Yoga teachers know that pre-existing physical conditions are important when teaching students. Yet, there are a few students who may manage to slip by an orientation. Maybe they arrive late, or the staff is helping other new students, but each student should be made aware of precautions for his or her health. Rheumatoid arthritis is one of the many ailments that Yoga teachers and students should talk about before practice.
A long-term disease leading to inflammation of the joints and tissues, rheumatoid arthritis (RA) can also affect other organs. Up to 1% of the world’s population is estimated to suffer from rheumatoid arthritis, with women experiencing it three times more often than men. Chronic and debilitating, those with RA may eventually require surgery to maintain movement in fingers, hands and other areas.
Can Yoga help those with RA maintain an active lifestyle? Some studies indicates yes: a study in the United Arab Emirates showed that patients who completed 12 sessions of Raj yoga, with exercise and breathing techniques, showed significant improvements in disease activity scores and health assessments. In 1994, the British Journal of Rheumatology published a study showing arthritis symptoms improving for patients who practiced Yoga and the Rheumatic Diseases Clinics of North America published two studies detailing joint stiffness and pain relief for Yoga practitioners in 2002.
Yet, even though Yoga may offer significant relief for RA, its practice should be approached with caution. The disease does not follow a steady, progressive course; instead, sufferers experience flare-ups followed by remission. Yoga practice suitable for someone in remission may be different from someone experiencing an active flare-up. RA affects joints symmetrically, in wrists, elbows, hands, shoulders, knees, feet and ankles most frequently. As the disease progresses, joints become more unstable and the patient’s range of motion is restricted.
It is important not to confuse asanas recommended for those with osteoarthritis and those with RA. Multiple joints are not affected in osteoarthritis, nor does it entail ongoing joint damage from inflammatory processes. Holding poses for increased lengths of time to strengthen static muscles is recommended for osteoarthritis but should be avoided for RA. According to a structural Yoga therapy research paper published in 2006, people with moderate to severe RA should avoid “high intensity exercise; prolonged weight-bearing exercise; prolonged immobility in seated or lying positions and stretching past the comfortable endpoint of range of motion,” among other lifestyle triggers.
Asanas involving pressure on the neck should be avoided, while poses like Dandasana or the Butterfly may be beneficial. Pranayama and smooth motions are well suited to Yoga practitioners with RA. Carefully evaluate whether symptoms are in remission or actively inflamed before practice.