By Kelley Pryor Amrein

Aging is the outcome of a long life and it is an outcome most people wish for. After all, the alternative to aging is not being around to grow older and who hopes for that. Many expectations surround the aging process including increased wisdom, greater patience, and comfortable self-confidence after years of pushing, striving, and working to build a career, a family, or both. Another set of expectations creeps in, however, as one begins the aging process and notices that first twinge of arthritis, receives the initial diagnosis of hypertension, accepts the rounding of the tummy or the expansion of the hips, or begins to forget a word or number here and there. Most of us take for granted that we will begin to slowly deteriorate into old age. We believe that robust good health is only for the young and as we get older we must accept the inevitable decline to sedentary pursuits and flabby muscles. Fortunately, we can turn to the practice of yoga to help us maintain physical and mental fitness.

In the book Younger Next Year for Women, co-authors Chris Crowley and Henry S. Lodge, M.D. enthusiastically promote increased exercise for the last third of our lives. Mr. Crowley and Dr. Lodge have also written a book, Younger Next Year, focused on men. They believe passionately that exercise, coupled with good eating habits and positive mental and spiritual focus, can keep both men and women from spiraling into rapid decline during the last 30 years or 1/3 of their lives. As Dr. Lodge says, “Some 70 percent of premature death and aging is lifestyle-related. Heart attacks, strokes, the common cancers, diabetes, brittle bones ,most falls, fractures, and serious injuries and many more illnesses are primarily caused by the way we live.” By living a life filled with challenging activity and social interaction, many of us can grow old gracefully and healthfully.

Practicing yoga can address many of the physical, mental, and social issues that face persons as they age. Yoga begins for many people as a physical practice, the focus being on performing postures or asanas to stretch and tone the body. The body becomes more flexible and stronger through a sustained practice of yoga. “ When you perform the asanas, wherever there are impediments in the body due to lack of circulation, so that you are suffering from rheumatoid arthritis, asthma, bronchitis, liver pain, stomach pain, intestinal pain and so on, the postures irrigate the system, and the impediments are washed away.”

Including yogic breathing practices, called pranayama, helps to cleanse the body and calm the mind, reducing the incidence of disease and occurrence of stress. Practicing pranayama also helps to clear and cleanse the respiratory system. Blood circulates more easily. We feel better and our bodies are healthier. Additionally, breathing consciously stills the mind, quieting the chatter inside our heads, bringing a feeling of peace and relaxation. “The regulation of breath keeps the respiratory gate clean and open, and through an unobstructed, undisturbed circulatory system, the blood will feed each and every part of our body. By allowing the blood to circulate to the areas of the body which are unhealthy, they are nourished, toxins are dissolved and the various ailments and symptoms of physical diseases can come to an end.”

As a yoga student progresses in the practice, he or she might notice a mental shift of focus. Gradually the practice of yoga has increased awareness of the inner self, the inner consciousness. A mental growth has begun and proceeds along with the physical achievements attained. This process makes sense, as the word “yoga” is defined as the yoking or union of the individual soul with the universal spirit. Yoga practitioners begin to see and feel how they are connected with one another and with something greater.

Socially, yoga provides a wonderful setting for forging new connections. As we age these social connections become more important. Our previous lives are changing. Our parents are aging or may be gone. Children are growing up and moving away. Friends may move or may pass on. Marriages or significant relationships may end in divorce or death. For these reasons it is vital that we make social connections to sustain us. Dr. Henry S. Lodge explains that our brains are wired to need social interaction. The ‘limbic’ brain or the creative, social part of our brain draws us to other people. We need these social interactions in order to survive and thrive. “Because of the limbic way we’re made, we are not emotional islands. Simply put, we complete each other. . Therefore we cannot make it alone.” A yoga class can bring people together and create a safe, nurturing environment for social engagement.

While it is easy to say that yoga will provide a form of physical exercise, mental awareness, and social connection for people as they age, it is sometimes difficult to draw individuals to a yoga class because they feel like they cannot participate completely. As people age they often develop physical limitations. A potential student who has osteoarthritis might shy away from a class, concerned about pain or stiffness inhibiting their practice. Another person might suffer from high blood pressure or heart disease and be concerned about injuring themselves in an intense yoga practice. Perhaps someone has developed osteoporosis and is worried that too much exercise might cause a fracture of weakened bones. Another person might be uncomfortable with excess weight brought on by a sedentary lifestyle including too much time at a desk. Many people just feel too stiff to participate in an activity that is often viewed as the province of the young, slender and extremely flexible.

In all of the above scenarios and in many other instances, yoga is accessible and can be very rewarding. It is simply important to proceed with caution as a student and to communicate fully with a teacher about concerns and limitations. Using osteoarthritis, high blood pressure, and osteoporosis as examples of potential age-related diseases, it is easy to explore how people with physical limitations can benefit from a yoga practice modified to fit their needs.

In osteoarthritis, the most common form of arthritis, the cartilage that covers the joints and keeps them operating smoothly has been worn away. Many things can cause this wear, including injury to the joint, genetic factors, and, most often, wear and tear to the area. The most commonly affected areas are the weight-bearing joints including the spine, hips, knees and ankles.

Yoga can help to prevent osteoarthritis, alleviate the pain of osteoarthritis, treat the cartilage damaged by osteoarthritis, and provide a way to relieve the stress brought on by the pain of osteoarthritis.

“Yoga is particularly well suited to help prevent or minimize the erosion of cartilage that causes the joint pain of osteoarthritis, and to create greater ease of movement and decrease pain within joint that have already sustained such damage.” Yoga can help to prevent osteoarthritis by causing the joints of the body to move in new and different ways. As the body creates new patterns of movement through yoga practice, flexibility and range of motion are increased. This new movement keeps the joints limber as we age. The movement of the joints in yoga lubricates the joints by distributing synovial fluid, the fluid surrounding the cartilage, thus protecting the joints. The increased movement and range of motion experienced in yoga can contribute to preventing the wear and tear that lead to osteoarthritis.

A Yoga practice can help in the treatment of osteoarthritis in several ways. First, the practice of yoga strengthens the muscles of the body, providing needed support to the joints. Strong muscles help to prevent further wear and tear and pain from osteoarthritis. Exercise and movement are both important parts of the treatment of osteoarthritis and help to increase strength, energy and endurance. The gentle movement of yoga is an effective remedy for the pain of osteoarthritis. Yoga postures increase the movement of the joints and lubricate the joints, helping to alleviate the discomfort of osteoarthritis already present. “One thing yoga does for sure is move the joints into extreme but safe positions, allowing the obscure corners and crevices of each joint to be awash with its lubricating, life-sustaining fluid.” In fact, persons who do not exercise at all can have more joint discomfort than those with an exercise regime.

Finally, Yoga provides an excellent way to reduce the stress brought on by continued pain and stiffness. Holding stress in the painful joints, feeling stress due to a perceived inability to exercise and move, and experiencing isolation as a result, is not good for the body. The breathing exercises in yoga, the yoga postures, and the community of people in a yoga class all aid in reducing stress.

Reducing stress and encouraging physical activity are important goals from anyone who has high blood pressure. High blood pressure is another disease often related to aging. Yoga can provide relief for people with high blood pressure by incorporating asana practice, pranayama practice, and relaxation practice for a total body experience.

Our hearts pump blood throughout our bodies through arteries. It is normal for our blood pressure to rise and fall throughout the day based on our level of activity. When our blood pressure remains elevated regardless of our level of activity, we may have a problem with high blood pressure or hypertension. In this situation, the heart is working harder to pump the blood. Many serious consequences can occur as a result of hypertension including heart attack, heart failure, stroke, kidney failure, and eye problems. There are many reasons why people develop high blood pressure. Weight gain can lead to an increase in blood pressure. Diet may also play a role in causing hypertension as well as genetic factors and the use of certain medications. Stress may play a role in developing high blood pressure and learning to calm the body can often be helpful in reducing blood pressure. Yoga provides a means of strengthening and calming the body which is essential for managing or reducing hypertension.

The practice of yoga can help students with hypertension increase their physical activity. This increase in activity can strengthen the body, increase cardiovascular fitness, and eventually help to reduce blood pressure. It is vital, however, that an individual check with his or her doctor before beginning a yoga program. Certain postures are not appropriate for persons with hypertension. A doctor should also determine what level of cardiovascular exercise is appropriate for an individual. Once the student knows his or her limits, a yoga program can be initiated.

To effectively reach cardiovascular conditioning a vigorous practice of the Sun Salutation series can be introduced. In addition to the Sun Salutations, many standing and seated postures are great for people with hypertension. The main caveat here is to keep the head above the heart in each asana, especially if hypertension is uncontrolled. In inverted postures where the head falls below the heart, the blood rushes to the head causing a rise in blood pressure rather than the intended decrease in pressure.

It is also important to refrain from holding postures for long periods and to continue breathing while in the posture. Long holds or holding the breath can increase the pressure in the body and raise blood pressure. “ . .Any yoga practice, even something as theoretically relaxing as a seated forward bend, can raise your blood pressure if you are uncomfortable or struggling with the pose. Carefully monitoring yourself as you practice is the best way to detect problems. If your breath is smooth and even, and you feel at ease, your blood pressure is likely to be stable.”

In pranayama practice, it is important for the student to practice breathing exercises that do not call for holding the breath. Holding the breath can result in a rise in blood pressure. Practicing abdominal breathing lying down is a relaxing practice which reduces tension and allows plenty of oxygen into the bloodstream. It is an excellent practice for relieving stress and helping to reduce blood pressure. Alternate Nostril Breathing, also called Nadi shodhana or Anuloma Viloma, has many benefits for one with high blood pressure. Alternate nostril breathing is just as the name suggests. The exhale and then the inhale occur on the left side with the right nostril closed. Smoothly, the left nostril is closed so that the exhale and inhale can be taken on the right side. This is practiced for several rounds of breath or up to 10 minutes. James Hewitt, in his book, The Compete Book of Yoga, lists the many benefits of Alternate Nostril breathing, including oxygenating and purifying the blood, toning and soothing the nervous system, and calming and steadying the mind. He suggests that this practice should be used regularly, even if time is limited, and it is especially effective to relax the mind.

Svasana or corpse pose is another excellent way to reduce stress and relax the body. This pose usually follows the asana practice and may be accompanied by a guided relaxation or short meditation. In Svasana the student fully rests the body, allowing for integration of the asana and pranayama practices. Often people are so busy that they neglect relaxation or decide that relaxing is the same as laziness. In fact, taking the time to relax and settle the mind is vital. The body can recharge, creativity can be sparked, excess nervous energy is released and the student emerges both relaxed and energized. “Many important physiological changes are taking place, reducing the body’s energy loss, removing stress, lowering your respiration and pulse rate, and resting the whole system. As you enter deep relaxation, you will feel your mind grow clear and detached.”

Yoga postures, breathing techniques, and relaxation can and should be a vital part of the treatment for high blood pressure. Timothy McCall points to studies that have been done to evaluate the physical response of students with high blood pressure to a practice of asana, pranayama and svasana, and meditation. In one study done in India, the patients who practiced yoga including breathing and relaxation had a higher drop in blood pressure than did students who were treated with drugs. Additionally, the yoga participants lost weight, an outcome which can be helpful to people with high blood pressure. Another study suggests that yoga and relaxation practices lead to more relaxed people and less agitated responses to stimulation keeping blood pressure spikes less drastic. Therefore, yoga should be encouraged as part of a regime to prevent and treat high blood pressure.

Another example of an age-related health issue which can be improved with a yoga practice is Osteoporosis. When we are young, our bones are dense and strong. Beginning a yoga practice when our bones are strong is a great way to maintain the strength and density of our bones as well as to maintain overall strength and flexibility. In an article about osteoporosis on the website Womenfitness.net, the author points to yoga as a wonderful way for women to keep their bones healthy. “The regular practice of weight bearing hatha yoga postures offers women everywhere a safe, scientifically proven way to build bone strength and avoid this debilitating disease” This same weight bearing exercise would also benefit men.

In osteoporosis our bones have lost calcium and minerals. Because bone density has decreased our bones are weaker. Bone density begins to decrease after our twenties and as we age we must be cognizant of the need to protect our bones and keep them strong. Many things can cause our bones to weaken including diet, lack of exercise, inadequate intake of vitamins and minerals, and menopause. Menopause is a crucial time for women. One result of menopause is the decrease in hormone levels which contributes to bone loss.

While engaging in weight-bearing exercises is important for people diagnosed with osteoporosis, it is important to be aware of the risk of fracturing weakened bones. Where an intense yoga practice might have been advantageous when bones were stronger, a more gentle yoga practice is called for now. High impact exercise puts a strain on joints and bones and can cause fractures. So, gentle exercise focused on protecting the bones while healthfully moving the body is the best and safest prescription. “Exercise cannot replace bone that’s already been lost, but it can help maintain strength in the bones. Simple movement can bring softness and agility to the joint. Agility helps us to maintain balance to prevent falling as we age.”

There are many cautions that people with osteoporosis must be aware of when practicing yoga. A qualified yoga teacher who understands the need for modifications is crucial in this situation. Because the most common sites for fractures in osteoporosis are the vertebrae in the spine, the hips and the wrists, it is necessary for a yoga teacher to ensure care when working these areas. Intense forward bends may be contraindicated as they could result in a fracture of the spine. The same is true for twists of the spine, especially forceful twists using the arms to leverage the body. If the wrists are impacted by osteoporosis, the body should not be supported on the hands. Other movements can be substituted to strengthen the arms and gently open the back.

Poses that might be beneficial for osteoporosis include gentle standing poses like trikonasana (triangle) and prasarita padottanasana (wide legged forward bend). These poses can be modified against a wall to provide balance and avoid slips and falls. They require the back to be in a concave position rather than a convex shape. This helps to avoid a fracture of the upper spine. They also promote flexibility and are weight-bearing exercises for the feet and legs.

Gentle backbends, like supported bridge pose, are excellent for strengthening the spine. Seated postures which avoid a strong pull of the spine are best for osteoporosis. Easy seated postures can open the hips, stretch the legs, and gently open the back. Some examples are baddha konasana (cobblers pose) and upavishta konasana (wide angle seated forward bend). The spine should be straight and the pose should be taken slowly and gently to protect the vertebrae. Students and teachers should always be cautious and make use of bolsters, blocks, and blankets to support the back, arms or neck or head in the postures.

Other postures to avoid are ones involving pressure on the neck. The neck should not be hyper extended and care should be taken if the head is tilted back. Bending too far forward can cause fractures in the upper vertebrae. Additionally, poses that place weight on the neck, such as headstand and shoulder stand, should be avoided unless the student is a regular yoga practitioner, or has permission from a doctor. In all cases the student and the instructor must take care to move slowly and gently.

As with osteoarthritis and hypertension, persons with osteoporosis will benefit from a pranayama or breathing practice to calm and cleanse the mind and body. At the end of the practice, the relaxation sequence is always beneficial to calm the system after physical exertion. Because stress has been linked to osteoporosis it is these relaxing practices are as necessary as weight bearing exercise to combat bone loss triggered by high levels of the stress hormone cortisol. Finally, the social aspect of yoga will encourage students to attend class and reap the benefits many benefits of the practice.

As we age, we may face health challenges. We may develop osteoarthritis, high blood pressure, osteoporosis or another age related disease. Our health may require that we proceed with caution in exercise, but that caution does not preclude having a sense of fun and adventure. Yoga is fun. It is full of adventure as we master new postures, learn new breathing techniques or find new ways to relax our minds and bodies. As we age, the benefits from yoga may be even more important to our systems. Yoga is a way to gently and lovingly address the physical reality of aging. “As we grow older and our bodies change, so should our relationship to our yoga practice change. Let that relationship allow you to approach your yoga with knowledge, gentleness, and acceptance.”

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1 Crowley, Chris, and Dr. Henry S. Lodge. Younger Next Year For Women. 1. 1. New York, NY: Workman Publishing Company Inc., 2007. 31. Print.

2 Iyengar, B.K.S. The Tree of Yoga. 1. 1. New Delhi: HarperCollins India, 1988. 80. Print.

3 Hewitt, James. The Complete Yoga Book. 1. 1. New York: Shocken Books, 1977. 56. Print.

4 Iyengar 81

5 Iyengar 3

6 Crowley, and Lodge 302

7 Ali, Dr. Mosaraf, and Jiwan Brar. Therapeutic Yoga. 1. 1. London: Random House, 2002. 77. Print.

8 McCall, Dr. Timothy. Yoga as Medicine. 1. 1. New York: Bantam Dell, 2007. 152. Print.

9 McCall 154

10 McCall 154

11 Ali, and Brar 77

12 McCall 154

13 McCall 154

14 Fishman, Loren, MD, and Ellen Saltonstall. Yoga for Arthritis. 1. 1. New York: W.W. Norton & Company, Inc., 2008. 26. Print.

15 Haaz, Steffany, MFA, RYT. “Yoga for People with Arthritis.” Yoga for Arthritis Patients from Johns Hopkins. 6/23/2009. Johns Hopkins, Web. 01/07/10. <http://www.hopkins-arthritis.org/patient-corner/disease-management/yoga.html>.

16 Ali, and Brar 127

17 McCall 362, 363

18 McCall 373

19 Mantica, Ana. “Yoga Cures: High Blood Pressure.” YogaLife.com:High Blood Pressure. iYogaLife, Web. 07/Jan/2010. <http://www.iyogalife.com/high-blood-pressure/Yoga_Cures_High_Blood_Pressure.php>.

20 Ali, and Brar 129

21 Hewitt 100

22 The Sivananda Yoga Center, . The Sivananda Companion to Yoga. 1. 1. New York, NY: Fireside, 2000. 24. Print

23 McCall 364

24 McCall 363

25 “Managing Osteoporosis Through Yoga.” WomenFitness. WomenFitness.net, Web. 20 Jan 2010. <http://www.womenfitness.net/yoga_osteo.htm>.

26 Nett, Jaki. “Poses for Osteoporosis.” Yoga Journal. Yoga Journal, Web. 13 Jan 2010. <http://www.yogajournal.com/practice>.

27 Francina, Suza. “Safe Yoga for Osteoporosis.” ELDR.com. ELDR.com, Web. 13 Jan 2010. <http://www.eldr.com/article/fitness/safe-yoga-osteoporosis>.

28 “WomenFitness”

29 Nett

30 Nett

31 Suza

32 McCall 445

33 Nett

Kelley Pryor Amrein is a certified Yoga teacher. She was certified as a Yoga teacher in India and the United States. Kelley teaches Yoga sessions in Amherst, New Hampshire.