Yoga Poses for Muscular Dystrophy – Everyday Health

No matter what your level of disability, a yoga practice is possible and offers mental and physical benefits.
If you have one of the many forms of muscular dystrophy, you may think that your lack of mobility or flexibility would make yoga a major challenge or even impossible.
The level of disability caused by muscular dystrophy can vary widely: Some people may have very little disability, while others have limited mobility and need a walker or a wheelchair to get around.
The good news is that people on either end of the spectrum can practice yoga, according to Judi Bar, the yoga program manager at Cleveland Clinic Wellness and Preventive Medicine in Ohio, who has an individual yoga therapist certification (C-IAYT) from the International Association of Yoga Therapists and is certified by Yoga Alliance, the world's largest nonprofit yoga association that certifies teachers and schools.
Although some aspects of yoga are physical, it’s not just a practice for very athletic or flexible people, says Bar. “As long as someone can breathe, they can do yoga; they can have the experience of mindfulness and breath and often improve their range of motion,” she says.
“The mental and overall benefits for yoga come from the different aspects of yoga which are breathing, meditation and relaxation, and postures. You put those three things together, and it can be a very nice blend,” says Bar.
If you’re considering trying yoga, it’s important to talk to your doctor first about the specific movements that are okay, as well as the ones you should avoid.
“The most useful advice I can give to an individual with muscular dystrophy when it comes to exercise is ‘If it hurts, don’t do it,’” says Lauren Elman, MD, the director of the Muscular Dystrophy Association clinic at the University of Pennsylvania in Philadelphia.
“Anything that is painful is really beyond what is necessary or recommended,” she says. The general rule for neuromuscular disease is that any muscle that does not have antigravity strength should not be exercised, says Dr. Elman, referring to the strength to move a muscle against the force of gravity.
“In a general class, the instructor might not be knowledgeable about your specific type of muscular dystrophy or your disease progression. It’s best to seek out an experienced yoga teacher or a yoga therapist who is trained to be able to help people in adapting different poses and understand the cause and effect, so they do no harm,” says Bar.
One of your healthcare providers or an internet search may help you find a yoga class that’s geared to people with your disease process, or to locate a yoga therapist for individual instruction, she says. Even if you don’t find a class geared toward people with muscular dystrophy, specifically, a class described as “adaptive” or “accessible” might be a good fit, as might a chair yoga class. Another possible option are classes designed for people with arthritis, multiple sclerosis, or another medical condition.
“When you find the right yoga fit for your needs and abilities, there are so many benefits on so many levels. These include not only physical benefits but also mental and emotional, too,” says Bar.
Yoga is an inward and outward experience, according to Bar. “The outward part is moving the limbs, stretching, and focusing on balance, and the inward part is the mind helping to move the body and focus the thoughts,” she says. Breathing can make that connection between those two aspects, says Bar.
“One of the many benefits of focusing on the breath is that it can be very calming,” says Bar.
“And although it may sound simple, staying still and breathing can be very complicated because we’re a society that likes to multitask.”
In a guided breathing exercise, the teacher may ask the participants to breathe in four counts and then breathe out four counts, says Bar. “There’s a focusing that happens with that, and the mind calms as each person is focusing on counting or listening to their breath,” she says.
A small study in Brazil, published in 2014 in Pulmonary Journal of Brazil, looked at the efficacy and safety of yoga breathing exercises in Duchenne muscular dystrophy, the most common form of muscular dystrophy in children. Although nearly two-thirds of the participants dropped out or couldn’t perform the exercises, those who completed the study had improvements in pulmonary function.
Regardless of what a person’s physical abilities are, it’s critical that yoga is presented in an uplifting way, says Bar. “Find out what you can do, and work with what you have that day; with patience and practice, yoga can help improve quality of life,” she says.
Chair yoga can be a great way to practice yoga for someone who uses a walker or a wheelchair for mobility, says Bar. “You get the blood flowing and improve circulation just by rolling the shoulders or moving our arms up and down,” she says.
There are many different yoga styles and poses that could be appropriate for people with muscular dystrophy, says Bar. One set of poses that you can do in or out of a chair is called the six actions, or six positions, of the spine. Briefly, those actions are:
“Some or all of these movements may be available to someone with muscular dystrophy, even if they use a wheelchair full-time,” says Bar. If you have scoliosis or any other problem with your spine related to muscular dystrophy, you’ll want to speak with your doctor and a yoga therapist about what’s safe to do.
RELATED: Your Everyday Guide to Living Well With Muscular Dystrophy
This is the practice of moving your spine from a concave, or forward-bending, position (Cat) to a convex, or backward-bending, position (Cow). These moves can be performed on your hands and knees on the floor, or while sitting in a chair.
“If a person is in a chair or wheelchair, I suggest that they try to sit up just a bit away from the back of the chair so they’re starting to use their core. The therapist can help move them to that position if they can’t get there on their own,” says Bar.
“If you can move your spine, sit up as straight as possible. We’re not trying to straighten out the curves or have military-type posture here, we’re simply trying to lengthen the spine as much as possible,” she says.
Take a deep breath in, and as you exhale the belly goes out as you curl and roll forward, says Bar. “Let the shoulders come down and look toward your belly button, and as you open back up, pull the shoulders back. If you do a round of three, that’s wonderful for getting blood flowing,” she says.
“First, we sit up straight and lengthen the spine as much as possible,” says Bar. If you’re sitting down or are in a wheelchair, pull your tummy in and lift one arm above your head while the other hand remains by your side. If you can’t lift your arms, let them remain at your sides, she says.
“Slowly drop one ear to your shoulder and start to let yourself bend to that side. The spine can move to the right and the left,” says Bar. “If you can activate your legs by pushing against the floor or the footrests of the wheelchair while you sit up, try that. Hold that position for a few breaths and then reset and try it on the other side,” she says.
The twist has the same starting position as the other spine movements: “Sit up straight, hold the tummy in and lengthen your spine, if possible. Begin to look to your right while both hands remain at around hip level; you can keep your left hand inside your left thigh, or the outside of the right thigh,” says Bar.
Keep the shoulders parallel and the spine perpendicular to the floor as you begin to rotate to the right, she says. “Don’t force anything. If you can stay there for three breaths, that’s great. Start small and only go as far as feels comfortable. Then come back and repeat the same movements on the other side,” says Bar.
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