Yoga helps reconnect an ALS patient's disconnected body

Bruce Kramer works on a pose
Bruce Kramer, with help from his son Jon Emerson-Kramer, works on a pose during an adaptive yoga class Monday, March 11, 2013 at the Courage Center.
MPR Photo/Jennifer Simonson

Editor's note: This is part of our continuing series of stories about Bruce Kramer, the former dean of the College of Education, Leadership and Counseling at the University of St. Thomas, as he copes with life after being diagnosed with ALS, also known as Lou Gehrig's Disease. You can read all the stories in the series by clicking here.

MINNEAPOLIS -- The ancient discipline of yoga keeps attracting new followers. By some estimates, 15 to 20 million Americans now practice one of its many forms. Devotees say not only do the stretches and poses release their stiffness and stress, but they come away calmer and more centered after a session.

Yoga is not only for the able bodied. Matthew Sanford has been teaching what's known as adaptive yoga to people with disabilities since 2002 at his Minnetonka studio, Mind/Body Solutions, and at Courage Center in Minneapolis. Kramer, who now uses a motorized wheelchair as his body grows weaker with ALS, or Lou Gehrig's Disease, is one of his students. For the past few months, he says yoga has given him a greater sense of freedom.

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In a small conference room at the Courage Center in Golden Valley, the room was ringed recently with people ending their day -- most in wheelchairs. Some are on the floor, propped up with cushions and pillows. All, including Kramer, have their eyes closed, listening to Sanford.

"Balance your head over your neck. Soften the skin on your face. Close your eyes top to bottom. If you haven't, let go of your day. Prepare your mind to do yoga," he says. "On these next few breaths, imagine someone's pushing on the inner edge of your shoulder blade and you're exhaling from the back ribs forward. You're exhaling through your nose, if you can, so there's a release."

Like most of his students, Sanford is in a wheelchair. At the age of 13, he was in a horrible car accident that killed his father and sister and left him paralyzed from the chest down.

Bruce Kramer deepens  twist pose
Bruce Kramer, right, with help from his son Jon Emerson-Kramer, foreground, and yoga teacher Matthew Sanford, second from right, deepens a twist pose Monday, March 11, 2013 during Sanford's adaptive yoga class at the Courage Center in Golden Valley.
MPR Photo/Jennifer Simonson

While the crash changed his life, Sanford says something else did too. A couple of months after the accident, he told doctors he could feel his body. The doctors told him the sensations were not real and would fade away as the memory of the accident faded too, but that didn't happen.

"I had this level of sensation. It was like a tingling or a hum, kind of like knowing where you are in space and that was a real sensation. They convinced me as a 13-year-old that it wasn't real and that's because we didn't know enough about the mind/body relationship at that point," he said. "A body worker first said, 'Hey! You feel more than you think and that started the process and I found yoga 12 years after the accident."

Decades later, using yoga and meditation, Sanford teaches about the complex physiological, emotional and spiritual connection between the mind and body where the brain can positively or negatively influence our bodies and the condition of our physical bodies can affect our mental state.

He says that even though many of his students can't lift a limb, that doesn't mean they don't have sensations.

"There's a level of sensation in the mind/body relationship that precedes this injury, that precedes disability. Energy is still flowing through your spine. Awareness is still traveling, not necessarily as easily through your body, but there is still a part of you that proceeds. So I'm trying to get them to reconnect to what is the very core of sensation, whether or not they can move their body."

Kramer has been attending adaptive yoga classes with Sanford for a few months. On this evening, as Kramer sits in his wheelchair, his son, Jon Emerson-Kramer is helping his father twist his body to the left and then to the right.

"There you go Bruce," Sanford says. "Right up through the chest. Soften a little bit. Don't work quite so hard. Trust more. Good! Then release."

"It's not so much about the poses," Sanford explains. "There's only so much he can do. It's about boiling down the core insights that are at the core of yoga that allow more complicated poses. For instance, awareness travels through the bones. There are ways to get certain adjusts that get energy moving down through your legs, even if you're paralyzed."

Kramer closes his eyes
Bruce Kramer closes his eyes while deepening a yoga pose with help from his son Jon Emerson-Kramer Monday, March 11, 2013 at the Courage Center.
MPR Photo/Jennifer Simonson

For some, adaptive yoga can lead to stronger limbs, which make it easier to get into, and out, of bed or the shower.

"What you see with a person with another type of disability is that it might improve their transfers, might improve the quality of their breathing, their ability to talk louder, like a whole bunch of things, it can be very dynamic," Sanford says. "It's all in the controlled chaos. There's a beautiful humanity that occurs between the students, between the assistants and the students, between the students and teacher. "

During the class, Kramer and other students, with the help of assistants, get out of their wheelchairs and down on mats and pillows.

"What we're trying to show Bruce is how to pin his hips. When his hips are pinned, let him feel energy go out through his limbs because the base of the spine is his reference."

Hovering above Bruce, who's on the floor, is an assistant, who has her hands on each shoulder, pressing down, and her feet tucked up under his hips, pulling upward.

"So what do you feel?" she asks him.

"I feel air. It lifts the sternum. I can feel the space above my head, the space under my arms. I feel the space between my hips and my underarms. It's an amazing feeling."

Sanford remembers how emotional it was the first time he was lifted out of a wheelchair and placed onto the floor for a physical therapy session. When the therapist placed his legs wide, he began to cry because he hadn't had his legs in a stance like that for so long. For Kramer, Sanford's yoga class has offered similar experiences.

Yoga teacher Matthew Sanford
Yoga teacher Matthew Sanford offers encouragement to his adaptive yoga students Monday, March 11, 2013 at the Courage Center in Golden Valley.
MPR Photo/Jennifer Simonson

"The first time they put me on the mat I started crying. It was so wonderful. It was the first time I had been off the chair and on the floor," he says. "To lie flat -- and I know the lying flat will probably go away at some point -- there's a sense of reference and a sense of I can almost pretend that I fill a vertical space. It's a very freeing activity. I find it's just a reconnection and I find that ironic that I'm reconnecting as everything is becoming disconnected."

On the ground, kneeling by his father, Jon Emerson-Kramer, attends the adaptive yoga class with Kramer. Jon's wife usually joins them too. It's created a special kind of closeness between them and Jon says he's noticed changes in his father.

"I think the classes are excellent. When we get him down and on his back he looks about three inches taller afterwards and after sitting in a chair all day I can only imagine how good that feels," Emerson-Kramer says.

Sanford agrees. In describing his teaching approach to adaptive yoga, Sanford says students are taught to perceive subtle sensations beyond the use of muscles, sensations affected by the awareness of the breath, of balance, the awareness of being grounded. That level of awareness makes him feel as if he's living in his whole body.

Kramer calls adaptive yoga a "reconciliation" that has allowed him to live peacefully and more fully in the moment, aware of his breath and body as it is, rather than as it was.

"A lot of what Bruce has been told to this point is he should push against the ALS. There is some of that that helps, too, but he needs to go underneath it, into more subtlety, and find what freedom really is. Because one of the things -- and this gets me choked up -- can't you feel how free Bruce is? On this other level?" Sanford says. "That's why you're interviewing him, because his wisdom is becoming manifest. There is an increase in freedom and living in Bruce while he's leaving. Bruce is very, very awake, and a very wise man, and he's living well as he's dying."

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You can read all the stories in this series by clicking here.