Yoga for Multiple Sclerosis

I have multiple sclerosis and have been practicing Iyengar yoga for a few months. It's been very beneficial. Is there anything I can focus on to bring more progress?

By Baxter Bell

— Jessica Howland, Kihei, Hawaii

Baxter Bell's reply:
Jessica, your entry into hatha yoga with the Iyengar method was a fortuitous choice. The ability to adapt the poses with props can be particularly beneficial with multiple sclerosis (MS), since flare-ups can affect strength, balance, and coordination.

It’s also important for you to know about a very unique Iyengar teacher, Eric Small (located in the Los Angeles area), whose personal story of developing MS in his late teens and reclaiming his health through his study with Mr. Iyengar is almost legendary. His experience eventually led him to work with the National MS Society to create a yoga teacher-training program for teachers who want to work with students with MS. I was fortunate enough to participate in this course in 2001 with Eric as the lead instructor.

Studying with an MS-trained instructor can improve your chances of moving through the practice at an appropriate pace for whatever stage of the MS cycle you may find yourself in. In addition, you will learn specific sequences designed for challenges such as fatigue, constipation, problems with digestion, lack of mental clarity, or balance. Balance, for example, can be addressed with asanas such as Tadasana (Mountain Pose), Virabhadrasana I (Warrior Pose I) and Virabhadrasana II (Warrior Pose II), and Trikonasana (Triangle Pose).

For a student with MS, there are three types of symptoms that hatha yoga directly addresses: fatigue and heat intolerance, numbness in the limbs and loss of coordination, and loss of flexibility and balance. Fatigue and heat intolerance appear to be the most limiting factors to MS students. To counter these limitations, students learn to master the breath and practice restorative postures. Both techniques cool the body and calm the nervous system. The simple breathing technique of lengthening the exhalation a little longer than the inhalation helps quiet the nervous system. It’s been observed that heat, stress, and tension can cause temporary worsening of MS symptoms, so keep the pace of practice relaxed but focused—keeping the body just shy of sweating is important.

MS can also result in a daily battle with numbness of the arms and legs, muscle spasms, and loss of coordination. The system of yoga emphasizes stretching and breathing, which can release tension and improve circulation and body awareness. Yoga practice can also facilitate harmony between the muscular and nervous systems of the body, possibly resulting in more fluid movement and relief from muscle tension. As a student’s level of body awareness improves, she can begin to recognize the first signs of stress on her system before it overwhelms her.

Finally, in addition to evolving body awareness, yoga increases flexibility and balance. The poses increase the range of motion in the joints and improve muscle tone, and work of most of the body’s muscle groups.

Your yoga practice can be tailored according to your needs. If you are in a period of remission and your balance is intact, you can often do most of poses practiced in an ordinary class setting. During periods of relapse, stay in the groove of practicing by doing a modified practice, for example lying supine on the floor or utilizing chairs and the wall.

The effect of hatha yoga on MS is of such great interest that the National Institutes of Health’s National Center for Complementary and Alternative Medicine division has funded a study of the effects of yoga on MS patients. Preliminary data shows improvement specifically in the fatigue experienced almost universally by individuals with MS. Hopefully this will lead to further research! Don’t forget to contact your local MS chapter, by calling 1-800-Fight-MS, to find out about teachers in your area who have completed the MS Yoga Instructors’ Workshop.

I wish you all the best in your search for better health!

Baxter Bell, M.D., teaches public, corporate, and specialty back-care yoga classes in Northern California, and lectures to health care professionals around the country. A graduate of Piedmont Yoga Studio's Advanced Studies Program, he integrates the therapeutic applications of yoga with Western medicine.

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