9. What if I have a medical condition?

I have bad knees. I experience knee pain. Can Bikram Yoga help me?

Whether the knees are arthritic or injured, Bikram Yoga may possibly help, as it is important to move the knees to get circulation to them and Bikram yoga helps you do this.

So how should you proceed? Make sure to listen carefully to the alignment instructions for each posture. When you are told to keep your feet parallel in standing postures, please do so. A half-inch in either direction away from parallel has its effects all the way up the knees and into the hips.

In standing balancing postures, it is also important to keep the standing foot straight and the standing knee pointing straight ahead. If your knee bows back (hyperextension) you should bring the weight forwards towards the toes so as to engage the quadriceps muscle and "lock the knee" as you  lift the kneecap upwards. This action brings the leg into one line and brings more strength and stability to the knees.

When you are bending your knees, in any of the standing postures, keep the knees directly over the feet. This will ensure that the knees and hips are strengthened evenly and symmetrically .

In Triangle Pose (Trikonasana), when you are told to push your hips forward as you bend your front knee, this will keep your hip in line with your knee and in line with your foot. This is also good for even strengthening of hip and knee joints.

In some of the standing postures, it might be very difficult to bend your knee to a 90 degree angle. So do the best you can without creating pain. Better to keep proper alignment, bending 1%, than to go 100% in poor alignment.

In the floor postures , notably Fixed-Firm, Half Tortoise and perhaps Rabbit, it might be difficult for you to bend your knees enough so that the hips sit on the heels. You may have to begin from a position up on your knees, instead of kneeling and modify the postures by opening your knees to get your hips to the floor. With time your knees will improve in flexibility and strength.

To test your knee flexibility, support your body weight with your hands on the floor and bend the knees gradually to the point (but not past) of slight discomfort. You must be able to relax and breathe in the posture, holding it steady, to allow healing to occur. As the discomfort decreases you can gradually take the weight off of your hands and allow more pressure on the knees. Eventually you may be able to go all the way into the posture, and you won't even remember the time when you couldn't sit fully down!

I have degenerative disc disease (or bulging or herniated discs). Can I still do forward bends?

Care must be taken with forward bends as this movement may force a degenerative disc back towards the spinal cord and spinal nerves creating pain. Therefore it is important to learn to bend forward properly. Bend forward slowly, even allowing the hands to slide down the legs. Only gradually increase the strength of pulling on your heels in forward bends. If you bend forward, pull and feel pain, release the pull and the depth of your forward bend.

Backward bends are recommended for building stability in the spine and spinal muscles. This movement has the added advantage of releasing pressure on spinal discs and may help reduce pressure of a damaged disc on nerves, thus relieving pain.

During any episode of significant back pain it is best to skip the sit-ups and just roll over onto your stomach.

As you continue your practice and you spine strengthens, you will gradually be able to do more and more of the series. The best results come from a regular practice.

My back hurts after I practice Bikram Yoga. Do you have any suggestions?

Please follow the instructions carefully when you are doing forward bends. For example, in the Half Moon - (Padahastasana) series, the instructions are to bring your torso on your thighs, chest to the knees, no light space anywhere between the torso and the thighs. If you try to straighten your legs without having this first part accomplished, you can create pain in your lower back. Also keep in mind the instruction "360 degrees stretching." What that means is to make the stretch even throughout the whole back side of the body.

You also want to follow these guidelines in Separate Leg Stretching. Our instructions are, “Suck in your stomach and bend your upper body down from your lower spine towards the floor.” It is difficult to suck in your stomach unless you exhale, so make sure to exhale as you fold forward. When you suck in your stomach, it supports the whole pelvis to roll forwards with the rest of your spine-this eliminates strain in the lower back.

Working carefully, mindfully, allowing your breath to flow with your movement will help you to gradually deepen your experience of the postures.

Should I still practice if I have Back Problems?

Back problems are felt by most of the population at some time in their lives. These injuries may be the result of a single major trauma or multiple small stresses on the spine over many years. The general recommendation is to exercise, with care, and get your body and spine moving.

It is always good, of course, to get a professional examination and advice about your condition so you fully understand what is happening with your body. This may be with a medical doctor, physiotherapist, osteopath or chiropractor. When exercise is recommended as part of your management of your condition, Bikram Yoga is an excellent choice as the addition of the heated environment allows for safer stretching and opening of the structures of the spine. Many students, even with chronic long-term back problems, report significant relief of their pain levels, often in a surprisingly short period of time.

Should I still practice if I have Arthritis?

When a patient with joint pain has an xray taken and the report is some sort of arthritic condition, the patient may assume that the arthritis is what is causing their pain. The pain is more likely due to an abnormal alignment or movement of the involved joint. This simply means that if you begin to carefully restore more movement into the injured area, you will most likely experience a reduction of pain levels. Some arthritic conditions may also involve chemical imbalances or toxic accumulation in the body. The improved blood circulation, respiration and profuse sweating that is associated with the Bikram practice may help cleanse the body of irritants that may be contributing to body pain.

Should I still practice if I have Asthma, Emphysema or Chronic Bronchitis?

If you have some sort of respiratory condition, you have probably already noticed that exercise is more difficult when your breath is compromised. A Bikram class, however, may an appropriate form of exercise for several reasons.

Firstly, the heat helps to warm up and open the body allowing the breathing exercises at the beginning and the end of the class and other postures to improve your respiration to a more optimal level.

The Bikram series includes a brief rest period between each posture, during which the student can “catch their breath” as they prepare for the next posture. Students are also reminded to rest if they feel overwhelmed. Generally the more regular a student practices, the stronger they become and the more deeply they are able to breathe.

High Blood Pressure?

Unstable high blood pressure responds so quickly to diligent Yoga practice that doctors sometimes doubt their instruments. (This quick response of the blood pressure is one of the most telling demonstrations of Yoga's ability to regulate and synchronize body systems.) If you are tested about a week after starting Yoga, you may see a slight rise in pressure. Don't be alarmed. By the second week you may notice an improvement in your blood pressure that may continue as long as you maintian your yoga practice.

Consult your doctor, use common sense, and don't push hard in any of the poses for the first three days. The poses in which high blood pressure patients must continue to exercise caution until their blood pressure checks out normally are: the backward bending portion of Half Moon Pose, Standing Bow Pulling Pose, Balancing Stick Pose, Cobra Pose, the third part of Locust Pose, Full Locust Pose, Bow Pose and the Camel Pose.

Depending on the severity of your condition, the postures mentioned above should be done for a count of no more than five (count to five in your head), building to ten counts after two weeks. If you are supple enough to do Fixed-Firm Pose to the complete expression of the posture the first few days, limit that to five counts as well. Be absolutely sure to rest between each set. It is also essential for heart patients to breathe normally during the postures. As for the Bow Pose, (in the floor series) you must never perform the pose without a qualified teacher present (i.e. don't do this at home!).

Care is needed because the majority of these postures are backward bending positions that create pressure in the chest, and thus on the heart. Do not eliminate them however as they are the very postures you need to help your condition. Take it easy when you start and gradually put more effort into the postures as your blood pressure reduces.

Should I still practice if I have a heart condition?

If you have been diagnosed with a specific heart condition, it is necessary to speak with your specialist before beginning any new exercise program. The Bikram practice may offer benefit to people with cardiovascular issues by strengthening the heart muscles and reducing blood pressure and cholesterol levels.

I've started getting a sore neck (knee, shoulder, lower back) what's going on? What should I do?

Any physical movement may potentially result in soreness, but it is important to understand the difference between "physical exercise" and "yoga". Physical exercise is the use of the body to achieve a goal at any cost. A good example of that is any competitive contact sport. Players continually put their bodies on the line to achieve the goal of winning. Yoga, however, is using the body to heal. Your practice may be undoing a lifetime of bad habits, and uncovering chronic injuries that you are now pushing against. It's peeling back the years, a process rarely without pain. But remember, your body is incredibly forgiving, and the yoga will help your body find a healthy equilibrium. Try to move in and out of every posture slowly and with awareness to test your limits, so you are able to stop before bad pain. Practicing at a level of manageable discomfort is good, as you allow the heat and postures to work the healing process. And remember never, never, never be afraid of raising any concerns with the teachers - you may be just trying a posture incorrectly. Please ask! Speak with your teacher, and keep doing the yoga.

I have Mesothelioma, can Bikram Yoga help me?

Patients suffering from mesothelioma have seen an increased quality of life, renewal of energy and even improved survival rates thanks to yoga practice. In addition, incorporating yoga into a mesothelioma treatment regimen, which might include treatment for pain and discomfort, provides the added emotional relief needed during a stressful time.

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