Peal advises students who hope to overcome limitations or recover from injuries to log the duration of the various poses they attempt, discovering the threshold where comfortableness begins to wane, and then to gently increase their efforts. “You want to avoid huge setbacks, and have tiny ones,” Peal says. “Stress the body just enough so that it makes changes that are helpful. The threshold will move up, but if you crash through it, it will move down.”
People who have complications involving the feet, such as neuropathy, Charcot foot, or even amputation of a toe, part of the foot, or a limb, can still practice yoga. In fact, yoga may be especially valuable for these people as a gentle form of physical activity that enhances feelings of well-being, while other forms of exercise can be problematic or impossible. The key is to know that almost every posture can be modified to make it comfortable, even for people who have difficulty balancing. Postures can still be effective when performed leaning against a wall, holding onto or seated in a chair, or using pillows and blankets for support.
Books, DVDs, Web sites, and classes are readily available for people interested in yoga, but few such resources exist specifically for people with diabetes. Two that do are the videos Healing Yoga for Aches and Pains and Healing Yoga for Common Conditions, produced by Matkin and his wife Lisa. (See “Yoga Resources” for information on where to purchase these videos.) Although the titles were changed for broader appeal, this set was originally developed specifically for people with diabetes, and it provides a thoughtful, gentle introduction.
Because the practice of yoga is so diverse, beginners should start the search for classes and teachers with honest self-reflection and a few questions. Question 1: What do I want? Yoga can offer stretching, strengthening, better balance, stress reduction, spiritual practice, emotional balance, or a vigorous cardio workout. Decide which elements are most important, and discuss these with prospective teachers. Question 2: What is my current physical and emotional state? Be honest. People who are initially couch potatoes will need to start slowly, and those who are very stressed may need individual work to learn to breathe correctly. Question 3: Can the prospective teacher completely accept my current state and help me take the next step? If not, find a teacher who can. Compassionate yoga teachers strive to match the yoga to the student, not the other way around. Modifying poses for ability level is essential. “There are a few poses where I cringe” at the original versions, says Peal. “Maybe for one in a hundred bodies that could be good, but for some, the amount of stress that is put on the ligaments is just a no.”
Matkin recommends that people with diabetes, and especially those with diabetes-related complications, start with a class in a medical setting or with individual instruction. The yoga industry lacks a national credential system or uniform standards, so instructors and classes should be selected with care. Look for instructors who have the most hours of training, as well as outside training in disciplines such as nursing, physical therapy, anatomy, and kinesiology. But most of all, “Find a teacher who cares,” Matkin advises.
What can first-time yoga students expect from a yoga class? There are huge differences in styles and approaches to yoga, and one class experience may be dramatically different from another. In many if not most classes, the instructor describes the postures to be done and also demonstrates them, so that new students can both listen and watch to learn and follow along. The names of postures and other practices may be given in English or Sanskrit, and often an instructor will use both terms. Some instructors may routinely suggest alternative postures for people with physical limitations; others may only make suggestions if asked.