HEALTH CARE PROVIDERS
I just finished participating in a survey for the PRIDE Study, which I have been participating in for several years. The PRIDE Study is the first large-scale, long-term national health study of people who identify as lesbian, gay, bisexual, transgender, queer, or another sexual or gender minority (LGBTQ+). Those of you who know me as a cis-gender woman, happily married to a cis-gender man with two beautiful biological children may wonder how I qualify as a research participant for the PRIDE Study. And you’d be correct in assigning me each of those labels. I am also bisexual. I identify as the B in LGBTQ+, which puts me squarely in the middle of the target audience for the PRIDE Study. But how would you know that? You wouldn’t. And that’s sort of the point.
There is an infamous research study that we teach about in research ethics training called by various names including The Tearoom Trade Study. In it, a researcher observed men having sex with men in public restrooms without their consent. He volunteered to be a “lookout” in case police or strangers entered but was in fact collecting data, both personal and behavioral. There is much debate about whether the knowledge gained from unethical research, such as the Nazi experiments on unwilling subjects, should be used or shared. And while the methods in the Tearoom Trade Study were deplorable, they dispelled widely held myths and stereotypes about human sexuality. An important finding was that many of the men in the “tearooms” were married to women. (It should also be noted that we can largely credit this study among a few others with the current procedures for informed consent by any human research subjects.)
Because I am a cis-gender woman who is happily (and faithfully) married to a cis-gender man and has two biological children, you might make assumptions about my sexuality and my identity that are untrue. In fact, when I came out to my parents, one of them inquired why I felt it was important to share this information, since I was already happily married to a man and my bisexuality was therefore largely irrelevant. But my identity is not irrelevant, no matter my family structure or my life choices. I am who I am and that continues to matter. It influences how I see the world, even if it doesn’t influence how the world sees me.
You might similarly ask why I am sharing this with you. What does this have to do with arthritis? With yoga? With Yoga for Arthritis?
First let’s start with arthritis. When you look at someone, can you tell if they have arthritis? Maybe they require a cane or a wheelchair. Maybe their hands are visibly stiff. Maybe their knees are swollen. But maybe they aren’t. When you look at them, do you know if they are in pain? Fatigued? Depressed? If they are twenty years old and appear able-bodied, would you consider that they might have been living with arthritis since age two? We are all more than meets the eye. We all have stories to share. We are all only ever partly seen. We all should consider how our assumptions shape our behaviors toward each other and whether or not those assumptions might be harmful.
And now yoga. Sadly, yoga in the West suffers from an epidemic of exclusion. As has been highlighted recently in relation to BIPOC, yoga is far too unwelcoming toward the many kinds of otherness that are not thin, white, young, middle-class and able-bodied. I am all of those things.
I am the image of yoga in America. And the fact that I could be in the public sphere for the past 20 years without outing myself as bisexual means that I have benefited from the privilege of straightness even if I don’t wear it as my identity. It is from this privilege that I have the opportunity and the responsibility to advocate for those in my own LGBTQ+ community who don’t feel welcome in heteronormative yoga spaces.
And finally, Yoga for Arthritis. As a bisexual woman and the founder of YFA, I am committed to advocacy for LGBTQ+ yogis, including those with the intersectional experience of arthritis and disability. Just as BIPOC with arthritis experience worse symptoms and health outcomes, LGBTQ+ persons often have reduced access to quality healthcare and higher incidence of comorbid mental health conditions, which are already elevated in the face of arthritis and chronic pain.
During the remainder of June, which may be one of the most complicated and challenging Pride Months in recent years, and in the months ahead, I call on each and every one of us to listen. Let’s listen to each other’s stories without the need to jump in, to relate, to commiserate, to explain. Let us recognize the inherent complexity in the stories we carry without trying to overcategorize or oversimplify.
We are more than our labels but our identities matter. We are more than our histories, but our experiences matter. We are all one, but we are also many.
Thank you for listening. Thank you for being you.
Love and Light,
Welcome to the Yoga for Arthritis monthly blog series that features our YFA members hard work, dedication, & passion. Without the ongoing efforts of these standout members, we would not be where we are today.
Why were you personally drawn to Yoga for Arthritis?
I was diagnosed with OA in my right hip and there was a period of time that I was in acute and chronic pain. I took inventory of my situation and asked myself what spiritual lessons did I need to learn from this and how could I impart this knowledge to others? I had a successful total anterior hip replacement in 2016. I met Nancy O'Brien at NY-IYI at an open house for Yoga for Arthritis Teacher's Training and I knew I could learn tools to be proactive in my own longevity and wellness. This enforced my ability and confidence to work with many people who have had total hip and knee replacements, back and neck surgeries. It is deeply gratifying and stirring for me to be a part of their recovery along their journey to wellness and deep healing.
What lessons have you learned through your Yoga for Arthritis journey?
Some disabilities are invisible and this can be very frustrating. Some of the 20 and 30 year olds I've worked with have more pain than my elders. In other words, I do not assume or compartmentalize people. I listen, observe the unsaid and assess. No matter the age, we all have our pride and it is important to treat each individual with the dignity and compassion they deserve. When I work with a new student in a class setting, at the very least we will have had a conversation and a mini intake of their history. I have championed both my personal clients and students to be proactive and voice their needs and they do and it is wonderful because we mutually remain current with one another and there is often dialogue between the PCP, Osteopath, and Acupuncturist which means better care for them.
What is it like to teach during COVID-19?
I stopped teaching face to face classes March 13 which was 4 days before NYC Gov. closed yoga studios and gyms.I just couldn't bring myself to practice business as usual even with the stringent Covid-19 protocols. In good conscience, I cancelled all live classes as I was particularly concerned for those with arthritis and compromised immune systems.
- What have been your experiences?
It is amazing and emotional that we literally all stepped up and were up and running our virtual classes within days. My husband supported me in taking over the computer room as my office, yoga studio and virtual gym. I guided many people on how to get on Zoom and over the course of the weeks called and emailed every single one of my students and clients to get current and to make sure they were all right. I log in virtually about 15 minutes early and I learned to keep the class open for about 10 minutes after we've ended our Class Session. On Zoom, when you are the host, instead of pressing end meeting for all, I press leave meeting and this gives me the option of staying on or leaving in case I have another appointment following my class. This is a golden opportunity for students to catch up, make 'dates" with one another and to experience the community connection.
Please tell us about your experience working with the underserved population.
So many stories, so little time...
While I was teaching at New York Presbyterian Brooklyn Methodist Hospital, NY-PBM and giving sessions to the hospital staff, it became clear to me what a privilege it is to serve all. The participating NY-PBM students were clinicians, cafeteria food servers, office workers and security. In other words, I witnessed first hand how Yoga was cutting through classism and elitism in the hospital culture and bureaucracy. I was not asking, "Are you a Dr?" I simply needed the student's name and work ID number and the beauty is I could hold them all in the same sacred space of inclusivity. I also was able to genuinely thank the NY-PBM Hospital Staff by saying, "Thank you for saving my Husband's Life, twice."
During the Group Acupuncture Therapy with Modified Yoga for Chronic Pain ( GAPYOGA) Research Study I witnessed how some of the patient's seemed to warm up to me because I am hispanic, obviously a woman of color and I speak Spanish. I learned that if I shared something appropriately personal and helpful without deviating from their treatment, we could form a genuine bond.
I am currently working with Self Help Virtual Classes online giving Sit and Be Fit Adaptive Yoga Classes. VSC has been giving virtual classes for 10 years to the homebound and the services are free.
All of these experiences are allowing me to be creative, to re-frame and to serve the populations that are nearest and dearest to my heart. Ideally, when I work with people, every student, client, patient and provider will feel, "You are my Favorite."
Where others can find your classes?
I'm currently teaching in Dolores' Zoom Room. This is a Spring and Summer none of us will ever forget! I expect to be back to teaching face to face classes in Brooklyn when it is safe and wise for my populations. I will keep my website updated: www.doloresnatividad.com
Dolores Marie Natividad "Lola" Bio:
Dolores Natividad is a certified ACSM Exercise Physiologist and earned her BA in Biology at Marymount Manhattan College. She has practiced Yoga since the mid-80’s and is certified by the International Yoga Therapist Association. Her passion led her to be part of the Wellness team at NY-PBM for 4 years offering Stress Management,Chair Yoga, Accessible Yoga and MELT Method to the Hospital Staff. Dolores maintains her private practice in NYC where she offers Strength Training,Yoga Therapy, MELT Method and Gyrotonics. She currently works privately with a wide spectrum of people from the elite athletes to Pre and Post Op, COPD, MS and Arthritis populations. It is Dolores’ privilege to have studied with the founders of these intact systems she implements: Swami Satchidananda, the founder of Integral Yoga Institute Julio Horvath the creator of Gyrotonics and Sue Hitzman, MELT Method innovator. Her personal mission and joy is to bridge verified complementary systems to Health Care.
Connect with Dolores: Vimeo / Facebook / Instagram / Youtube
MESSAGE FROM DR. STEFFANY MOONAZ
Dr. Martin Luther King Jr. has said that "a riot is the language of the unheard". (1) Right now, there are a lot of people feeling unheard. No matter who you are and whatever your relationship to social justice, you may be feeling a multitude of emotions related to the inequality that sparked these riots as well as the riots themselves. This is an opportunity to bring our yoga practice off the mat. Yoga teaches us to sit with discomfort, to notice it, to listen to it, to avoid defining ourselves or our world by the stories it elicits. We are called not to ignore the discomfort, but to be with it as it rises, as it transforms, as it transforms us. But yoga also teaches us to practice ahimsa- non-harming. We are called to right thoughts, right speech, right action. The challenge and the practice is to determine what those are from moment to moment. Actions can harm, but inaction can also harm. In my own religious tradition, we are taught about the sin of inaction and the sin of indifference. The ways in which we are spiritually and ethically called to respond in this challenging moment, amidst such vast inequality compounded in the face of a worldwide pandemic, will be different for each of us. There is no right way to respond, but let us not neglect that stirring in the soul to recognize and act in honor of our interconnectedness and shared humanity. Dr. Martin Luther King Jr. also taught us that "the ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy." In these challenging times, I pray that each of you is safe and well, that you find ways to feel connected, and that we are each doing what we can to bend the moral arc of the universe toward ever-increasing justice for all.
Police brutality toward Black, Indigenous, and People of Color (BIPOC) is able to occur only because it is bred, supported, and/or ignored by a larger environment of systemic racism that plagues every aspect of daily life in America, including healthcare and self-care. Even within our own work, we see that BIPOC experience arthritis at similar rates as white persons, but with worse symptoms, higher comorbidities, more serious outcomes, and less access to quality care. This is true for countless health conditions and it is not okay. Here at Yoga for Arthritis we are committed to increasing access to the tools of yoga for BIPOC with arthritis. This includes a commitment to research initiatives that are conducted for and in partnership with communities of color.(2, 3, 4) It also includes lifting up our BIPOC yoga professionals in the service of their communities. Yoga teaches us that we are all one and that the Divine light in each of us connects us all. We stand in solidarity with people everywhere who are taking the right action toward greater social justice and inclusion in yoga and beyond.
Reposting on social media is not enough. Signing petitions is not enough. Monetary donations (while important) are not enough. While each of us will be taking personal action in our own neighborhoods during the immediate aftermath of recent events, we will take a long-view as an organization toward an even greater commitment to inclusiveness in general and anti-racism specifically. Below we are listing the specific actions that Yoga for Arthritis will take to be part of the solution because either you are doing something to dismantle the system or you are perpetuating it.
We will continue to partner with BIPOC researchers to ensure that our research initiatives are with and for the communities they aim to serve.
We will commit to seeking out BIPOC yoga providers to help us provide relevant, high-quality research interventions.
We will publish in journals that are open-access and free of charge, and will disseminate our findings to publications that reach communities of color.
We will feature BIPOC YFA Teachers in our newsletter, on our website, and on social media.
We will solicit ideas from BIPOC members of our community about how to best increase access awareness, inclusiveness, and anti-racism.
We will provide free content to platforms that will reach BIPOC patients with arthritis who might not otherwise have access to our work.
If you are interested in taking action toward greater access to healthcare (including integrative health practices) and self-care for BIPOC, here are some ideas to consider:
Find and support local providers of healthcare and self-care (such as yoga) that are accessible to BIPOC geographically, economically, in representation, in leadership, and in offerings
Campaign and vote to ensure more equitable funding for institutions that disproportionately serve BIPOC
Campaign and vote for transportation services that allow access to healthcare and self-care for those without reliable transportation
Donate to funds that cover healthcare for those without insurance or who can’t pay for quality care
Support BIPOC business that provide healthcare and self-care in your community
Volunteer with organizations that provide quality healthcare and self-care for BIPOC
Support BIPOC students who are interested in pursuing a career in healthcare, public health, or integrative health practices such as yoga
Follow the lead of BIPOC in your community who have been doing excellent and important work in these areas for years. Lift them up and support their cause with your time, your dollars, your voice.
Never stop working on your own assumptions, your own biases, your own thoughts, words and actions. Use your yoga to be an example of continuous self-improvement.
Let us know what we can do to support you in your efforts above or otherwise.
In sharing these words of Dr. King's, I would like to acknowledge the frequency with which his work is so often taken out of context in ways that are ultimately harmful. I would urge readers to read and consider the full text from which I'm quoting, Dr. King's "Letter from a Birmingham Jail."http://okra.stanford.edu/transcription/document_images/undecided/630416-019.pdf
If you have any questions or concerns, please reach out to the Yoga for Arthritis team at firstname.lastname@example.org.
We are here to support you in any way possible.
Here at Yoga for Arthritis, we have recently been asked for our professional opinion about holding classes in-person now that restrictions are starting to loosen in some locations. Rather than answer these on a case-by-case basis, we are sharing our perspective on this issue for your consideration. Each of you, yoga professionals and yoga students alike, will have to make your own decisions given the information available and your own particular situation. Here are some thoughts to keep in mind as you do so. We have always been an evidence-informed organization based in yogic values, led by a public health researcher. This is reflected in the guidance below.
1. Yoga for Arthritis classes contain a high proportion of students in higher risk categories. These include: older age, chronic disease, auto-immune conditions, use of immune-suppressing medications, multiple comorbidities, systemic inflammation. What is appropriate for these classes may be different than what is appropriate for general yoga classes. The same may apply for therapeutic yoga, senior yoga, gentle yoga, etc. That being said, there are certainly students in high risk categories that attend general yoga classes, perhaps without disclosing those risks or even without being aware of them.
2. Some individuals with arthritic conditions (including lupus) are struggling to access their prescribed meditation due to medication hoarding by those who believe such medications might be effective against COVID-19. An inability to access medications for stable disease management creates even greater risk of disease flares and immune dysregulation.
3. Yoga practice with a mask may be problematic for those with respiratory conditions or anxiety. It may also be physically and/or emotionally challenging to wear a mask during more strenuous practices. If only the instructor is wearing a mask, it does not prevent transmission from one student to another.
4. Maintaining 6 feet of distance between individuals may be insufficient to prevent transmission when confined to an enclosed space for an extended period of time.
5. As restrictions are lifted, those with higher risk may still be uncomfortable attending studio classes. It may be beneficial for both studios and students if some classes remain accessible remotely in order to serve these populations.
6. As the weather changes, it may be possible to hold classes outdoors. Outdoor classes could allow for greater social distancing, improved air flow, less anxiety with extended mask use, and reduced risk of transmission between students.
7. In-studio classes should take extensive precautions to reduce risk of transmission such as: reducing/limiting class sizes, eliminating use of a waiting room/changing room, spacing out classes to avoid overlap of arrival/departure, removing communal mats/props or using CDC-approved cleaning products between every use, allowing digital pre-pay to remove use of a front desk, etc. Reducing the use of communal props may be an issue for classes that rely heavily on props, which may be another reason these classes stay remote longer.
8. While we are all eager to feel a greater sense of community than is possible under current circumstances, we don’t want to do so at the risk of our most vulnerable, nor do we want anyone to choose between their yoga practice and their respiratory health. In the unfortunate circumstance that transmission of COVID-19 does happen in a studio setting, we want to be certain that we did everything we could to be responsible and protect our communities from harm (ahimsa).
9. In all cases, please be diligent with understanding the current laws and guidelines for your own jurisdiction. While it is fine to be more cautious than these guidelines, it is not fine to be less so. Since these may differ across county lines and from one week to the next, be sure to stay appropriately informed and responsive.
10. There are many different opinions about this virus, it’s risks, policies, treatments, and more. People are nervous, emotional, defensive, and even angry. Let’s use our yoga to reflect and honor our common humanity and be the example of the light we’d like to see shine through these challenging times.
If you have questions about anything we have written here, if you would like to discuss your particular circumstances, or if there is something you think it important to share, please don’t hesitate to contact us privately.
As a Reiki practitioner and yoga teacher, I work a lot with the chakra system. Throughout the years, I've led workshops to help my students understand and connect to their energy centers. I am passionate about giving tools to all my students, family, and friends in order for them to become their own healers.
I fully believe that I am simply a guide, rather than a guru. Meaning I hope everyone gets in tune with their magical healing powers, so they can radiant on their own. When creating Radiant Beings, Align Your Chakras I wanted the beginner who never heard of Chakras to understand the content and the seasoned energy healer to use this a quick and easy reference.
Radiant Beings, Align Your Chakras is a quick and easy guide to center your energy through positive & empowering affirmations, crystals, and yoga poses. Every single being is made up of energy and sometimes our energy centers get blocked, misaligned so within this book you learn how to quickly recenter yourself. I focused on the seven main chakras within our physical bodies.
Chakras are areas of energy within the body that run from the base of the spine all the way to the top of your head. Chakra is a Sanskrit word meaning wheel. These invisible wheels of energy keep us vibrant beings! Imagine these wheels are swirling energies where matter and consciousness meet.
Each chakra has its own symbolism and effect on the different facets of our make up - physical, emotional, mental, and spiritual. Within this book, you will be given different yoga poses, crystals, and affirmations to balance and activate your amazing energy sources... on your very own! You have the power to heal yourself!
Through my own self-studies, I have learned yoga, affirmations, and crystal healing helps on all levels of chakra work. So, why not share the powerful combination of healing with you? The more tool you have, the better!
I will leave you with this: Become your own healer! Work with what best resonates with you! Know you have the power to heal yourself and change your own frequency. Become an observer of self through noticing the subtle changes of self. Be gentle and kind to yourself.
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Class with Posey Online
About Posey Kettler Daves: Posey is a full-time yoga teacher, Yoga for Arthritis business manager, and USUI Reiki practitioner. Ever since she was a young girl she knew she was placed on this earth at this given time to help others heal.
Posey has her masters in mental health counseling, which she uses daily with human interaction, yet she is not a practicing counselor.
Posey's calling came through a different form of healing - yoga. She believes in the power of yoga. Her own life has been transformed through all facets of the practice. She loves nothing more in life than to see her students and fellow teachers shine and grow through their own practice.
Posey believes we are all radiant beings who deserve to shine brightly.
Connect with Posey:
My grandmother suffered from arthritis. I remember she used to joke about being a weather vane because she could feel the barometric changes in her swollen knuckles. As I age, I have a keen interest in staying as active and mobile as I can, while adapting my lifestyle as needed. I am also grateful to be able support a number of family members with arthritis.
What lessons have you learned through your Yoga for Arthritis journey?
I think one of the biggest lessons I have learned and am still learning is that the yogic path is truly a holistic journey. It is rich and endless and it doesn't stop when you leave your yoga mat. One of the reasons I love Steffany's Yoga Therapy for Arthritis book so much is that it elucidates the whole person approach to movement and lifestyle.
Working one-on-one as a mentor for Level II candidates continues to be a joy and a passion! I've benefited greatly from my Yoga for Arthritis trainings by being able to skillfully provide adaptations for students in private practice and in the group therapeutic classes I've taught over many years.
I am currently working virtually as a Yoga for Arthritis Mentor. I am also leading two online COVID-19 support groups for the Integral Yoga Institute (SF).
Jaymie is a certified Yoga Therapist, Ayurveda Health Educator, HeartMath® provider, and a National Board-Certified Health & Wellness Coach. A veteran yoga therapist with over 20 years teaching experience, Jaymie most frequently serves those in mid-life who have any combination of concerns including arthritis, stress, anxiety, poor sleep, heart disease, insomnia and chronic pain. Jaymie is proud to work virtually as a YFA Level II mentor. As a Lifestyle | Health and Wellness coach, she works virtually with clients all over the world, and is an Associate Coach for BetterUp. Website: www.resilienceforlife.com
The Transition Network is an inclusive community of professional women, 50 and forward, whose changing life situations lead them to seek new connections, resources and opportunities. Through small group interactions, programs and workshops, members inspire and support eachother to continue a life of learning, engagement and leadership in the world. As a national organization, The Transition Network is a voice for women who continue to change the rules. For more information, go to www.ttn-nyc.org.
As women reach the age of 60 and beyond, our sense of ourselves as strong, independent and capable women can be shaken by the onset of Arthritis It is useful to know this possibility -- and to be prepared with at least a rudimentary plan of action – should anything happen to ourselves, or to our friends. So, what do we actually know about Arthritis? And why would Yoga be relevant?
Arthritis is the Number One cause of disability in the United States. Osteoarthritis (OA) and Rheumatoid Arthritis (RA) are the most common of the over 100 forms of Arthritis, and both can affect every aspect of our lives -- from our mobility to our ability to be with those we love, or even to simply be by ourselves – in peace. Yoga is relatively well known to most of us, but less well known as an effective therapy to address the symptoms of Arthritis. In the past two decades American Yoga has developed a strong, and research-based therapeutic branch, and Arthritis was one of the first conditions to benefit from that research.
The ethical, spiritual and energetic components of classical Yoga provide relief for the pain and stress Arthritis patients undergo. The physical poses, or asana, are very gentle movements that lubricate the joints, strengthen and stretch muscles and increase balance. They lead the body to relaxation. Another Yoga practice, meditation, meditation contributes to the stress relief and relaxation that arthritis patients need to be able to cope with their challenges. It’s not “just exercise.” Further, classical Yoga philosophy is based on non-harming of self and others and is focused on seeking contentment, peace of mind and compassion for oneself and well as for others. A Yoga for Arthritis class contribute to a fundamental nervous system shift -- from the stressed out “fight or flight” sympathetic nervous system of a body tensed up by inflammation and anxiety, to the tranquility offered by the “rest and digest,” para-sympathetic nervous system. It is this repeated transition – and education in how to make the transition -- to a relaxed body with peace of mind that allows for hope among the students, as well as acceptance of what is.
This is so important, because there is no cure for Arthritis. Osteoarthritis (OA) develops with life; an athletic lifestyle, a traumatic injury or excess weight might contribute more to the wear and tear of the cartilage in the joints, than might a different lifestyle, but osteoarthritis seems to be a part of the life of all vertebrates, from fish to humans. Among us the joints affected by OA are the weight-bearing and working joints, such as hips, knees, shoulders and hands. The cartilage in the joints weakens, the joints become inflamed and lead to pain, limited mobility and psychic distress.
Rheumatoid Arthritis (RA) also affects the joints, but RA has a different source: it is an autoimmune disease, in which the patient’s own immune system attacks and inflames her joints. In general, women are more prone than men to suffer from all immune diseases, including RA. The joints affected are usually hands and wrists, feet and ankles and elbows and knees, but RA can also affect other body systems, such as the respiratory and cardiac systems. RA tends to strike at a younger age, sometimes even in early childhood. RA can be especially disabling, not only because of multiple joint inflammation, but also because it starts so much earlier and gets worse with age. Notably, by the time women are over 50, both OA and RA have become women’s diseases, because after menopause, when women lose the cushioning effects of estrogen, they start to account for the majority (60%) of OA cases. While there may be a genetic component to both OA and RA, the genetic mechanisms are not known.
Since all forms of arthritis are chronic, “management” is the only recourse for arthritis patients. They experience more depression than the general population, and in general, depressed people experience more pain along with more anxiety, sleeplessness and stress. Medical management of arthritis includes medications, and gentle exercise is usually recommended for its physical and psychological benefits. The exercises mentioned on the Arthritis Foundation website include two-minute workouts, walking, bicycle riding, Tai Chi and yoga.
Clearly, everyone should be as active as they can and as long as they can, with the activities of their choice. But Yoga offers an array of strategies to manage Arthritis that is simply unmatched.
In the past 15 years or so the yoga landscape changed dramatically for older adults, as Yoga teacher training shifted to Yoga therapy teacher training. Now, Yoga therapists who would teach Yoga classes to the elderly learned not how to teach their students to achieve classical Yoga asana, or poses, but to adapt the poses, or even pieces of the poses, to the capacities of the students. Also, Yoga therapists were required to understand the health challenges facing older populations, among them Arthritis, osteoporosis, heart disease, chronic pain and stroke, and to adjust their teaching accordingly.
As a result of this new, therapeutic ‘branch’ of American yoga, Yoga for Arthritis is the first program to specifically address the needs of arthritis and to offer complete yoga practice specifically designed for the individual needs of people with OA and RA.
The Yoga for Arthritis program is available in New York City as Yoga for Arthritis and Chronic Pain the Integral Yoga Institute of New York (IYINY) on West 13th Street. The teachers are a team of graduates from the program, well versed in the physical aspects of the disease, skilled in adapting poses to individual needs and in helping students learn how to shift their own nervous systems from the stressed sympathetic to the relaxed parasympathetic nervous system. Books that would be useful to arthritis patients include: Yoga Therapy for Arthritis, A Whole Person Approach to Movement and Lifestyle, by Steffany Moonaz; Yoga for Arthritis by Loren Fishman and Ellen Saltonstall, and Relax into Yoga for Chronic Pain, by Jim Carson, Kimberly Carson and Carol Krucoff.
But how significant – or scientific -- are positive self-reports by Yoga practitioners, students and teachers alike? For many years positive Yoga therapy research results were acknowledged, but were followed by “howevers,” referring to small sample size, lack of objective outcome measures (as opposed to participant self-reports) and specification of the biological mechanism at work. Nonetheless, the shift to Yoga therapy for the elderly attracted the interest and support of the National Center for Complementary and Integrative Health (NCCIH). Now, the scientific bar has been raised, and yoga research is hot and sophisticated!
Thus, for example, at the 2019 NCCIH-supported Symposium on Yoga Research (SYR), there were three projects that studied the effects of Yoga on RA patients. All three trials had over 100 participants, randomized into Yoga and control groups; and each trial cited different but specific physiological markers in the immune and neuroendocrine systems that showed statistically significant reduction of inflammation in the Yoga groups -- the “neuro-biological mechanism of effectiveness.” The rigor and sophistication of trials and results like these validate all those self-reports by students whose pain, stress and anxiety were relieved by their yoga for Arthritis practice.
Commenting on the value of Yoga in the face of improvements in the medical care for Arthritis, Dr. Loren Fishman, the New York City physiatrist with a specialty in Yoga, observes, “Even so, medications do have side effects and surgery, well, it’s always good to avoid surgery if possible. Yoga offers a pleasurable alternative – and at the very least it can minimize the use of medications and delay consideration of surgery.” My own thought is that if you are lucky enough not to have Arthritis, tell your friends who do about this article. They will love you more!
Elizabeth de G. R. Hansen, Ph.D., C-IAYT.
Yoga teacher and Yoga Therapist in New York City with focus on yoga for the elderly. Yoga research on arthritis and diabetes. Publications in Journal of International Association of Yoga Therapists. Current interests, yoga and the disabilities of age.
I began my yoga career teaching older adults in community settings. I found much of what I had learned in my Power Yoga training was not appropriate for my senior students due to arthritis and other health issues. Yoga for Arthritis showed me how to adapt yoga poses in a way that was safe and beneficial for my students. Recently I was diagnosed with arthritis in my knees. By using my Yoga for Arthritis training, I have been able to maintain a healthy and safe practice for myself as well.
I have learned that the symptoms of arthritis can be greatly reduced through the practice of Yoga.
The Yoga for Arthritis training helped me make yoga accessible to all my students. It also helped me understand the many different types of arthritis, how the disease symptoms manifest, and how to use research to inform my teaching.
Though my in-person classes are currently on hiatus, you can practice along with me online by subscribing to my YouTube channel. For more details and to register for a class, click the link on my website yogastretchandmove.com.
Dana HalkowskiI, C-IAYT, RYT500, YFA Certified Instructor
Dana has been practicing yoga for 30 years. She is a RYT500 and a certified yoga therapist with a Master of Science in Yoga Therapy from the Maryland University of Integrative Health. In addition to her Level II certification in Yoga for Arthritis, she is also certified in Yoga for Depression.
The following article has been written for Yoga for Arthritis by Christa Fairbrother. See exciting changes announced on February 4th, 2020 by the AEA here.
As a Yoga for Arthritis teacher and former staff member, I’m passionate about helping people with arthritis gain more comfort and movement in their lives. I do that through sharing yoga and especially aqua yoga.
The Arthritis Foundation’s Exercise Program was taken over by the Aquatic Exercise Association(AEA) several years ago. Being a YFA instructor, an AEA instructor, and so passionate about aqua yoga for arthritis, I needed to step up and take the Arthritis Foundation Aquatics Professional training offered through AEA. I was really curious about how the different perspectives on arthritis and movement on land vs in water were expressed in the training.
These are some observations I had, in case you’re thinking this training represents learning potentials for you as well or are looking for larger perspective on movement for arthritis.
First some general background on the Program. The Arthritis Foundation Exercise Program is a group exercise program for seniors living with arthritis. The classes are usually offered at community/rec centers, senior centers or YMCA’s. There are land-based and aquatics-based classes in the Program.
Some background information and research support on the land component of the Program can be found at HERE.
To become a trained instructor for the AF Program, the AEA offers a training course for people who are already trained fitness professionals. After finishing the course, upon passing the exam, you’re either an AFEP (Arthritis Foundation Exercise Professional for the land component) or an AFAP (Arthritis Foundation Aquatics Professional for the aquatics component). I participated in the online training course and will be addressing my comments towards that. Because YFA instructors are interested in the land-based exercise component of the program I’m just speaking to that here.
The purpose of the AFEP program is to increase or improve the participant’s: balance, coordination, cardiovascular endurance, flexibility and ROM, muscular strength and endurance, posture, relaxation and weight bearing of participants.
It does this through an exercise program that can be done freestanding or in a chair.
The AFEP training course teaches the Program through a manual and video instruction. The manual has been recently redone and is very well illustrated and referenced. The videos cover individual exercises as well as background videos on the purpose of the program, information about arthritis and teaching tips.
“Only use the exercises or combinations of exercises included in the AFEP/AFAP manual. Remember to STICK TO THE BOOK”. The capitalization is mine to highlight that the Program emphasizes exercises over exploration. The yoga idea of teaching to the purpose of the pose versus achievement of form has no room here. The program is about achievement of form.
As yoga teachers we see people move in unergonomic, habitually poor movement patterns all the time. Getting people to move more efficiently for their bodies helps people get out of pain. If someone moves in the same old poorly aligned, inefficient way, big surprise it might hurt. Trying to get people moving with better alignment is one way of the ways we can help people reduce pain as yoga teachers. The AFEP program stresses exercises over ergonomics or customization so it doesn’t allow room to develop the svadhyaya of better ergonomics.
“Don’t allow participants to ‘invent’ their own exercises or perform exercises they may have learned elsewhere.” Unfortunately, that undermines people’s ability to develop self-knowledge, awareness, and agency which are integral to the eight limbs of yoga.
A huge plus of the Program is its emphasis on breath and mindfulness which is often not included in fitness programs. It encourages deep breathing for relaxation. They encourage body check-ins and awareness in a mindful way. They advise including a relaxation component in every class such as deep breathing, progressive relaxation, visualizations and guided imagery, or autogenic training.
The Program doesn’t address some of the more current theories in pain research such as the impact of pyscho-emotional states on pain or how chronic pain transforms our neural networks. As yoga teachers we’re looking to address pain on all the koshas; this Program focuses on the traditional interpretation of pain as a static physical concept.
“Stop an exercise if it increases knee/hand/back (there’s a long list of body parts here) pain”. As yoga teachers we don’t want to cause or increase people’s pain. That’s a given. But the AFEP Program doesn’t address two big elements of living with chronic pain that people with arthritis face.
If you’re in pain all the time and you move a painful joint and it’s painful, does that really mean it’s making anything worse? Chronic pain rewires our circuitry to be overly sensitized to pain. New movement needs to be introduced with caution walking the fine line of ahimsa vs tapas. The encouragement to really get to know your pain and get creative in your relationship with it to help you manage better in all aspects, not just exercise, isn’t addressed.
We’re not blobs and we can’t sit around and do nothing ever again because it hurts to move. Getting ‘fit” is about overtaxing something and causing the appropriate amount of stress for growth. Living with arthritis isn’t any different. We need strong muscles to support weak joints. It might be a little uncomfortable in the moment to do a new exercise but where is it uncomfortable? We don’t want joint pain or joint stress; we want to develop muscles. We need to develop some discernment around our pain to be able to separate where the pain is occurring. The AFEP Program doesn’t emphasize body awareness enough to drill down into this idea of good pain that’s helping me get healthy/fit/more limber/build cardiovascular endurance vs bad pain which is aggravating swollen/damaged joints.
The course does include a great diversity of arm movements you can include in chair yoga classes and is quite extensive for an online program. It’s a great introduction to the fitness needs of people living with arthritis for fitness professionals who’ve worked with more able-bodied adults or who want to start teaching these types of classes at gyms or senior centers.
As a yoga teacher, I’m obviously biased towards the benefits and structure of yoga, however I do think as yoga teachers we have some real advantages compared to other fitness professionals.
Yoga provides us with a clear scope of practice, the 8 limbs. Those 8 limbs provide us with a wealth of resources to help people beyond physical movements. Not everyone is willing to go to a yoga class and this program is a great, safe substitute, but there’s a lot more power in the full Yoga for Arthritis program for this population. Yoga for people with arthritis empowers them to live fully in their bodies in all its aspects, including the ones that hurt, not just move their limbs.
Aquatic Therapy Rehab Institute Certified
Aquatic Fitness Professional & AFAP
Autoimmune Yogi Warrior
Lover of tea and books
Certified Aqua Yoga Specialist
Certified Yoga for Arthritis Instructor
Welcome to Conversations with Dr. Steffany Moonaz, a new series of chats with folks sharing their expertise and insights into all things yoga and Arthritis. Our first guest is Amber Karnes of Body Positive Yoga. Dr. Moonaz and Amber dive into the world of the effects of body weight on Arthritis and how stigma can create barriers between the research and the lived experience of practicing yoga with arthritis and in a larger body. Amber shares the perspective of some research, the history behind the BMI (Body Mass Index) chart and some tools in navigating a yoga class as well as a doctors office with a fat positive and empowered perspective.
Amber Karnes is the founder of Body Positive Yoga. She’s a ruckus maker, yoga teacher, social justice advocate, and a lifelong student of her body. Amber trains yoga teachers and studio owners how to create accessible and equitable spaces for wellness and liberation. She also coaches with human beings who want to build unshakable confidence and learn to live without shame or apology in the bodies they have today. She’s the co-creator of Yoga For All Teacher Training, an Accessible Yoga trainer, and a sought-after expert on the topics of accessibility, authentic marketing, culture-shifting, and community-building. She lives in Baltimore, Maryland, with her husband Jimmy. You can find her at bodypositiveyoga.com.
Link to Ragen Chastain's Article: What to Say at the Doctors Office
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