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Foreword
It gives me an immense pleasure to write this foreword for Dr. Vineeta Ketkar’s book titled Rope and Belt Therapy for Painful Knee Osteoarthritis.
As she rightly mentions the book bridges a gap between modern science & ancient wisdom for effective treatment of OA Knee Joint.
She explains as to how Yoga plays an important keyrole in non pharmacological treatment for OA Knee i.e. controlling pain and improvement in movements of Knee joint by Rope and Belt Therapy. Part I--gives comprehensive details of Anatomy, Kinematics, Pathophysiology and medical management OA Knee involving Patello femoral and Tibio femoral joints. She also explains, clinical history of the patient, examination of the affected knee joint, laboratory investigations and diagnostic imaging. In Medical management she mentions different modalities of treatment from non pharmacological to pharmacological (Drug Therapy) and various surgical procedures including chondrocyte transplantation.
Part lI-- briefs on evolution of science of Yoga; medical Yoga, medical yoga therapy, in this case,especially applicable to OA knee. She elaborates about, Rope and Belt Therapy playing an important role in the treatment of OA knee along with breathing techniques and behavioral guidelines.
Thereafter the author explains how Rope and Belt Therapy works by explaining its principles.She corelates its action with correction of mechanical axis, alignment of bones & plantar arches corrections. It is interesting to note as to how the rope and belt therapy helps in various corrections of the OA Knee Joint.
She has detailed about modified yogic postures as phase 1 & 2 which are to be practiced by patients everyday. This will be very useful to patients to slow down the progression of Osteoaethritis.She has explained in detail about the modality of ambulatory belts & the instructions for their use.This will help the patients of OA knee to be mobile. There after she has narrated the Rope & Belt Therapy ,to be given by experienced yogatherapists at therapy center. Here she explains the principles of distraction & weight distribution to minimize pain & improve mobility.
Finally scoring system used to assess the results will convince the readers of the book and patients of OA Knee who are practicing Rope and Belt Therapy. She guides about indications, contraindications and limitations of this therapy.
The book is a scientific document for OA Knee patients. However the proof of pudding lies in eating. The best proof, of the effective role of Rope and Belt Therapy in the treatment of OA knee is patient himself. The ultimate success of Rope and Belt Therapy will depend on the total co-operation of the patient.
I have not come across a book like this in which both allopathic treatment modalities are combined with Yoga in the form of Rope and Belt Therapy for OA Knee which is rampant in aging patients, women more than men. It must be stressed that Rope and Belt Therapy will be effective in Grade I & II of OA Knee patients, which can be stretched up to early Grade III.
For Grade III and Grade IV patients there is no option but undergoing TKR Surgery. If there is an involvement of one compartment only then either uncondylar replacement or HTO can be undertaken with excellent results. However it must be clarified that, those who have undergone unicondylar replacement or HTO, ultimately face TKR over a period of time.
Dr. Mrs. Vineeta Ketkar did her MBBS from LTMMC Sion, Mumbai and has been practicing as Family Physician since 1981. Because of her genuine interest in Yoga, she learnt Yoga in depth at Iyengar’s institute of Yoga in Pune for 10 years, and she worked as an instructor in Kabir Baug Yoga Institute, Pune for 14 years. After achieving the mastery in all aspects of Yoga, she decided to start her own institute which gave birth to Unnati Yoga Institute in 2006 at Hardikar Hospital. She got excellent response from day one. Over the years the Institute has trained 764 Medical and Yoga Professionals & has become a reputed centre of Medical Yoga in Pune which has treated 4600 patients.
She holds seminars from time to time for doctors & young aspirants of Yoga. She also trains young students for Government certified examinations in Yoga. With all her heavy schedule she has devoted focused time to write this unique book on Rope and Belt Therapy i.e Yoga Therapy for OA Knee joint.
My hearty congratulations to her on writing this unique book, perhaps the first one of this kind. I look forward to have more such books from her in years to come.
My best wishes to her in her future undertakings.
Padmashri Dr S.M.Hardikar. FRCS, Emeritus Professor Orthopaedic, Honorary Fellow of British Orthopaedic Association Founder Hardikar Orthopaedic Hospital, Now Multispeciality Hospital
Preface
Rope and Belt Therpay was formulated by Dr. S.V. Karandikar around year 2000. He started prescribing it at his renowned Yoga Therapy Institute. Patients with mild to moderate Osteoarthritis found significant relief from pain and stiffness. The therapy reduced the requirement of pain relieving medicines, and enjoyed mobility which added quality to their life. Severe OA cases, were benefited by 20% to 30%l relief of pain and stiffness, which helped them to plan for surgical option.
After witnessing its efficacy with reproducibility and predictability, I started using it at Unnati Yoga Institute in Hardikar Hospital from 2006.I am highly obliged for the unconditional help & guidance received from Padmashri Dr S.M.Hardikar sir. This Therapy is to be given by trained Yogatherapists at well equipped Yoga Institute with wooden benches for patients to sit for therapy. Patients are not supposed to sit on floor.
I added a set of modified Yogic postures to be practiced by patients everyday. This practice is aimed at continued therapeutic effect for palliation and restoration.The modified Yogic postures are based on Classical Yogic postures. They are modified for their specific action and safety. They are called @Home Yogic Postures. They are taught to patients with instructions. These instructions are crucially important to develop awareness in patients, regarding the joints, their movements, muscles working on joints and their status to aim optimal erect posture.
As I was convinced and experienced the usefulness of Rope and Belt Therapy coupled with Yogic Postures, for osteoarthritis of Knee joint, I started an educational course for Medical and Yoga professionals in 2007 to reach society at large. I wrote a brief write up for covering various aspects of this therapy for this course. While teaching this subject to students, I found the need to write this book to explain the anatomy, pathology, clinical assessment and planning the Rope and Belt Therapy Schedule for OA-knee patients.
This book consists of two parts. First part gives a quick update of anatomy and joint kinematics with details of Pathophysiology of Osteoarthritis and its medical management. Second part is dedicated to the subject Science of Yoga, Medical Yoga, Medical Yogatherapy- the today’s need and Rope and Belt Therapy.
The Rope and Belt Therapy has two parts. One is ambulatory belts,to be learnt and used by patient in day to day life. Second is therapy to be given by trained Yogatherapists at therapy center.
It explaines @Home Yogic postures sequence; with it’s mode of action, instructions, figures and photographs.
The attempt is to give comprehensive information of Osteoarthritis with an innovative approach to minimize pain and stiffness and to improve mobility.
I humbly dedicate this book to B K S Iyengar Guraji who pioneered the use of Ropes and Belts in the practice of Yogic postures for perfection & to enhance their effects.
I also dedicate this book to Aacharya Dr. S.V. Karandikar, to fulfill the oath of promotion of Yoga therapy, taken at the beginning of his intensive teaching.
Rope and Belt Therapy and @ Home Yogic Postures are based on functional anatomy and aim at corrections in OA Knee patients. It offers a methodical approach to correct the weight bearing (mechaincal axis) of body. It guides patients for optimal posture, walking pattern, hence attends the spine, hip joint, knee joint, ankle joint and plantar arches.It brings about correction of mal-alignment of femur and tibia, distribution of half of HAT (Head, Arms and Trunk) weight equally in both compartments of knee joint.
This book helps to understand Anatomy and Joint kinematics of Knee joint. The content to explain these fundamentals are taken from Joint structure and function-4th edition by Pamela K.Levangie and Cynthia C.Norkin. In fact this book has motivated me to write my book. I could explain the modaility of action of Rope and Belt Therapy designs, with the help of joint kinematics described in this book. I am grateful to these authors and Publisher - F A Davis, copyright 2006, for giving me the written permission to use the contents of this book to explain Rope & Belt Therapy.
Now about the subject of Osteoarthritis, the description about introduction, epidemiology, pathology, pathogenesis and pathophysiology is taken from Harrison’s Internal Medicine- 15th edition volume2. I am grateful to the Publisher-Mc Graw Hill copyright 2001, for the written permission to use the contents.
Dr Bijlani sir’s six chapters on Yoga in Understanding Medical Physiology,opened new doors for me.I was deeply fascinated by his words & scientific correlation. I do not have sufficient words to express my gratitude towards him for wholehearted encouragement, I always receive from him.He has given me full permission to use his describtion, from all of his books, long ago. I sincerely thank JAYPEE for giving me written permission to use contents from this book.
I sincerely hope that this book will guide the Medical & Yoga professionals to help the society to minimize 1) use of pain relieving medicines 2) progression of Osteoarthritis of Knee Joint.
For Purchase.... Contact - Dr Vineeta Ketkar - 8390572626 Whatsapp.
Mail on - info@gnosismedicalyoga.com
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Foreword
I sincerely appreciate the efforts taken by Dr.Vineeta Ketkar to write such a comprehensive book on non surgical approach for Spondylosis & Disc Disease. What is commendable is she offers her clinical skills to diagnose the problem with her background of a fully trained and experienced allopathic physician. Over the last few years her approach in this regard is astute and she is able to recommend the correct line of treatment because of her background of allopathic physician who has taken up this challenging work only out of passion.
This book is her attempt to elaborate her philosophy and principles of treating Spine problems through Yogic methods from a Medical perspective. Her unique training in both subjects makes her eminently qualified to do so.
Yoga of any class from the little I understand, deals with perfect union of mind with the creator and towards this suggests various methods of achieving this on a continuous basis. Borrowed from these pathways various schools have emerged which trains the body postures which not only improves mental wellbeing but is able to treat pain originating from the Spine and also treat degenerative problems. It is known to rejuvenate not only the spirit but also the physique adding years and improving the natural reparative body processes. This applies to both the strength of bones and muscles and the intervertebral discs and facet joints.
In addition, Yogic science brings us back (maybe I should say forward) to our root resonance of our being. Hence it leads to a natural calmness of the mind without having to struggle to get rid of anxiety and depression which commonly is associated with spinal problems. Healthy mind leads to a healthy body is an age old adage. We can then more productively engage in our ‘given’ duties. There is a resurgent interest worldover of this ability in this science to take care of body, mind & intellect.
A comprehensive book by a trained, experienced allopathic physician would therefore go a long way in helping the health practitioners in their pursuit of treating Spinal problems. It would spell the science behind this art. Therefore this book would definitely prove useful for health professionals.
Part I of the book gives comprehensive details of Anatomy, Kinematics, Patho-physiology and Medical management of Spondylosis & Disc Disease. She also explains, clinical history of the patient, examination of the case to rule out neuro vascular deficit, laboratory investigations and diagnostic imaging. In Medical management she mentions different modalities of treatment from non pharmacological to pharmacological (Drug Therapy) and various surgical procedures.
Part II of the book briefs on Evolution of science of Yoga; Medical Yoga& Medical Yoga therapy. Then she elaborates about modified Yogic postures which are taught to patients. These are meant to develop awarenessof proper shoulder & pelvic girdle positioning. As she rightly says, these postures are a life time investment for healthy spine.
The importance of process of conscious relaxation by neuro-linguistic programming (Shavasan), breathing techniques and behavioral guidelines is explained by her in a great detail.
Thereafter the author explains how Rope and Belt Therapy works by explaining its principles. Ambulatory belts help in passive correction of shoulder & pelvic girdle, offering quick relief of pain & stiffness to some extent. It is interesting to note as to how the Rope and Belt therapy helps indistraction in cervical spine, mobilization of scapulae & stretching of short flexors & extensor muscles of shoulder joint. These effects help in neck pain & stiffness, pain of Brachial radiculopathy & back pain due to increased thoracic kyphosis. This approach appears to be palliative as well as restorative.
She has also detailed about distraction effect at lumbosacral junction, correction of increased lumbosacral angle & anterior pelvic tilt. She also gives practical tips to understand the co relation of pelvic mobility & lumbar flexibility.
Finally scoring system used to assess the results will convince the readers of the book and patients of Spondylosis who are practicing Rope and Belt Therapy. She guides about Indications, Contraindications and Limitations of this therapy.
A WORD OF CAUTION FOR READERS & USERS OF THIS BOOK, IS ALL LOW BACK PAIN IS NOT SPONDYLOSIS, BUT OSTEOPOROSIS, COMPRESSION FRACTURE, TB SPINE, MULTIPLE MYELOMA& MANY OTHER CONDITIONS SHOULD BE KEPT AT THE BACK OF MIND.
ACUTE PID CASES IN CERVICAL & LUMBAR REGION MAY NEED EMERGENCY DECOMPRESSION SURGERY. MYELOMALACIA IN CERVICAL REGION DUE TO PID NEEDS SURGICAL INTERVENTION. LUMBAR CANAL STENOSIS DUE TO DEGENERATIVE CHANGES NEEDS CAREFUL EVALUATION.
Dr. Mrs. Vineeta Ketkar did her MBBS from LTMMC Sion, Mumbai and has been practicing as Family Physician since 1981. Because of her genuine interest in Yoga, she learnt Yoga in depth at Iyengar’s institute of Yoga in Pune for 10 years, and she worked as an instructor & teacher in Kabir Baug Yoga Institute, Pune for 14 years. After achieving the mastery in all aspects of Yoga, she decided to start her own institute which gave birth to Unnati Yoga Institute in 2006 at Hardikar Hospital. She got excellent response from day one. Over the years the Institute has trained 786 Medical and Yoga Professionals & has become a reputed centre of Medical Yoga in Pune which has treated 5600 patients.
She conducts an educational course, twice a year for doctors & Yoga professionals to teach Medical yoga approach & Rope & Belt Therapy. She also trains young students for Government certified examinations in Yoga. Her clinical practice as a Family Physician has firm roots in all strata of society. I appreciate her sincere efforts to help patients beyond medicines. I express my well wishes to her in the pathway of Total Heallth Care.
Dr Sunil Nadkarni
Spine Surgeon
F.R.P.S.(ED)
M.Ch (LIVERPOOL)
Preface
Rope & Belt Therapy was formulated by Dr Shrikant V Karandikar around year 2000. He started prescribing it at his renouned Yoga Therapy Institute at Pune. Patients with degenerative disorders of knee & spine found significant relief from pain & stiffness.The therapy reduced the requirement of pain relieving medicines and patients enjoyed mobility at knee joint & flexibility of spine which added quality to their life. Rope & Belt Therapy offers palliative & restorative care for knee joint & spine.
After witnessing its efficacy with reproducibility & predictability, I started using it at Unnati Yoga Institute in Hardikar Hospital since 2006. I am highly obliged for the unconditional help and guidance received from Padmashree Dr S M Hardikar sir. My first book on Rope & Belt Therapy for Osteoarthritis of knee joint is published by esteemed Publishing House, namely JAYPEE in March 2020. It has received an excellent response & is found to be useful for Family physicians, Yoga professionals & Physiotherapists. This has boosted my energy to write a second book on Rope & Belt Therapy for Spondylosis & Disc Disease.
This therapy is to be given by trained Yogatherapists at well equipped Yoga Institute with wooden benches, ropes, belts, blankets & necessary arrangement in the form of hooks or fittings on wall.Patients are not supposed to sit on floor.
I added a set of modified Yogic postures to be practised by patients in day to day life.This practice is aimed at continued therapeutic effect for palliation & restoration. The modified Yogic postures are based on classical Yogic postures.
They are modified for their specific action & safety. They are called @ Home Yogic Postures. They are taught to patients with instructions. These instructions are crucially important to develop awareness in patients, regarding to joints, their movements, muscles working on joints & their status to aim optimum erect posture.
As I was convinced & experienced the usefulness of Rope & Belt Therapy coupled with Yogic Postures for Osteoarthritis of knee joint & Spondylosis & Disc Disease, I started an educational course for Medical & Yoga professionals in 2007 to reach society at large. I wrote a brief write up for describing various aspects of this therapy for the course. While teaching the subject to students, I found the need to write a book to explain anatomy, kinesiology, pathophysiology, clinical assessment & planning the Rope & Belt Therapy schedule. This is the design of content in my first book for Osteoarthritis of knee joint. Now the same plan of describtion is giving birth to this second book for Spondylosis & Disc Disease.
This book consists of two sections. First section gives quick update of anatomy & joint kinematics with detailed pathophysiology of Spondylosis & Disc Disease & its medical management.
Second section is dedicated to the subject of Science of Yoga, Medical Yoga, Medical Yogatherapy & Rope & Belt Therapy.
The Rope & Belt therapy has two parts. One is ambulatory belts,to be learned & used by patients in day to day life. Second is the therapy to be given by trained Yogatherapists at therapy center. It also includes @ Home Yogic Postures which are explained with their mode of action, instructions, figures & photographs.
The attempt is to give comprehensive information of Spondylosis & Disc Disease with an innovative approach to minimize pain & stiffness in lumbar & cervical region & radiating pain in upper & lower limbs due to radiculopathy.
I humbly dedicate this book to BKS Iyengar Guruji,who pioneered the use of ropes & belts in the practice of yogic postures for perfection & to enhance their effects. I also dedicate this book to Acharya Dr Shrikant V Karandikar, to fulfil the oath of promotion of Yogatherapy, taken at the beginning of his intensive teaching.
Rope & Belt Therapy and @ Home Yogic Postures are based on functional anatomy & aim at corrections in patients of Spondylosis & Disc Disease. It offers a methodical approach to correct the position of Line of Gravity passing near the vertebral column by optimising the curvetures at cervical & lumbar regions. It guides the patients for optimal erect posture during working hours in various body positions. At cervical region,it helps in distraction of cervical vertebrae, scapular mobilisation,restoration of shoulder joint movements & shoulder girdle position, (includes optimising Thoracic kyphosis) minimizing strain on Trapezius, Levator scapulae, Splenius cervicis, Semispinalis cervicis & Longissimus cervicis. At lumbar region, it helps in restoration of lumbar spine flexibility,pelvic mobility, correction of Lumbosacral angle, optimising lumbar lordosis & strengthening of core muscles supporting the lumbar spine.
This book helps to understand anatomy & kinematics of vertebral column. The contents to explain these fundamentals are taken from Joint Structure & Function, 4th edition by Pamela k Levangie and Cynthia C Norkin. In fact this book has motivated me to write this second book of mine. I could explain the modality of action of Rope & Belt Therapy designs, with the help of joint kinematics described in this book. I am grateful to these authors and publisher-FA Davis, copyright 2006, for giving me the written permission to use the content of this book to explain the principles of Rope & Belt Therapy.
Dr Bijlani sir’s six chapters on Yoga in Understanding Medical Physiology, opened new doors for me.I was deeply fascinated by his words & scientific correlation. I do not have sufficient words to express my gratitude towards him for wholehearted encouragement. He has given me permission to use the content from his book.
I sincerely hope that this book will guide the medical & Yoga professionals to help the society to minimize the use of pain relieving medicines & to slow down the progression of Spondylosis & Disc Disease.
PLEASE NOTE-EACH CASE OF CERVICAL & LUMBAR SPONDYLOSIS & DISC DISEASE SHOULD BE EXAMINED TO RULE OUT NEUROLOGICAL & VASCULAR DEFICIT. MEDICAL YOGATHERAPY IS NON SURGICAL-CONSERVATIVE TREATMENT, ADVISED WHEN THERE IS NO NVD.(NEUROVASCULAR DEFICIT)
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Foreword
It gives me great pleasure to write this forward to Dr. Vineeta Ketkar’s book titled “ASHTANG YOGA AND MODERN MEDICINE” for yoga teachers. I know Dr. Vineeta Ketkar since 1985 as practicing family physician in Vishrantwadi, Pune. I saw closely her keen interest in always updating her medical knowledge through discussions and referring various articles and publications. I am the witness for her passion in yogic sciences and its clinical application along with Modern Medicine.
With this knowledge she started yoga therapy in treating various lifestyle diseases like backache, neck pain, joint pains, diabetes, hypertension, heart diseases, digestive disorders, obesity and female problems. She has already trained many students by taking coaching sessions for them. Now with vast experience in the field of yoga therapy, she has written this book for yoga teachers in very simple and easily understanding language with lot of scientific information. She has explained Anatomy and physiology with the help of colorful and self explanatory pictures. She has also explained about Yogic Diet.
Hath yoga practical and salient points about benefits of pathway of yoga described in Bhagavad Gits.
My hearty congratulations to Dr. Vineeta on writing this unique book. I hope that this book will guide both yoga and medical professionals to help the society to relieve their sufferings.
Dr. Ravindra Sethiya
M.D.(Medicine)
Senior Consulting Physician + 40 years
Popular for Educational lectures
Preface
Way back in 1981, I started working as a family physician in the outskirts of Pune. My first twenty years were busy in attending the patients of age group one month to 80+years. The diseases were predominantly communicable, infectious type. Slowly the pediatricians were ready to offer their services. So concentrating the clinical practice for adult patients was a new face. This new face changed its look as the vaccinations were implemental methodically, hygienic conditions improved & education reached the lowermost strata of society. Does that mean out clinics were empty? No way patients were plenty, but with a different set of health complaints. Now clinics were full of patients with non communicable diseases. These are now labeled as Lifestyle disorders.
In my personal life, I felt an intense desire to practice some kind of physical activity to maintain my health. So I joined aerobics, but at the end of one month, I felt that this rigorous activity is not enjoyed by me. Then I joined Yoga training center. Here was the implantation of my new life. I was attracted to this magnetic subject & it became part of my daily routine occupying more & more time.
All credit goes to RIMYI which disciplined my practice. Dr. S V Karandikar introduced the theme of connectivity of Yogic science & Modern medicine. He being an allopathic practicing physician, his teaching showed me the clear path of my approach. He opened the wide spectrum of therapeutic applications which are giving predictable results. I learned the concept of Cause & Effect theory to reach the roots of diseases & disorders. He also explained the concept of 5R-namely, resolve, reverse, restore, rejuvenate & regenerate to take care of tissues.
In 2000, a senior physician suggested a book of an eminent personality, Dr. Ramesh Bijlani on “Understanding Medical Physiology”. This book dedicates six chapters on Yoga. His words & explanation strengthened & enriched my understanding. No I could see my journey as a Yoga Physician working in two domains, clinical & educational.
I was deeply interested in teaching the Yogic Science in Modern Medicine language & apply it in therapeutic spectrum with correlation of both sciences. Doors of Hardikar Hospital opened to me in 2006 for this activity. Eminent Orthopedic surgeon Padmashree Dr. Hardikar sir guided & extended the help to me to establish this project. Today’s Gnosis Medical Yoga Foundation has its roots in Hardikar Hospital.
We started offering educational course in Medical Yoga for Beginners. (Yoga Teacher Course) I wrote a brief study material for this course, which is getting transformed into a handy book for Yoga Teachers now.
Its first section explains the human anatomy in brief. Second section explains about functioning of various systems of human body, i.e. human physiology. Third section briefs about selective diseases & shows the pathway for helping the patients suffering from these conditions.
In addition this book explains first sixteen Patanjal sutras from Samadhipad, sutras from Sadhanpad & Vibhutipad dedicated for Ashtang Yoga. It also introduces five shlokas from Bhagvatgeeta. These Patanjal sutras & shlokas explore the ancient wisdom which can be applied in today’s life too. The co relation of Yogic Science with Modern Medicine is mind blowing. Yama&Niyam form the behavioral science, working at Limbic system. Asana work on voluntary skeletal muscles for strength, endurance, optimum length, co ordination & conscious relaxation. Pranayam, as the name explains leads to energy conservation & extension. This is brought about by Autonomic balance in Sympathetic & Para sympathetic nervous systems.
Pratyahar can be explained by studying the pathways of special senses. As the stimulus reaches the respective part of cortex, it is also relayed to Limbic system, where it gives rise to emotoions. Thoughts of cortex & emotions of limbic system control our behavior. Understanding this connection of sub conscious level (limbic system) & conscious lever (cerebral cortex) gives us insight about the process of Pratyahara.
The new neuronal connectivity but natural, takes a prolonged, uninterrupted, disciplined & dedicated practice, which teaches a balance between mind & intellect.
Dharana is a concentration meditation, which minimizes the thought process. Dhyana is the effect of Dharana, which teaches us to be in present tense. Mahamuni Patanjali has defined the seven limbs of Ashtang Yoga, which can be understood in the language of modern medicine. As Dr. Bijlani explains, during meditation (Dhyana) there is no change in alpha rhythm in EEG, after applying the stimulus in form of hot tube or vibration or a big sound.
This book guides the beginners to think & practive Yogic science with the fundamental knowledge of body structure & function. They are motivated to experience the effects of Ashtang Yoga in their body, mind, energy levels, cognitive function & personality. Medical Understanding of selective diseases makes them think to apply the wisdom of Ashtang Yoga in helping the patients.
I am sincerely thankful to Julie for wonderful photographs of Yogic postures and to Dr Kaval for figures and images.
This book is just an introduction of the subject, hence has a vast scope of elaboration. I sincerely hope that this book will be useful for beginners who wish to be Yoga Teachers.
Dr. Vineeta Ketkar