Dealing with Static

Multiple Sclerosis is an autoimmune disease in which the body's defense system attacks and destroys the mye!in sheaths surrounding the nerves. These sheaths play much the same role as insulation around an electrical cord. Without the insulating myelin, the nerve impulses from brain to body begin to short out and become confused or misdirected. Symptoms can include fatigue, vertigo, clumsiness, muscle weakness, slurred speech, unsteady gait, and blurred or double vision. In some people the disease may consist of mild attacks and long, symptom-free periods throughout life, with very few permanent effects. Others experience a progressive series of attacks with less complete recovery after each one.

In the first category is J., a 35 year-old Pilates instructor, former dancer and figure skater who is pursuing a graduate degree in physical therapy. J. regularly attended my fairly vigorous mixed-level classes, and then called me for private sessions shortly after receiving the MS diagnosis. We began work right away.

Conventional wisdom dictates a cooling, gentle or even restorative yoga practice for MS, which is what I initially did with J. However, she has been extremely active for much of her life, and continually pressed for a more vigorous practice. I knew I needed to respect J.'s needs, so I modified the typical vinyasa-style asana practice to a more mindful and meditative sequence. I emphasized meditative or cooling pranayama practices such as Shitali, Nadi Shodhana, and Pratiloma Ujjayi, and at least fifteen minutes of guided imagery per session, eventually incorporating Yoga Nidra. J. has a well-developed sense of body awareness, and is able to let me know when the practice is too much for her.

The main benefit for J. over these past months has been her increased ability to handle stressors in her life through mindfulness, body awareness, and pranayama. She has also been able to simplify her life and release attachment to some goals that she set for herself before her diagnosis. It has been nearly a year since her last major flare-up, and her perspective on life is quite a bit different then when we first met. She now has her own Pilates; studio, has just been accepted in the PT graduate program at USC, and she is currently developing a Pilates program for MS with the local chapter of the National MS Society.

An example of the more progressive form of MS can be found in S., a 43 year-old former ER nurse who was diagnosed when she was 28. Her symptoms are much more pronounced than J.'s, including near-blindness, severe vertigo when reclining on her back, slurred speech, and muscle weakness. She has been wheelchair-bound for seven years. S. was referred to me through the MS Society as a last ditch effort to get her moving and keep her from being sent to a nursing facility. She has been one of my most challenging and rewarding experiences as a practitioner of therapeutic yoga.

S. is afraid of trying anything new, and has been unable to keep up a consistent exercise program. However, I recognized S. as a person who had overcome challenges in her past, and was capable of doing so again. In fact, during one of our first chair-modified yoga sessions she confided in me that she would like to try to walk again, and that has been my priority with her ever since.
My work with S. starts with transferring her out of her wheelchair and into a regular folding chair with a folded sticky mat on the seat-pan to keep her from sliding, and a yoga strap around her waist as a safety belt. I also place a folded blanket on the chair back between her shoulder blades to help open her chest to promote better breathing, and to counteract the effects of years of sitting hunched over in her wheelchair.

From here we go through the entire ITT yoga therapy session with body/breath awareness, modified asana, guided imagery, meditation, and sharing. On occasion we work with affirmations. S. is capable of lifting her legs without help, so I concentrate on leg, hip, and low-back strengthener such as leg-raises with straight and bent knee, as well as leg lengtheners, such as hasta padangusthasana which she does beautifully with a yoga strap. Upper body asanas are mainly to release the shoulders, including yoga mudra, modified gomukhasana, and urdhva hastasana. With her hands on a high countertop in her kitchen she can do an excellent variation of downward facing dog to stretch the back and arms. With two folding chairs placed close together she can do seated forward bends, hip openers like butterfly, and even seated spinal twists including ardha matsyendrasana. Placing her hands on the floor in front of her gives S. a seated version of uttanasana.

We end each session by having S. stand up for as much as one minute. I usually wheel her close to the high kitchen countertop, which she uses for support. I place a sticky mat on the floor, help her pull herself up to standing then ask her to count to 30, to take her mind off her fear of falling. She has also taken a few tentative steps standing behind her wheelchair for support. While she may never again be able to walk without some kind of assistance, she is slowly proving to herself that the ability to do so still lives inside her. As a result of our work, S. is now practicing yoga every day!

For more information on MS, contact your local chapter of the National Multiple Sclerosis Society. For an introduction to Yoga for MS, see the July/August 1997 issue of "Yoga Journal" with a profile of Eric Small, an lyengar teacher diagnosed with MS in the early 1950's who has brought himself back to good health through yoga.

If there are any questions or concerns that I might be able to help you with, please e-mail me at yoga2go@aol.com, or call me at (818) 566-4041.