December 9, 2013

Yoga for People Living with Parkinson’s Disease. ~ Catherine Genzler

I’ve taught yoga since 2004 and, for the last four years, have been privileged to teach yoga classes that are sponsored by the Muhammad Ali Parkinson Center and tailored to people who are living with a diagnosis of Parkinson’s disease (PD).

In conversation, people often ask me why yoga is good for people who are living with PD, or any other chronic illness or dis-ease for that matter. I always say the same thing: Yoga is good for people who live with PD for the same reasons it is good for anyone because the foundation of a yoga practice is the breath. When we breathe better, we feel better. Yoga is yoga.

It is true that Parkinson’s disease is a degenerative disease of the nervous system and that there is no cure. It is also true that medications can work well to treat the motor symptoms of PD that include rigidity of the limbs and trunk, tremor, and slowness and/or instability of movement.  Although medications are essential in managing PD, they may also lead to unpleasant side effects.  As such, the emotional and spiritual body may experience anxiety and/or depression as a possible consequence of the medications and/or an understandable reaction to the changes in a person’s entire world.

Let’s revisit the question: Why is yoga good for someone who is living with Parkinson’s disease? And let’s consider the symptoms and consequences, one-by-one.

Rigidity of the limbs and trunk

Breathing exercises are a great way to introduce a physical practice to someone who may not be familiar with yoga. Intentional breath-work helps to improve function of the respiratory system as well as improve the physical infrastructure of the torso. Teaching a student to move his/her torso as in “cat-cow” is a simple, yet exceptionally efficient, method of explaining the fluid movement of yogic breathing.

Moving the body in and out of Warrior One—arms uplifted symmetrically or asymmetrically—and the feet moving forward and back, can provide great relief for stiff muscles. Using the breath as a guide for movement helps to create a rhythm and potentially generate new pathways for muscle memory to develop. If a student prefers (or needs) to be seated for the postures the arms and legs may still be positioned and repositioned in support of the breath.

For some people, an early symptom of PD is that one arm may stop swinging in concert with the natural gait of walking. A yoga practice that integrates asymmetrical movements of the arms and legs may help a student reclaim a more normal pattern of body movement.


While a yoga practice has not been proven to arrest the incidence of tremor (trembling on one or both sides of the body) it has been my experience that, once a student is confident in their surroundings, and with the other people in their yoga class, the concern about tremors lessen a bit, therefore alleviating the practice of using energy to try and minimize involuntary movements.

What I have also observed is a gentle release of the worry about the outward “signs” of PD when a student accepts that no one in the class cares that someone else is tremoring, or not. The face relaxes; the shoulders relax; the neck can move more freely; the chin and eyes lift—maybe even a smile!  Whew.  In fact, I have witnessed marked relaxation come over a students’ body as he/she moves toward the final resting postures, the profoundly relaxed breathing rhythm, and an outwardly visible improved sense of wellbeing.

Impaired balance.

Improved balance is a consequence of a regular yoga practice—not a requirement for it. I’m not the first person to say that, nor will I be the last. It is important for a yoga student to feel safe whether he/she is practicing on a mat, near a wall, standing or seated; we all need to feel safe. If a student needs to have a chair or a wall near him/her, so be it. The mere attempt at working on balance requires that a student shift his/her mind from its normal “soundtrack” or chatter, to intensely focusing on something else.

I teach my students to engage in balancing postures by first cultivating the rhythmic breath, then engaging mental focus, and finally integrating physical posture. That way, if the balanced posture is elusive, the student has successfully engaged mental focus and breathing. The balanced posture is a consequence of letting go, initially by imagining it and then physically experiencing it.  My students tell me that they have experienced improved balance when they stop trying so hard to find it.

Slowness of movement and/or instability when moving. 

While teaching yoga to students who live with PD, I encourage them to view their movements as “mindful” and “deliberate” and not be concerned with any perception of “slowness”. There is an important emotional shift in vocabulary from a word or term that could have a negative connotation to something that is useful and productive.

For example, I have led my students in a small group as we walk across the room—forward and backwards—while holding the powerful Warrior I posture, confidently lifting and then placing the feet, raising the eyes and chin, and controlling the breath. This kind of work helps to improve spatial awareness, (the ability for a person to interpret themselves in relation to his/her surrounding environment), bolsters confidence and improves his/her sense of wellbeing.

Anxiety and/or depression.

I have been told that receiving a diagnosis of Parkinson’s disease can be emotionally devastating.  I have also been told, by more than one of my students, that receiving the PD diagnosis was a whole lot better than hearing the news about some other disease. Either way, when dis-ease arrives at your doorstep, life is bound to change.  Along with change, comes fear, anger, confusion, the tension between acceptance and rejection, and myriad other unpleasant emotions. Using the breath as a tool to calm the mind and steady the sympathetic nervous system can be a simple, yet very powerful method of managing anxiety and depression.

When we are anxious, the digestive process may slow too much or accelerate, creating problems. A deliberate, yet gentle, yoga practice that incorporates compressive postures and twists—seated or standing—can help a student to manage blood pressure and digestive functions. Alleviating anxiety may help a student to relax enough to sleep a little better; improved sleep will certainly support overall wellness.

Beginning to practice yoga is an intimate process, particularly when the desire arises from a diagnosis like PD. The practice seems to find us when we need it the most. I like what T.K.V. Desikachar says about this in his book, The Heart of Yoga (1995).

One of the basic reasons many people take up yoga is to change something about themselves: to be able to think more clearly, to feel better, and to be able to act better today than they did yesterday in all areas of life. In these endeavors yoga can be of great help, and it requires no prerequisites that must be fulfilled before we set out on this path.

Just because yoga originated in India does not mean that we must become a Hindu in order to practice it. On the contrary, it is not even expected of a Hindu that he or she practice yoga. Yoga does not require a particular belief system and, if we already have one, it is not challenged by yoga. Everyone can begin, and at the point at which we start is very personal and individual, depending on where we are at the time.

It is true that we feel better when we take time to honor our own needs—body, mind, and spirit.

Honoring our own needs means that we must be courageous enough to do our own work:  work like finding a practice that will support and sustain a more peaceful body, mind, and spirit, meeting ourselves right where we are…living with Parkinson’s—or not.

Yoga is yoga.


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