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== Indications ==
== Indications ==
<div style='text-align:justify;'>Vyayama is indicated for healthy individual (swastha) [Cha.Sa.Sutra Sthana-30/8], strong person with good immunity (balavan) [Su.Sa.Chikitsa Sthana-25/51], people who are accustomed to unctuous diet (snigdhabhoji) [Su.Sa.Chikitsa Sthana-25/51], person with excess kapha and fat deposition in body (kapha medanvita) [Su.Sa.Chikitsa Sthana-32/15]; health issues like diabetes (prameha) [Su.Sa.Chikitsa Sthana-11/11; Cha.Sa.Chikitsa Sthana-6/61] and obesity (sthaulya) [Cha.Sa.Sutra Sthana-23/25; Su.Sa.Sutra Sthana-15/32]; and in winter (hemanta and shishira ritu) [A.S.Sutra Sthana-4/10-13], as well as spring season (vasanta rtu) [A.H.Sutra Sthana-3/11; Cha.Sa.Sutra Sthana-6/24].Vyayama is most conducive in winter and spring season. [Su.Sa.Chikitsa Sthana-24/46] </div>
<div style='text-align:justify;'>Vyayama is indicated for healthy individual (swastha) [Cha.Sa.Sutra Sthana-30/8], strong person with good immunity (balavan) [Su.Sa.Chikitsa Sthana-25/51], people who are accustomed to unctuous diet (snigdhabhoji) [Su.Sa.Chikitsa Sthana-25/51], person with excess kapha and fat deposition in body (kapha medanvita) [Su.Sa.Chikitsa Sthana-32/15]; health issues like diabetes (prameha) [Su.Sa.Chikitsa Sthana-11/11; Cha.Sa.Chikitsa Sthana-6/61] and obesity (sthaulya) [Cha.Sa.Sutra Sthana-23/25; Su.Sa.Sutra Sthana-15/32]; and in winter (hemanta and shishira ritu) [A.S.Sutra Sthana-4/10-13], as well as spring season (vasanta rtu) [A.H.Sutra Sthana-3/11; Cha.Sa.Sutra Sthana-6/24].Vyayama is most conducive in winter and spring season. [Su.Sa.Chikitsa Sthana-24/46] </div>
== Contra indications ==
=== Seasons: ===
<ul style='text-align:justify;'><li>Summer (greeshma ritu) , hot season [A.H.Sutra Sthana-3/26-27; Su.Sa.Uttara Tantra-64/40-41; Cha.Sa.Sutra Sthana- 6/29]</li>
<li>Rainy seasons (varsha ritu) [Cha.Sa.Sutra Sthana 6/36; Su.Sa.Uttara Tantra-64/49].</li></ul>
=== Physiological: ===
<ul style='text-align:justify;'><li>Soon after having food [A.H.Sutra Sthana-2/11; Su.Sa.Chikitsa sthana-24/50-51]</li>
<li>Exhausted by other physical activities- [Su.Sa.Chikitsa Sthana-24/49-51],</li>
<li>After coitus [Su.Sa.Chikitsa Sthana-24/50-51]</li>
<li>Feeling thirsty [Cha.Sa.Sutra Sthana-7/35; Su.Sa.Chikitsa Sthana-24/50-51]</li>
<li>Feeling hungry [Cha.Sa.Sutra Sthana-7/35]</li>
<li>Pregnancy [Cha.Sa.Sutra Sthana-25/40]</li>
<li>Small children [A.H.Sutra Sthana-2/11; Cha.Sa.Sutra Sthana-7/35]</li>
<li>Old people [A.H.Sutra Sthana-2/11; Cha.Sa.Sutra Sthana-7/35]</li>
<li>Person having more natural or vitiated vata dosha [Cha.Sa.Sutra Sthana-7/35]</li>
<li>Persons who are talkative or speaking loudly [Cha.Sa.Sutra Sthana-7/35]</li>
<li>Exhausted by walking, weight lifting, coitus etc. [Cha.Sa.Sutra Sthana-7/35]</li></ul>
==== Psychological: ====
<ul style='text-align:justify;'><li>Persons who are desirous of increasing body weight. [Cha.Sa.Sutra Sthana-21/28]</li>
<li>Those who are angry, sad or scared [Cha.Sa.Sutra Sthana-7/35]</li></ul>
=== Pathological: ===
<ul style='text-align:justify;'><li>Diseases due to vata and pitta [A.H.Sutra Sthana-2/11] </li>
<li>Bleeding disorders (raktapitta) [Su.Sa. Chikitsa Sthana-24/50-51] </li>
<li>Breathing disorders (shwasa) [Su.Sa.Chikitsa Sthana-24/50-51] </li>
<li>Cough (kasa) [Su.Sa.Chikitsa Sthana-24/50-51] </li>
<li>Chest injury (urakshata) [Su.Sa.Chikitsa Sthana-24/49-51] </li>
<li>Emaciation (shosha) [Su.Sa.Chikitsa Sthana-24/50-51] </li>
<li>Lean person (karshya) [Su.Sa.Sutra Sthana-15/33; Su.Sa.Chikitsa Sthana-25/50-51] </li>
<li>Disorders of abdomen (udara) [Cha.Sa.Chikitsa Sthana-13/17; Cha.Sa.Chikitsa Sthana-13/100] Vertigo/ giddiness (bhrama) [Su.Sa.Chikitsa Sthana-24/50-51] </li>
<li>Skin eruptions (visarpa) [Cha.Sa.Chikitsa sthana-21/115] </li>
<li>Fractures (bhagna) [A.S.Uttara Sthana-32/38; Su.Sa.Chikitsa Sthana-3/4; 3/25] </li>
<li>Arthritis (vatashonita) [Su.Sa.Chikitsa Sthana-5/17] </li>
<li>Enlargement of bodily organs (vruddhi) [Su.Sa.Chikitsa Sthana-19/2-3] </li>
<li>Urinary calculi (ashmari) [Cha.Sa.Chikitsa Sthana-26/76] </li>
<li>Rhinitis by aggravated vata (vatika pinasa) [Cha.Sa.Chikitsa Sthana-26/143] </li>
<li>Ear diseases (karna roga) [Su.Sa.Uttara Tantra-21/3] </li>
<li>Poisoning (vishabadha) [Su.Sa.Kalpa Sthana-6/31] </li>
<li>Acute fever (taruna/nava jwara) [Su.Sa.Uttara Tantra- 39/156-157; Cha.Sa.Chikitsa Sthana-3/138-139]. </li>
<li>In ulcer (vrana) up to 6 to 7 months [A.S.Sutra Sthana38/41; Su.Sa.Sutra Sthana-19/20; Su.Sa.Sutra Sthana 5/39]</li>
Vyayama is forbidden in all above conditions, and if this is violated it will agitate the condition or delay wound healing. [Su.Sa.Sutra Sthana-23/21] </ul>
=== Convalescence : ===
<div style='text-align:justify;'>Following treatments like purgation therapy (virechana) [Sha.Sa.Uttara Khanda-4, p340], oral administration of lipid formulation of drugs (snehapana) [Cha.Sa.Sutra Sthana- 13/63; Cha.Sa.Sutra Sthana-14/67; A.S.Sutra Sthana-25/31], and sudation therapy (swedana) [Cha.Sa.Sutra Sthana-14/67; A.S.Sutra Sthana-26/24]; before regaining strength after purificatory therapies (panchakarma) (Su.Sa.Shareera Sthana-8/24]; prior to attaining complete strength after the relief of fever (jwaramukta) [Cha.Ci-3/332; Su..Ut-39/160; A.S.Ni-2/76], and for 1 year after healing fissure-in-ano (bhagandara) [Su..Ci-8/14] vyayama is contraindicated. </div>
== Precautions of vyayama ==
<div style='text-align:justify;'>Vyayama shall be performed after considering variables like age, strength, body constitution, geography, seasons and diet pattern. [Su.Sa.Chikitsa Sthana 24/48] <br/>Vyayama soon after food consumption causes rheumatoid arthritis (amavata). [Madhava Nidana 25/1] <br/>Vyayama shall not be done before proper digestion of food [A.Hr.Sutra Sthana 2/11] as it precipitates skin diseases (kushtha) [Cha.Sa.Nidana Sthana5/6; Su Sa.Nidana Sthana-5/3; M.Ni-41/2; Cha.Sa Chikitsa Sthana.7/5] <br/>Over exertion in outdoor settings may manifest as fever (jwara), hence conducive and comfortable climatic conditions are necessary for vyayama. [A.S.Nidana Sthana 2/58] </div>
== Concept of ativyayama ==
<div style='text-align:justify;'>Ativyayama refers to bodily exertion beyond the recommended limits. Over exertion undisputedly destroys the body just like the lion who tried to defeat an elephant attacking directly. [A.H.Sutra Sthana-2/15; Cha.Sa Sutra Sthana7/35] It also results in aggravation of vata [A.H. Nidana Sthana 1/15] especially prana vayu [A.H.Nidana Sthana16/19; A.S.Nidana Sthana 16/17]; and aggravation of pitta [A.H.Nidana Sthana -9/35]. Chronic over-exertion will manifest as chest injury (urakshata) even without any external trauma. [Ma.Ni.10/19] <br/>Care should be taken, to abstain from over-exertion [Cha.Sa.Sutra Sthana-7/34] as it will eventually reduce the quality of semen/ ovum (shukra) [Cha.Sa Chikitsa Sthana30/135-139], which is reflected as extreme tiredness, lack of enthusiasm, weakness to perform all physical and mental activities, breathing difficulties and higher brain faculty derangement. [A.S.Uttara Sthana 49/5; Cha.Sa Chikitsa Sthana2/3] Hence, a wise person should always abstain from over-exertion. [Cha.Sa Sutra Sthana-7/34] Those vanquished by vyayama are eligible for oleation (snehana) therapy. [A.H.Sutra Sthana 16/5; Cha.Sa Sutra Sthana13/52] </div>
== Complications of ativyayama ==
<div style='text-align:justify;'>Excessive thirst (thrishna), emaciation (kshaya), dyspnoea with fever and fainting (pratamaka), bleeding disorders (raktapitta), fatigue (shrama), lethargy (klama), severe cough (kasa), fever (jwara), and vomiting (chardi) are caused due to excess vyayama. [A.H.Sutra Sthana2/14; A.S.Sutra Sthana3/364]. <br/>Other health issues, in which over-exertion is the patho-physiological factor are hiccups (hikka shwasa) [Su.Sa.Uttara Tantar 50/3-4; Cha.Sa.Chikitsa Sthana 17/11; M.Ni12/1-2], especially that develop soon after food intake (kshudra hikka) [Cha.Sa.Chikitsa Sthana17/34]; cough (kasa) [Su.Sa.Uttara Tantra 52/4, M.Ni11/1; A.H.Sutra Sthana 2/14; A.S.Sutra Sthana 3/64-65], anaemia (pandu) [Cha.Sa.Chikitsa Sthana 16/8; M.Ni 8/2], obstructive jaundice (shakhashrita kamala) [Cha.Sa.Sutra Sthana16/125], bleeding disorders (raktapitta) [A.S.Sutra Sthana-3/64-65; M.Ni 9/1], chest infections including tuberculosis (rajayakshma) [M.Ni 10/14], emaciation (shosha) [M.Ni 10/19], neurological and musculo-skeletal disorders (vatavyadhi) [Cha.Sa.Chikitsa Sthana 28/16-19; M. Ni 22/2], arthritis (vatarakta) [Su.Sa.Nidana Sthana-1/40-41], dysuria (mutrakrichra) [M.Ni 30/1; Cha.Sa.Chikitsa Sthana 26/32], burning sensation while urinating (ushnavata) [Su.Sa.Uttara Tantra 58/22-23; M.Ni- 31/25], obstructed blood vessels (siragranthi) [Su.Sa.Nidana Sthana 11/8; A.H.Uttara Sthana 29/10; A.S.Uttara Sthana 34/11; M.Ni38/16], chest injury without external trauma (urakshata) [Cha.Sa.Nidana Sthana- 6/4), abdominal colic (shula roga) [M.Ni 26/2), suppuration of intestinal organs (antravidradhi) [Su.Sa.Nidana Sthana-9/16], headache over one side (ardhavabhedaka) [M.Ni60/11], polyp in female reproductive organ (yonikanda) [Ma..Ni 63/1], internal lumps due to vata (vataja gulma) [Cha.Sa.Nidana Sthana-3/6], haemorrhoids due to vata (vatika arsha) [Cha.Sa.Chikitsa Sthana-14/13; M. Ni3/34; 5/4) and pitta (pitta dominant arsha) [Madhava Nidana-5/5], cardiac disease due to vata (vata dominant hridroga) [Cha.Sa. Suta Sthana- 17/30; Cha.Sa.Chikita Sthana- 26/77], diarrhoea due to vata (vatika atisara) [Cha.Sa.Chikitsa Sthana 19/5], vomiting due to vata (vata dominant cchardi) [Cha.Sa.Chikitsa Sthana- 20/7], appearance of lipid in urine (vasa meha) [Cha.Sa.Nidana Sthana 4/36]. Ativyayama causes trauma in the thoracic region and it will result in traumatic cough (kshataja kasa). [Su.Sa.Uttara Tantra 52/11] <br/>By over exertion, the end-product of digestion/chyle (rasa dhatu) dries up and reduces its quality. Thus the person will become lean. [Su.Sa. Sutra Sthana 15/33] </div>
== Concept of avyayama ==
<div style='text-align:justify;'>Avyayama is the lack/ reduced physical exertion yielding in aggravation of kapha dosha [Cha.Sa Nidana Sthana 1/25] and vitiation of channels of transportation of lipids (medovaha srotodushi). [Cha.Sa.Vimana Sthana -5/16] <br/>The condition is encountered in diseases due to deranged lipids (medoroga) [Ma.Ni 34/1], obesity (atisthaulya) [Cha.Sa.Sutra Sthana 21/4; Su.Sa.Sutra Sthana-15/32], obstinate urinary diseases including diabetes (prameha) [Su.Sa.Nidana Sthana 6/3], diabetes due to kapha (kaphaja prameha) [Cha.Sa Nidana Sthana-4/5], chronic stage of diabetes with aggravated vata (madhumeha) [Cha.Sa.Sutra Sthana 17/79-80], worm- infestation (krimiroga) [Su.Sa.Uttara Tantra 54/3; M. Ni7/4], oedema due to kapha (kapha dominant shopha) [Cha.Sa.Sutra Sthana18/7-8], abdominal disorders due to kapha (kaphaja udara) [Cha.Sa.Chikitsa Sthana 13/29], hemorrhoids due to kapha (kaphaja arsha) [Cha.Sa. Chikitsa Sthana 14/18-19; Ma.Ni 5/7], and a type of erysipelas (granthi visarpa). [Cha. Sa. Chikitsa Sthana 21/39] </div>
== Contemporary approach ==
===Difference between physical exercise and vyayama: ===
<div style='text-align:justify;'>The WHO definition of physical activity is any bodily movement produced by skeletal muscles that requires energy expenditure. [4]. It can be household work, moving from one place to other, lifting an object etc. Exercise is a subcategory of physical activity that is planned, structured, repetitive, and purposefully focused on improvement or maintenance of one or more components of physical fitness [5]. Vyayama is of three types- physical, verbal or mental, among them only physical exercise is meant for health maintenance, and it must be implemented at right amounts, with due precautions. Mental exertion has a tiring effect and therefore it cannot be considered as a healthy practice. [6] Vyayama is an anabolic/ constructive activity as per Ayurveda, with benefits like ability to perform activities, increased digestion, reduction of unwanted fat deposits, fitness etc. It is recommended to be practiced, along with an adequate lipid diet in moderate quantity, and therefore burn-out is not a goal of vyayama. Hence, it is a conducive physical exertion. There is a clear-cut difference between vyayama, ayasa (exertion) and shrama (fatigue), where the latter two are catabolic in nature, which results in exhaustion and burn-out. Both these are dangerous to health. On the other hand, vyayama should be stopped prior to exhaustion. </div>
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