Asthma is a distressing disorder of the bronchial tubes characterised by recurrent attacks of wheezing, coughing and a sense of suffocation resulting in difficulty with breathing. There is a narrowing of the bronchial tubes which makes breathing harder: it is usually because the contraction of muscle in the bronchial wall reduces its diameter, making it harder for air to pass. There is also a swelling of the membrane lining which causes the narrowing, often because of excessive amounts of mucus within the bronchial walls.


Causes

There are many causes and factors to be considered with the condition of asthma: psychological; hereditary; allergic factors such as food, environmental and atmospheric pollution; and infection of the respiratory passages. These causal factors tend to overlap variably from one person to another.

On a psychological level, suppression of negative emotions such as jealousy, anger, resentment and hatred are often precipitating causes – as are loneliness, longing for affection, emotional hypersensitivity, fear of rejection and hesitation in life. In management of asthma through yoga, these psychic factors are brought before the conscious mind. The sufferer learns, through a heightened sense of awareness, to recognise and accept without self-judgement these emotional conditions that bring about disease, and to gradually resolve these difficulties.

Another major cause of asthma is exposure to allergens such as food products, drugs, medicines, dust, animal hair, smoke, atmospheric pollution (either in the home or the environment) and changes in the weather (attacks of asthma are higher in winter and the rainy seasons). It is important to eliminate any allergens from the home. Unhealthy diet and lifestyle also play a role. A high mucus-producing diet of dairy food and refined carbohydrate products such as bread and cakes is excessively taxing on an asthmatic’s already weakened digestive system – not to mention, on the respiratory tract.

The hereditary factor in asthma is also recognised, for the disease frequently appears to be passed on from one generation to another.


Symptoms

The symptoms of an oncoming asthma attack usually begin several hours prior to the actual attack. The common symptoms are precipitated by bouts of emotional or psychological tension and also possibly by excessive exercise and food intolerance. In most asthmatics there is a sudden onset of cold symptoms such as nasal congestion, nasal irritation and bouts of sneezing, indicating that the nasal mucous membrane is becoming swollen and secretory in response to a psychological or environmental trigger.

As the attack progresses there is an increasing insufficiency of air, causing distress and anxiety. As it becomes more and more difficult to breathe, mucus secretion becomes thick and sticky and a cough develops. The chest becomes hyper-expanded and the lungs hyper-inflated. An untreated attack usually continues in a vicious circle. The longer the asthmatic fights to breathe, the longer the attack continues and the more severe it becomes. The more severe the attack, the more distressed the asthmatic becomes and the more unable to relax. This continues until exhaustion forces the asthmatic to give up all sense of control of the breathing process, and it is at this point that the attack automatically subsides and normal breathing takes over.


Treatment

From the medical point of view there are certain medications that ease the symptoms of acute attacks. All of the medications are suppressants. They do not cure the condition and may even weaken the immune system. Some of the drugs have been proven to have dangerous side-effects. Anti-asthma drugs should not be discontinued suddenly and should not be taken or discontinued without proper health care guidance.

The practice of yoga is ideally suited to the asthmatic sufferer with impaired breathing ability. Yoga, taking breath as the basis of all the postures, is highly effective in re-educating breathing habits and improving resistance to attacks. Yoga helps in restoring depleted and blocked pranic energy channels. This is achieved gradually and persistently with a combination of the asanas (postures), pranayamas (breathing techniques), shatkriyas (cleansing practices) and meditation. Yoga looks at the dietary aspect, considering food allergies and mucus-producing foods, and suggests a balanced, healthy consumption of preferably organic, vegetarian food.

Only with consistent and regular daily practice of the yogic methods of asanas and breathing techniques is it possible to relieve the condition of asthma – if not cure it altogether.


Posture

During an attack an asthmatic feels breathless, panics, and tries to grasp in more air using the neck and upper chest muscles. This, therefore, completely distends the chest and lungs, causing the shoulders to rise and the back to become rounded. Breathing in this manner often becomes a habit, leading to the development of poor posture, hunched shoulders, rounded back and often the barrel or pigeon-shaped chest. With such posture the abdomen prevents the downward movement of the diaphragm, thus restricting the lungs from full expansion.

The lower part of the lungs is constricted. In asthma there already is some mucus clogging which puts an extra strain on the system. Bad posture constricts the diaphragm, also preventing full diaphragmatic breathing. This inhibits the energy pranic (life force) flow and impairs vitality. Correct spinal alignment is absolutely necessary for diaphragmatic breathing to be efficient so that the diaphragm is able to move up and down and generate a store of energy and vitality.


Breathing

The diaphragmatic breath is the most efficient way to breathe, especially for asthmatics. This breath is dynamic and should be employed during all waking hours: in and out of the nose. On inhalation the lower ribcage is extended. This stretches the diaphragm which is attached to the ribs and spine and is a sheet of muscle that separates the chest cavity from the abdominal cavity. As it stretches it loses its dome-like shape and descends toward the abdominal cavity. This creates pressure in that area as the abdominal wall is held in a controlled position through a slight tension in the abdominal muscles. At the same time, it creates release in the chest, allowing the lungs to effectively fill with air.

On exhalation the opposite occurs. The ribcage is contracted, thereby allowing the diaphragm to return to its original position. This creates tension in the chest, aiding the lungs, while at the same time there is now a state of release in the abdominal area. The diaphragm functions very much like a piston in a cylinder (the cylinder in this case being the trunk). During inhalation there is a release in the chest and pressure in the abdomen, while during exhalation there is pressure in the chest and release in the abdomen. This massages the internal organs in both the chest and abdomen.

Our health is affected by the way we breathe. The way we breathe is a direct reflection of our mental and emotional state. It is important for the asthmatic to make the diaphragmatic breath a natural way to breathe. With regular practice the sufferer learns to be more aware of the breath as a natural process and breathes automatically.


Relaxation

The asthmatic must learn to relax completely. One of the main problems during an asthma attack is that as breathing becomes more and more difficult the sufferer tends to panic and fight for breath, therefore tensing the body and making breathing even more laboured and difficult, eventually exhausting themself. Yogic relaxation techniques teach the asthmatic to relax the entire body and mind almost at will, especially when relaxation is practised daily. An awareness of the tension in the body will develop. It is especially important to relax the face, neck and chest. Quite often an asthma attack can be induced by fear, shock, emotional stress or an upheaval in the normal living pattern. If an asthmatic knows how to relax the mind and body many of these attacks need not occur.


Diet

Firstly, it would be highly recommended that an asthmatic undergoes a series of allergy tests to inform them of possible food allergies that can aggravate the condition. Then, at least, there is an awareness of what foods to avoid.

From the yogic point of view a vegetarian diet is best suited. Avoid all meat and fish and also all diary products (especially cow products, for they have been known to be mucus-forming). Eat lots of fresh vegetables and fruits in season – preferably organic. Basically, eat simple, non-stimulating foods that are highly nourishing. Natural, unfiltered honey provides many of the nutrients, especially bee pollen which is considered to be an excellent remedy for asthma. Raw seeds and nuts and sprouted seeds provide live enzyme nutrition, which means that the foods have a powerful life force in them.

Heavy, oily and dried foods should not be taken as they excessively tax the already weakened digestive system. It is difficult to attain relief or cure for asthma when constipation (which is common with this condition) exists. Therefore, a fibrous diet is essential. All chemically treated, processed, flavoured and preserved foods should be avoided or at least kept to a minimum. Heating spices such as chilli, pepper, garlic and ginger are advised, for they help break up mucus in the system so that it can go through its natural elimination channels.

The diet should also include manganese-rich foods such as peas, beans, blueberries, nuts and buckwheat. Chronic manganese deficiency may possibly be one of the contributing causes of asthma according to some health care professionals. The best juices for asthma are lime, comfrey, horseradish and garlic. Garlic and horseradish juices can be taken in small amounts mixed with carrot and beetroot juice. Lemon or lime juice is best taken with warm water first thing in the morning.

It is further recommended that as soon as an attack appears imminent, the asthmatic should avoid eating and practise diaphragmatic breathing in the relaxed yoga position of shavasana.

In the Yoga Book of Management of Common Diseases, Swami Satyananda Saraswatirecommends an effective remedy: lay thin slices of raw onion and garlic on a plate and spread pure honey on each piece; cover with an inverted plate and let stand overnight. Taking a spoonful of garlic/onion syrup four times a day may provide relief for some individuals.


Cleansing Kriyas


Neti Kriya
This is a technique that is profoundly effective in dissolving and removing mucus wastes from the nasal mucous membranes, respiratory tree, stomach and lower digestive tract.

Technique: Use a small pot with a spout to pour lightly salted water in one nostril and out the other. If the nostril is blocked the water will flow down into the mouth and can be spat out. After performing this technique on both sides, blow any excess water out, one side at a time. It is recommended that Neti be practised each morning before eating.

Kunjal Kriya
This is a way of ridding the stomach of toxins. By practising Kunjal Kriya an acute attack of asthma can be terminated, and a threatened attack can be averted by directing the build-up of nervous energy that is possibly causing the attack.

Technique: Drink four glasses of lukewarm water, each with a teaspoon of natural sea salt. Then contract your stomach and put two fingers down your throat until you bring all the water up.


Pranayama breathing techniques


Nadi Sodhana
This is commonly known as ‘alternate nostril breathing’. This breathing technique helps to develop an awareness of and control over the inflowing and outflowing breath, and a greater awareness of thoughts, feelings and mental states. It is also incredibly stress-releasing.

Technique: Place your right middle and index fingers on the centre of the forehead, then gently place your ring finger over the left nostril and close it. Now, take a deep, expansive breath in through the right nostril for a count of four, hold the breath in for four counts. Release the ring finger from the left nostril and close the right nostril with the thumb, breathing out for a count of eight. Hold the breath out for four counts and continue breathing in the left nostril to the count of four; pause for four and breathe out the alternate nostril for a count of eight. Practise four to six rounds daily.

Cleansing breath
The cleansing breath releases stresses and tensions from throughout the mind and body. It helps clear mucus from the bronchial tubes and is an excellent exercise first thing in the morning.

Technique: Stand erect with the spine straight and the head and chin facing the ceiling. Feet should be hip-width apart and arms relaxed at the sides of the body. Inhale gently and raise the arms above the head. Exhale through the mouth, making a ‘ha’ sound while dropping the body and arms forward. Complete the exhalation with the body bent forward, arms hanging loosely to the floor. Inhale automatically as the body and arms are raised. Rest for a moment, then repeat five times.

Breathlessness exercise (5)
his exercise is useful for returning the breath rate to normal when the asthmatic is suffering from breathlessness. At commencement, breathing will be quicker than usual. However, with concentration and endurance the breathing will become slower and more even as the breathless state diminishes. It is advised that the asthmatic masters this exercise while free of any asthmatic symptoms so that it can be used to full advantage during an attack.

Technique: Stand with feet together; upper body bent forward; head dropped forward; arms extended at shoulder level; and palms of the hands pressed against a wall at shoulder level. Inhale gently, relaxing (but not protruding) the abdominal muscles. Exhale fully, drawing the abdominal muscles well in. Allow the next inhalation to follow automatically without force and repeat the exercise several times, placing emphasis on the process of exhaling.


Asana postures


Simhasana - The Lion Pose (1a & b)
The Lion Pose stimulates the circulation of blood throughout the body and directs a flow to the throat and larynx. Because it exercises the neck and facial muscles it is especially beneficial for asthmatics as they tend to tense the face and neck tremendously, especially during an attack. The Lion Pose teaches an awareness of tension in that area and releases negative emotions.

Technique: Sit with back straight and buttocks on the heels. Exhale until the lungs have been emptied. Then open the eyes and mouth wide and protrude the tongue down as far as possible, at the same time straightening the arms and tensing the whole body. While the mouth is open and the tongue protruded, make a growling sound like a lion or a big, loud ‘ha’ sound. Open the mouth even wider and hold the ‘out’ breath, if possible, for six seconds. Breathe in again and repeat a few times. Now close the eyes and experience the benefits of a completely relaxed face and mind for a few moments.

Matsyasana - The Fish Pose (2)
The Fish Pose helps to expand the chest and thorax area, making it more mobile. The spine is strengthened and a rounded back corrected. The full expansion of the chest facilitates deep breathing, which helps relieve spasm from the bronchial tubes.

Technique: Sit with back straight and legs extended. Now support the body with the hands and elbows and lie back on the floor. Arch the back and gently move the head back, if possible pressing the crown of the head on the floor. The shoulders and back should be off the floor. Stay in this position for 15 to 30 seconds, breathing deeply into the chest and feeling the expansion of the lungs. Release gently from the pose, lying on the back for a few moments. Then hug the knees toward the chest and place the nose between the knees (to counterbalance the neck releasing backward), lengthening the back of the neck.

Yoga Mudra (3)
Yoga Mudra is highly beneficial for the asthmatic because of the reverse position of the upper body. The blood from the lower regions begins to flow upward, and with the compression of the torso, massages the veins of the lower bronchioles. It is releasing for the spine and especially for the shoulders. With the abdominal muscles pulled in, the pose encourages a massage for the internal organs, which is healing for the digestive system.

Technique: Sit in an easy crossed-legged position. Put the arms behind the back with hands clasped and spine straight. Inhale, and lower the head towards the ground as far as you can without straining the back. Holding the breath out, lift the arms as high as you can in the air and hold for a count of six. As you hold the breath draw the navel in towards the spine, contracting the abdominal muscles. Inhale as you gradually lift the body and arms at the same time. Relax and cross legs over in the opposite way. Repeat from the beginning.

Majrasana - The Cat Pose (4a & 4b)
The Cat Pose strengthens the abdominal and spinal muscles. It aids in loosening the neck and shoulder muscles. It also teaches the use of full exhalation followed by a natural and automatic inhalation, using the diaphragm and full expansion of the breathing muscles.

Technique: Kneel down on the hands and knees in a comfortable position with the hands directly under the shoulders and the head held up. Exhaling quickly, arch the back, drop the head and tuck the chin towards the sternum. Draw the abdomen well in and hold the position for a moment. While inhaling, arch the spine, looking towards the ceiling, lifting the chest and stretching the front of the neck. Repeat this exercise six times.


Yoga for the treatment of disease

Yoga can truly bring about and maintain perfect health for the mind and body. The yogic philosophy views life and disease in a totally different way. Instead of seeing disease such as asthma as something to be feared, yoga views disease as our teacher and shows us through a process of awareness that we have become unbalanced. Disease is telling us is that we need to make some changes to regain balance and harmony within the mind and body. Yoga teaches us that we must learn to be aware of and use our suffering to further progress along the spiritual path. In a way, disease is a blessing in disguise: if we take this as an opportunity to review our emotional and physical patterns, we start to become aware of how we create disease in our lives.


Meditation

To view the full spectrum of yoga and its benefits, meditation as a technique of healing and awareness must be included. Meditation, especially from the asthmatic’s viewpoint, helps the scattered thoughts of the mind to settle and leads to a state of self-realisation. In this state the sufferer can realise the psychological factors that led to their condition of health. Meditation also releases energy within the body which can be used for healing. When the mind is anxious or stressed, the body secretes many chemicals and hormones into the bloodstream which inhibit the natural functions of the body. Meditation calms this process.

Through the various and profound tools of yoga we learn that the mind is not separate from the body – nor are the emotions. Therefore, we realise that as human beings each of us is an integrated whole. The thoughts within our minds affect the functioning of our bodies. In practising yoga we learn to get in touch with our own healing powers and to activate the wisdom of healing within the body. This gives us tremendous power in that we are all capable of changing the thoughts, feelings and physical lifestyle habits that may cause stress and unhappiness and result in disease. Yoga can be a lifestyle that helps to lay the foundations of greater peace, fulfilment, glowing health and joy in life.