LESSON 3

The Joint-Freeing Exercises: Pavanmuktasana

 

What is the Joint-Freeing Series (exercises) and why is it so important?

The Joint-Freeing Series (JFS) is a series of movements or exercises formulated by Makunda Stiles, a prominent yoga teacher, yoga therapist, and author. In his presentation of the JFS (Pavanmuktasana in Sanskrit) in his book, Structural Yoga Therapy, he introduces it with these words, “Ideally, before beginning your daily yoga asana practice, you will check in with your body. This series accomplishes this goal and systematically loosens all joint movements. The Pavanmuktasana series moves each joint gently and systematically through its full and natural range of motion.” Please view the video demonstrating this series and practice the movements for Pavanmuktasana Series 1 in the link below from the Yoga Journal.

In addition to allowing you to check in with your body, the JFS can also help manage the pain and discomforts associated with arthritis and other inflammatory conditions of the joints that unfortunately, come all too often as we age. According to Jana Long, therapeutic yoga teacher, “motion is lotion,” and this series does indeed, lubricate the joints. Importantly, it can be done in a chair, which is very helpful for people who may already be experiencing some limitations in their mobility. In this introduction, we focus on arthritis – what it is, how to manage the discomfort, and how to stave it off to the extent possible, as background for the Zoom portion that will focus on the joints and the JFS.

 

What is arthritis and how prevalent is it?

According to the Mayo Clinic, arthritis is the swelling and tenderness of one or more joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis results from chronic wear and tear of the joints, and a breakdown of the cartilage that lines the ends of the bones. Rheumatoid arthritis, on the other hand, is an autoimmune disorder where the immune system mistakenly attacks the body’s own tissues. It affects the joint linings, and causes painful swelling that can eventually result in bone erosion and joint deformity. Both conditions are painful and can limit movement. Rheumatoid arthritis, an autoimmune disease, can also impact other body systems, including skin, eyes, lungs, kidneys, heart, and more. This occurs in about 40% of rheumatoid arthritis sufferers. About 1.3 million Americans suffer from rheumatoid arthritis.  Osteoarthritis is far more prevalent. The New York Times reports that, “an estimated 50 million Americans have osteoarthritis; the lifetime risk of getting the diagnosis is 40 percent. Once the degeneration of the cartilage lining a joint begins, there is no treatment available to restore it.” (NYT, August 24, 2020).

Both arthritis conditions are painful, and can cause a lack of mobility that can be debilitating and interfere with one’s ability to lead their normal life. While medications can slow the advance of rheumatoid arthritis, there are no medications for osteoarthritis at this time. Because of the prevalence of osteoarthritis, the rest of this lesson will focus on that rather form than rheumatoid arthritis. Further information on both conditions can be found in the links below.

 

What are the risk factors for osteoarthritis?

With 40% of the adult population affected by osteoarthritis (OA), as expected, the list of risk factors is broad. According to the Centers for Disease Control and Prevention, the risk factors for OA are:

  • Joint injury or overuse—Injury or overuse, such as knee bending and repetitive stress on a joint, can damage a joint and increase the risk of OA in that joint.
  • Age—The risk of developing OA increases with age.
  • Gender—Women are more likely to develop OA than men, especially after age 50.
  • Obesity—Extra weight puts more stress on joints, particularly weight-bearing joints like the hips and knees. This stress increases the risk of OA in that joint. Obesity may also have metabolic effects that increase the risk of OA.
  • Genetics—People who have family members with OA are more likely to develop OA. People who have hand OA are more likely to develop knee OA.
  • Race— Some Asian populations have lower risk for OA.

Unfortunately, only two factors on this list can be modified. We cannot change our race, and the genes we inherit from our parents are what we get, like it or not. And while we can lie about our age, we cannot prevent the passage of time.

What can we impact? Let’s start with joint overuse and activity, and look at healthy ways to keep moving, especially for people with arthritis. Experts recommend a combination of activities:

  1. Low-impact aerobic activities that do not put stress on the joints. This includes brisk walking, cycling, swimming, water aerobics, light gardening, and dancing.
  2. Muscle-strengthening activities that involve all major muscle groups done two or more days a week. These can include lifting weights, working with resistance bands, and yoga.
  3. Flexibility exerciseslike stretching and These exercises help maintain the range of motion and alleviate joint stiffness once you start moving. This is where the JFS specifically comes in.
  4. Balance exerciseslike walking backwards, standing on one foot, and tai chi are important for those who are at a risk of falling or have trouble walking. Yoga also includes a variety of postures to build and maintain balance.

The other modifiable risk factor is obesity, but addressing obesity is easier said (and written) than done. Despite the plethora of book titles, websites, and magazines that pledge you will lose weight with their program or system, it is very difficult to lose weight and maintain a significant weight loss once we reach adulthood. There are many factors involved in the weight we maintain. Among them are: our genetics, our metabolism, the delicate balance of hormones in the body, our food preferences, eating styles, and more. So, what can we do?

[These guidelines are based on evidence-based public health recommendations, are not exhaustive, and should not be taken as medical nutrition therapy.]

  • Eat to be healthy with nutrient-rich foods you enjoy so you won’t feel deprived. Create rainbow on your plate with colorful veggies and fruits. Develop a fully or mostly plant-based diet comprised of veggies and fruits, whole grains, beans and legumes, and if you eat animal protein, eat fish and keep the meat lean. If you are a vegan, ensure you are taking a Vitamin B12 supplement or foods that are fortified with Vitamin B12, which is almost exclusively found in animal products. A prolonged deficiency of Vitamin B12 can lead to serious problems like pernicious anemia, where the body cannot make enough red blood cells; heart palpitations; nerve problems; memory loss, and depression; and other serious problems.
  • Adopt a Mediterranean style way of eating. Many cultures eat in this style but use foods that are specific to their location and culture. Think beans and corn tortillas, brown rice and dahl, whole wheat bread and peanut butter. Refer to the Harvard School of Public Health nutrition page in the links below, and if you participated in Prime of Life Yoga II, review the chapter on nutrition.  This style of eating ensures you get plenty of phytonutritents and antioxidants, which are important for addressing the inflammatory aspects of these conditions.
  • Eat when you are hungry and only when you are hungry, and stop when you are full. Sounds obvious? Yet, many of us cannot discern when we are hungry or full because we are responding to cues other than what our stomach is telling us. Mindfulness can help. It’s helpful to check-in with your body and your mind so see if are really feeling physical hunger, or if you are prompted by a social or visual cue to eat. Eat slowly and savor each morsel. Slow down so you notice when the taste stops being satisfying. This happens sooner than you may think. Give yourself time before taking seconds. It takes time for your mind to get the message from your tummy that you are full.
  • Use small plates and not large dinner plates. We tend to eat less when the plate is small.
  • Avoid short-term programs that promise miracles and require restrictive diets, unless your restriction is to eliminate empty calories, such as cookies, cakes, etc.
  • Remember, chocolate is not one of the food groups, but feel free to petition the USDA to make it one.
  • Don’t be hard on yourself. Changing habits, especially dietary ones, can be hard. Reward your positive changes with non-dietary treats, whatever that many be for you. But, also, allow yourself a food treat once in a while, if that’s important to you.

Following these guidelines, if you are overweight or obese, you will likely lose weight slowly, overtime, and will be more likely to maintain the loss. You are invited to explore the links below for the Harvard School of Public Health, Healthy Plate, and for Healthline/Mindful Eating.

In Summary

            Arthritis, particularly osteoarthritis, is very common among Americans, especially as we age. It is more prevalent in women than men. Yoga is one of several exercise practices that can keep the body moving and flexible, lubricating the joints to keep them mobile and minimize discomfort and pain. The Joint Freeing Series of movements (JFS) is particularly helpful for ‘juicing the joints’ and keeping them moving and maintaining mobility.  High impact exercise is not recommended as it puts unhealthy stress on the joints for a person with arthritis, and can lead to injury, which itself is a risk factor for arthritis. A healthful diet is important in and of itself, and is particularly important as a way to manage weight, as extra weight puts extra stress on the joints.

 

Additional reading and viewing

Yoga Journal online, practice video by Jana Long

https://www.yogajournal.com/videos/joint-freeing-series

 

The Arthritis Foundation

https://www.arthritis.org/health-wellness/detail?content=aboutarthritis&_ga=2.93365341.1721895942.1598297102-89438374.1598297102

 

The Center for Disease Control and Prevention

https://www.cdc.gov/arthritis/index.htm

 

The Mayo Clinic

https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

 

Rheumatoid Arthritis.Org

https://www.rheumatoidarthritis.org/ra/facts-and-statistics/

 

Harvard School of Public Health

https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/

 

Healthline.com

https://www.healthline.com/nutrition/mindful-eating-guide

 

National Institutes of Health

https://www.nccih.nih.gov/health/antioxidants-in-depth

 

Web MD

https://www.webmd.com/diet/guide/phytonutrients-faq#1

 

The New York Times

https://www.nytimes.com/2020/08/22/health/arthritis-cartilage.html

 

 

Suggested reading to delve deeper

 Structural Yoga Therapy  by Mukunda Stiles

Food Rules: An Eater’s Manual   by Michael Pollan

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