Should You Try Yoga as a Treatment for Your Fibromyalgia?

Should you try yoga as a treatment for your fibromyalgia?Yoga. It’s everywhere. From passers-by on the sidewalk toting yoga mats, to health headlines in the media, it seems like yoga has saturated the mainstream. But if you live with a chronic condition, like fibromyalgia (FM), you may be unaware of what twisting yourself into a pretzel has do with managing your daily symptoms. In fact, you may be unaware that yoga isn’t about twisting yourself into a pretzel at all.

Research is clearly on the side of trying yoga to manage your fibromyalgia symptoms. The Oregon Health and Science University published a study in 2010 that compared the impact of an eight week yoga program on FM patients against a control group who received standard FM treatment. Researchers found that “pain was reduced in the yoga group by an average of 24 percent, fatigue by 30 percent and depression by 42 percent”.

So what is yoga actually all about? And how can it help you manage your chronic condition?  To answer these questions, I asked my good friend and yoga therapist, Kathrin Gottwald, who also blogs at Soulicious Moments.  Kathrin explains that “A carefully tailored yoga practice can not only lead to more flexibility and muscle tone, but also more awareness and potentially a different way of experiencing yourself and life.” This mind-body aspect of yoga exercise is at the core of what makes it effective. “Yoga means union,” explains Kathrin, “it is a practice to establish a feeling of connection to ourselves, others and the world around us.”

Should you try yoga as a treatment for your fibromyalgia?

Before my diagnosis, I was a beginner yoga student. Although I was never a very athletic person, I found I craved my weekly class. Week to week, I noticed that my strength, balance and flexibility improved. I enjoyed being in my body, rather than in my head, for those 60 minutes. After my diagnosis, I assumed by yoga days were over. I could barely sit on the floor, after all!

Eventually,  I attended a pain management class, which included a yoga component led by a teacher who herself had fibromyalgia. I began to include certain yoga poses into my daily stretching routine. Finally, I found a DVD with a yoga routine designed specifically for FM (see below). The genius part of the program is that they show each pose at 3 levels of ability, so you can customize your program based on your daily level of pain. I try to do this routine twice a week. I have the same benefits as before, even though my yoga routine is much gentler and shorter than before: feeling a positive connection to my body, feeling more present, and feeling my flexibility, balance and strength improve.

Beyond physical benefits, yoga is about developing body awareness and mental presence. Kathrin elaborates: “Yoga is not about perfecting the poses or contorting yourself into difficult positions, but it is all about how you relate to yourself and that which you encounter and experience in life. Especially for people living with chronic conditions it can be very beneficial to find skillful ways of relating to themselves and their illness.”

I also include a breathing practice three to four times a week along with my yoga routine. This is also an important part of yoga. As Kathrin notes, “In yoga the breath is considered our life force. The practice is to consciously move this energy within you and use it skilfully. Observing the breath and resting your awareness on your breath is already a yoga practice in itself.” Even if you are having a flare, and all you can do is breathe, you can still practice yoga. This practice has to do with sitting or lying quietly and focusing on the breath. When thoughts or sensations distract you, as they inevitably will, you gently bring your attention back to the breath as soon as you realize you have gotten carried away.

I find yoga helps me ‘practice’ being in the here and now, helps me to know the contents of my own mind and heart better, and increases my awareness of my body, so I can check in with what I am able to do day to day. In Kathrin’s words, “Yoga practice starts with being. We do not need to constantly strive to be different and improve. When we practice, we are just striving to be more fully ourselves.”

So if you want to start a yoga practice, where do you begin? You can work one-on-one with a yoga therapist or teacher. Kathrin explains that “in yoga therapy you work with a specific intention of finding more skilful ways of relating to yourself and your condition. This is a very personal and individual path. The yoga therapist will develop a targeted practice for you, which will be individually adapted as needed”.

More and more studios are beginning to offer targeted classes, like yoga for back pain or chair yoga, which you may be able to join. I definitely recommend asking if you can observe a class before joining, to ensure it is at your level and uses a therapeutic approach.

If this is out of your price range, several resources you can consider are listed below. These include instructional DVDs or online routines you can do at home. This is usually better for people with some yoga experience, to avoid injury.  However you start, I hope you find greater presence, connection, and health!

 

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Aquatic Ai Chi Therapy Seen to Reduce Pain of Fibromyalgia

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Self-Care for Chonic Illness: Research Round-up

Research Roundup

Part of being a health nerd means enjoying reading research. As a health nerd and a blogger I figured I should start a series of the most interesting recent research on chronic conditions. Learning about self-care has been an important part of my health journey, as well as a source of enjoyment for my inner nerd. So here is the first installment of my Research Roundup series, organized by self-care skills – Lifestyle, Exercise,  Attitude, and Nutrition. I hope this encourages you to make self-care part of your health journey! #SelfCareMvmt

  • Lifestyle: A recent Australian study investigated the most effective strategies for improving sleep among an elite women’s basketball team. The results may help you prioritize which strategies to try if you suffer from insomnia or poor quality sleep. The most effective bedtime routines were: turning off all electronic devices at least an hour before bed (that includes your phone), practicing mindfulness or meditation, and sleeping in a cool environment. These strategies were found to improve sleep and performance on the court.
  • Exercise: A New York Times editorial recently argued that moving more, not weight loss, is the cause of the dramatic health benefits of exercise demonstrated in hundreds of research studies. From arthritis, to cardiovascular disease, to Parkinson’s, to chronic fatigue syndrome, to depression, a massive meta-analysis found that exercise improved health and well-being among all these chronic conditions. It’s no wonder that the Academy of Medical Roil Colleges calls exercise a ‘miracle cure’. But moving more, as the editorial pointed out, does not require shedding blood sweat and tears. Instead, researchers recommend 150 minutes of moderate exercise per week. This could involve walking your dog or walking laps around your living room, cycling at the gym or gardening at home, doing seated tai chi by following an instructional DVD or vacuuming your house.
  • Attitude: Forgiveness can protect your health from the negative effects of stress, according to a new study. Researchers assessed 148 participants in terms of stressful life experiences, mental and physical health, and their tendency to forgive. As expected, high levels of lifetime stress correlated with worse health outcomes. Unexpectedly, a high tendency towards forgiveness eliminated the negative impacts of stress on health. In other words, forgiveness of yourself and others acts as a buffer against stress, eliminating the connection between stress and mental or physical illness. Interestingly, forgiveness is a trait that can be cultivated. Prior research has demonstrated that briefly praying or meditating on forgiveness can increase your ability to be forgiving in close relationships.
  • Nutrition: A new study weighs in on the debate about whether eating grains is good for you. You may be familiar with the paleo diet. Its proponents argue that the human digestive system has not evolved beyond the hunter-gatherer diet. Grains, they argue, are a modern invention evolutionarily speaking, and wreak havoc in the human body, whether through causing inflammation or exacerbating autoimmune conditions. On the other side of the debate, researchers argue that grains provide necessary nutrients, fiber and energy. This study comes down on the latter side of the argument. An international team found that a higher consumption of whole grains correlated with a lower risk of chronic disease and premature death from all causes. Three servings of whole grains per day (90 g/day) was associated with a 22% reduction cardiovascular disease risk, 15% reduction of cancer risk and 51% reduction in diabetes risk. It is important to know that no benefits were associated with intake of refined/processed grains or from white rice. (If you are interested in how to differentiate whole grain from refined grain products, follow this link).

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Photo by Lukasz Zajac

Shared to Fibro Friday Link-up at the Fibro Blogger Directory and Chronic Friday Linkup

Move More: How I Actually Started Exercising with a Chronic Condition

Move More: How I Actually Started Exercising with a Chronic Condition

Does just seeing another article about exercise make you want to turn the page? It often makes me want to. When I got diagnosed with my chronic condition all the information about exercise seemed so out of touch with the reality of my life. If I’m already tired, sore and busy then I’m not going to be able to go to the gym. I can’t afford a personal trainer. With my back pain there is no way I can participate in the group yoga classes I used to take in university. Even more frustrating was the fact that all the research I came across proved how beneficial exercise is to health. I knew that I should exercise but I felt like I couldn’t.

 

But what if I could?

One day I came across an(other) article reporting on research that showed yoga could improve fibromyalgia, my chronic condition (OHSU, 2010). The results were impressive – pain was reduced by 24%, fatigued by 30% and depression by 42%. Great, I thought, another thing I can’t do that would help. But in this case I also found that two of the researchers were part of a nonprofit organization that produces exercise DVDs for fibromyalgia, including one on yoga and Pilates (link below). I ordered the DVD and skeptically waited for it to be delivered. I was surprised and excited to find that I was able to do the routine – which was shown at three different intensity levels so I could modify the poses as needed. I found that the at-home instructional DVD format was affordable, convenient and accessible – I could do it when I was able, for as long as I could and without wasting energy traveling somewhere and back.

Woman stretching arms behind back

Photo by Steven Depolo

During my health coach training I learned that yoga, tai chi, qi gong, and stretching are all range-of-motion or flexibility exercises. These types of exercise can also build strength and promote balance, but primarily focus on lengthening tight muscles and moving joints through the full span of movement they are intended to achieve. “Limited flexibility can cause pain, lead to injury, and make muscles work harder and tire more quickly (p. 92, Lorig et al., 2013).

My positive experience with the yoga/pilates DVD encouraged me to find other programs with a similar format. One of my favorites is the Tai Chi for Health series by Dr. Paul Lam (link here), especially the Tai chi for Arthritis program that was designed in conjunction with the Arthritis Foundation. This instructional video that takes you step-by-step through 12 lessons until you have the movement sequence memorized.  I enjoyed learning an entirely new way of moving and began to feel more confident that I could include exercise in my weekly routine.

I also started seeing a physiotherapist who put together a thorough stretching routine for me to do daily. Without doubt, this is the single most effective thing I tried to improve my health and well-being. My pain has decreased and my daily functioning has improved, along with my quality of life.

Many flexibility/range-of-motion exercises programs also share a second common feature as mind-body movement practices. For example, “Yoga is a set of theories and practices with origins in ancient India. Literally, the word yoga comes from a Sanskrit work meaning “to yoke” or “to unite”. It focuses on unifying the mind, body, and spirit, and fostering a greater feeling connection between the individual and his/her surroundings” (Moonaz, 2015). Greater body awareness, stress reduction, emotional balance, and improved energy are all benefits of mind-body exercise programs (Moonaz, 2015).

Flexibility/range of motion exercise programs are a great starting point for anyone who has not exercised for awhile, or who has a health condition that makes movement challenging. They are easy to do at home or you can find many classes offered in your community. Gradually incorporating these routines 2-3 x/week and practicing daily stretching is how I was able to actually begin to  move more. Below is a quick primer on what these kinds of activities are so you can pick the right one for you and a link to programs that I have tried:

Yoga: “Yoga involves directing your attention and breath as you assume a series of poses, or stretches” (Gaiamlife, n.d.).

Qi Gong and Tai chi: “The term qi gong (or chi kung) describes the complete tradition of spiritual, martial and health exercises developed in China. Tai chi is one of the most common of these. Practicing qi gong involves performing a series of movements while paying attention to the body and staying aware of the breath. The exercises are especially effective for developing balance, focus, coordination and graceful, centered movement” (Gaiamlife, n.d.).

Stretching: Poses to lengthen muscles and increase range of motion in joints

 

References:

OHSU. (2010). OHSU Research Suggests Yoga can Counteract Fibromyalgia. http://www.ohsu.edu/xd/about/news_events/news/2010/2010-10-14-ohsu-research-sugge.cfm

Moonaz, S. et al. (2015). Yoga for Arthritis. Johns Hopkins Arthritis Center. http://www.hopkinsarthritis.org/patient-corner/disease-management/yoga-for-arthritis/

Gaiam Life. (n.d.) How to Choose a Mind Body Exercise. http://life.gaiam.com/article/how-choose-mind-body-exercise

 

 

 

Exercise at home: Tai Chi for Arthritis

tai chi

My husband and  I decided this week that we need to focus on regularly doing stress relieving exercise. We came to this conclusion after one of those pointless arguments that you have in the middle of a stressful week, when you aren’t really dealing with what is actually bothering you. One problem with having chronic pain is that every week can seem like an especially stressful one – flareups can interrupt like mini crises, causing a flurry of last-minute adjustments to make sure all the necessary things get done. Life can start to seem like a giant game of whack – a – mole (that carnival game where the ‘moles’ pop their heads up faster than you can hit them with the hammer). We realized that if we just keep trying to react to all those inevitable stressors faster and faster, from forgotten pill refills to unexpected financial costs to family demands on our time, the only result will be that we are burned out, not that our to-do list will ever stop growing.

I think we need to try to get a little bit of control by managing our stress better, not doing our chores faster. I have an upcoming mindfulness-based stress reduction (MBSR) course happening at my hospital later this fall, which I think will be really helpful. However, another important thing to include is exercise. This is difficult for chronic pain and fatigue patients, for obvious reasons. It can also be hard for our spouses and caregivers because they often don’t have time between working and doing the household chores to fit in some exercise. I’m very lucky to have a man in my life who is willing to do so much for me – but he sometimes forgets to take care of himself in the process.

I think that it is very convenient to have an at-home option for your exercise. Walking and aqua fit are great, but if the weather is bad or you don’t have the energy to trek out to a pool somewhere, it can often mean no exercise at all. I think a really good resource are at-home DVDs.

I was excited to find a resource called Tai Chi for Arthritis by Dr. Paul Lam . I had never done tai chi before I got this DVD and I have to admit that I generally associated it as an exercise that was most appropriate for elderly people. Like a lot of other things that I’ve had to revise, I’ve learned that this stereotype is just not true. This is a really good instructional video that takes you step-by-step through 12 lessons until you have a movement sequence memorized.

I particularly like tai chi because the entire program involves standing, not transitioning from lying to sitting to standing which other exercise forms like yoga tend to do. There is also a seated tai chi DVD available on his website if that is easier for you. It is entirely possible to take rest breaks if needed between lessons. The DVD also includes warm-up and cool down segments. It’s nice to be learning an entirely new way of moving – it feels like a new skill rather than a simplified exercise protocol. Although it is very gentle, I can feel afterwards in my shoulders and mid back that I have been exercising. Dr. Paul Lam is also a very Zen individual, and watching him is just in itself calming!

This program was specifically designed by the Arthritis Foundation in the US and Dr. Paul Lam, who is a medical doctor and tai chi instructor. Some of the health benefits discussed on the Tai Chi for Health Institute website include:

  • Muscle strength is important for supporting and protecting joints. It is essential for normal physical function.
  • Flexibility exercises enable people to move more easily. Flexibility also facilitates the circulation of body fluid and blood, which enhances healing. Many arthritic conditions such as fibromyalgia, scleroderma and spondylitis are characterized by joint stiffness and impaired physical function. Tai chi gently frees up stiff joints and muscles.
  • Fitness is important for overall health and proper functioning of the heart, lungs and muscles. Tai Chi for Arthritis can improve all of these components.

Several studies of the program were completed and they demonstrated pain relief and improved balance for patients with arthritis. I’m going to focus on trying to do this program two to three times a week. Hopefully I will begin to feel more of the physical benefits, but especially the stress lowering effects of exercise in general and tai chi in particular!

My partner (who does not have chronic pain) is going to be doing a beginner yoga DVD by Rodney Yee which looks really good. It focuses on learning each posture correctly and then gives you a couple of routines to learn. It’s good to remind the people that we love and who take care of us to look after themselves once in a while!