WHAT IS BALANCE?
Our sense of balance is a complex interaction between the inner ear, vision, and somatosensory systems (physical cues that tell the brain where the body is in space). Those suffering from vestibular disorders can experience dizziness, vertigo, disorientation, and poor coordination. Fatigue is common, as are postural misalignments due to holding yourself stiffly or overcompensating to remain upright.
Yoga can help vestibular patients regain balance, focus, movement, and coordination. It can also reduce dizziness.
What Types of Yoga Are Good For Vestibular Patients?
There are several types of yoga poses, or asanas: meditative, cultural, and therapeutic poses.
Meditation helps to calm the mind and reduce anxiety. Because stress is a trigger for many vestibular patients, reducing stress can also help to minimize symptoms like dizziness and vertigo. Controlled breathing, or pranayama, is a tool that can help you control your energy level, reduce stress, increase your endurance and reduce your anxiety.
Cultural asanas are so named because they play a central role in forming a comprehensive physical culture of exercise and general well-being. Cultural asanas are sub-divided into physical asanas and relaxative asanas. Physical asanas greatly assist in rendering the body healthy, while relaxative asanas work on the Chitta (the understated aspect of consciousness) level, eliminating physical and mental tension.
Certain therapeutic poses can be helpful for different ailments, like imbalance, dizziness, diabetes, arthritis, or back pain. Yoga can be considered “therapeutic” when poses are adjusted to fit the unique needs of the practitioner. Some yoga classes are designed for special groups with unique needs, such as people with balance issues.
Integration of Vestibular and Yoga Theory
The human balance system is extremely complex, with multiple organs working in rhythm to maintain balance (and avoid dizziness). The vestibular system – the balance system in the inner ear – must coordinate with the brain and the rest of the body. Three aspects of the vestibular system help with balance: vestibular ocular reflex (VOR), vestibular spinal reflex (VSR) and balance strategies.
VOR is a reflex that maintains visual focus when the head is moving in a different direction and/or at a different speed than the body. When practicing yoga poses, focusing on a focal point while moving the head and body in a different direction helps to foster the VOR.
VSR helps to maintain the body’s alignment, as well as the head’s position in relation to the body. It also stabilizes the head during movement of the body. Practicing yoga “balance poses” helps to foster this VSR, especially when you practice the poses with eyes closed.
There are 3 strategies needed to maintain balance.
- Ankle strategy – Activated in the ankle joint to maintain your center of mass
- Hip strategy – Activated when your center of mass moves the hip joint forward and backward
- Stepping strategy – Activated when your center of mass moves away from your body
Tips for Vestibular Patients
- Practice against a wall: Patients with balance issues should work near a wall to avoid falls, or have a chair as a balance aid; the back of the chair can be held like a ballet bar.
- Breath: Focus on breathing slowly. Consciously relax the muscles in your neck, jaw, chest and diaphragm. This will also help reduce anxiety.
- Feet: Balance can be enhanced by working with the feet, e.g., using toe separators, going barefoot as often as possible to keep the muscles of the feet strong and flexible, and getting foot massages to keep awareness alive in the feet.
- Be gentle: Have compassion for your body. Healing is always slower than desired, and pushing too much goes against the yogic belief that we are already perfect.
- Start where you are. Pay attention. Try hard. Accept the limitations of your embodiment. This is the practice of yoga.
Types of Yoga Poses for Balance
(See Appendix in downloadable pdf for images of each pose.)
- Forward bending – padahastasana
- Half waist bending – ardhakati chakrasana
- Backward bending – ardha chakrasana
- Triangle pose – trikonasana
- Revolved triangle pose – parivrtta trikonasana
- Side angle pose – parsvakonasana
- Warrior pose – virabhadrasana
- Tree pose – vrikshasana (advanced pose)
Types of Pranayama (Breathing) to Reduce Anxiety and Stress
- Alternate nostril breathing (nadisudhi) – 5 rounds
- Sectional breathing: Abdominal, intercostal, clavicular breathing – 5 rounds each
- Full Yogic breathing: Total lung breathing – 5 rounds
- Female bee breath (bhramari) – 5 rounds
In addition to balance yoga poses, the following poses are beneficial for strengthening and relaxation. Some of these are advanced yoga poses, and it is recommended you practice them under the guidance of an experienced yoga instructor. Consult your health care professional before starting a new exercise practice.
- Mountain pose (tadasana)
- Corpse pose (savasana)
- Auspicious pose (svastikasana)
- Kneeling meditation pose – with or without support block (seiza or vajrasana)
(To help patients lift their spirits and correct their posture):
- Bridge pose – taught with support (setu bandh sarvangasana)
- Camel pose – hands to sacrum & toes under for increased stability (ustrasana)
- Locus pose – head above heart (salabhasana)
Poses to Let the Eyes & Nervous System Take a Break
- The reclined bound angle (supta baddha konasana)
- Supported bridge – block at sacrum (setu bandh saryangasana)
- Child’s pose – wide-legged or narrow knee (balasana)
Muscle Stretching Poses
- Head of the cow (gomukhasana)
- Staff pose (dandasana)
- Seated angle pose (upavista konasana)
- Lying down big toe pose (supta padangusthasana)
- The rising sun pose (surya namaskar)
- Half pigeon, one-legged or double-legged pigeon pose (kapotasana)
- Saddle pose (supta virasana)
- Toes pose with toes tucked (vajrasana/seiza)
- Yoga for Balance blog post, by Emma Rodgers – vestibular patient and yoga teacher – and Denise Schneider – physical therapist and yoga teacher.