Many doctors recommend yoga to their patients with Scleroderma, seeing it as a gentle stretching program that will benefit the symptoms of skin tightness and joint contractures, and yet, yoga can offer much more to those affected:

• The poses offer increased flexibility and mobility, and also strength and stamina.
• The breathing exercises of yoga can improve circulation, oxygenation and muscle function while reducing the respiration rate, heart rate, and blood pressure.
• The yoga kriyas can improve the function of the digestive and elimination systems, reducing the serious health issues presented by constipation.

The broad range in the severity of symptoms was the greatest challenge in preparing the program. While writing the script for the video, Kathy reviewed the evaluation forms from the two classes she presented at the national conference, and listened to the two audio tapes of those presentations to hear the questions asked by the participants.

• The pranayama workshop had fairly uniform positive responses.
• Although overall response to the program on yoga postures was very good, those who did not feel the program met their needs were the most severely affected, who could not do most of the movements. Kathy had presented a significant amount of chair work, but for those unable to leave their chairs, the floor work had not been helpful.

The greatest impact on a person living with Scleroderma is the lack of mobility due to tightening of the skin and joint pain and swelling or contractures. The effect of Raynaud’s phenomenon (95% affected) combined with the joint contractures and skin tightening in the fingers causing digital ulcers (over 50%) causes limitation in hand extension, difficulty doing many day to day tasks, and a feeling of helplessness.

Another greatly affected area is the knees and hips, resulting in problems walking and driving, or even getting out of bed or a chair.

Gastrointestinal problems affect 85%, and cause extreme discomfort and unhealthy weight loss, limit comfortable sleeping positions, and lead to a host of other health problems from reflux, constipation and diarrhea.

The stress response worsens the disease activity, so the stress of living with Scleroderma makes the symptoms of Scleroderma worse.

These are the areas Kathy chose to focus on.

When Kathy worked with an individual she was able to tailor the yoga program specifically to their needs and abilities. Preparing a program to be presented in a one hour video format, to students who may never have done yoga before, without a teacher present, and for such a broad range of mobility called for more that one presentation for each pose.

• The program begins with an introduction to the props used to assist those with more limited ability, and to relieve the symptoms of reflux in the floor work
• Full diaphragmatic breath is practiced, to fully oxygenate the muscles, improve relaxation, and improve the function of the smooth muscle of the colon.
• Hip openers
• Twists, to extend the spine, stretch the spinal muscles, tone and massage the internal organs, and improve the digestive and elimination functions
• Straight knee stretches for the hamstring, abductor and adductor, essential to maintaining the knee and hip mobility necessary for walking
• Reclining core strengtheners, vital to maintaining mobility in walking and driving
• Inversions help to oxygenate the organs and muscles, and circulation of the lymph system so important in reducing inflammation
• Hand exercises to reduce pain and keep mobility and function

Again, most of these postures can be practiced by every body type, flexibility type, and level of limitation with modifications and the use of props available for safety and comfort.

Research was completed. Patients were polled. A program was designed. A video was made.