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Monday, March 18, 2013

Range of Motion: Yoga's Got It Covered!

by Nina and Shari
Moving the Shoulder Joints
In the spirit of trying to focus on the benefits of yoga practice (see We Didn't Mean to Scare You) and not just potential problems, I’ve asked Shari Ser to work with me on a series of posts about the special benefits of yoga asana practice. One of the special benefits of yoga asana practice that I’ve really come to appreciate in recent years is how helpful it is for maintaining and/or improving range of motion in our joints. Yeah, I know that sounds kinda nerdy—and “range of motion” is definitely a technical anatomical term. But I really feel it is worth understanding this concept and why it is one of the ways in which yoga is such a wonderful and versatile form of exercise. I decided to start by asking Shari to go over the basics.

Nina: What is range of motion?

Shari: Our bodies move through space because of the unique construction of how our bones fit together to form joints. Muscles are what make these joints move through space; physical motion is caused by muscle contractions. All joints in the human body have an optimum amount of motion, but specific joints in the body, such as hip joints or shoulder joints, don’t move the same way due to unique architectural constructs. When we describe joint motion we are talking about how much movement occurs at a specific joint, and this motion is called the RANGE OF MOTION (ROM).

All joints of the human body have a prescribed degree of movement. Range of motion is described very precisely by medical professionals, and they have determined specifically how much motion a shoulder joint has, a knee joint has, a thumb joint has, and. These measurements are considered the "normal" range of motion of the joint.

When a joint moves more than the prescribed degree of normal movement, that joint is called “hypermobile.” (Have any of you had a yoga teacher tell you that one or more of your joints is hypermobile?) When a joint moves less than the prescribed degree of normal movement, that joint is called “hypomobile.” There is also a basic principle regarding joint movements: the more flexibility, the less stability; the more stability, the less flexibility.

For those who have an overly mobile joint, we can practice yoga to gain stability and strength to control our excessive flexibility and ROM.

For those who have limitations in ROM, which can be caused by muscle weakness, muscle tightness, arthritic boney changes where some barrier is stopping movement (like bone spurs), inflammation and swelling from acute injuries, yoga can be used as a therapeutic modality for ROM gain. 

Nina: Yes, I have often heard from my teachers, that students who are overly flexible need to build strength and stability and students who are tight need to work on increasing flexibility. And since we have both stretching and strengthening in yoga, it’s perfect for both groups. But let’s talk now about why range of motion is important for healthy aging.

Shari: A yoga teacher once said to me, “I do yoga so I can do the other things in my life that are important to me.” I don’t think I understood her comment way back then, but now in my 50’s I definitely do! To maintain optimum ROM throughout all my joints allows me to continue to be independent and take care of my business. Several posts back, Baxter talked about independence in seniors when he visited nursing homes or assisted living facilities (see Transferring and Yoga: Wisdom from Jane Fonda). It is the little things that we take for granted, like bending down to pick up a paper clip or tying our shoes. If I didn't have full mobility in my shoulders, hips, back, knees, or the dexterity to do a fine task like tying my shoes, I would either have to change my style of footwear or ask for assistance! The other objective in keeping up your joint ROM is "use it or lose it." Putting your body into positions (asana) that it might not do daily allows for ROM maintenance, keeping arthritis at bay, keeping muscles strong and healthy, and encouraging full body circulation by the squeezing and soaking that asana encourages.

Nina: Why is yoga better than other forms of exercise in maintaining ROM in joints?


Shari: If you have limited time to exercise and are looking for the best type of exercise for ROM, yoga is often recommended. But why wouldn't another type of full body exercise like walking or swimming be just as good? In our yoga practice we rarely do the same routine daily. For a well rounded yoga practice—whether we are in a class or practicing on our own—we vary what we do. We emphasize different motions to cause our joints to move in many different ways and directions. Some days we might choose to do standing poses and focus our practice on hip motions or our spinal motions like twists or forward bends, or backbending. Other days we might emphasize our shoulders and spines in backbends or inversions. Our choices are practically limitless and often depend only on our skill set, time and focus. In other types of exercise like walking, we might vary our walks by emphasizing a hilly walk or a walk with a lot of stairs. We can vary our speed of walking and our stride length. We can certainly walk to increase our heart rate, and we can definitely bring our hearts into a training zone. But walking does not improve our ROM and quite often can actually make us less flexible. Swimming, another full body exercise is also quite popular, and while it definitely can improve ROM through varied strokes and resistance, it does not fully involve all our joint ROM like yoga.

In addition, the beauty of yoga for ROM maintenance and improvement is the adaptability of asana to meet us where we are. With a skilled teacher almost every single yoga asana taught to a beginner can be modified to take into consideration ROM loss. With the usage of different props and static holding of an asana we can improve flexibility and motion significantly over time. The only downside is that yoga changes are slow and take patience.

Nina: That’s a great point about how all the poses can be practiced in one form or another, even by beginners, because that means that all the benefits for joint range of motion are available to every practitioner. So what kind of yoga practice would you recommend for someone who is concerned with maintaining and/or increasing range of motion in their joints?

Shari: Your practice should include a wide array of poses that are kept lively, with focusing on a different concept each time you practice. No daily practice should always be the same because we will not improve our abilities and an unvarying practice can lead to overuse injuries.

To maintain or increase ROM in a particular joint, such as your hip or shoulder joints, we need to challenge the joint we are focusing on. Taking the joint into a stretch and statically holding the stretch for up to 30 seconds will cause scar tissue to begin to stretch. The key point here is to make sure that the stretch feels broad and there is NO RIPPING sensation. This is when props might be suggested to make a pose more accessible, and then once the pose is understood, slowly removing the prop support so you have to "work a bit harder." There are plenty of techniques for stretching which all of us have touched on in the past so you might want to review these posts again (see How to Stretch among others). Also when there are ROM limitations on one side only, please only go into the range of movement for the stiff joint and limit the more flexible side. This will help you keep symmetrical in your practice.

Nina: Thanks, Shari! For me, at this point in my life, I really value how yoga includes such a rich variety of poses and ways of practicing that allow us to take our joints through a variety of motions. For example, the various standing poses, many with a feet-wide-apart stance, take your hips and shoulders through forward bending, twisting, backbending, and so on. I can’t do them all every day, so I try to balance my week by doing different standing poses on each of the days so by the end of the week, I’ve gotten through most if not all of them. I also do regular hip stretches to maintain ROM in my arthritic right hip—and so far, that’s been working well! 


And, dear readers, I hope this discussion helps deepen your appreciation of yoga asana practice. And if your practice isn't already filled with variety, I hope you'll be encouraged to start to mix it up!
 

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