Return of the old school – Re thinking the practice of Pawanamuktasana to help with
management of Auto Immune Diseases.
Auto immune diseases are amongst the fastest growing classification of conditions affecting
modern health and produce their own specific health challenges. These conditions can include
both systemic inflammations i.e. Lupus and Rheumatoid Arthritis to Organ specific disease
pathology i.e. Auto Immune Hepatitis and Ulcerative Colitis. An auto immune disease is
classified as any of a large group of diseases characterized by abnormal functioning of the
immune system that causes your immune system to produce antibodies against your own
tissues.
Symptoms can often be vague and none specific for prolonged periods until a health crisis is
identified. Treatment then depends upon the condition identified and can involve Analgesic pain
relief, Steroid therapy, Immune suppressants and in certain circumstances surgery.
Having any type of auto immune diagnosis can present as the proverbial king hit for previously
healthy individuals and is almost certainly life changing. Decisions often need to be taken of
where an individual is within the process of disease management and the road back to health
I.e. Changes to diet, stress management, life’s priorities and exercise programs are often
discussed and commenced.
As Yoga teachers and Yoga therapists we all subscribe to health screening questionnaires and
with the management of AID it is important to adopt a step by step process to the Yoga asana's
initially implemented. We need to fully understand and comprehend the complexities of the
conditions that we are being asked to provide a holistic yogic intervention for. Key objectives
then need to be planned for with realistic time frames. Recovery will not be as effective however
if the client does not buy into the whole process and support is of paramount importance.
The standard treatment for some AID is to prescribe Cortical Steroid therapy to dampen down
the initial immune inflammatory response and then provide Immuno suppressive medications to
keep the immune system suppressed. This is a recognized allopathic intervention but requires
regular blood screening to ensure that the patient is not being poisoned by the toxic medications
prescribed.
A holistic approach sees this intervention as symptom management only and the damping of
the immune system as attempting to break something that is already broken. Much more
emphasis is then placed on the investigation of AID triggers i.e. Heavy metal toxicity, Dioxin
poisoning, Vaccinations and Leaky gut sensitivities.
When an individual has affected a lifestyle choice and decided to try yoga there is an
opportunity to help facilitate a healing for that person in a logical step by step approach. Often
the individuals are not super flexible, or ate a Sattvic diet prior to diagnosis. We as practitioners
are often faced with the reality of an individual with major health issues and changes, poor diet,
poor flexibility and fear. Fear alone is enough to stimulate a negative Cortisol response which
can affect joints, energy levels, energy meridians and organs over time on a physical level as
well extensively documented mental and emotional traits.
When Corticosteroids have been prescribed these are often in high doses over a prolonged
period of time and can cause, brittle hair, calcium depletion from bone, this over a period of time
can lead to an increased risk of brittle bone disease and possible Idiopathic fractures. Mood
swings, moon face and rapid weight gain are amongst symptoms commonly noted. Steroids in
addition can cause Potassium depletion and Sodium retention which causes muscle weakness,
loss of energy and joint pain. Therefore it is essential to promote a program of postures that
complements the non-aerobic ideals that are based around yoga and take it nice and slowly so
that any initial pain and lethargy can be overcome. Additionally steroids can also cause rare
symptoms namely avascular necrosis particularly around the femoral head. Severe joint pain
after postures would need immediate medical attention and teachers need to be vigilant.
In the cases of AID where Arthritic changes are evident some calcium crystallization can occur
around joints and further complicate matters, ie Calcium Pyrophosphate deposits can result in
acute crystal arthritis. Apetite crystallization can occur in the joints and on the tendons causing
degrees of Caliform tendonitis. Both of these ultimately cause joint pain and impaired blood
flow.
Pawanamuktasana according to the work of Swami Satchyanada Saraswati in his Seminole
book, Asana Pranayama, Mudra Bandha is a series of yogic practices divided into two main
groups: part I – Anti Rheumatic exercises and part II - Anti Gastric exercises. There is an
additional third series which is designed to remove energy blocks. Pawanamuktasana literally
translates to postures that allow movement and the liberation of energy, or gas release
postures. This allows recovery and rejuvenation to joints which may be stiff, atrophied, or under
an Immuno inflammatory response and suffering the effects of Allopathic prescribed
pharmacological interventions.
The postures in part I are taught mainly to beginners, and individuals with issues around
flexibility. These principles can be easily adapted for all complex health challenges, particularly
AID. This series is very easy to explain, simple to teach and learn. This should form the base for
the beginning of Yoga practice for AID and with time more complex basic postures can be
added depending on the client response and realistic time frames.
The systematic series of movements stimulate blood flow and the augmentation of synovial fluid
and lymphatic activity within the synovial joints. As the micro climate of the joint is re-energized
and re-vascularized, waste cellular material is disposed of resulting in increased levels of joint
Homeostasis. As the synovial fluid provides the cushion and lubrication for joints, any exercises
that promote both the production and reabsorption of this fluid will be of great benefit.
The complications of prolonged immobility including muscle atrophy Joint calcification, ligament/
tendon shortening and fibrosis are well documented. Therefore it is essential to AID suffers to
gently reanimate the body in a way that will not be injurious to effect the principle of the Gunas,
namely energy overcomes inertia to provide equilibrium.
Joint and associated muscle group movement helps to augment both Venous and Lymphatic
circulation. This helps to prevent venous pooling and lower limb cellular waste accumulation.
The venous system does not have the same pressure gradient as the arterial system and relies
on venous cusps within the veins and the constant muscular skeletal augmentation to allow the
blood to return to the heart for recirculation. The anti-gastric exercises in part II facilitate the
gravitational flow of blood back to the heart as the lower limbs are often placed at a higher angle
than the thoracic cavity.
PMA part III as well as complimenting part I and II with movement is specifically designed to
remove energy blocks and clear energy meridians. However not all of these postures may be
achievable or desirable initially, this group of postures greatly stimulate the nerves in the legs.
So when these simple series of postures are examined more closely we begin to see the
beginning of a roadmap for yoga with disease management which can form the initial
framework particularly for bodies which need to be healed on a number of levels and following
both Yogic and Ayurvedic principles.
Other areas of interest to consider with AID are diet, holistic testing and phyto -nutrient supplementation. Although these do not relate directly to yoga, the Yoga teacher / therapist will
need to be aware and discuss how additional strategies would or may help with practice
particularly if the yoga therapist is an established, health care practitioner.
Diet is best kept to organic sattvic food to reduce GMO intake, pesticide residue and dioxin
contamination. Supplements like turmeric, alpha lopoic acid and milk thistle are very effective
compounds to help with cellular healing and regeneration.
Additionally any food sensitivity testing can be recommended prior to the commencement of
Immunosuppressive medications as these can dampen the inflammatory response and markers
during testing. This fact is often overlooked in both holistic and allopathic circles.
I consider a program of Pawanamuktasana combined with Pranayama and Yoga Nidra for
Autonomic nervous system balance and regulation, an ideal way to begin an introduction into
yoga for AID suffers. After this is consolidated with class and home practice further postures can
be added depending on the student’s passion, flexibility, insight and disease progression /
Management.