Yoga Therapy for Parkinson's Disease and Multiple Sclerosis. Jean Danford
Up and down
Instruction
1.Start with the arms stretched forwards and palms facing down.
2.Push the heel of the hand away, and turn the fingers up towards the ceiling.
3.Flip them downwards. Up and down.
This can be varied using slow or fast movements, and a number of repeats. It can also be coordinated with the breathing – for example, two repeats for the inhale breath and two for the exhale.
Other variations are:
•Polishing: With the arms outstretched and palms facing down, move laterally from the wrist, out and in, as if they are moving on a flat surface.
•Wrist circling: With the hands in fists and the fists joined together, circle the wrists several times in both directions. Progress to doing this with the hands apart, but still circling the fists in the same direction.
Parkinson’s note: The same challenge with coordination will occur here as with other joint-mobilising practices. In Parkinson’s there is commonly difficulty with nerve transmission. You may observe that the student is moving the whole arm rather than just the wrist. Take time to work with this. Gently hold the arms still and encourage the work to happen in the wrists. Or give verbal direction, to bring this into focus and to isolate the wrist movement. This way we encourage full use of the body and retrain the nerve impulses.
Steeple
Instruction
1.Join the fingertips together.
2.Press them inwards and encourage the fingers to move towards each other, keeping the palms apart.
3.Encourage a stretch up into the length of the fingers and the finger joints.
4.Release the stretch, make the hands soft and repeat a few times.
Encourage the group to stop and release their hands whenever they feel the need.
Parkinson’s/MS note: Prolonged practice can be tiring even for these hand/finger exercises; encourage awareness of any tension that might build up in the shoulders.
FEET
The feet are often affected by muscle spasm, joint stiffness, rigidity and poor circulation. Working on the feet is important for better standing and walking.
•Start by standing with good alignment, parallel feet, hips and knees. Have a chair nearby if needed for support. Explore your own feet with a range of practices such as:
–Awareness enquiry: Where is your weight? Left/right, toe/heel, inside edge/outside edge?
–Inking: This brings aliveness and wakes up the nerve endings.
Inking
Instruction
1.Place one foot forward in a very deliberate step.
2.Feel the heel; roll your foot around along the outside edge and then onto the ball of the foot and through each toe. Imagine you are putting your foot on an ink pad and you have to get as much ink onto the sole of the foot as possible.
3.Press firmly through every part, and then do the same on the other foot.
4.Wriggle your toes. Lift them all up off the floor, if you can. Place the little toes down first, then all the others. (Not many people can actually do this, but it can be fun.)
Teaching focus
•Bring attention to the sense of aliveness experienced in the feet as the nerve endings are stimulated.
•Encourage the students to feel into both feet, and explore any differences they notice, any tingling, warmth, numbness, stiffness or immobility.
•This improves circulation.
High heel press
Instruction
1.Lift one heel and press the ball of the foot into the floor, then swap over to the other foot.
2.Move on to lift one foot as the other lowers. This also gets the knees moving a little, and is good for warming up if the feet are cold.
3.Awareness of the foot positions should be brought into all standing postures.
Make your feet talk
Basic stretches and joint rotation are essential. The wide range of commonly known Pawanmuktasana for the feet is useful. These can be done from a standing position to encourage strength and balance, or from a chair or floor seated position.
Contraindications of applied Ahimsa: Although these joint freeing moves are generally safe for everyone, they would be contraindicated if toe joints were swollen and painful, as they might be in rheumatoid arthritis, bunion or similar joint problems or plantar fasciitis. I would always recommend working within a pain-free range.
Point and flex
Instruction
1.Simply point the toes away, lengthening through the ankle, and then pull the toes up, as you push the heel away.
Teaching focus
•Bring attention to the movements felt in the lower leg, as this action involves far more than just the foot itself.
•Isolate the toe joint action by keeping the ankle down but the toes up, as in ‘ankles down, toes down, toes up, ankles up’.
•Using a resistance band can really help strengthen the feet and toes, which is especially helpful for those who have difficulty in feeling what is happening. The student should place the band around the toes and ball of the foot and hold the ends firmly. They should action the movements by pushing and spreading the toes into and against the band. People with Parkinson’s find this resistance helpful, but be careful of catapult action of suddenly released bands!
Circling
Instruction
1.With both feet together, draw circles with your toes and ankles.
2.Try it with the feet apart and then move them both in the same direction (this is counterintuitive, but good for coordination and the brain).
Flippers
Instruction
1.With the heels together, flex the ankles and pull the feet apart.
2.Draw the soles of the feet together. Try to join the little toes.
Teaching focus
•This tones and strengthens the flexor muscles in the sole of the foot, helping to combat flat feet. Again it is useful to draw attention to the action in the lower leg.
Spread and scrunch
Instruction
1.Open out the toe joints as much as possible, and try to make a space between each toe.
2.Scrunch the toes up, as if making a ‘fist’ with your feet.
Teaching focus
•Although it is helpful in the first instance to sit with the group and to demonstrate, hands-on help may be needed. Physically moving the feet (check out permission first) can help the student to be more able to then do the movement alone.
•If there is little movement, add in visualising so that creative thinking can enhance the experience.
•Use humour to engage a light-hearted positive energy.
Parkinson’s note: There is often a malfunction in motor control that limits activating a particular joint, and this may result in movement transferred to the joint above or below, as the student tries to follow the instruction only to find the message has been scrambled, so their knees and hips move instead of their ankles. This is where hands-on help and instruction to focus can really assist. Moving near to or in front of the student