When you think about ways to treat multiple sclerosis, yoga may not spring to mind. After all, MS causes muscle stiffness, weakness and even physical disability; yoga requires muscle flexibility and strength.

Yet it turns out, yoga is gaining popularity as a complementary MS therapy. It’s recommended by the National MS Society and noted by the U.S. Department of Veterans Affairs. And many health care professionals also point their patients toward yoga. “I recommend yoga to people living with MS as part of their exercise program,” says Megan Weigel, an advanced registered nurse practitioner who specializes in MS care at Baptist Neurology in Jacksonville, Florida.

Weigel, herself a yoga devotee, was impressed by the difference she saw yoga making for people with MS. Five years ago, she and a friend with MS co-founded a nonprofit group that offers free yoga classes to people with the disease. “I have seen students do poses in yoga class that I would have never imagined they could do based on their physical exam in my clinic,” Weigel says.

[See: How to Practice Yoga When You Have Arthritis or Another Chronic Condition.]

About MS

In MS, the immune system attacks myelin — the protective covering on nerves — in the spinal cord, brain and optic nerves. The damage makes it harder for the nerves to send signals throughout the body. That means the muscles may not function properly, and people with MS often experience muscle weakness, stiffness, fatigue and pain. If it’s hard to move or walk, muscles may atrophy.

MS damage can also cause problems with vision and cognition, and it can lead to secondary conditions such as depression or anxiety, and problems with breathing, bladder or bowel control.

Understanding Yoga

Yoga is a mind-body exercise with roots that stretch back thousands of years to the gurus of ancient India. Today, yoga practiced in the U.S. combines breath control with a series of stationary poses or postures that require you to stretch, twist, bend and reach. Concentrating on the postures while focusing on breath helps clear the mind, giving yoga a meditative quality.

There are many forms of yoga, such as Bikram yoga (performed in a hot, humid room), yoga for seniors, chair yoga (performed while seated) and restorative yoga (which focuses more on relaxation).

In a typical yoga class, an instructor guides students through postures and breathing techniques. There’s usually a warmup of stretching and breathing exercises, followed by a series of strengthening and balancing postures, and then a cool-down period with encouragement to rest and meditate.

[See: 14 Ways to Protect Seniors From Falls.]

Yoga Benefits for MS

Yoga has many physical and psychological benefits for people with MS. For example, yoga helps:

— Manage stress. “The meditative qualities and breathing exercises help reduce stress. That’s important, since stress has been found to negatively impact those with MS,” notes Courtney Capwell, senior physical therapist with Rhode Island Hospital Adult Rehabilitation Services.

— Stretch muscles. “Some people with MS have muscle spasticity, which means the muscle abnormally contracts or experiences involuntary muscle spasms. Stretching the muscles often reduces spasticity,” Capwell explains.

— Strengthen muscles. Holding a yoga posture requires your core (abdominal) muscles as well as muscles in the upper and lower extremities. Using the muscles strengthens them.

— Improve balance. “Having stronger core muscles improves posture and balance,” Capwell says. A small randomized study of yoga suggested that it helped improve balance among women who took part in weekly 60-minute yoga classes for six months.

— Manage depression or anxiety. “The student learns to control breathing, anxiety and maintain composure in a pose,” Weigel explains. “That’s helpful in allowing people living with MS to find calm in the midst of unpredictable days.”

The meditative aspect of yoga is especially helpful to Marleigh Brown, 44, a busy working mom who lives in Wrentham, Massachusetts. She was diagnosed with MS in 2009, and now counts on weekly yoga classes to keep life in perspective. “I bounce from one thought to another all day long. With yoga, it’s about focusing on the breath and consciously letting each of those thoughts go as they pass through the mind. When I leave class I have calmness and clarity. I’m more present with my kids. And if I don’t get to something today, it’s OK,” Brown says. “It’s empowering, and it’s from yoga.”

And there appear to be even more benefits of yoga for MS. “Studies report benefits in fatigue, various measures of walking, quality of life, mood, bladder function and attention,” Weigel says.

It’s Adaptable

Another helpful aspect of yoga for MS is that it can be performed seated or on a mat on the floor, and it can be tailored to your skill level.

Some examples of yoga postures that can be adapted for MS include:

— A forward fold. This is normally performed standing, reaching down toward the toes and letting the body hang down to provide a stretch through the lower spine, hips and legs. This same posture can be achieved seated, with the legs open wide.

— Triangle pose. This is normally done standing, with the legs wide apart. You reach your right arm down the outside of the right leg, bringing the left arm over and across the head to create a side bend. This stretches the trunk muscles, which helps to open the rib cage and allow the diaphragm to expand for better breathing. This same posture can be performed seated.

— A plank. This core strengthener is normally done in a pushup position, putting force on the hands, toes and feet. But it can also be performed on the hands and knees or it can be done while standing against a wall.

Adapting postures helps stave off MS fatigue during yoga, since postures can be done in intervals. “You can ramp up the intensity of a pose or series of poses and sustain this workload for two to three minutes, then ramp down and perform less intense meditative relaxation for a few minutes. This offers options to best fit a participant’s ability and fatigue level,” Capwell says.

Getting Started

Talk to your health care team before pursuing yoga. When you have the green light, look for a yoga class that suits your level of physical ability and a qualified instructor. “We recommend teachers who are registered with the Yoga Alliance, have at least a 200-hour certification and some knowledge of multiple sclerosis or adaptive yoga,” Weigel suggests. “Another option is to work with a yoga therapist, a professional who has had extensive training in yoga therapy, in addition to yoga teacher training.”

[See: Who’s Who At Your Doctor’s Office.]

Local hospitals, MS centers and the local chapter of the National MS Society are all good places to ask for referrals.

Keep in mind that it may take a few classes before you feel comfortable practicing yoga. “It’s easy to get discouraged when everyone knows what they’re doing. But avoid comparing yourself to others in the class,” Brown says. “Be patient. Let the instructor know you are new to yoga and need a little extra TLC. They want you to love it, too.”

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How Yoga Helps When You Have MS originally appeared on usnews.com