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Role of Yoga Therapy in Asthma


By : Yogi Anil Singh,
Yogacharya, University of Lucknow

What is Yoga Therapy?

Ancient yog techniques, due to their psychological and physical effect on body and mind can be employed in the treatment and management of Physiological and psychosomatic disorders, but it should be remembered, that basically traditional yog was not developed as a system of therapy.

Yoga therapy in its present form is a new discipline, created by the marriage of traditional yog with modern medicine. By tailoring yoga practices to individual needs. Whilst taking medical consideration into account, yoga therapy is more effective than general yoga practice as a safe means of treating medical conditions and also applies equal focus on mind, body and spirit, but avoids judgment and communicates the form and essence of yoga.

What is Asthma?

Asthma is an ancient Greek word meaning "Panting Breath". It is the most troublesome of the respiratory diseases. An asthmatic attack begins when the bronchial tubes in the lungs become constricted. The tubes having become narrow, the inhaled air becomes trapped in the tiny air sacs at the end of the tubes, making the release of beneath difficult.

Asthma attacks occur when, the muscles around the bronchi go into spasm. The bronchi narrow and breathing becomes difficult. Inflammation can also swell the lining of the air tubes. Mucous may increase blockage to the air tubes as well. The reason that bronchospasms can be triggered by allergies is that histamine, the chemical most responsible for allergy symptoms, seems to play a role in asthma attacks as well. But many other things besides histamine can trigger an attack : strenuous exercise, cigarette some, respiratory infections, industrial chemicals, aspirin, pet dander, indoor pollution and the sulfites added to many foods. Stress also plays a role in asthma. Severe anxiety can trigger attacks, and stress generally aggravates asthma symptoms.

Physiology of Asthma

Respiration, like other essential bodily functions, is involuntary. Our bodies are programmed from birth to perform these functions automatically, without having to think about them. Respiration is unique, however, since it can be voluntarily modified by the average person. This capability is the basis for breathing techniques that have been part of the yoga tradition for thousands of years. For asthmatics, these techniques can be the foundation for a program of breath retraining that can help them manage their disorder. Breathing is ideally a process of maximum efficiency with minimum effort. Its efficiency depends on the correct functioning of the diaphragm, a strong sheet of muscle that separates the heart and lungs from the abdomen. Each breath starts in response to a message from the respiratory center in the brain which causes the diaphragm to activate. It flattens into a disc, making the lower ribs swing out and thus increasing the volume of the chest cavity. The lungs follow this expansion, creating a partial vacuum that pulls air into the lower lungs, much like a bellows.

When we exhale, the diaphragm simply relaxes. The lungs have a natural recoil that allows them to shrink back to their regular size and expel air. The abdominal muscles and muscles f the rib cage can enhance this process, but it is the release of the diaphragm and the recoil of the lungs that are the crucial elements in the exhalation. After a pause, the breath cycle begins again, a pumping rhythm we can all easily feel. When our breathing apparatus is working efficiently, we breathe 14 times per minute at normal condition. In a healthy person, this rate increases appropriately when the physical needs of the body require it.

Like other involuntary bodily functions, breathing is usually controlled by the autonomic nervous system, which enables the human organism to run like a well-oiled, self-correcting machine. There are two branches to this system: the parasympathetic and sympathetic. The parasympathetic branch, known as the "relaxation response," controls resting functions of the body. It slows the heart and breathing rate and activates digestion and elimination.

The sympathetic branch has the opposite effect. It rouses the body and regulates active functions related to emergencies and exercise. When emergencies arise, the sympathetic branch floods the body with adrenaline-the well-known "fight or flight" response. The heart rate goes up and breathing rate increases to supply the body with an infusion of oxygen. If the danger is real, the increased energy is used. If not, the including anxiety and hyperventilation (overbreathing).

Since few of us are immune to the constant stresses and strains of modern life, the alarm bells of the sympathetic nervous system are constantly being rung. It is a real juggling act to maintain a healthy autonomic balance, a challenge at which asthmatics generally fail.

Although most asthmatics are unaware of it, we tend to chronically breathe at a rate two to three times faster than normal. Paradoxically, instead of providing more oxygen, verbreathing actually robs our cell of this essential fuel. We do take in more oxygen when we overbreathe; but, more importantly, we also breathe out too much carbon dioxide.

Most of us learn in school that when we breathe we expel carbon dioxide as a waste gas, but we don't learn that expelling just the right amount of CO2 is critical for healthy breathing, If CO2 levels get too low, the hemoglobin that carries oxygen through the blood becomes too "sticky" and doesn't release sufficient oxygen to the cells. Eventually, starved for oxygen, the body takes drastic measures to slow breathing so CO2 and build back up to safe levels. These measures produce the classic symptoms of an asthma attack: Smooth muscles tighten around the airways, the body further constricts them by producing mucus and histamine (which causes swelling)-and we're left gasping for breath.

Modern Treatment of Better or Worse

Successful treatments for asthma have always been elusive. Remedies changed little through the ages and have included herbal tinctures, relocation to arid climates and, believe it or not, smoking tobacco and cannabis. With the development of bronchodilators or "rescue" inhalers during the 1960s, everything changed. These beta-agonist drugs (the most popular is albuterol) bring rapid relief from the most common symptoms of asthma. Airways quickly reopen, wheezing stops, and mucus clears. This lets the asthmatic relax and breathe more easily. These sprays seemed to be the big breakthrough that would banish asthma forever, but they have a downside. Many asthmatics overuse their inhalers. Though doctors warn against this, it's easy to seem how such a pattern develops. People are less likely to avoid the situations that trigger asthma attacks if they know a puff or two from an inhaler will magically banish their symptoms. Inhaler overuse can also mask a silent increase in chronic airway inflammation, giving asthmatics a blunted perception of how severe their asthma is, so that they put off getting further treatment until they have a real crisis. According to the Canadian Respiratory Journal (July/Aug. 98), "regular use of short-term betaagonists as maintenance therapy for chronic asthma is no longer recommended." Articles in several other prominent medical journals have also documented that even normal use of albuterol eventually worsens asthma. In other words, while inhalers relieve symptoms in the short term, in the long run they contribute to an overall increase in the frequency and severity of attacks.

Doctors now recognize the limits of rescue inhalers and often recommend the use of newer drugs, primarily corticosterids, which treat an asthmatic's chronic inflammation. With the development of these anti-inflammatories, medical treatment of asthma has entered a new era. Prednisone, the most popular of these drugs, is now the last line of defense against asthma and has saved many lives, including my own. Regular use can reduce the need for bronchodilators and prevent asthma attacks. However, prednisone is a potent drug with severe adverse effects that can include dependence, hormonal changes, weight gain, glaucoma, and severe bone loss. With long-term use a person can be affected by problems more crippling than asthma itself.

Yogic Treatment
Exercise -I : Deep Relaxation

This exercise helps you establish a calm state before doing the other exercises. Begin by lying down with a firm pillow or a folded blanket under your head. Bend your knees and rest your feet flat on the floor. It that is not comfortable, place a bolster or rolled blanket under the knees. Feel free to shift your position and stretch if you become uncomfortable. Some people like to play calming music as well. Place your hands on your belly, close your eyes, and turn your attention inward. How do you feel? Are you uneasy, uncomfortable, buzzing, or distracted? Is it difficult to lie still? Is your mind racing? The goal is to let go of all that, which is not always easy. It may take several minutes to relax deeply. Give yourself time.

With each exhalation, let your belly sink away from your hand and into the back body. After a gentle pause, can you feel the belly rise effortlessly when you inhale? This relaxed action cannot be rushed, so don't force the movement in any way; an easy rhythm will settle in as your state of relaxation deepens.

Exercise - II : The Wave

I call this exercise "The Wave" because of the soothing movement that ripples up and down the spine when the body settles into your natural breath. This movement helps unlock the diaphragm and massages the abdomen, chest, and spine, releasing tension that can interfere with healthy breathing. After Deep Relaxation, place your arms on the floor alongside your torso. Close your eyes and turn your attention to the belly and the way it melts into the pelvis each time you exhale. Begin The Wave by gently relaxing the lower back into the floor as you exhale, and then lift it a couple of inches as you inhale. The hips stay on the floor as the lower back rises and falls. This need not be a big movement, and the pace of breathing should be slow and easy. Allow yourself to settle into and slightly amplify this rhythmic wave, and notice if you can feel movement all the way up and down the spine. Repeat this exercise 10 or 15 times before continuing to the next technique.

Poor breathing habits may confuse you and cause you to reverse the coordination of movement and breath, so pay close attention. If you find yourself feeling tense, take a few normal relaxing breaths between cycles.

Exercise - III : Softening the Inhalation

In this exercise you will try to soften the effort you use to inhale, and to decrease the length of your inhalation until it is shorter than the exhalation by as much as half. When you first try this exercise, you may feel an urgent desire to breathe in more. Instead, remember that over breathing is a habit that perpetuates your asthma.

To identify your basic relaxed breathing rate, begin by counting the length of your exhalation, the pause afterward, and the following inhalation. After several minutes, start to modify your breath rhythm to emphasize the exhalation. Use the baseline length of your exhalation as the gauge for any modifications you make : In other words, don't struggle to lengthen your exhalation; instead, shorten your inhalation. With practice, this will become easier. In the meantime, take several of your baseline breaths between cycles if you feel anxious or strained.

Exercise - IV : Complete Diaphragmatic Exhalations

An inability to exhale fully is a defining symptom of asthma. I practice this frequently whenever I feel short of breath. Lie on your back with your eyes closed and arms stretched out along your sides. Beginning with an exhalation, purse your lips and blow the breath out in a steady. Your will feel a strong action in the belly as the abdominal muscles assist the exhalation. Your exhalation should be longer than usual, but it is important not to push this too far. If you do, it will be difficult to pause after exhaling and your subsequent inhalation will be strained.

Pause for a few seconds after your exhalation, relaxing the abdomen. Then, keeping your throat open, allow the inhalation to flow in through the nose. Because of the stronger exhalation, you should be able to feel the inhalation being drawn down effortlessly into the lower chest. Count the length of the exhalation, the pause, and the inhalation. At first, try to make the exhalation at least as long as the inhalation; do this by shortening your inhalation, as in the previous exercise. (Unlike the previous exercise, in which you breathe at your normal resting rate, your breath here will be both longer and stronger.) Eventually, aim to make your exhalation more than twice as long as the inhalation and to make the pause after the exhalation comfortable rather than hurried. Since asthmatics find exhalation difficult, it may help you to imagine the exhalation flowing upward, like a breeze within the rib cage, as the breath leaves the body. Repeat five to 10 cycles of this exercise. As with all the exercises, I recommend you take several normal breaths between cycles.

Exercise - V : Extended Pause

This exercise is designed to help regulate the CO2 levels in the body. It doesn't give the same quick fix as an inhaler, but it can turn an asthma attack around if you start it early enough. By pausing before you inhale, you give the body a chance to slow down and build up the level of carbon dioxide. An overbreather may find this to be the hardest exercise of all. At the outset it may the difficult to pause for even a few seconds, but if you keep trying you will notice improvement, perhaps even during a single practice session. Eventually, the pause can extend up to 45 seconds or even longer.,

Position yourself as before : on your back, knees bent, with feet flat on the floor. In this exercise I recommend that you consciously shorten your inhalations and exhalations. (Your breath rate should not become rapid, though; the shorter inhalations and exhalations are balanced by the longer extended pause.) Inhale for one or two to four seconds, and then pause. During the pause should be like the natural relaxation that occurs as you exhale. You can extend the pause by consciously relaxing wherever you feel specific tensions.

As with all these exercises, patience yields better results than force. Repeat the exercise 5 to 10 times, and feel free to take normal breaths between cycles.

There are, of course, many other breathing techniques that can be beneficial in the management of asthma, but I can personally vouch for the transformative power of the exercises in this program.

Exercise - VI : Catch Your Breath

Once I understood that breaking the cycle of over breathing is essential to overcoming asthma naturally, I could draw on all my years of experience with pranayama. I experimented with breathing techniques to see what would restore my natural breath rhythm. Over time I settled on a handful of exercises that were both simple and effective at slowing my breath rate and reducing the incidence and severity of my asthma. There are certain precautions to consider as you embark on this program. The program may ultimately reduce your dependence on medication or enable you to do away with it altogether, but this should not be done hastily or without the approval of a doctor. If you have diabetes, kidney disease, or chronic low blood pressure, have had recent abdominal surgery, or are pregnant, you should consult with your physician before doing these exercises, I also strongly suggest that asthmatics avoid additional breathing exercises which call for rapid breathing (kapalabhati/bhastrika), retention of the inhalation (antara kumbhaka), or tightening the throat (strong ujjayi). Asthmatics must realize that many breathing exercises which are quite beneficial for a normal breather may have a paradoxical impact on an asthmatic, and also do Jal-Neti, Ghrit-Neti, Gomukhasana, Matshyasana daily with above exercises.

Nutrition

Some studies indicate that people with Asthma have environmental allergies. Although food allergies may also contribute to the problem, some researchers believe food allergies only rarely sinusitis. If other treatment approaches are unsuccessful, people with sinusitis may choose to work with a nutritionist in order to evaluate what, if any, effect elimination of food and other allergens might have on reducing their symptoms.

Histamine is associated with increased nasal and sinus congestion. Vitamin C (2,000 mg three times per day) reduced histamine levels in people, has been reported to relieve symptoms of acute Asthma. Eliminate mild and all milk products from the diet, including prepared foods that list milk as an ingredient. An overwhelming majority of patients report dramatic improvement in Asthma conditions after two months of this dietary change.

Do not smoke. Do not spend time around smokers or in smoky environments.

Emotional Aspect

There is an emotional aspect to every illness. Often times, it is the emotional thoughts or "excess emotions" that will lead to illness. The following therapies are utilized for calming the mind, help with stress relief and focuses on our mental powers over any situation. The ability to balance you emotional, mental, physical and spiritual self is up to you. Here are some suggestions :

What is your experience with this disorder? Sharing you own experiences often helps others.

But I also know, from my experience, that if you make these behavioral changes a daily regimen, you'll gain valuable tools for managing your asthma.
 



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