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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
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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
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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
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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
(viii) (ix)
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
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(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
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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
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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
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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
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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
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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.
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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
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cause.Hence research continues. Let us see how yogis under stoodthis problem of psychoso- matic 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
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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
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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.
.
.
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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
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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 free- dom 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
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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.
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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.
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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.
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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.
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• Hold each position (forward and backward) for a few seconds.
• Practice with normal breathing.
• Repeat ten times.
Note
• This can also be practiced sitting in a chair.
• If necessary, practice each foot separately.
4. ANKLE ROTATION
Sthiti: Daï ãásana
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.
• Practice with normal breathing.
5. KNEE BENDING
Sthiti: Daïãásana
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.
• Practice with normal breathing.
• 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
Sthiti: Daïãásana
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.
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• Practice with normal breathing.
• Bring back the right leg down on the floor.
• Now repeat the same with the left leg.
Note
• While rotating allow the leg below the knee to hang freely
• You can do this, even sitting in a chair or at the edge of a cot.
• With this practice of Knee rotation, there is no risk of injuring the knee
joint.
7. KNEE CAP TIGHTENING
Sthiti: Daïãásana
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
Sthiti: Daï ãásana
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.
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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.
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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.
>
>
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C SAKTI VIKASAKA SÜKÚMA VYÁYÁMA
1. MANIBANDHA ÙAKTI VIKASAKA (Wrists)
Sthiti: Táãásana
PRACTICE• Stretch your arms straight in
front of the chest at 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.
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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
Sthiti: Prone Posture
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
Sthiti: Prone Posture
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
Sthiti: Supine Posture
PRACTICE Take the right leg and place it on the left thigh. Place the left leg on the right thigh as in Padmásana.
9. VIPARÈTA KARAÏ I WITH WALL SUPPORT
Sthiti: Supine Posture
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
Sthiti: Supine Posture
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.
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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.
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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.
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PRÁÏ ÁYÁMA
A. POSTURES FOR PRÁÏ ÁYÁMA& MEDITATION
1. VAJRÁSANA
Sthiti: Daï ãásana
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)
Sthiti: Daï ãásana
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.
Repeat this breathing cycle five times.
Note
Avoid movements of abdomen.
III. UPPER LOBAR (CLAVICULAR) BREATHING (ÁDYA)
Sthiti: Vajrásana
PRACTICE Sit in any meditative posture.
Place the hands resting on thighs in 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.
Repeat this breathing cycle five times.
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).
Repeat this breathing cycle five times.
Note The whole process should be relaxing and comfortable, without any
tension in the face. Roughly gauge the time of your inhalation and exhalation. Take one
third of your inhalation time for adhama ,one third for 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.
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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.
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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.
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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.
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4
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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.
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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.
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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.
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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.
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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:
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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
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Ásanas - Standing, Prone, Supineand Sitting postures) - 9 Min
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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
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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.
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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.
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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
64 Quick Relaxation Technique 3 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
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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
64 Quick Relaxation Technique 3 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)
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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
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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