“Spirituality is not a separate part
of us, it is bound up with the body and the whole person, long before
we enter this world. The word “spiritual” is often off-putting or
misunderstood, because it is thought to be something esoteric and hard
to define. But it is not, it is about coming from the heart.”
~ Unknown
Muscular Dystrophy
The muscular dystrophies (MD)
are a hereditary group of muscle diseases (affecting mainly males)
which involve a progressive weakening and degeneration of the muscles
controlling movement. They are incurable, and more often than not
fatal. However, the worsening of the disability can be slowed by
physical interventions like physiotherapy, and yoga therapy.
Myotonic MD seems to be the most common type affecting adults, and can be identified by the following symptoms:
- Delayed muscle relaxation after contraction
- Impaired nourishment of non-muscular tissue
- Weaknesses in the facial muscles, arms, legs and also the muscles affecting speech and swallowing
- Baldness
- Intellectual impairment
- Respiratory problems, and
- Heart Abnormalities in early adulthood
Duchenne MD
seems to be the most common type affecting children. The signs and
symptoms, as listed below, usually appear when the child reaches 3-5
years of age:
- Frequent falls
- Difficulty running, jumping, and getting up from a sitting or lying position
- Excessively large or well developed calf muscles
- Effected posture and gait
- Exaggerated lower back lordosis
- Weakness in the lower extremities
- Mild mental retardation
- Breathing difficulties and chronic disorders involving the heart muscles may develop during adolescence, usually once the individual becomes wheelchair bound.
From a yogic physiological perspective,
Vyana vayu will be affected by the widespread impact of MD on all the
differing muscular systems throughout the body, likewise much of the
body’s energetic system, including each of the chakras. One of the most
significant areas affected in Myotonic MD,
are the muscles involved in speech and swallowing. This is likely to
impact the throat chakra, the centre for communication and expression.
This, combined with the individual’s inability to move their own body
as they might wish is likely to generate extraordinary levels of
frustration, anger and/or a sense of hopelessness or a combination of
all of these emotions and more.
Regardless
of the level of degeneration, yoga therapy has the potential to provide
a wonderful opportunity for encouraging individuals to feel pleasure in
their bodies once more. It can also help individuals to realise they
can still move their bodies in meaningful ways.
Given the nature of
this disease, it would be important for most clients to include
relaxation (with frequent rest periods throughout the asana practise),
meditation (particularly mindfulness) and breathing practises (ujjayi
and alternate nostril were recommended in one article to create clarity
and counter fatigue and lethargy and yogic breath and viloma – to
stretch and strengthen the muscles associated with breathing, for it is
the strength of these muscles that usually determines the length of
life for affected people).
Several texts recommended the
individual be taken passively through the asana component of their
practise (this of course depends on the individual’s capacity). This
passive experience not only supports the individuals reduced capacity,
but allows the person to relax and begin to let go of the frustration
of their “body no longer moving like it used to”. As individuals are
taken through each pose it is recommended that the focus is on slow
movement, particularly into and out of poses, this allows time for the
individual to relax tight and sore muscles and breathe into the
sensations, encouraging a deeper release as they learn to relax more
fully. By encouraging mindfulness throughout, the client has the
opportunity to learn they may not need to react to intense sensations,
and may ultimately bring about a greater understanding of pain (and
subsequently a greater ability to manage it) and hopefully create a
more supportive relationship with the body.
In terms of specific
practises, there seemed to be a consensus that the main focus be joint
rotations (Pavanamuktasana series). The degenerating muscle movement
eventually leads to a restriction in the range of movements through
each joint. Specifically the ankles, knees, hips and once the disease
progresses, the joints of the upper limbs are affected too. Therefore,
working slowly through the Pavanamuktasana series, concentrating on
each joint, whilst also remembering to give prolonged stretching to hip
flexions, hamstrings and calves would form the basis of the therapy.