilize the stiff joints but can prevent further aging process.Although the damaged cartilage may not get replaced, furtherdeterioration and wearing out can be arrested.

In chronically damaged joints with pain and deformities, thesurrounding muscles would be very weak because of long standinginactivity. Similar to physiotherapy many yoga practices whenpracticed with deep internal awareness and repeated, can helpyou to strengthen the muscles around. Ùakti vikásaka Sükúmavyáyámas are specific practices that provide the non-weightbearing isometric as well as isotonic exercises that strengthen themuscles that provide the weight bearing support to the damaged

joints. The additional contribution of yogic sukúma Vyáyáma isthe deep relaxation, which takes away the muscle fatigue.

Can yoga reverse OA changes?Working with the Práï amaya and Manômaya Koùa level prac-tices of Práï ayama and dháraï a and dhyána, helps you to movetowards a more balanced functioning of all organs of the bodyincluding the joints. Stress reduction that emerges out of the no-tional correction at the Vijnánámaya Koùa reduces the basic fearsof l ife that is responsible for the rapid process of aging. Youcontinue to perform in the same set up with efficiency. Theinner equipoise, contentment, absolute fearlessness and confi-dence to accept all ups and downs of life would almost arrest theprocess of further aging. It would give you a rechanged refreshedlife with a total change in your world view, moving towards

positive outlook. Stress reduction at this deep level of notionalcorrection is the one that can revert the programmed gene func-tion to a normal rate of cell repair in the cartilage.

The further chapters in this booklet gives you step by stepinstruction for the regular daily practices that would help you towork at all 5 Koùas inorder to improve your health and movetowards complete freedom from illness.




ÙITHILÈKARAÏ A VYÁYÁMA AND YOGÁSANÁS

A. STHITI (initial) and ÙITHILA (relaxation)

postures for all Ùithilèkaraïa Vyáyáma and Yogásanás.

Sthiti: Initial standing posture -Táãásana

Stand erect with feet close together.

Place the hands along the thighs withfingers stretched out.

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

Close the eyes and observe the balance.

Standing Relaxation Posture -Ùithila Táãásana

Stand erect with legs about six to

twelve inches apart, hands hangingfreely by the side of the body withthe shoulders collapsed.

Make sure that the body iscompletely relaxed.

Gently close the eyes.

Sthiti (Initial) for Sitting Posture -Daïãásana

Ùithila (Relaxation) for Sitting Posture - Daïãásana

Sit with legs stretched apart and relax.

Slightly incline the trunk backwards, supporting the bodyby 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.

2

31 32

Sit with both legs stretched with heelstogether.

Place the palms on the floor by the side of the buttocks.

Keep the spine, neck and head erect.

Close the eyes.






35 36

B ÙITHILÈKARAÏ A VYÁYÁMA

1. PASSIVE ROTATION OF TOES

Sthiti: Daï ãásana or sitting in a chair.

PRACTICE

• Bend the right leg at the knee, place the right foot on the leftthigh.

• Keep the spine erect.

• Bring the awareness to the toes.

• Bend the toes slowly forward andbackward.

• Keep the feet upright and the anklesmotionless during the practice.

• Hold each position (forward andbackward) for a few seconds.

• Practice with normal breathing.

• Repeat ten times.

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 6inches).

• Bring the hands near the buttocks finger pointing backwards.

• Slightly lean backwardsshifting the body weighton to the arms.

• Keep the spine and neck

erect.• Bring the awareness to

the feet.

• Move both feet slowly forwards and backwards, bending themat the ankle joints.

• Try to stretch the feet forward to touch the floor, and thenpull them up towards the knees.

• Move the individual toeswith the left hand (i.e.,passivemovement) bendingthem forward & backward,right & left followed byclockwise and anti- clockwise rotation five times

each.

• Then hold all the toes with the left-hand, rotate and bendthem 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: Daï ãásana

PRACTICE

• Sit with the legs outstretched and the feet together.

• Place the hands beside the buttocks fingers pointing forwards.




37 38

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


• Repeat ten times.

Note

• This can also be practiced sitting in a chair.

• If necessary, practice each foot separately.

4. ANKLE ROTATION


PRACTICE

• Separate the legs byabout a foot.

• Bring the awareness toboth feet.

• Slowly rotate both feetfrom the anklestogether in oppositedirections.

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

• Repeat 10 rounds.

• Change directions and repeat 10 rounds.


5. KNEE BENDING


PRACTICE

• Bend the right knee andclasp the right thigh withthe hands under them.

• Now straighten the rightleg by pulling up theknee cap so that the rightheel is off the floor.

• Keep the arms straight.

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

• Then straighten the right leg with heel off the floor.


• This is one round. Practice ten rounds.• Repeat the same practice ten rounds with the left leg.

Note

• Bring the awareness to the knee joint during the practice.

6. KNEE ROTATION


PRACTICE• Lift up the right thigh.

• Bring the right knee to 90o.

• Support the thigh withinterlocked hands.

• Keep the right leg parallel to the ground.

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

Note

• 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.




39 40


• 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.

7. KNEE CAP TIGHTENING


PRACTICE

• Stablize the position of the right foot throughout the practicewith the help of the left hand.

• Gently move the right knee up towards the chest and thengently push it down and try to touch the ground with theknee.

• Repeat this up and down movement of the right knee 10times.

• Inhale while the knee goes up and exhale while the kneecomes down.

• Repeat the same with the left leg.

Note

• 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.

9. FULL BUTTERFLY


PRACTICE

• Bend both the knees, draw thelegs along the ground, to bringthe soles of the feet to presseach other and the heels touchthe perineum.

• Completely relax the innerthigh muscles.

• Close your eyes and bringyour awareness to theknees.

• Slowly pull the knee capsupwards and then releasethem.

• Repeat this practice 20times with normalbreathing.

Note• Do not practice mechanically. Practice with full awareness.

8. HALF BUTTERFLY Sthiti: Daï ãásana

PRACTICE

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

• Place the right hand on top of the right knee.




41

Stage - I (Clasping the feet with the hands)

• 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 strokewith 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 theground, allowing them to spring up again.• Normal breathing.• Repeat twenty to thirty times.• Straighten the legs and relax.

10. WAIST ROTATIONSthiti: Táãásana

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,

then to the back and to the left.• Ultimately bring it back to the front

where you started. This completes oneround.

• Inhale during forward movement.Exhale during backward movement.

• Practice ten rounds in clockwise and ten rounds in anti-clockwise direction.

• Come back to normal standing position, drop down the handsand 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

fists clenched.• Rotate both the fists in opposite

directions.• Practice ten times with normal

breathing.• Repeat the same practice in reverse direction.

42

N o t e

• Do not force the movements.

• Try to keep the back, neck and head straight.

• Also keep the trunk steady during the practice.

>

>








47 48

C SAKTI VIKASAKA SÜKÚMA VYÁYÁMA

1. MANIBANDHA ÙAKTI VIKASAKA (Wrists)

Sthiti: Táãásana

PRACTICE• Stretch your arms straight in

front of the chest at shoulderlevel, keeping them parallelto the ground.

• Make tight fi sts of yourhands (palms facing down).

• Now, move the fists up anddown vigorously from thewrists.

• Repeat 10 rounds.

2. KARA TALA ÙAKTI VIKÁSAKA ( Palms)

Sthiti: Táãásana

PRACTICE

• Stretch the arms sideways atshoulder level with palmsfacing downwards

• Bend the elbows and spreadout and stretch all the fingures.

• Bring the palms near thechest.

• Now, move the palms up anddown vigorously from thewrist.

• Feel the strong tightness andstretch in the fingures andpalms.

• Normal breathing

3. ANGULI ÙAKTI VIKÁSAKA (Fingers)

Sthiti: Táãásana

PRACTICE

• Throw out your arms in front, keepingthem parallel to the ground at shoulderlevel.

• Simultaneously give the fingers of botharms the shape of the hood of a cobra.

• Now, stiffen the entire length of the armsfrom the shoulder joints to the finger tipsas 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.

4. KAPHONI ÙAKTI VIKÁSAKA (Elbows)

Sthiti: Táãásana

PRACTICE• Stretch the arms straight down beside the

body, palms facing forward and make tightfists.

• Bend the arms at the elbows and raise yourclenched fists forward to the level of theshoulders 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.




49 50

Then while exhaling bend forward trying to touch the headto the ground without bending the knees.

Repeat this 10 rounds.

Note

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.

7. JANGHA ÙAKTI VIKÁSAKA (THIGHS)Sthiti: Táãásana

PRACTICE

Stretch out the arms straight infront at shoulder height, palmsfacing downwards.

While inhaling bend your kneesgradually till your thighs comeparallel 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.

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 fistsfacing each other.

Now, push both the arms forwards forcefully and vigorouslyto the level of the shoulder.

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

Sthiti: Táãásana

PRACTICE Spread your legs apart as far as possible. Place your hands on the hips with the

thumbs pointing forward and the fingerspointing backward.

While inhaling bend backward from thewaist as far as you can. Maintain thisposture for sometime.






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4. BHUJAÑGÁSANA

Sthiti: Prone Posture

PRACTICE

Bend the arms at the elbows and place the palms beside thelower chest at the level of the last rib exerting leastpressure on the palms.

Keep the elbows close to each other and let them notspread out.

Inhale and come up. Arch the dorsal spine

and neck backwardsas far as you can.

Keep the body belowthe naval in touchwith the ground

Maintain the finalposition with normal breathing for one minute with leastpressure on the palms.

While exhaling come back to sthiti position. Relax in Makarásana.

2. ARDHA CAKRÁSANA

Sthiti: Táãásana

PRACTICE

Support the back at the waist by thepalms, fingers pointing forwards.

Inhale and bend backwards from the

lumbar region. Drop the headbackwards, stretching the muscles of the neck.

Maintain for a minute with normalbreathing.

Return to Sthiti.

Relax in Táãásana.

3. PÁDA HASTÁSANA

Sthiti: Táãásana

PRACTICE

Stand erect with legs together.

Inhale slowly and raise the armssideways.

At this horizontal level, turn thepalms upward.

Continue to inhale and move the

arms upwards until the bicepstouches the ears. Turn the palmsforward.

Stretch up the body from the waist.

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

Exhale while going down further until the entire palm restson the ground and chin touches the knees.

Maintain in this final posture for about 2 - 3 minuteswithout bending the knees.

Inhale, come up slowly to the vertical position and stretchthe arms above the head.

Exhale, drop down the arms, turn the palms downwards atthe 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.




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5. ÙALABHÁSANA


PRACTICE Make fists of your palms with the thumbs tucked in and

place them under the thighs, with back of the handstowards the ground.

While inhaling raise both the legs up as far as

comfortable without bending the knees.

Maintain this position for about one minute with normalbreathing.

Come back to Sthiti position while exhaling. Relax in Makarásana.

Note Pull up the knee caps and squeeze the buttocks to improve the

posture.

6. DHANURÁSANA


PRACTICE

Bend the knees and holdthe ankles by the palms.

As you inhale, raise thehead and the.chestupwards.Pull the legsoutwards and backwardsso that the spine is arched back like a bow.

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

Keep the legs together.

Maintain for about half a minute with normal breathing.

Slowly come back to Sthiti while exhaling.

Relax in Makarásana.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

PRACTICE Inhale, raise the legs together

slowly and gracefully (withoutbending the knees) till it formsabout 450 to the ground.

Continue to inhale and raise thelegs further to 900 position andbring the arms downwards placingthem next to the buttocks.

Exhale raise the buttocks and thetrunk , taking support of the armsand elbows, without lifting the

head. Rest the elbows on theground firmly and support the back with both palms.

Retaining the legs parallel to the ground, straighten thetrunk by pushing it with the hands untill the chin is wellset in the suprasternal hollow.

Inhale and raise the legs vertically keeping the body erectand come to the final shoulder stand position.




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Maintain effortlessly with normal breathing for about 2 to3 minutes. Carefully avoid all jerks.

Slowly come back to Sthiti step by step and relax inÙavásana

8. MATSYÁSANA


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

9. VIPARÈTA KARAÏ I WITH WALL SUPPORT


PRACTICE

Lie down on the back besidethe wall, placing the bodyparallel to the wall.

Raise both legs to 900, slidethem on to the wall, keepingthe knees straight.

Raise the buttocks and thetrunk off the ground, rotate thetrunk to make it perpendicular to the wall, support the bodywith the hands at the waist allowing the legs to rest on thewall. In this final position, the legs are completely on thewall. 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 legsback to the floor, and relax.

Note Make sure that you have achieved perfect balance before you

release the hands supporting the trunk.

10. HALÁSANA


PRACTICE Inhale raise the legs together slowly and gracefully

(without bending the knees) till it forms about 450 to theground.

Continue to inhale and raise the legs further to 900 positionand simultaneously bring the arms down placing them nextto the buttocks.

Place the palms on either side of the head with fingerspointing 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 bybending the dorsal and cervical spine backwards.

Exhale and release the hands after the weight is wellbalanced on the head and catch hold of the big toeshooking the index fingers around them.

Press the elbows on the ground to bear the weight of theupper 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 People with neck pain low back pain and hyper tension should

avoid this posture.






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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 catchthe right big toe.

sthiti and relax for a while in Ùithila Daï ãásana.

Repeat the same on the other side.

14. ARDHA MATSYENDRÁSANA

Sthiti: Daïãásana.

PRACTICE Bend the right leg at the knee

bydrawing it along theground.

Place the sole of the right footagainst 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

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

Exhale, twist the waist to the left and bring the right armaround the outer side of the left knee. The left knee acts asa fulcrum for getting maximum twist of the spine. Catch theleft big toe with the right hand. The right triceps rests onthe outer side of the left knee.

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

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 Daï ãásana.

Repeat the same, on the other side.

15. UÚTRÁSANA

Sthiti: Daïãásana.PRACTICE

Sit in Vajrásana.

Stand on the knees.

Place the palms on the waistwith fingers pointing forwards.

Inhale and bend the trunkbackwards and place the palmson the heels.

Maintain for about a minutewith normal breathing.

Exhale while coming back to Sthiti.

Relax in Ùithila Danãásana.

Note

The thighs should be perpendicular to the ground.

Take the right arm backand keep the palm on theground in such a way thatthe trunk is kept erect witha proper twist.

After maintaining forabout a minute withnormal breathing return to

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

Do not sit on the heels.




Relaxation Techniques

16. INSTANT RELAXATION TECHNIQUE (IRT)

Sthiti: Ùavásana

17. QUICK RELAXATION TECHNIQUE (QRT)

Sthiti: Ùavásana.

PRACTICE

Phase I

Feel the abdominal movements.Observe the movementsof abdominal muscles going up and down as you

breathe in and out normally. Observe 5 cycles.

Phase II

Synchronize the abdominal movements with deepbreathing.The abdomen bulges up with inhalation and sinksdown with exhalation. Observe 5 cycles.

Phase III

As you inhale deeply and slowly, energize the body andfeel the lightness. As you exhale completely collapse all themuscles, release the tension and enjoy the relaxation.Observe 5 cycles.

Chant ‘AAA’ in a low pitch while exhaling. Feel thevibrations 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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PRACTICE

Bring your legs together; join the heels and toes togetherand place the palms by the side of the thighs.

Keep the face relaxed with a smile all through thepractice.

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-I

Bring your awareness to the tip of the toes, gently move yourtoes and relax. Sensitize the soles of your feet; loosen theankle joints; relax the calf muscles; gently pull up the kneecaps release and relax; relax your thigh muscles, buttockmuscles; loosen the hip joints, relax the pelvic region andthe 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.

Shift your awareness to your nose, observe your nostrils, andfeel the warm air touching the walls of the nostrils as youexhale and feel the cool air touching the walls of the nostrilsas you inhale. Observe for a few seconds and relax yournostrils. Relax your cheek muscles, feel the heaviness of thecheeks and have a beautiful smile on your cheeks. Relax youreye balls muscles, feel the heaviness of eye balls, relax youreye 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 vibrationin your head region.

Phase-IV

Observe your whole body from toes to head and relax, chantan AUM in a single breath. Feel the resonance throughoutthe 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. Mergeyourself 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 upwhen you are ready.

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Phase-II

Gently bring your awareness to the abdominal region andobserve the abdominal movement for a while, relax yourabdominal muscles and relax the chest muscles. Gently bringyour awareness to your lower back, relax your lower back,

loosen all the vertebral joints one by one. Relax the musclesand nerves around the back bones. Relax your middle back,shoulder blades and upper back muscles, totally relax. Shiftyour awareness to the tip of the fingers, gently move them alittle and sensitize. Relax your fingers one by one. Relax yourpalms, loosen the wrist joints, relax the forearms, loosen theelbow joints, relax the hind arms-triceps, biceps and relaxyour shoulders. Shift your awareness to your neck, slowlyturn your head to the right and left, again bring back to thecenter. Relax the muscles and nerves of the neck. Relax yourmiddle part of the body, totally relax. R..e..l..a..x .. . ChantU-kára and feel the vibration in the middle part of your body.

Phase-III

Gently bring your awareness to your head region. Relax yourchin, lower jaw and upper jaw, lower and upper gums, lowerand upper teeth and relax your tongue. Relax your palates-hard and soft, relax your throat and vocal chords. Gently shiftyour awareness to your lips, relax your lower and upper lips.




PRÁÏ ÁYÁMA

A. POSTURES FOR PRÁÏ ÁYÁMA& MEDITATION

1. VAJRÁSANA


PRACTICE

Fold the right leg and bring theright heel under the right buttock.

Sitting on the right heel, fold theleft leg and bring the left heel underthe left buttock.

Sit erect comfortably with the

buttocks resting on both the heelsand 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)

Sthiti: Daï ãásanaPRACTICE Bend the right leg completely at the knees and place the

foot under the left thigh with the heels pressed against theperineum.

Bend the left leg at the knee and place the left heel on theright heel.

3 Tuck the toe of the left foot

into the fold of the rightknee.

Push the right hand into thefold of the left knee andpullup the right big toe toensure that it is kept pressedagainst the left inner thigh.

Make sure that both theknees are resting on theground.

Sit erect with hands resting onthe thighs in Cin mudrá withelbows bent.

Note

Although the posture is exactly the same, it gets the name Siddhayoni

Ásana in women and Siddhásana in men.

3. SUKHÁSANA

Sthiti: Sit in Daïãásana

PRACTICE

Fold the legs and cross themto place the feet under op-posite legs.

Sit comfortably with spineerect. The hands rest on thethighs in Cin Mudrá with theelbows bent.

Note

Here the knees do not touch the gro und.

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B. MUDRÁS FOR PRÁÏ ÁYÁMA AND MEDITATION

1. CIN MUDRÁ

Touch the tips of the thumbs with the tips of theforefingers.

Keep the other fingers striaght.

Rest the palms on the middle of the thighs.

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.

3. ÁDI MUDRÁ

Make fists of both hands with the thumbs tucked in.

Rest the fists on the thighs.

4. BRAHMA MUDRÁ

Make fists of both palms with the thumb tucked in andplace them on either side of the navel with the palms facingupwards 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 thepalm.

Use the thumb to gently close the rightnostril.Use the ring and the little fingercombination to close the left nostril.

Note This mudra is used during different types of

uninostril práï áyámas. 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.

C. PREPARATORY PRACTICES FORPRÁÏ ÁYÁMA

1. CLEANSING BREATH (KAPÁLABHÁTIKRIYA)


Sit in any meditative posture.

Keep your spine and neck erectperfectly vertical to the ground.

Close the eyes and collapse the

shoulders. Relax the whole body completely.

PRACTICE

Practice rapid breathing with active and forceful exhalationand passive inhalation.

During each exhalation, blast out the air by vigorousflapping movements of the abdomen in quick succession.

Inhale passively by relaxing the abdominal muscles at theend 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 .

Note

Throughout the entire practice the spine must be kept erect without any movement of the trunk, neck or the face.

I t 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:

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

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Therapeutic :

It provides a nice massage to all the abdominal organs. Peoplewith digestive problems are highly benefited. It cleanses thelungs and also the entire respiratory tract. It is good for asthmaticsand for other respiratory disorders.

Spiritual:

It removes the distractions of the mind and prepares it for

meditation. The practitioner achieves a state of KevalaKumbhaka, i.e. automatic cessation of breath.

Limitations:

Practice of Kapalabhati is to be avoided in case of moderate andsevere High Blood Pressure Ischemic Heart Disease, Vertigo,Epilepsy, Hernia, Gastric Ulcer, Slip Disc and Spondylosis.Women during menses and advanced stage of pregnancy shouldavoid.

2. VIBHÁGÈYA ÙVASANA (SECTIONALBREATHING)

This is a preparatory breathing practice for Práï áyáma. Itcorrects the wrong breathing pattern and increases the vitalcapacity 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.

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 besmooth, continuous and relaxing.

Note

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

II. THORACIC (INTERCOSTAL)BREATHING (MADHYAMA)

Sthiti: Vajrásana

PRACTICE Place the hands resting on the thighs in

Cinmaya Mudrá.

While inhaling, expand the chest cageforwards, outwards and upwards.

While exhaling relax the chest wall andreturn to resting position.


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 Ádi-Mudrá.

While inhaling raise the collar bones andshoulders upwards and backwards.

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While exhaling drop down the shoulders to the restingposition.


Note

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

Place the hands resting on theabdomen at the navel in BrahmaMudrá.

During inhalation, the Adhama,Madhyama and Ádya práï áyámaoccur sequentially.

Now exhale in the same sequence (abdominal, chest andclavicular).


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 madhyamaand 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.

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

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 Y ogic

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 breathingwill help in calming down your mind and revitalising it.

Limitations

It has no limitations.

75 76




D. PRÁÏ ÁYÁMA

1. SÜRYA ANULOMA VILOMAPRÁÏ ÁYÁMA

Sthiti: Vajrásana

PRACTICE

Adopt Násika mudrá with your right hand. Close the left nostril with the little and

ring fingers of Násika Mudrá.

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

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

One cycle of inhalation and exhalation forms one round.

Practice nine rounds.

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 VILOMAPRÁÏ ÁYÁMA

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 timeduring the practice.

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

Note

Time taken for exhalation should be longer than inhalation.

Anxiety patients may practice this Práï áyáma 27 rounds before breakfast, lunch, dinner and before sleep (4 times a day).

Benefits

(For Süryanuloma-V iloma and Candranuloma-VilomaPráï áyáma)

Physical :

These Práï áyámas help in clearing of the nasal passages. Withregular and long practice, flow of breath through each of thenostrils becomes smooth and slow.

Therapeutic :

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

For specific significant imaprovement, the recommendedschedule is to have twenty-seven rounds of this Pranayamasfour times a day (before breakfast, lunch, clinner and beforegoing to bed). Systematic practices have benefited large numberof obese and under weight persons to achieve normal weight.

Spiritual :

Cleaning of Surya and Candra Nadis is the first step to bringthe balance between the two Nadis. They aid in unbfolding of the inner layers of consciousness.

Limitations

For Süryanuloma-V iloma Práï áyáma, people suffering fromhibloodprusser, any heart disease and underweight problemshould a avoid this practice.For Candranuloma-Viloma Práï áyáma, people suffering fromobesity and any type of allergic should avoid it.

77 78




79 80

3. NÁDIÙUDDHI PRÁÏ ÁYÁMA

Sthiti: Vajrásana

PRACTICE Sit in any meditative posture.

Adopt Násika Mudrá.

Close the right nostril with the rightthumb and exhale completelythrough the (left) nostril. Theninhale deeply through the same leftnostril.

Close the left nostril with your ringand little finger of the NásikáMudrá, release the right nostril.Now exhale slowly and completelythrough the right nostril.

Inhale deeply through the same (right) nostril. Then close

the right nostril and exhale through the left nostril. This isone round of Nádiùuddhi práï áyáma.

Repeat nine rounds.

Note

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 cleansingthe nasal tract. It increases the vitality. Metabolic rate decreasesas in case of all other Práïáyáma prctices. It increases the digestivefire and appetite.

Therapeutic :

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

Spiritual :

It induces tranquility, clarity of thought and concentration. Itclears pranic blockages and balances Ida and Pingala

nádis,causing Shuúumna nádi to flow which leads to deep statesof meditation and spiri tual awakening. It helps to maintainBrahmacharya which is a pre-requisite for spiritual progress.

Limitations:

No Limitations.

4. COOLING PRÁÏ ÁYÁMAS

I. ÙÈTALÈPRÁÏ ÁYÁMA

Sthiti: Vajrásana

PRACTICE

Place the palms resting onthe thighs.

Stretchthe tongue forwardpartly out of the mouthand fold it so as toresemble the beak of acrow.

Slowly suck in the air

through the beak and feel the jet of cool air passing downthe throat into the lungs.

Slowly exhale through the nostrils, feeling the movement of warm air all the way up from the lungs through the throatand the nasal passages.

This completes one round of Ùètali Práï áyáma.

Repeat nine rounds.




81 82

II. SÈTKÁRI PRÁÏ ÁYÁMA

Sthiti: Vajrásana

PRACTICE Place the palms resting on the

thighs.

Fold the tip of the tongueinwards horizontally.The folded

tongue slightly comes outbetween the two rows of teethand provides a narrow openingon both sides.

Slowly suck the air in throughthe two sides of the tongue. Feel

the cool stream of air diffusing throughout the mouth andthroat into the lungs.

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

This completes one round of Sètkári. Repeat nine rounds.

III. SADANTA PRÁÏ ÁYÁMA

Sthiti: Vajrásana

PRACTICE

Place the palms resting on thethighs.

Let the upper set of teeth touchthe lower set of teeth.

Keep the tip of the tongue justbehind the teeth.

Inhale through the crevices of the teeth and feel the cool airmoving slowly and continuously into the mouth andpassing down the throat into the lungs.

The warm air is exhaled out slowly through both thenostrils. Feel the warmth of exhaled air.

This completes one round of Sadanta. Repeat nine rounds.

5. BHRÁMARÈPRÁÏ ÁYÁMA

Sthiti: Vajrásana

PRACTICE Assume Cinmudrá. Inhale deeply. Exhaling, produce a low pitched

sound resembling the humming of afemale bee.

Feel the vibrations in the entire head. This is one round. Repeat nine rounds.

Note During the practice of Bhrámarèuse ‘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.

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.




4

83 84

MEDITATION

A. NÁDÁNUSÁNDHÁNA(A-kára , U-kára, M-kára, A-U-M)

1. A- KÁRA CHANTING Sthiti: Vajrásana

PRACTICE

Sit in any meditative posture andadopt cin-mudrá.

Feel completely relaxed and closeyour eyes.

Inhale slowly and completely. While exhaling chant ‘A AA’ in a

low pitch. Feel the sound resonance in the abdomen and the lower

parts of the body. Repeat nine times.

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.

3. M-KÁRA CHANTING

Sthiti: VajrásanaPRACTICE

Sit in any meditative posture. Adopt Ádi Mudrá. Inhale slowly and completely.

while exhaling chant ‘MMM’ in alow pitch. Feel the sound resonance in the

entire head region. Repeat nine times.

4. A-U-M CHANTING

Sthiti: Vajrásana

PRACTICE 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.




85 86

B. OM- Dhyána (MEDITATION)

Sthiti: Any Meditative Posture

PRACTICE Sit in any comfortable meditative

posture feeling completely relaxed.

Phase I

Close your eyes and start chantingOM mentally. Allow the mind torepeat OM continuously withoutany break. I f there are destractions,chant OM faster, not giving achance for distractions.

After a while the chanting slowsdown. Consciously slow it down further. If the mind jumpsto 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 anunbroken stream of effortless flow of OM japa in yourmind.

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 inwhich you start feeling the vibrations of the japa in somepart of the body and later throughout the body (threedimensional(3D) awareness).

Phase III As you slow down the japa of OM, observe the gap

between two OMs. As you slowdown further, the gap goeson becoming wider and wider to diffuse into silence.

Phase IV The experience of inner silence helps to expand from the

three dimensional awareness of the body to all pervasive

awareness(beyond the limits of the body). The bed of silence becomes deeper and more expansive. Visualise andfeel 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 awhile.

Phase V

From this deep ocean of silence in the heart region, let oneOM emerge as an audible sound which diffuses into theentire body and the space all around. Enjoy the beautifulvibrations.

Blink the eyes slowly, gently open the eyes and come outof meditation.

Note

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




87 88

KRIYÁS

NETI

1. JALA NETI (Cleaning the nasal passage)

Sthiti: TáãásanaPRACTICE

5

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

Stand with the legs apart

Hold the neti pot in your righthand.

Insert the nozzle of the Neti potinto the right nostril.

Keep the mouth open andbreathe freely through themouth.

Ti lt the head first slightlybackwards, then forwards andsidewards to the left so that thewater from the pot enters the

right nostril and comes out through the left by gravity. Allowthe flow till the pot is empty.

Repeat the same on the left side.

To clear the nasal passages of the remaining water, blow outthe water by active exhalation through alternate nostrils asin Kapálabháti.

2. SÜTRA NETI OR RUBBER CATHETER NETI

Sthiti: Táãásana

PRACTICE

Insert the blunt end of a thin softrubber catheter horizontally intothe right nostril.

Gently push it along the floorof the nose until the tip is felt inthe back of the throat.

Insert the right index and themiddle finger through themouth and catch the tip of thecatheter at the back of the throat.

Pull it out through the mouth and gently massage the nasalpassage by catching the two ends of the tube.

Remove the catheter through the nose.

Repeat on the left side.Note

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: TáãásanaPRACTICE

Drink about one and a half liters of lukewarm saline water(about 1% saline) as quickly as you can until you feel l ikevomiting it out.

Churn the stomach by twisting exercises.




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

Now with the help of themiddle three fingers of theright hand, tickle the backof the throat to vomit out(vaman) all the water.

Repeat the process of tickling the throat until nomore water comes outwhich may mean that allwater has been vomited .

With continued practice onecan stimulate the vomitingsensation and vomit out thewater without using thefingers at the throat.

Relax completely in DRT for about 15 to 20 minutes.

Have a bland breakfast after about half an hour.Note

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

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.

With long practice one can learn to vomit all the water as if it is acontinuous jet. This is called Gajakaraï i.

6

INTEGRATED YOGA MODULE FORARTHRITIS (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. I t is with this inview that this IYMA (Integrated Yoga Module for Arthritis) hasbeen specially tailor made to cater to the needs of yoga therapyparticipants, with different types of arthritis

What is IYMA ?

The IY MA or Integrated Yoga Module for Arthritis is a combi-nation of various yoga practices so arranged to work at all levelsof human existence – Physical, práï ic, mental, emotional andintellectual levels. As described in chapter 1, the root cause forthese diseases (RA and OA) is Ádhi in Manomaya koùa whichpercolates down to Annamaya koùa (Physical body) via thePráï ámaya koùa. Unless the root cause is eradicated, we cannotaffect a complete normalisation. Hence, IAYT uses all the tech-niques needed to set right the imbalances at these three levels.

The Integrated Yoga Module I and II recommended as an hourpractice that can be practiced on alternate days consists of spe-cially chosen yoga practices at all these three levels.

What is the basis for IYMA ?

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 upemotional upsurges at mental level that shows up as increasedrespiratory rate and imbalance of flow of breath between the twonostrils at the práï a level. These two aspects are called Tamasand Rajas.

89 90




What is the solution?Both these aspects have to be handled intelligently at subtle levels,says the commentary on Máïãükya UpaniúatMáïãükya Karika).

The wisdom from this traditional text says

ue³esmebyeesOe³esledef ®eÊebef Jeef #eHlebMece³esledHegveëmekeÀ<ee³ebef Jepeeveer³eeled meceÒeeHlebve®eeue³esled~

Laye sambodhayet cittam vikúiptam ùamayet punaçSakaúáyam vijánèyát samapráptam na cálayet.

(Máïãükya Kárèká 3 - 44)

When the mind gets to a state of drowsiness, stimulate and awakenit; 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 thestate of balance. Once you touch this balanced state do not disturbit (stay in that state as long as you can).

Each stimulation helps to end the stagnation and open up theconstrictions. Immediately following this stimulation when youlet go consciously you go into deep relaxation. After therelaxation continues for a while, the system reaches a saturationpoint often leading to stagnation or drowsiness. It is then, thatwe need to stimulate again. Successive stimulations andrelaxations one after the other thus help to release the stresses atdeeper and deeper levels.In essence in the fi rst phase, you shatter the Tamas throughstimulation and then calm down the Rajas. Thus a combinationof stimulation- relaxation is the key. A series of successivestimulations and relaxations help to go on clearing all the deepseated stresses (the adhis) in a systematically organized mannerand this helps to fully normalise your system at all the five levelsof existance.

In this module the stimulations are provided by Sithilèkaraï aVyáyáma (step 1), Sukúma Vyáyáma (step 3), Asanas (step 5),Praï áyama (step6) and devotional songs (step 8) where as IRT,QRT(step 8), DRT and meditation (step 7) provide the relaxationcomponent. While step 1, 3 and 5 provide the physical

stimulations, the stimulations in práï áyáma(step 6) anddevotional sessions(step 8) at the mental level take you to thesubtle levels of mind and emotions to provide very deep rest.

The practice of complete silence in the end expands the mind toits source of all pervasive ocean of peace and bliss, which is thebasis for removal of all imbalances.

The IYMA uses this basis and sets itself the sequence as follows:

91

Steps

1 Stimulate

2 Relax

3 Stimulate

4 Relax

5 Stimulate

5a Relax

6 Stimulate

7 Relax

8 Stimulate

QRT - 3 Mints

Ùithilèkaraï a Vyáyáma - 7 Mints

Ùakti Vikásaka Sükúma Vyáyáma - 4 Mints

IRT and QRT - 3 Mints

DRT - 7 Mints

Práï áyáma - 12 Mints

OM meditation +Nadanusandana

Devotional Songs - 5 Min

Silence - 2 Mints

Resolve

92

Ásanas - Standing, Prone, Supineand Sitting postures) - 9 Min




c. Expansion of Awareness The mind becomes calm with practices such as Ásanas andPráï áyama as evidenced by lower breathing rate and reducedmetabolic rates. This helps in expanding your awareness by medi-tation; devotional sessions harness your emotions. From focussedattention to linear, surface and three dimensional awareness, youexpand. This helps in performing actions in our day to day ac-tivities with ease.

Similarly you learn to move from violent to softer and more cul-tured emotions as you practice devotional sessions. Softening of emotions to gain mastery over them is a science by itself. ( seeour book on “Bhakti Y oga” - 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.

I. Reduces the laziness and lethargy.II . Develops regularity.

III. Helps in learning the techniques nicely.IV. Subtle effects through unseen vibrations charging the

place automatically bring wonderful feeling of wellnessand positive health.

V. Sounds produced in synchrony during the practices helpin developing group awareness.

VI. Painful agravations of the ailments also reduce as we workin group.

VII. Higher emotions of sharing and caring for others helpyou to overcome the pain.

e. Resolve

At the end of this eight stepped practices a few minutes of si-lence would help a great deal in expanding your vision furtherand develop confidence to combat the disease fully. After thisyou allow a resolve to soak deep into your system.

Resolve (Sankalpa) is a selected positive short sentence that yourepeat at the end of each session before you chant the closing

93 94

Dimensions of IYMA

Having understood the basis for IYMA, we now proceed to un-derstand the dimensions of IYMA, that help you to release subtlestagnations, tensions and stiffnesses at the physical level, imbal-ances at the práï a level, and eradicate Ádhi at Manomaya Koùalevels.

a. Recognition is half solution

Closing the eyes throughout the practice helps in building aninternal awareness which is the key to the release of innate ten-sions and pains.

b. Move deeper and deeperIn phase one, we use stretch and relaxation of muscle fibres tomake them more supple. Repetitions help to make them moreand more relaxed. As you move on to next phase, perceive theblood flow changes in the limbs and joints; you can sensitizeyourself 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 thenerve impulses. When you experience a mild pain during thestretch of a joint, concentrate on the intensity of pain and thearray of large number of nerve impulses, followed by reduction

of these impulses when you return to the original position. Thisis the stage when you can allow the relaxation to deepen further.In step 7 when you generate the sound vibrations you developthe awareness of the complete body with greater sensitivity, betterharmonisation and relaxation.

When the practices are repeated day after day, the joints becomemore and more flexible, muscles become stronger and softer,

and the movements become easier. Loosening of joints and im-proved mobility obviously help to improve the quality of life.

Patience, pays. Slow and steady wins the race. Do not rush andpush to the limits of elasticity. While a good stretch is recom-mended you must learn to work with awareness and graduallyincrease the stretch of muscles. And relax them deeply withawareness.




prayer. Repeat the same sentence slowly and clearly in yourmind with full attention and a deep feeling of the meaning of thesentence . Select positive words and try to avoid words withnegative adverbs. Selected sentences could vary from week toweek. 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 worriedII. my immune system is not fighting against my own tissues.

95




96

Integrated Yoga Module forARTHRITIS

Eight steps- one hour-Alternate DaysSet - A

Ùitilèkaraï a Vyáyáma

(Loosening Exercises)35 Passive rotation of toes 10 2 min

35 Toe Bending 10 ½ min

37 Ankle Rotation 10 ½ min

38 Knee Rotation 10 ½ min

39 Knee Cap Tightening 25 1 min

40 Full Butterfly 10 ½ min

42 Waist Rotation 10 ½ min

42 Wrist Rotation 10 40 sec

43 Shoulder Rotation 10 40 sec

46 Neck Bending 10 1 min46 Neck Rotation 10 40 sec

64 Quick Relaxation Technique 3 min

Sakti Vikasaka Sukúma Vyáyáma47 For Wrist - Mani Bandha Ùakti Vikásaka 10 ½ min

47 For Palms - Kara Tala Ùakti Vikásaka 10 ½ min

48 For Fingers - Anguli Ùakti Vikásaka 10 ½ min

48 For Elbows - Khaponi Ùakti Vikásaka 20 ½ min

49 For Arms - Bhuja Bandha Ùakti Vikásaka 20 ½ min

49 For Back - Kati Ùakti Vikásaka 10 ½ min

50 For Thighs - Jangha Ùakti Vikásaka 5 ½ min

51 For Calf Muscles - Pindali Ùakti Vikásaka 5 ½ min

63 Instant and Relaxation Technique 1 min


Steps Pg.No. Practice Rounds Duration

1

2

3

Prone Postures

54 Bhujangásana ½ min

55 Ùalabhásana ½ min.Supine Postures

56 Sarvángásana 1½ or 2 min 57 Matsyásana 1 min

Sitting Postures

61 Vakrásana 1+1 min. 62 Uútrásana ½ min.

64 Deep relaxation technique 7 min

PRÁÏ ÁYÁMA

Preparatory Practices for Práï áyáma 71 Cleansing breath (Kapálabháti Kriya) 1 min

73 Vibhágèya Ùvasana (Sectional Breathing) 4min

Práï áyáma 77 Sürya Anuloma V iloma Práïáyáma 2 min 79 NáãèÙuddhi Práï áyáma (9RDS) 3 min

81 Sitali/ Sitkari/ Sadanta Práïáyáma 2 min

MEDITATION83 Nadánusandhána 3 min

85 OM Dhyána (Meditation) 5 min

Devotional Song 5 min

Silence

Total 60 min

5a

8

6

YogásanaStanding Postures

52 Ardhakati Cakrásana ½ +½ min

53 Ardha Cakrásana ½ min53 Páda Hasthasana 1 min.

5

7

4

97




Integrated Yoga Module forARTHRITIS

Eight steps- one hour-Alternate DaysSet - B

Ùitilèkaraï a Vyáyáma(Loosening Exercises)

35 Passive rotation of toes 10 2 min37 Ankle Rotation 10 ½ min

38 Knee Bending 10 1 min

39 Knee Cap Tightening 25 1 min

40 Full Butterfly 10 ½ min

42 Waist Rotation 10 ½ min

42 Wrist Rotation 10 40 sec

43 Shoulder Rotation 10 40 sec

46 Neck Bending 10 1 min

46 Neck Rotation 10 40 sec

64 Quick Relaxation Technique 3 minSakti Vikasaka Sukúma Vyáyáma

47 For Wrist - Mani Bandha Ùakti Vikásaka 10 ½ min

47 For Palms - Kara Tala Ùakti Vikásaka 10 ½ min

48 For Fingers - Anguli Ùakti Vikásaka 10 ½ min

48 For Elbows - Khaponi Ùakti Vikásaka 20 ½ min

49 For Arms - Bhuja Bandha Ùakti Vikásaka 20 ½ min

49 For Back - K ati Ùakti Vikásaka 10 ½ min

50 For Thighs - Jangha Ùakti Vikásaka 5 ½ min

51 For Calf Muscles - Pindali Ùakti Vikásaka 5 ½ min

63 Instant Relaxation Technique 1 min


YogásanaStanding Postures

52 Ardhakati Cakrásana ½ +½ min

Steps Pg.No. Practice Rounds Duration

1

23

4

53 Ardha Cakrásana ½ min

53 Páda Hasthasana 1½ min

Prone Postures

55 Dhanurásana ½ min

Supine Postures 58 Viparèta karaï i 1½ min 56 Halásana 1 min 57 Cakrásána ½ min

Sitting Postures

60 Ùáùánkásana 1 min. 61 Ardha matsyendrásana 1 min.

64 Deep relaxation technique 7 min

PRÁÏ ÁYÁMA

Preparatory Practices for Práï áyáma71 Cleansing breath (Kapálabháti Kriya) 1min

73 Vibhágèya Ùvasana (Sectional Breathing) 4 min

Práï áyáma77 Candra Anuloma Viloma Práï áyáma (21 RDS) 2 min

79 NáãèÙuddhi Práï áyáma (9RDS) 3 min

81 Sadanta Práï yáma 2 min

MEDITATION

83 Nadánusandhána 3 min

85 OM Dhyána (Meditation) 5 min

Devotional Song 5 min

Total 60 min

6

7

8

5

5a

Other practices for both the sets

Kriyas - Jalaneti, Sutraneti and Vamana Dhouti, once aweek

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

98 99




100 101

Passive rotation of toesPg 35, 10 Rds, 2 min

Toe BendingPg 35, 10 Rds, ½ min

Ankle RotationPg 37, 10 Rds, ½ min

Knee Cap TighteningPg 39, 25 Rds, 1 min

Half Butterfly Pg 39, 10 Rds, ½ min

Neck BendingPg 44, 10 Rds, 1 Min

Ankle bendingPg 36, 10 Rds ½ min

Knee RotationPg 38, 10 Rds, ½ min

Pg 38, 10Rds, 1 minKnee Bending

Pg 40, 10Rds, ½ min

Full Butterfly

> >Waist RotationPg 42, 10 Rds, ½ min

Wrist RotationPg 42, 10 Rds, 40 sec

Shoulder Rotation

Pg 43, 10 Rds,40 sec

Neck RotationPg 46, 10 Rds, 40 sec

INDEX

For Palms - Kara Tala Ùakti

Vikásaka Pg 47, 10 Rds, ½ min

For Arms - Bhuja Bandha ÙaktiVikásaka

For Back - Kati Ùakti Vikásaka

For Thighs - Jangha Ùakti VikásakaPg 50, 5 Rds, ½ min

Pg 52, ½ + ½ minArdhakati Cakrásana

For Wrists - Mani Bandha

Ùakti Vikásaka Pg 47, 10 Rds,½ min

For Fingers - Anguli Ùakti VikásakaPg 48, 10 Rds, ½ min

For Elbows - Khaponi ÙaktiVikásaka Pg 48, 20 Rds,½ min

Pg 49, 10 Rds, ½ min

Pg 49, 20 Rds, ½ min

Pg 51, 5 Rds,½ min

For Calf Muscles - Pindali ÙaktiVikásaka

Ardha Cakrásana Pg 53,½ min

Pg 53, 1½ minPáda Hasthasana

BhujangasanaPg 54,½ min

Pg 55, 30 secDhanurásana

Pg 55,½ minSalabhasana




Pg 57, 1 minMatsyásána

Pg 62,½ min

VakrásanaPg 61, 1+1 min

Uútrásana

HalásanaPg 58, 1 min

Pg 58, 1½ minViparèta karaï i

ÙáùánkásanaPg 60, 1 min

Pg 59,½ min

Cakrásana

Ardha MatsyendrásanaPg 61, 1 min

Quick Relaxation TechniquePg 64, 3min

Instant Relaxation TechniquePg 63, 1 min

Deep Relaxation TechniquePg 64, 3min

SarvángásanaPg 56, 2 Min

Cleansing breath (Kapálabháti Kriya)Pg71, 1min

Candra Anuloma VilomaPráï áyáma Pg 77, 21 Rds, 2 Min

Vibhágèya Ùvasana (SectionalBreathing) Pg 73, 4Min

OM Dhyána (Meditation) Pg 85, 5 min

NáãèÙuddhi Práï áyámaPg 79, 9Rds, 3 Min

NadánusandhánaPg 83, 3 min

Ùitali PráïyámaPg 80, 2 min

Sètkári Práï yámaPg 81, 2 min

Sadanta Práï yámaPg 81, 2 min

Documents

Yogic Cure for Arthrities