Exercise Those Ringing Ears Away

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2 Disclaimer All the information presented in this book is for educational and resource purposes only. It is NOT a substitute for or an addition to any advice given to you by your physician or health care provider. Before making any changes to your lifestyle or exercise habits, and before acting on any information in Tinnitus Escape, you must consult your physician. Please understand that you are solely responsible for the way that information in Tinnitus Escape is perceived and utilized, and that you act on this information at your own risk. The authors are not responsible for any errors in this book. Furthermore, in no way will persons associated with Tinnitus Escape be held responsible for any injuries or problems that may occur as a result of acting on the information contained in Tinnitus Escape. Some manoeuvres in this book may not be suitable for individuals with certain pre-existing conditions. Before beginning any new exercise regime, it is imperative that you discuss your intentions with your physician.

3 Exercise Those Ringing Ears Away It s a story as familiar as it is tragic. A tinnitus sufferer, overwhelmed by the constant, nagging buzz in their ears, suddenly finds life spinning out of control. Caught in a downward spiral, the stress and anxiety that the phantom ringing in their ears inspires begins to infect all facets of a tinnitus sufferer s life. Unable to enjoy the simple pleasures that once gave life meaning, many tinnitus sufferers find themselves slipping deeper and deeper into an abyss of depression. It s a vicious circle. The more that the tinnitus alienates you from your life, the worse it seems to get. Being unable to escape the persistent ringing can be so discouraging that it may make you believe that your pre-tinnitus life is beyond hope. Fearful of loud noises, unable to concentrate on anything except the phantom chainsaw in your ears, you feel like your personal and professional aspirations are a thing of the past. Now what I am about to tell you may sound counterintuitive. I can just picture you rolling your eyes when I tell you that one of your best chances of taking control of your tinnitus is through exercise. Many of you might think this sounds crazy, because just the thought of doing anything other 2

4 than sitting in a darkened room far away from any loud noises sounds like a nightmare. I know where you are coming from: when even engaging in a light-hearted conversation with friends or family sounds too demanding, the thought of exercising and moving around may sound about as appealing as torture. But let me tell you, the quicker that you get off your couch and begin adding a little vigorous physical activity to your daily routine, the quicker you re going to be able to rehabilitate your life and take control of your tinnitus. We ve all heard the sales pitch about the power of exercise and the positive health benefits it inspires. If we want to live longer, feel better and have more stamina, regular exercise and physical activity is the Holy Grail that will improve everything from our mood to our sex lives. Well that may be doubly true if you suffer from tinnitus. One of the many benefits of a committed exercise regime is that it can make you appear younger and feel more confident. Not only does physical activity help prevent excessive weight gain - by increasing the number of calories you burn and making you look more trim and fit - but physical activity also reduces your risk of cardiovascular disease, and a wide array of other health concerns, including stroke, type 2 diabetes and cancer. 3

5 As a tinnitus sufferer, it is especially important for you to understand that quality of life improves with physical activity. Exercise stimulates various brain chemicals, which elevate your mood and help you to better cope with anxiety and stress. Not only that, but exercise and physical activity helps to deliver a healthy dose of oxygen to your body s cells and tissues, thus improving the efficiency of your heart, lungs and ears. A steady regime of exercise also contributes to deeper, more enriching sleep. And as a tinnitus sufferer, isn t the allure of a solid eight hours of sleep something your heart craves? Instead of the endless droning in your ears, which makes it difficult for you to slip into unconsciousness, just imagine night after night of uninterrupted therapeutic sleep. That kind of healthy rest will soon translate into better coping skills, a calmer demeanor, clearer thinking, and a stronger, healthier immune system. Now before you go out and run a marathon or engage in a high-impact aerobics course, there are certain facts that you need to know. While regular exercise can decrease the intensity of the ringing in your ears, there are certain exercises you should avoid. A surprising fact is that certain exercises may result in, or aggravate, tinnitus. The jarring of the head that occurs during high-impact aerobics and sports can cause otoconia calcium crystals in our ears jarred out of their normal places which can result in inner ear problems. So if you suffer from tinnitus, you should avoid any exercises that involve sudden 4

6 jerking or jumping movements. Soccer, running, aerobics, basketball, volleyball, and football should all be practiced at a moderate pace. Also, if you are not in the habit of exercising, your best strategy for moving forward is to begin slowly. Try to incorporate a low-impact physical activity into your daily routine. Exercises like yoga, walking, swimming, or riding a bike are excellent choices. And don t forget: always consult your physician before starting an exercise regime. Another key point to remember, especially when engaging in a routine of yoga, is to never push your body past its comfort level. Be patient and don t push yourself so hard that you feel pain. 5

7 Expectations are also crucial. You can t expect a radical change in your tinnitus overnight. The benefits of exercise are accrued over time. But if you are persistent and committed, you ll gradually notice the phantom ringing in your ears fading further and further into the background. 6

8 A Regime of Relaxation Tinnitus is observed in almost 10% of individuals, and it can adversely affect a person s quality of life. Many patients with tinnitus suffer from debilitating effects, including anxiety, insomnia and depression. Fortunately, for tinnitus sufferers, research into the use of mind-body techniques and yoga in the treatment or management of tinnitus has revealed a plethora of interesting information. In the pages to follow, we will learn about different types of exercises that can aid in tinnitus management. What exactly is the mind-body technique? By paying close attention to sensations in different parts of the body, in an environment free of distractions, the individual can channel positive thoughts to help reduce, and even overcome, persistent tinnitus, and improve their overall wellbeing. Mind-body techniques include relaxation, hypnotic techniques, therapy for cognitive behavior, and biofeedback training. Relaxation exercises encourage a calm state of body and mind that helps to relieve the anxiety. Individuals suffering from tinnitus often find it difficult not to stress over their tinnitus symptoms, and are consequently inclined towards bouts of depression and anxiety. 7

9 In 1964, Harvard professor Dr. Herbert Benson, a pioneer in mind/body medicine, introduced a relaxation response method, which looked at the effects of meditation on blood pressure and stress relief. Credited with popularizing meditation within Western culture, by renaming it relaxation response therapy, his studies demonstrated how meditation can lower stress and improve health. According to Dr. Herbert Benson, making an effort to quiet our minds is an invaluable daily exercise, which will not only reward the practitioner with inner peace and better health, but will also better prepare us to deal with life's unexpected stressors. Relaxation response utilizes a number of techniques, including the art of visualizing, progressive relaxation of muscles, walking, acupuncture, massage, swimming, breathing techniques, prayer, meditation, tai chi, qi gong, and yoga. The goal of relaxation response is to separate yourself from the everyday routine of stress and anxiety, by seeking some quiet, calm objectivity. There are classes that offer some reprieve from tinnitus symptoms. Individuals may choose to attend the classes, but may not be regular about it. For some, it is possible that one day, certain exercises have a beneficial effect; however, the same exercises may prove to be ineffective at another point in time. This should not discourage individuals from being regular with these exercises. There are few exercises that can be performed independently, without the need to attend classes. In the following sections, we shall go over exercises that can lower anxiety and depression. There are two common forms of relaxation exercises: autogenic training and the progressive muscle relaxation exercise. Relaxation exercise - Autogenic training In autogenic training, the individual directs positive thoughts to his or her own self, and relaxes the mind. A relaxed mind improves the general feeling of well-being in the body. 8

10 While sitting in your chair, close your eyes and allow your imagination to come to life. Begin by picturing yourself walking out of the room you are in, and moving towards an environment of your choice. You might find yourself in a beautiful garden, at a famous monument, a relaxing beach, or a soothing spa. Visualize yourself soaking up the sights and exploring your surroundings. For example, if you choose a beach, imagine the sight and sound of waves as they wash onto the shore. Standing in the surf, you feel the sea rolling over your feet. Stay in this place for as long as you please. When you feel you have taken in all the sights, slowly make your way back to your room. Open your eyes and savor the feeling of rejuvenation. Progressive muscle relaxation In the progressive muscle relaxation exercise, the individual uses breathing techniques, and the mind, to focus on relaxing the different body muscles. 9

11 This exercise is perfect when carried out in an uninterrupted fashion for 15 to 30 minutes. Find a place where you can be left alone for the session. Once you find a quiet place, seat yourself in a chair and concentrate on relaxing the muscles in your body. Do not cross your hands, feet, or knees during this exercise. Sometimes tinnitus-affected individuals can find quiet rooms very unsettling, as they can amplify their perception of the tinnitus. In this case, play some soft background music, which is appealing and relaxing to both your ears and your body. Once you have settled into your seat, start to focus on your breathing. Take a deep breath - fill up your lungs and suck in the abdomen. Then breathe out through the mouth and concentrate on allowing your body to release tension. Pay attention to your breathing and maintain an even, steady rhythm. Once you feel your body relaxing slowly, focus on specific parts of your body. Tighten your toes and keep them in that position for a minute before relaxing them. Do the same with your thigh muscles, calf muscles, elbows, palms, shoulders. You should feel your whole body progressively relax. Once finished, the tension you may have been experiencing before the exercise should be lessened. Mindfulness-based Therapy Mindfulness involves paying attention to life in a non-judgmental manner. Mindfulness is a Buddhist concept, utilized by Jon Kabat-Zinn, Professor of Medicine Emeritus, University of Massachusetts Medical Center, to create a mindfulness-based stress reduction program. Psychologist Jennifer Gans of the University of California, San Francisco, conducted a 2013 pilot study, and observed that mindfulness was effective at reducing tinnitus. Mindfulness-based therapy encourages individuals to learn to live with tinnitus without being overwhelmed, and can provide a means of improving the quality of life of such individuals. 10

12 Mindfulness-based therapies include yoga and meditation. They have been observed to be effective in treating anxiety symptoms and depression. Dr. Holl, an experienced therapist from Hachen, Germany, developed a tinnitus-specific mindfulness-based treatment regimen known as Tinnitus Atemtherapie. Recent research has looked into the efficacy of mindfulness-based therapy in treating tinnitus. Mindfulness-based therapy comprises breathing exercises (to induce relaxation and decrease muscle stress), meditation, self-massage (and other gentle body movements), imagination exercises, and exercises that increase self- and body-awareness. Mindfulness Meditation The mindfulness approach was developed with the help of meditation principles. In mindfulness, the mind is encouraged to perceive the present moment in a non-judgmental manner. Practicing meditation can enhance this mindfulness-based approach. The meditation route to mindfulness is strikingly similar to the progressive relaxation regimen. In mindfulness meditation, however, the limbs are exercised during meditation to improve their flexibility. 11

13 Begin mindfulness meditation by sitting in a comfortable chair. Place your hands on the armrest, and keep your feet flat upon the ground. Relax the muscles around your eyes and maintain a lazy gaze. Feel your palms and thighs relaxing into the chair. Now slowly focus on your breathing. Take a deep breath through your nose, feel the air fill your lungs, and suck in the abdomen. Breathe out through your mouth and feel your body relax. Keep paying attention to the passage of air through the nasal passage. Slowly turn your focus towards the part of the body that is tense, and repeat the breathing process, keeping that part of the body in mind. Note the release of tension with each exhale. While in this relaxed state, begin to move your fingers and toes slowly from side to side or from top to bottom. The flexibility of the body improves following circular motion of the feet, neck, and shoulders. You will feel much more relaxed by the end of this exercise regimen. There are other forms of mind-body techniques that require the assistance of therapists and cannot be performed by you alone. These techniques include cognitive behavioral therapy, biofeedback, and hypnosis. In all these exercises, the primary goal is to relax and focus your thoughts on aspects of the body other than the coexisting symptoms of tinnitus. Cognitive Behavioral Therapy This form of therapy involves the control of an individual s thoughts. For example, if there are negative thoughts due to depression and anxiety, this therapy encourages an individual to recognize those feelings and begin changing their train of thought. The individual is encouraged to harness positive thoughts, and thus counter negative emotions. 12

14 Biofeedback In this form of therapy, the individual is trained to control involuntary processes such as blood pressure and heartbeat. The individual is connected to a monitor that records these processes. Observing these processes will allow you to become better equipped to control them, helping you to lower both your blood pressure and heart rate. Hypnosis Hypnosis is a method that exploits the suggestibility of the mind to encourage mental healing. Once you are in the hypnotic state, therapists 13

15 use suggestion to guide you into a deeply relaxed state; it is also used to help treat depression, fear, anxiety, and even tinnitus. If you are interested in hypnotherapy, consult your physician. He/she will be able to refer you to someone qualified to administer this procedure. General Exercise Research has shown that the severity of tinnitus increases with certain sensory-motor movements of the head, neck, eyes, and jaws. However, some researchers maintain that select exercises can actually reduce the impact of these movements on tinnitus. Some researchers even believe that the movements that increase tinnitus may reduce tinnitus, if they are repeated often enough. It is essential for individuals with tinnitus to feel relaxed in order to overcome their tinnitus-induced anxiety. The primary aim of any exercise is to increase the feeling of well-being in the body. Low-impact exercises such as swimming, walking, and yoga have been shown to improve the wellbeing of individuals suffering from tinnitus. Other exercises for tinnitus that can be performed in your home or workplace are given below. Simple exercises for tinnitus The following exercises are performed in a seated position, either on the floor or on a chair. 1. Sit in an erect posture. Bend your neck upwards so that you re looking skyward and then tilt your neck downwards so that your chin reaches your chest. Now tilt your head backwards. Repeat 20 times. Then move your neck sideways from left to right. Repeat this 20 times. Do not overexert to the point of strain. This exercise can be repeated three times in its entirety. 14

16 2. Sit in an erect posture. Open your mouth wide and, maintaining this position, lift your head upwards so that your eyes are facing skyward. Slowly breathe in and out. Return your head to the normal position and repeat the process. 3. Sit in an erect posture. Tilt the head downward so that your chin touches your chest. Intertwine the fingers of both of your hands behind your neck and then tilt your head backwards, pushing against the hands. This exercise can be performed twice a day and repeated three to five times at each session. 4. Stand in front of a mirror. Cradle your chin using both your hands and keep your mouth wide open. Touch the roof of the mouth with your tongue and alternately move your jaw upwards (to force it near the tongue) and downwards (to force it against your hands). Do not 15

17 overexert. Perform this exercise for a minute and repeat three times a day. 5. Keeping your mouth wide open, lift your tongue to touch the roof of the mouth and move it backwards until it reaches the point closest to the tonsils. Then bring the tongue forwards so that it stretches outwards to its maximum length. Repeat throughout the day. Yoga Yoga is almost synonymous with spirituality and invites a healthy bridge between our mental and physical selves. There are numerous variations of yoga. Hatha yoga, kundalini yoga, and ashtanga yoga are just some of the many forms of the practice. New age yoga - such as Bikram s hot yoga and aerobics-style yoga are also gaining popularity. History of Yoga The term yoga is a Sanskrit word that denotes the yoke of a chariot. It was used in the Rig Veda to describe warriors in their chariots. In the third century BCE, the process of yoga was used to describe the relationship 16

18 between the body, mind, and intellect. It was also considered a path to salvation. At the same time, the chanting of mantras was introduced into yoga theory. Yoga was formulated in classical Sanskrit texts written between the third and eighth century BCE, and was called Patañjali yoga, named after the sage Patañjali, who developed the principles and theory. Patanjali described yoga as a spiritual practice comprised of 8 distinct parts: Pranayama breathing control Yama and Niyama an ethical code of conduct in life Asana physical exercise Pratyahara self-awareness by retreating from external stimulation Dhyana meditation Dharana focus and concentration Samadhi being in communion with what is being concentrated upon Benefits of Yoga 17

19 Some of the main benefits of yoga practice are: Enhanced visual perception. This means perceiving more than what we see with our eyes. Yoga also provides us with an opportunity to focus on the inner workings of reality, rather than on its superficial manifestations, and promotes: Increased awareness: Through yoga, one tries to reach a higher spiritual level. Through meditation, one can attain shared consciousness with the universe. Enhanced understanding: Yoga provides you with a means to understand suffering and how to move beyond it. With regular practice and meditation, it is possible to overcome physical and mental suffering. Overcoming maya: Yoga takes you beyond the unreal world of illusion and reveals the real world of truth, where the impermanence of life is revealed. All the distracting desires and doubts that play upon our emotions can be calmed once you gain control of your body, mind and senses. Modern yoga Credit for modern yoga goes to Swami Vivekananda, who introduced the concept of rãja yoga to a Western audience at the World Parliament of Religions in 1902, in Chicago. This form of yoga is a way of striving to attain 18

20 self-realization. Later in the 20 th century, Tirumalai Krishnamacharya re-invented hatha yoga, the ancient practice of yoga from the 10 th and 11 th centuries. The new version of hatha yoga included British military gymnastic exercises, yoga postures, and local Indian wrestling techniques. T.K.V Desikachar, B.K.S Lyengar, and K. Pattabhi Jois were Krishnamacharya s disciples, and they expanded on this form of hatha yoga with their own innovations. Krishnamacharya s form of yoga is what we have become most familiar with today in the West. Yoga is being practiced more and more frequently in local gyms, schools, universities, and offices. It is being offered in school classes to young children, and has been found to reduce stress in classrooms, and improve physical and emotional well-being. The same phenomenon is occurring in workplaces, where it is being used to reduce stress and increase productivity. Yoga also affords the opportunity to try and reduce the frequency of avoidable disease conditions, such as cardiac arrests, high blood pressure, asthma, and many other stress conditions. Yoga and tinnitus Tinnitus may be controllable with appropriate preventive exercise. Yoga postures and exercise can increase blood circulation and may reduce the impact of tinnitus symptoms on your well-being. Specifically, yoga postures designed to treat ear, nose, and throat conditions may help to alleviate tinnitus stress conditions. Research data has demonstrated a reduction in tinnitus intensity following treatment of defects in a protein receptor that recognizes a neurochemical called GABA (gamma-aminobutyric acid-benzodiazepine-chloride). It has been demonstrated that yoga enhances the production of GABA. Therefore, yoga may have a positive effect on tinnitus via GABA pathways. 19

21 Yoga exercises for tinnitus Yoga exercises have been seen to improve the circulation of blood throughout the body, relieve stress in the body, and increase positive thoughts in the mind. Increased blood circulation through the ears helps to reduce pain and infection in the ears, and improve nerve function, thus having a potentially beneficial effect on tinnitus. The following exercises, classified into breathing exercises and yogic postures, all enhance blood circulation in the body. 20

22 Breathing exercises 1. Anuloma Viloma (Breathing through alternate nostrils) This breathing technique aids blood circulation and enhances the nervous system. It can calm the body and mind and relieve stress; these effects may help tinnitus sufferers. Steps 1. Sit cross-legged either with your feet on your thighs (Padmasana) or below your thighs (Sukhasana). 2. Press your right thumb against your right nostril to block inhalation through your right nostril, and breathe in through your left nostril. 3. Press your ring finger against your left nostril and the little finger against your right nostril to block inhalation. Bend your head downwards. 4. Suck in the abdomen while keeping your head bent and your chin touching your chest. 5. Maintain this posture for 5 seconds before returning your head to the normal position. 6. Release the thumb and exhale from your right nostril. 7. Repeat this procedure beginning with your left nostril and your left hand. 8. Perform this procedure a total of 25 times. 21

23 2. Suryabhedana Unlike anuloma-viloma, this exercise involves breathing only through the right nostril. The procedure is the same as for anuloma-viloma. Steps 1. Close your left nostril with your ring finger and your little finger of your right hand. 2. Inhale deeply through your right nostril. 3. Close your right nostril with your right thumb. 4. Gradually breathe out through your left nostril. Repeat this procedure 10 times, always inhaling through your right nostril and exhaling through your left nostril. 3. Kapalabhati This exercise can improve immunity in the body, and consists of forceful exhalations. 22

24 Steps 1. Breathe in deeply and tuck in the abdomen. 2. Breathe out forcefully while feeling the abdomen flapping with each forced exhalation. 3. Perform this procedure 20 times, and take a break by taking deep breaths. 4. Ujjayi pranayama This pranayama is useful for ear, nose, and throat (ENT) ailments. It is meant to relax the body and calm the mind, and may alleviate anxiety and stress. The basic posture is the same as for kapalabhati. Steps 1. Sit while crossing your legs as in Padmasana or Sukhasana. 2. Breathe in deeply through the nose and breathe out through the mouth by saying Aah. 3. Repeat this step 5 to 8 times. Now repeat this procedure, but make the Aah sound through a closed mouth. Perform this entire exercise 25 times. 23

25 Yoga postures 5. Tadasana Standing mountain posture This yoga pose helps in improving blood circulation, increasing awareness, and enhancing breathing. It boosts the energy levels, provides a refreshing start to the day when practiced in the morning, reduces stress levels, and calms the mind. This may help to relieve stress in individuals with tinnitus. Steps 1. Stand with the feet together 2. Place your hands at your sides with palms touching the sides of your thighs. 3. Breathe in and slowly stretch your hands out in front of your body, stretching them over your head until your arms touch your ears. 4. While stretching your hands above your head, stretch your body until you are standing on your toes and your feet are stretched. 24

26 5. Touch your palms together in a namaste (folded in prayer) above the head. 6. Stay in this position for 20 to 30 seconds. 7. Breathe out and slowly bring your hands and feet back to the relaxed position (hands at your sides, palms touching the sides of your thighs, feet touching the ground). 6. Parvatasana Sitting mountain posture This posture provides relaxation and assists in the reduction of stress. It also improves breathing. Those with knee problems will require adequate support to perform this exercise. Steps 1. Sit in a resting position with the knees folded and legs crossed. You can cross the legs with the feet resting on the ground (Sukhasana) or cross the legs and place the feet on the thighs (Padmasana). 2. Rest the palms on the thighs and close the eyes 3. Breathing in slowly, raise the hands upwards and keep it stretched till the arms touch the ears. 4. Bring both the palms together in a Namaste above the head and fix the eyes on the hands. 5. Remain in this pose for 20 to 30 seconds 25

27 6. Slowly breathing out, bring the hands down to the resting position by placing the palms on the thighs. 7. Padahastasana Hand-to-toe posture This posture may help to improve the ringing sensation in your ears, as it improves blood circulation in the ears. Steps 1. Stand straight with your hands at your sides and palms resting on your thighs. 2. Breathing in slowly, lift your hands upwards and stretch them so that your fingers point upwards. 3. Breathing out, bend down forwards so that your hands wrap around your big toes, with your right hand holding your right toe, and your left hand holding your left toe. 4. Keep your knees straight without bending. 5. Breathing in, stretch your torso and elbows so that they remain taut. Your neck should not feel any pressure. 6. Breathing out, bend your torso, and move your hands closer to your toes before releasing them. 26

28 7. Straighten your back and bring your hands back to the resting position. 8. Navasana Boat posture This posture helps to increase blood circulation, and improves the muscles of the stomach, back, thighs, and neck. By lowering muscle stress and relaxing the mind, this exercise may reduce tinnitus. Steps 1. Lie down on your back with your hands at your sides in a resting position. 2. Slowly raise your legs so that your feet face the ceiling. 3. Breathing in, lift your head and torso upwards. 4. Stretch your hands out parallel to your body. Your body shape should now resemble the letter V. 5. Breathe normally. Your hands and feet should be at the same level, and your abdomen should be sucked in while you breathe. 6. Maintain this posture for 15 to 30 seconds. 7. Breathing in and out, release the posture and return to the resting position. 27

29 9. Uttanpadasana Raised leg posture This asana improves blood circulation and is good for the back. Blood circulation is improved in the head region, which encompasses the ears, eyes, nose, and throat. Steps 1. Lie down on your back with your hands stretched out to the side and your palms facing downward. 2. Breathing in, slowly raise the legs upwards until the bases of your feet face the ceiling and your knees are erect and stretched. 3. Maintain this posture for 10 to 15 seconds, keeping the abdomen tucked inside. 4. Breathing out, slowly bring your legs back to resting position. 5. Repeat this exercise 5 times, with an interval of 10 seconds between each repetition. 28

30 10. Viparitakarani Legs-against-the-wall posture This asana is useful for improving blood circulation in the region of the head, neck, and shoulders. Steps 1. Sit against a wall, with your knees folded against your chest. 2. Slowly lie down, stretching your back against the floor. 3. Straighten your legs against the wall. 4. Use your elbows to support your torso. 5. Relax your body and stretch your hands out on the floor. 6. Relax the body, close your eyes, and breathe normally. 7. Slowly bend your knees towards your chest, and return to a normal sitting position. 11. Pavanamuktasana Wind relief posture This asana helps to relieve indigestion, especially in obese individuals, and it also strengthens the muscles of the stomach, back, thighs, and neck. Tinnitus may be reduced through decreased muscle stress and relaxation of the mind. 29

31 Steps 1. Lie on your back with your hands by your side, palms facing down in a resting position. 2. Lift up your legs and stretch them. 3. Bend the knees. 4. Breathing in, pull your knees towards your chest and clasp your knees with your hands. 5. Breathing in and out, pull your knees upwards so that they touch the chest. 6. Remain in this folded position for 10 to 15 seconds. Then release your legs and return to the resting position. 7. You can repeat this posture 5 times with an interval of 15 seconds between each repetition. 30

32 12. Sarvangasana Standing-on-shoulder posture In this asana, blood circulation is increased to the head and neck region. By combating stiffness, this asana may improve blood circulation. Sarvangasana is a difficult asana and needs to be performed slowly. Steps 1. Lie down on your back, and keep your arms stretched out by your sides with your palms facing the ground. 2. While inhaling, slowly raise your legs upwards to form a 90 degree angle with the floor. 3. Keeping your hands on your waist and breathing out, lift your torso, and push your legs upwards while resting on your head and neck. 4. Breathe normally in this posture for 20 to 30 seconds. 5. Return to the normal posture by curving your torso, bending your knees and breathing out. 6. This asana can be repeated 3 times, with a 30-second interval. 31

33 13. Karna Pidasana Pressure on the ear posture This is a complicated asana, requiring a lot of practice to master. Steps 1) Lie on your back and place your arms at your side. Keep your palms facing downward. 2) While inhaling and keeping your legs at a 90-degree angle, slowly raise your legs. 3) Breathe in and out normally. 4) Keep your hands on your back to support your legs. 5) Slowly bend and move your legs above and beyond the head to an angle of 180 degrees, until they touch the other side of the ground. 6) Do not strain your neck, but remain relaxed in this position while breathing in and out. 7) After a minute, slowly bring your legs back to a horizontal position, all the while breathing out. 14. Gomukhasana Cow posture This asana is performed to improve flexibility in the hips and shoulders. 32

34 Steps 1. Sit with your legs outstretched and your hands resting by your side, your palms facing the ground in a resting position. 2. Bend your left knee such that your left foot is near your right buttock. 3. Lift your right leg and bend it over your left leg until your right foot is near your left buttock. 4. Fold your left hand over your head until it touches your back. 5. While breathing in, fold your right hand backwards at the elbow and reach for your left palm behind your back. Interlock your fingers. 6. Maintain this posture for 10 to 15 seconds. 7. Breathing out, release this posture and return your arms to your sides. 8. Stretch out your legs and return to the normal resting position. 15. Bhujangasana Cobra posture This asana strengthens your shoulders and abdomen, and may improve the sensory-motor nerve responses of your ears; it may therefore be effective against your tinnitus. 33

35 Steps 1. Lie down on your abdomen, stretch your hands out in front of you, and fold them into a namaste pose in a resting position. 2. Gradually move your hands to the chest area, place your palms facing down near the chest, and keep your elbows straight. 3. Breathing in, push down on your palms and lift the elbows. Curve your back and lift your head to face the sky. 4. Remain in this stretched posture for 15 to 30 seconds. Do not apply too much pressure. 5. While breathing out, slowly return to the resting position. 16. Ustrasana Camel posture This asana relieves stress in your abdomen and back. It may be repeated 5 times, with a gap of 15 seconds between repetitions. 34

36 Steps 1. Sit on your heels and rest your hands on your thighs. 2. Gradually raise the body upwards so that it moves away from the heels and is supported by the bent knees. 3. Now move your hands backwards so that each hand wraps around the corresponding ankle. 4. Breathing in and out, slowly arch your back and head backwards until you feel a stretch in your abdomen. 5. Remain in this posture for 20 to 30 seconds. 6. Gradually relax and return to the normal resting posture. 35

37 17. Matsyasana Fish posture This posture helps to improve a clogged throat, and eases the ringing sensation common among tinnitus patients. Perform this exercise five to seven times, taking pauses of 15 seconds. Steps 1. Lie down and keep your hands at your sides, with your legs outstretched. 2. Cross your legs and place your feet on your thighs (as in Padmasana). 3. Now place your hands below your tail bone and rest your elbows on the ground. Meanwhile, arch your back and breathe in. 4. Lift your shoulders and neck while arching your back. 5. Bend your head such that its tip touches the ground and your chest points upwards. 6. Breathe in deeply, maintaining this posture for 20 to 30 seconds. 7. Breathe out deeply and return to the normal resting position. 36

38 18. Adhomukhasvanasana (Downward facing dog posture) This asana is good for stretching the limbs, helping to ease the discomfort caused by tinnitus. Steps 1. Stand straight with your hands by your side and your palms on your thighs in a resting position. 2. Bend down and let your palms touch the ground, keeping your fingers spaced apart. 3. Let your eyes face downwards towards the ground. 4. Gradually move your legs backwards until you feel a stretch in your legs and hands. 5. Your feet and palms should be along the same line; your hands and legs should be stretched straight. 6. Breathe in and tuck in your abdomen. 7. Breathing out, slowly return your legs up to your palms, and lift your hands until you reach the normal resting position. 37

39 19. Parivritta Trikonasana Triangular posture This asana looks like a triangle - hence its name. It is effective at improving the strength of the lower body and arms, as well as blood circulation to the ears. Steps 1. Stand with your legs stretched apart and your feet placed firmly on the ground. 2. Breathe in deeply, bend forwards, and place your right palm on the ground near your left foot. Breathe out while bending forwards. 3. Lift your left hand upwards such that it is along the same line as the body and your right hand. 4. Focus your gaze on the outstretched fingers of your left hand. 5. Hold this posture for 15 to 20 seconds. 6. Gradually return to the normal posture while breathing normally. Now that you are aware of some of the exercises aimed at improving your tinnitus, the time to strike is now. The quicker you start an exercise routine, the sooner you might begin to notice those phantom sounds in your ears 38

40 fading into the background. Not only might your tinnitus appear less prominent, but you will likely feel healthier and fitter than ever before. 39

41 References: 16 Home Remedies and Natural Cure of Tinnitus [homepage on the Internet]. c2015 [cited 2015 Apr 15]. Available from: American Tinnitus Association. Treatment Information [homepage on the Internet]. c2015 [cited 2015 Apr 15]. Available from: British Tinnitus Association. Self help for tinnitus [homepage on the Internet]. c2015 [updated 2015 Feb 12; cited 2015 Apr 15]. Available from: Cramer H, Lauche R, Dobos G. Characteristics of randomized controlled trials of yoga: a bibliometric analysis. BMC Complementary and Alternative Medicine. 2014, 14:328 Gans JJ, O'Sullivan P, Bircheff V. Mindfulness Based Tinnitus Stress Reduction Pilot Study. Mindfulness. 2013; 5(3): Kreuzer PM, et al. Mindfulness-and body-psychotherapy-based group treatment of chronic tinnitus: a randomized controlled pilot study. BMC Complement Altern Med. 2012;12:235. Shulman A, Strashun A, Goldstein B. GABA-Benzodiazepine-Chloride Receptor-Targeted Therapy for Tinnitus Control. Int Tinnitus J. 2002;8(1):30-6. Simmons R, et al. Head, neck, and eye movements that modulate tinnitus. Semin Hear. 2008;29(4): Stylecraze. 15 Yoga Asanas to Cure Tinnitus and Hearing Problems [homepage on the Internet]. c2014 [updated 2014 Sep 25; cited 2015 Apr 15]. Available from: 40

42 Tinnitus Library. How Yoga Increases GABA and Improves [homepage on the Internet]. c2013 [updated 2013 Aug 5; cited 2015 Apr 15]. Available from: University of Maryland Medical Center. Mind-body medicine [homepage on the Internet]. [cited 2015 Apr 15]. Available from: Weintraub, MI. High-impact aerobic exercises and vertigo: a new cause for bilateral vestibulopathy. Neurology. 1990, 40:Suppl 1:326 abstract. White DG. Yoga, brief history of an idea. press.princeton.edu/chapters/i9565.pdf 41