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Poses for Spina Bifida

I have a good friend who was born with spina bifida and has paralysis from her knees down. Can you recommend a routine of seated and lying-down poses?

By Sudha Carolyn Lundeen

—Greg

Sudha Carolyn Lundeen's reply:

The term "spina bifida" is used to describe a range of spinal anomalies that can be present at birth. A diagnosis of spina bifida means that there is an incomplete closure of the vertebral bones somewhere along the spinal cord, leaving space for the meningeal membranes that cover the cord to protrude. The severity of the symptoms depends upon the degree of injury to the cord. Partial or total paralysis is one possibility. Sometimes surgery is needed to close the spinal opening.

Without working with your friend directly, I cannot give a specific sequence for her. There are too many variables that would need to be taken into consideration to tailor a practice plan to her needs?including her age, overall lifestyle, energy level, physical history, personal goals, level of motivation, and available time for practice.

However, I can give some general suggestions and recommend that she work with someone to help her find adaptations and sequencing that support her specific needs. If she is in a wheelchair a lot, she will be prone to shallow breathing and collapsing in her lower back. A good place to start would be to teach her spinal alignment, core strength, and Ujjayi Pranayama.

Have your friend start by pressing her sitting bones into a chair or wheelchair, drawing her tailbone back, and moving into a dog tilt while simultaneously pulling her abdominal muscles in towards her spine. With a strong core and steady Ujjayi breath, she can safely move into modifications of Ardha Chandrasana (Half Moon Pose) and Seated Forward Bend, and a Seated Twist (such as Bharadvaja's Twist).

Half Moon Pose can be done first from this position with her hands at her sides, simply moving her trunk from side to side, and later on raising one or both arms overhead while reaching laterally through the trunk. For the spinal twist, your friend should bring her feet close together and then squeeze the inner thighs toward each other to ground the legs. With both hands grasping the left arm of the chair, she can pull towards her torso with her right hand and push away with her left, initiating the spinal twist from her pelvis. She should repeat the twist on the other side, keeping the throat, neck, and shoulders relaxed and her eyes gazing back in the direction of the twist as far as is comfortable.

To stretch her lower back in a modified Seated Forward Bend, have your friend sit with her hips at the back of her chair with her legs separated wider than hip distance. She may need to brace her legs to keep the knees in alignment with her ankles. Then she should bend forward in gradual stages, initiating the movement from her hips, with her hands on the chair arms for support. Eventually, she can release over like a rag doll, arms on the floor or cushions, relaxing her head and neck. She can also visualize the breath flowing up and down the spinal column. To come out, she should press her hands onto her thighs, lift up, and pause to notice the effects of the postures.

She can also practice Bhujangasana (Cobra Pose) to open her chest, develop back strength and pelvic stability, and strengthen the arms. Have your friend lie on her belly, with her feet 4-5 inches apart, place her hands palm-down near her shoulders, (elbows drawn in towards the ribs), and press her pubic bone down towards the floor, pulling her abdominals strongly back towards her spine. On an inhalation, she can lengthen her spine and elongate her neck by imagining the tops of her ears lifting towards the crown of her head, while drawing her shoulder blades down and back and lifting her chest off the floor. She should slowly lower to the floor on an exhalation.

Encourage your friend to repeat this Cobra sequence several times, lifting on an inhalation and lowering on exhalation. With each new round, she can experiment by lengthening the inhalation and exhalation by a couple of counts. Once the body is warmed up, she can practice lifting and holding for 2-4 breaths.

Any of the reclining restorative poses would also be terrific for relaxation. A modified Viparita Karani (lying on her back and placing her lower legs on a chair or sofa seat) would be a great way to get the benefits of elevating the legs.

Lastly, I would recommend Ujjayi (ocean-sounding) breath and Nadi Shodhana (Alternate Nostril Breathing) Pranayama to strengthen and clear her nerve pathways.

There is so much within the practice of yoga that would benefit your friend. Definitely encourage her to try it out.

Sudha Carolyn Lundeen is certified as an Advanced Kripalu Yoga Instructor, Holistic Health Nurse, and Phoenix Rising Yoga Therapist. She is the former Director of Kripalu Yoga Teachers Association, has been leading programs on yoga, health, and healing for over 20 years, and is a senior faculty member at Kripalu Center for Yoga and Health in Lenox, Massachusetts. She offers private yoga coaching and specializes in helping women navigate the experience of breast cancer.
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