The Value of Yoga for People with Multiple Sclerosis
“Yes, it is difficult to get down on the mat and get up, but I can still do it. Every week I do things that would horrify my wife if she knew!” Student A. Gill Ansty has run a weekly Yoga class for people with Multiple Sclerosis (MS) and who use sticks for walking, for the last 15 years at the Chilterns MS Centre in Buckinghamshire. In that time, the charity has moved from their previous ‘hut’ to a purpose-built therapy centre with state of the art facilities with a wide availability of treatment options, including Yoga classes.
by BARBARA DANCER
Gill began teaching people with MS when she took additional training with the Yoga for Health Foundation. This organisation particularly focused on Yoga for those with MS, mainly through residential weekends, at their centre in Ickwell Bury, Bedfordshire. “My work experience at the Yoga for Health Foundation was based on working with 20 people, all with MS, who were staying there for the weekend. It was very hands on and you had to really get involved,” Gill explains.
In order to work with Yoga and someone with MS, it is important to understand something about the condition. MS is an autoimmune disorder, which typically starts when people are young adults but it can be difficult to diagnose. It characterized by sclerosis or scarring where there is loss of the myelin covering to the nerves, a process called demyelination. This disrupts the ability of the nerves to conduct electrical impulses to and from the brain, on any part of the spinal cord and within the brain itself. This results in common symptoms such as loss of feeling or a clumsiness in legs or arms, balance problems, painful muscle contractions, fatigue, cognitive problems and vision problems.
Despite fatigue being a major symptom, Gill’s class includes plenty of postures. “People have made a huge effort just to get to the class and when they are here, they want to work” says Gill. But the way they work is modified to take into account the challenges that this group have. Her knowledge and understanding, gleaned over the years of teaching people with MS, seem particularly beneficial because of the way she gets the class to practice asana and move limbs where there is limited sensation or there can be pain, especially if muscles spasm. She encourages students to draw together the mental and physical aspects of motor control, based on the teaching at Ickwell Bury. Students ‘visualize movement’, in effect, mentally practising what they will do before actually making the movement. There is a sense here of setting up and practising the neural connection, before putting the neural connection into action and undertaking the movement. There is research to indicate that even thinking about movement has a measurable benefit to the body . Hypothetically, although a certain movement may not be possible for an individual, because the demyelination and scarring may be too severe, it is possible that thinking about a movement will have a beneficial effect.
Gill emphasizes using the breath too, in particular breathing into postures, to manage the mind and body response to potentially painful movement. Yoga sessions end with time for relaxation and this is the class’s favourite bit!
The inspiration for teaching at the Chilterns MS Centre came from a young woman called Louise. Gill explains: “I was teaching a yoga class at a local gym, which Louise started attending. Louise had been living with MS for a while and, because I was used to working with people with MS, I felt confident about including her in the gym class.” When Louise started going regularly to the Chilterns MS Centre, Gill asked if she could teach yoga there, which she continues to do some 15 years later.
She then went on to teach Louise one-to-one. “We worked a lot together on things that would really help Louise,” said Gill. A good example of this is the use of specific yoga movements, which Louise would use as part of her daily routine. She used a seated twisting Yoga posture adapted by Gill, to improve her ability to empty her bladder.
Louise had no sensation in her feet, so in her practice sessions – for two foot support or bridge posture – Gill would place her hands either side of Louise’s knees and ask her to focus on pushing the knees away, rather than pushing down through the feet, to rise up into the posture. For relaxation in savasana, Gill learnt that if she placed her hands on Louise’s feet and legs and just held them down with the gentlest of pressure for a while, that they would slowly relax from the spasm that they were in. “And I learnt that using bhavana (an internal visualization technique) to create a mental image or feeling, really works. The image you focus on really does matter,” Gill explains. “And the way you think about yourself matters the most.”
Gill has doubts about the benefits of someone with MS attending a general yoga class. “Although some say all yoga is therapeutic and a gentle class is good for everybody, actually you can do much more with someone if you understand their needs and you apply what you know using your experience as a teacher.”
MS symptoms vary widely and include weak limbs, tingling sensations, unsteadiness, blurred vision and fatigue. Gill’s experience also bears this out – that everyone is different and is affected by MS in different ways: “ The common denominator is fear and yoga takes away that fear. Until you take away some fear, you don’t really know how your body works.” Gill feels the condition of MS is only part of what students face. “There is the illness and the fear – the fear is a projection of “what if”. That puts tension into the body – a holding on. You need to let go of it to understand how the body really is.”
For Gill’s class, working on crash mats, means the everyday hazards of stumbles and falls are less of a fear and to laugh about this helps people to relax. “Yoga works on getting rid of the fear.” Gill comments. One of Gill’s students would drive himself to the class and park in the Centre’s car park. “He would get out of his vehicle and using his Nordic walking sticks, walk the short distance from his car to the Centre. As he walked, his knees would slowly bend more and more with each step until by the other side of the car park, he was down on the floor. And laughing,” Gill remarks.
She obviously cares deeply about the people in her class and is positive about their future, especially now that she is setting up another regular yoga class. There are on-going discussions with the physiotherapy team at the Centre about assessing students’ abilities in standing, walking and aspects of mental health as they attend the yoga class but, in the meantime, another regular weekly class is in demand. “I’ve got fellow yoga teacher Tara Hawes helping me now, which is amazing and so that if I ever leave … well, I won’t leave them because I’m so attached to them,” Gill says.
Finally, a view of using yoga from one of Gill’s students, Arthur Godwin:
“I’ve had MS for 45 years and been doing yoga for 15. My health is getting worse but it would be much worse if I did not go to yoga. I do them [the Yoga postures] but it is a struggle. Life is difficult but it would be much harder if I did not go to yoga.”
Gill Ansty is running one-day workshops, with the support of the Chilterns MS Centre, to train other Yoga teachers in the techniques she uses to teach yoga for people with MS. This could enable more people with MS to maximize the benefit that they can gain from yoga. Gill’s goal is to see Yoga being offered in every MS Centre in the country.
Her one-day intensive training workshop looks at how to understand what a group or individual with MS needs and how to provide supportive use of asana and other techniques. Plus there is an invaluable chance for workshop students to gain practical, hands-on experience by observing a class of people with MS and seeing how the theoretical part of the workshop is applied in real life. It will be a special and extremely valuable day for anyone who wants to teach yoga to people with MS or who wants to learn additional skills in therapeutic Yoga for people with MS.
Training to Teach Yoga for People with MS
Location: Chiltern MS Centre, Halton near Wendover, Bucks HP22 5LX
Workshop details: Theory and practical application, discussion and the opportunity for observation of a class and talking with class students
Contact: Gill Ansty at firstname.lastname@example.org
Numbers will be limited to ensure that class students are not overwhelmed and to keep a good balance of class students to student teachers.
 One example of a study: The Power of the Mind: The Cortex as a Critical Determinant of Muscle Strength/Weakness
Brian C. Clark, Niladri Mahato, Masato Nakazawa, Timothy Law, James Thomas
Journal of Neurophysiology Published 1 October 2014 Vol. no. , DOI: 10.1152/jn.00386.2014
© 2017 Barbara Dancer All rights reserved.