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Our senior population is growing rapidly as is their interest in leading active, fit lives. On the whole, we live longer than we used to, and we all want high-quality living and good health to be a part of our older years. As we grow older, however, we typically become more susceptible to ailments that are linked to aging, and, as a result, we tend to move less. The less we move, the more susceptible we become to a variety of ailments, and so it becomes a truly vicious cycle.

Although many of us feel that we should follow the advice of “taking it easy” as we grow older, that is actually what we shouldn’t do. Extended periods of sitting lead to muscular shortening, tightening and weakening. Lack of weight-bearing activity contributes to osteoporosis. Lack of movement and stretching leads to joint deterioration and loss of flexibility. Of grave concern for our senior population is the lack of balance which stems, in part, from sitting rather than standing and from not challenging one’s balance in various positions. Complications resulting from falls among people over the age of 65 frequently lead to a multitude of serious problems, sometimes culminating in death.

Many health concerns have been linked to the sedentary lifestyle which is typical of many older people, including, but not limited to, the following:

1. reduced joint flexibility
2. arthritis/bursitis
3. high blood pressure
4. increased body fat and decreased lean body tissue
5. osteoporosis
6. low back pain
7. breathing difficulties
8. poor blood circulation
9. vision problems
10. chronic pain
11. stress-related symptoms
12. inability to sleep peacefully

In light of our growing senior population and the health conditions associated with aging, researchers are beginning to take a closer look at the health concerns of this population and at how these issues can be addressed. Yoga is considered by many to be a tremendous tool for combating the concerns of an aging society. The following information will explain how Yoga can be used with this population to increase mobility and reduce many health concerns facing the elderly.

YOGA: AN EXERCISE PROGRAM FOR ALL AGES

Yoga has been shown to help alleviate or reduce many of these health challenges, making it an increasingly popular exercise choice for our older adult population. Senior Yoga classes are popping up everywhere – health clubs, senior centers, assisted living residences, and even church basements. The many benefits of Yoga have long been said to slow – or even slowly reverse – the aging process. This is undoubtedly a good part of the reason that this 4000+ year old practice has survived and flourishes today. It’s also a primary reason that Yoga, according to the 7th Annual IDEA Fitness Programs Report, has experienced the most growth of any fitness program over the past seven years.

Armed with knowledge of the medical conditions of her class participants and the ability to modify poses to accommodate each participant’s health circumstances, a well-informed Yoga instructor can benefit all of her class, particularly the senior participants, given the age-related health concerns that they face. Most of you are aware of the well-researched and documented strengthening and flexibility gains brought on by the practice of Yoga. This article highlights several of the research findings as to the other ways in which Yoga benefits the elderly.

KEY ELEMENTS OF YOGA

Union of Mind, Body, and Spirit: Those who practice Yoga in its purest form view it as much more than just a form of exercise. It is considered a holistic experience which rejuvenates the mind, body and spirit. Even among those who practice “Westernized” (i.e., more fitness-focused) Yoga, the experience is generally felt to be more than strictly physically beneficial. The practice is calming and provides a rare opportunity in our chaotic lives to leave the outside world behind and be at peace, with a focus only on our physical, mental, and spiritual selves.

Mindful Breathing: As we age, we stop breathing fully. Yoga reminds us that it is important to exhale as fully as we inhale. As we grow older, we lose flexibility in our ribcage, and sometimes suffer from spinal deformities, creating less room for lung expansion. Mindful breathing takes into consideration the three purposes of breathing: replenishing, warming, and cleansing. Focusing on full inhalations and exhalations serves to slow down the heart rate which, in turn, improves focus and increases concentration.

Asana/Pose: The Sanskrit term “asana” is translated as pose or posture. The final positioning of an asana is achieved when all body parts are positioned correctly and mindfully. The goal of the positioning of an asana is that a balance is realized between each side of the body and that no undue stress is placed on any particular organ, muscle, joint or bone.

TEACHING YOGA TO SENIORS

Following are suggested guidelines for practicing Yoga with active older adults:

1. Be aware of health concerns and ability level for each of your class participants. Keeping class size small, if at all possible, will help you in obtaining, remembering and making use of this information.
2. Always cue body alignment and posture. Also, slow down the transition between poses. This can be accomplished by cueing each pose thoroughly, describing the positioning of each body part. Start the cueing at the top of the body, moving downward.
3. Reduce the length of time for which an asana is held. Older participants may not have the strength required to hold the pose for a longer period of time but will gain strength from practicing the pose even for ten or fifteen seconds. The pose can be repeated, if desired.
4. Avoid the use of Sanskrit labels for the poses. Use of the English terms is much less intimidating to the participants. Using terminology that participants understand will help them to remember and master the poses.
5. Train your participants to focus their gaze in a specific spot to assist with balance. This is especially important with older adults whose balance may be challenged. In rotational poses, advise your senior students to focus their gaze toward the ground or straight ahead rather than upward.
6. Whenever you cue the class to stretch one area, cue them also to release tension in another.
7. Focus on the participants’ success. Encourage them and praise their efforts. Create a supportive environment, and your students will want to come back for both the health benefits and the psychological perks.
8. Offer plenty of options for each pose and be aware of the props you have available to assist with body alignment and balance, as well as to support and protect joints. Don’t be afraid to use unconventional props – water bottles and purses can offer nice support in a forward bend, for example! Keep in mind that seniors often lack physical contact in their lives. Offer them modifications that encourage them to use each other for support and balance, when appropriate, to increase physical contact.
9. Focus on poses which stretch and strengthen areas which are typically tight or weak in seniors. Ankles, hips, hamstrings, low backs, and pectorals need special attention. Along these lines, be cautious of the weight that they put on their wrists as seniors’ wrists are often weak.
10. Do not perform a lot of complicated poses, but always include at least one pose that is a bit more challenging.
11. Maintain proper fitness etiquette at all times.

SUGGESTED POSES FOR AN ACTIVE SENIOR YOGA CLASS

Adapt positions as necessary to prevent undue strain:

• Plank
• Cobra
• Cat
• Cow
• Tabletop
• Warrior I
• Warrior II
• Triangle
• Pigeon
• Seated Twist
• Tree
• Shoulder Stand
• Laying Twist
• Happy Baby Pose
• One-legged Downward Dog

Sleep: Older adults are often plagued with difficulty falling asleep and staying asleep. The result is a fragmented, poor night’s sleep which reduces daytime alertness. In many cases it is advisable to avoid the use of pharmaceutical sleep aids in older people due to the risk of side effects.

A recent study compared the impact of Yoga, including physical postures, relaxation techniques, and voluntary regulated breathing, and Ayurveda (an herbal preparation) on sleep in the geriatric population (Manjunath, Telles, 2005). Sixty-nine seniors living in the same residence were stratified based on age and were randomly assigned to three groups: Yoga, Ayurveda and Wait-list (no intervention of any sort).

The groups’ sleep patterns were evaluated via self-assessment over a one-week period prior to the intervention and after three and six months of their respective interventions. The results were enlightening. The Yoga group showed a significant decrease in the time it took to fall asleep (an approximate average decrease of ten minutes) and an increase in the total number of hours slept (an approximate increase of 60 minutes). The other two trial groups showed no significant change in sleep. The study’s conclusion was that Yoga practice improved quantity and quality of sleep among the geriatric population.

Strength/Arthritis: A study was conducted that measured improvement in hand grip in rheumatoid arthritis patients versus non-arthritic volunteers following Yoga training (Dash, Telles, 2001). The results were significant. Hand grip strength in both hands (measured with a grip dynamometer) increased in non-arthritic adults and children AND in rheumatoid arthritis patients following Yoga. Hand strength did not improve among the corresponding control groups.

Diabetes: A study at the University College of Medical Sciences in New Delhi evaluated 30-to-60 year old patients with Type II diabetes (Jain, Uppal, Bhatnagar, Talukdar, 1993). A 40-minute-per-day regimen of Yoga was followed for a period of 40 days. The results showed a significant decrease in fasting blood sugar levels. Furthermore, these patients showed an average improvement in lung capacity of approximately 10 percent. This suggests that, over time, Type II diabetics can achieve better blood sugar control and pulmonary functions when they follow a daily Yoga regimen.

Hypertension: Researchers at Bhabha Atomic Research Centre, Medical Division, in Mumbai (formerly known as Bombay), India, evaluated the overall benefits of Yoga on risk factors for heart disease (Damodaran, Malathi, Patil, Shah, Suryavansihi, Marathe, 2002). A group of 20 patients, 35 to 55 years of age, all of whom had mild to moderate high blood pressure, began a daily one-hour Yoga program. Prior to the implementation of their Yoga program and following three months of Yoga, biochemical and psychological parameters were studied. The overall results were quite impressive. After three months of Yoga practice, the patients experienced a decrease in blood pressure, as well as a decrease in blood sugar, cholesterol and triglycerides. Feedback also indicated that the patients were calmer.

Excess Weight: Recent research found that practicing Yoga regularly for at least half an hour per week may help offset middle-age weight gain (Kristal et al, 2005). It is estimated that people typically gain about one pound per year between the ages of 45 and 55. Researchers at Fred Hutchinson Cancer Research Center found that weight gain in those who practiced Yoga weekly for at least four years had a 3.1 pound reduction in expected weight gain.

Mood/Anxiety: The Harbor-UCLA Medical Center conducted a study to assess what effect, if any, Yoga has on stress levels (Gaur, 2001). During the study, all participants expressed that their moods and anxiety levels were improved as a result of their Yoga sessions.

Chronic Pain: Yoga practice has been shown to aid those suffering with chronic pain. A study by the Harbor-UCLA Medical Center (Gaur, 2001) found that patients experiencing chronic pain either improved or maintained their symptoms after only four weeks of practicing Yoga. No patients experienced deterioration, and every patient significantly reduced the amount of needed pain medication.

Many people speculate that any form of group activity, be it Yoga or otherwise, is mood-elevating for seniors as they may be living alone and/or have limited social interaction due to physical limitations. The social aspect of attending a group exercise class, as any instructor who works with seniors will tell you, is invaluable. The contact group provides a sense of belonging.

Lung Problems/Breathing Difficulties: Breathing difficulties in 86 bronchial asthmatics were treated by a Yoga-chair breathing procedure composed of simple neck muscle relaxation movements and postures (or “asanas”) with breathing exercises (Nagarathna, Nagendra, Seethalakshmi, 1991). Seventy percent of the episodes were relieved within approximately 30 minutes. The patients gained confidence in this breathing technique and used it before resorting to prescription medication. Reduced anxiety worked well toward relieving the acute breathing difficulty episodes.

Evidence highlighted in this article, as well as substantial additional research regarding the health benefits of Yoga, is causing many to take notice and explore the use of this practice in varied settings. Even some insurance companies now cover the cost of Yoga and other therapies that were previously considered “alternative” because of the far-reaching health benefits that have been reported. Furthermore, most United States medical schools now include courses in these alternate forms of therapy. The number of Yoga participants, both young and old, is expected to continue to increase as a result of the proven health benefits of this ancient practice. Fitness instructors should respond, in turn, by focusing efforts on learning how to implement Yoga for the health and well-being of the aging population.

7th Annual IDEA Fitness Programs Report (2002).

Damodaran A, Malathi A, Patil N, Shah N, Suryavansihi, Marathe S (2002). Therapeutic potential of yoga practices in modifying cardiovascular risk profile in middle aged men and women. J Assoc Physicians India 50(5): 631-2.

Dash M, Telles S (2001). Improvement in hand grip strength in normal volunteers and rheumatoid arthritis patients following yoga training. Indian J Physiol Pharmacol 45(3): 355-360.

Gaur, S (2001). Preliminary findings of the Harbor-UCLA Medical Center study presented at the American Psychiatric Association’s annual meeting in May 2001.

Jain, SC, Uppal A, Bhatnagar SO, Talukdar B (1993). A study of response pattern of non-insulin dependent diabetics to yoga therapy. Diabetes Res & Clin Practice 19:69-74.

Kristal et al, "Yoga Practice is Associated With Attenuated Weight Gain in Healthy Middle-Aged Men and Women," Alternative Therapies in Health and Medicine, July/Aug 2005; vol.11; no. 4; p. 28-33.

Manjunath NK, Telles S (2005). Influence of Yoga and Ayurveda on self-rated sleep in a geriatric population. Indian J Med Res 121(5):683-90.

Nagarathna R, Nagendra HR, Seethalakshmi R (1991). Yoga-chair breathing for acute episodes of bronchial asthma. Lung India ix, 4:141-144.