Yoga for Multiple Sclerosis: Breath Awareness and Multiple Options

Students with MS in yoga class, Oakland, California
Four women doing Warrior 2 pose, two seated in foreground,
two standing by wall in background, facing away, mats, props, and a cane
on floor near students

by Patrice Priya Wagner


When I teach yoga to people with multiple sclerosis (MS), I bring a first-hand knowledge of the disease because I was diagnosed with it in 1988. My illness has progressed slowly over the years with some invisible symptoms like fatigue and heat intolerance worsening much more than any visible manifestation like difficulty walking. The way MS presents in each individual can be so different that I often call it a "designer disease;" it's hard to find two people with the exact same set of symptoms showing up to the same degree.

In my teaching, the breath leads each part of our practice because it's the main connection between body and mind for all of us. At the start of a session, we pay attention to our natural breathing pattern and scan through our body to get a baseline reading on how we feel at that moment in time. After observing the breath, we'll gently begin to take deeper and slower inhalations and exhalations perhaps using the ujjayi breathing practice. Slowing and deepening our breath before starting warm-up stretches is never wasted time since it can show us the way to a steady mind and can set the mood for our entire practice and, perhaps, for the rest of our day.

Observing the breath continues into the asana practice---as we feel how our body moves into, holds, and comes out of poses. I encourage staying aware of the breath while doing poses for two main reasons. Not only does a slow, steady breath keep us comfortable as we move from pose to pose but, in addition, if we notice that our breath has become shallow or labored it serves as a warning that we've gone too far in a pose or stretch and need to ease up.

When I cue stretches and poses, I always offer more than one variation so students can choose what works best for them. Not only does this let everyone feel included in the class regardless of their physical ability but it also encourages self-agency to individuals who may have lost touch with their bodies or stopped trusting themselves to choose what's best for themselves.

As the end of class nears, teaching the subtle practices of pranayama and meditation doesn't involve a one-size-fits-all mentality either but, rather, requires suggesting different approaches for students to find their way to an internal space of quiet, calm, and safety regardless of what they may be going through in their life.

Just as the breath helps keep us comfortable and safe while doing asana, it can offer deeper states of relaxation during the concluding parts of class: pranayama, yoga nidra/guided relaxation, and meditation. My experience living with MS since 1988 and teaching yoga to people with MS since 2008 has been that using the breath to steady the mind may be the most helpful and direct way to find comfort for those of us living with this disease.

Resources for teaching variations on poses:

• Accessible Yoga: Poses and Practices for Every Body by Jivana Heyman
• Adaptive Yoga Moves Any Body by Mindy Eisenberg

Patrice Priya Wagner will be presenting at the Accessible Yoga's Conference Online October 14-17, 2021.

Patrice Priya Wagner RYT 500, C-IAYT, has taught yoga to people with disabilities in Oakland, California since 2008. She trained with Integral Yoga in the San Francisco Bay Area, Accessible Yoga with Jivana Heyman, and Restorative Yoga with Judith Lasater. Priya has been published in New Mobility Magazine, Works and Conversations, Artweek, and Accessible Yoga's Blog. She's on Accessible Yoga's Board of Directors and currently serves as Managing Editor of the Accessible Yoga Blog.


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