The Sanskrit word vyayama means specific activity. Generally, it denotes physical exercise which impart strength and firmness. [Cha. Sa. Sutra Sthana-7/31] Vyayama is benificial to healthy and unhealthy individuals, with an added clause of due caution and supervision. Vyayama in healthy people improves and maintains health: whereas, it is preventive as well as therapeutic tool for various diseases (e.g.: lifestyle disorders, joint dislocation etc.). In fact, vyayama is a cost-effective means for a disease-free generation. This chapter describes concept of vyayama and its application in healthcare management.
Blessymol EV 2
1Associate Professor, Department of Swasthavritta, VPSV Ayurveda College, Kottakkal, Kerala, India |
2Medical Content Writer,Smriti Meditation Practioner
3 Rheumatologist, Orlando, Florida, U.S.A.
4 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
|Publisher||Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India|
|Date of publication:||January 05, 2023|
Vyayama includes all the exertional activities, which impart stretching of different body parts [Su.Sa.Chikitsa Sthana-11/11- Dalhana commentary]. Vyayama, is the best tool for improving firmness/ fitness [A.S.Sutra Sthana-13/2; Cha.Sa.Sutra Sthana 25/40], and is reflected as the ultimate for stability [A.H.Uttara Sthana-40/55]. In fact, it is the best way to get rid of obesity.
However, vyayama endorses only the physical activities; thereby excluding mental and verbal exertion in this domain. [Cha.Sa. Sutra Sthana 7/31 Chakrapani]. Therefore, vyayama plays a vital role in preservation of health and management of disease.
Etymology and derivation
Features of optimal vyayama
Vyayama is one among the best practices for preservation of health (ekanta pathyatama). [Su.Sa. Sutra Sthana-20/6] For a healthy person, right amount of vyayama at right time is wholesome. [Dalhana on Su.Sa. Sutra Sthana 20/6]
Extent of exercise is determined by one’s own capacity. One should stop exercise before getting tired. [Cha.Sa. Sutra Sthana 8/18] Strong persons, and those habituated to fat rich diet can daily practice vyayama up to half of their capacity in cold seasons like hemanta & shishira (winter), and in vasanta ritu (spring). During rest of the seasons, vyayama can be executed with mild to moderate strength. [A.H.Sutra Sthana-2/11-12] [Su.Sa.Chikitsa Sthana-24/45-46]
Vyayama shakti or strength of performing physical exercise is an important patient examination tool in Ayurveda. [Cha.Sa. Vimana Sthana 8/94] A healthy individual can withstand exercise or any physical activity [Cha.Sa. Sutra Sthana 21/18]. Whereas, lean or emaciated person is deprived of the ability to perform exercise [Cha.Sa. Sutra Sthana 21/13].
Amount of vyayama
Kleda (moisture or interstitial fluid) does not accumulate in tissues by virtue of regular exercise. [A.S.Sutra Sthana 11/56; Cha.Sa.Chikitsa Sthana 15/239] Obesity can be checked by regular vyayama as it endows well-built musculature to the person. [Su.Sa. Chikitsa Sthana 24/39-42] Well-built compact physique, charming appearance, and tolerance to cold/ heat/ hunger/ thirst are the revered qualities .The exercise generated robust digestive fire can properly digest food items even if they are incompatible, heavy to digest and causing burning sensation in stomach.
Recommendations for those who practice daily vyayama
Post- vyayama procedures
Forbidden activities/ behaviors after vyayama
- Summer (greeshma ritu), hot season [A.H.Sutra Sthana3/26-27; Su.Sa.Uttara Tantra 64/40-41; Cha.Sa. Sutra Sthana 6/29]
- Rainy seasons (varsha ritu) [Cha.Sa.Sutra Sthana 6/36; Su.Sa.Uttara Tantra 64/49].
- Soon after having food [A.H.Sutra Sthana 2/11; Su.Sa.Chikitsa sthana 24/50-51]
- Exhausted by other physical activities- [Su.Sa.Chikitsa Sthana 24/49-51],
- After coitus [Su.Sa.Chikitsa Sthana 24/50-51]
- Feeling thirsty [Cha.Sa. Sutra Sthana 7/35; Su.Sa. Chikitsa Sthana 24/50-51]
- Feeling hungry [Cha.Sa. Sutra Sthana 7/35]
- Pregnancy [Cha.Sa. Sutra Sthana 25/40]
- Small children [A.H.Sutra Sthana 2/11; Cha.Sa. Sutra Sthana 7/35]
- Old people [A.H.Sutra Sthana 2/11; Cha.Sa. Sutra Sthana 7/35]
- Person having more natural or vitiated vata dosha [Cha.Sa.Sutra Sthana 7/35]
- Persons who are talkative or speaking loudly [Cha.Sa.Sutra Sthana 7/35]
- Exhausted by walking, weight lifting, coitus etc. [Cha.Sa. Sutra Sthana 7/35]
- Persons who are desirous of increasing body weight. [Cha.Sa. Sutra Sthana 21/28]
- Those who are angry, sad or scared [Cha.Sa. Sutra Sthana 7/35]
- Diseases due to vata and pitta [A.H.Sutra Sthana 2/11]
- Bleeding disorders (raktapitta) [Su.Sa. Chikitsa Sthana 24/50-51]
- Breathing disorders (shwasa) [Su.Sa.Chikitsa Sthana 24/50-51]
- Cough (kasa) [Su.Sa.Chikitsa Sthana 24/50-51]
- Chest injury (urakshata) [Su.Sa.Chikitsa Sthana 24/49-51]
- Emaciation (shosha) [Su.Sa.Chikitsa Sthana 24/50-51]
- Lean person (karshya) [Su.Sa.Sutra Sthana 15/33; Su.Sa.Chikitsa Sthana 25/50-51]
- 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]
- Skin eruptions (visarpa) [Cha.Sa.Chikitsa sthana 21/115]
- Fractures (bhagna) [A.S.Uttara Sthana 32/38; Su.Sa.Chikitsa Sthana 3/4; 3/25]
- Arthritis (vatashonita) [Su.Sa.Chikitsa Sthana 5/17]
- Enlargement of bodily organs (vruddhi) [Su.Sa.Chikitsa Sthana 19/2-3]
- Urinary calculi (ashmari) [Cha.Sa.Chikitsa Sthana 26/76]
- Rhinitis by aggravated vata (vatika pinasa) [Cha.Sa.Chikitsa Sthana 26/143]
- Ear diseases (karna roga) [Su.Sa.Uttara Tantra 21/3]
- Poisoning (vishabadha) [Su.Sa.Kalpa Sthana 6/31]
- Acute fever (taruna/nava jwara) [Su.Sa.Uttara Tantra 39/156-157; Cha.Sa. Chikitsa Sthana 3/138-139].
- In ulcer (vrana) up to 6 to 7 months [A.S.Sutra Sthana 38/41; Su.Sa. Sutra Sthana 19/20; Su.Sa.Sutra Sthana 5/39]
Vyayama is forbidden in all above conditions. Vyayama can adversely affect pathologies in these conditions. [Su.Sa.Sutra Sthana 23/21]
Precautions of vyayama
Vyayama soon after food consumption causes rheumatoid arthritis (amavata). [Madhava Nidana 25/1]
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 Sthana 5/6; Su Sa.Nidana Sthana 5/3; Ma.Ni.41/2; Cha.Sa Chikitsa Sthana 7/5]
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]
Concept of ativyayama
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 Sthana 30/135-139], 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 Sthana 2/3] 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 Sthana 13/52]
Complications of ativyayama
Other health issues, in which over-exertion is the patho-physiological factor are hiccups (hikka shwasa) [Su.Sa.Uttara Tantra 50/3-4; Cha.Sa. Chikitsa Sthana 17/11; M.Ni 12/1-2], especially that develop soon after food intake (kshudra hikka) [Cha.Sa. Chikitsa Sthana 17/34]; cough (kasa) [Su.Sa.Uttara Tantra 52/4, M.Ni 11/1; 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 Sthana 16/125], bleeding disorders (raktapitta) [A.S.Sutra Sthana-3/64-65; Ma.Ni 9/1], chest infections including tuberculosis (rajayakshma) [Ma.Ni 10/14], emaciation (shosha) [Ma.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.Ni. 38/16], chest injury without external trauma (urakshata) [Cha.Sa. Nidana Sthana 6/4), abdominal colic (shula roga) [Ma.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; Ma. Ni. 3/34; 5/4) and pitta (pitta dominant arsha) [Madhava Nidana-5/5], cardiac disease due to vata (vata dominant hridroga) [Cha.Sa. Sutra Sthana 17/30; Cha.Sa. Chikitsa 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]
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]
Concept of avyayama
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; Ma. Ni. 7/4], oedema due to kapha (kapha dominant shopha) [Cha.Sa. Sutra Sthana 18/7-8], 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]
Difference between physical exercise and vyayama:
Types of exercise
a) Endurance, strength, balance and flexibility. Endurance exercises otherwise known as aerobic exercises, improve heart rate and respiratory rate. They help in preventing diseases due to wear and tear. Swimming, dancing, brisk walking etc. are some examples of endurance exercises. Strengthening exercises increase muscle strength, prevent falls and improve body balance. They include weight training, wall push-ups, lifting the body weight etc. Balance exercises enhance body balance and thereby prevent falls (eg: yoga, heel to toe walking). Flexibility exercises are stretching itself.
Contemporary approach: Exercise and work-out has become a part of a popular lifestyle measure in addition of being health promotion tool. Group exercises like dance, zumba etc. are mainly meant for fun gathering methods. Intention of such activities are relaxation, shaping the body, and in most cases, an a lacunae surfaces in an analytical approach in implementing these activities based on the individual’s needs. Additionally, self-exercise/ work-out, using social media is very common which also shares, the same drawback.
Personalization of exercise: Physique, physical activity, age, dietary intake, etc. of each individual is variable, so exercise must be designed in accordance with the needs of the person.
Combined effect of diet and exercise: In order to achieve fitness and health, diet restriction or exercise alone is not very beneficial. Combined and wise execution of these two are the key to achieve the expected results. Vyayama is hence, included in daily regimen (dinacharya) with an optimal magnitude.
Role of prajna and prajnaparadha in exercise adherence: Awareness regarding one’s health status, bad habits, health behavior (dhi) are the key for initiating action- (dhriti). Both these bring forth enthusiasm and endurance towards exercise (maintenance/ adherence). When the individual lacks enthusiasm (dhriti bhramsha/ prajnaparadha), the adherence to exercise fades. Thus, continuous loop of prajna installation and prajnaparadha installation (relapse) play in cyclical adherence and non-adherence to exercise, which is the core theme behind ‘dushchikitsya atisthoola’ concept.
Fit India Movement: An Indian government initiative aimed at improving the health of citizens by daily exercise. It was launched on the National sports day 2019 (August 29). It includes age appropriate fitness protocol for 5-18 years, 18-65 years and above 65.
- Systematic regular exercise can improve cognitive function and memory. .
- Exercise can be used as a tool for primary prevention in the past phase (before the onset), secondary prevention (in present cases) and prognosis of heart failure. .
- Regular aerobic exercise can decrease the depressive symptoms and thereby the pro-inflammatory IL6. .
- A study recommends that hypertensive individuals should aim to perform moderate intensity aerobic exercise activity for at least 30 minutes on most (preferably all) days of the week in addition to resistance exercises on 2–3 days/week. .
- Studies show that there is no improvement in Hba1c with high dose of exercise. 
- Low amount of moderate intensity exercise combined with diet is the most effective intervention for improving health-related quality of life. Also, low amount of moderate intensity exercise provides the greatest impact on mental well- being. .
- Chronic exposure to exercise in obese children and adolescents shows increase in heart rate, parasympathetic activity and sympathetic-vagal balance. .
- Voluntary exercise helps in the influx of immune cells in tumors, and reduction in tumor incidence and growth among mouse models. .
- Aerobic exercise is the best tool for treating Parkinson's disease .
- Physical exercise can be used as an alternative to antidepressants in older adults .
- Mental exertion is a psychophysiological state caused by sustained and prolonged cognitive activity. The activities/ occupations that demand physical exertion will have a hampering influence by prior mental exertion. .
- Plant protein can also enhance resting muscle protein synthesis (MPS). Plant protein containing essential amino acids especially leucine facilitates prolonged adaptations to exercise training similar to animal protein. .
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- ↑ Rajavallabha Nighantu; Chapter 2; sloka 12; NIIMH-National Institute of Indian Medical Heritage. e-Samhita [Internet]. Available from: http://niimh.nic.in.
- ↑ Kaiyadeva Nighantu; Chapter 8; sloka 153; NIIMH-National Institute of Indian Medical Heritage. e-Samhita [Internet]. Available from: http://niimh.nic.in.
- ↑ Kaiyadeva Nighantu; Chapter 8; sloka 246-248; NIIMH-National Institute of Indian Medical Heritage. e-Samhita [Internet]. Available from: http://niimh.nic.in.
- ↑ WHO. Physical activity [Internet]. 2022 [cited 2022 Dec 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity
- ↑ Dasso NA. How is exercise different from physical activity? A concept analysis. Nurs Forum [Internet]. 2019 Jan 1 [cited 2022 Dec 14];54(1):45–52. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/nuf.12296
- ↑ 6.0 6.1 Silva-Júnior FL e, Emanuel P, Sousa J, Silva M, Teixeira S, Oliveira Pires F, et al. Prior Acute Mental Exertion in Exercise and Sport. Clin Pract Epidemiol Ment Heal. 2016;12(1):94–107.
- ↑ NIH. Four Types of Exercise Can Improve Your Health and Physical Ability | National Institute on Aging [Internet]. National Institute on Aging NIA. 2021 [cited 2022 Dec 14]. Available from: https://www.nia.nih.gov/health/four-types-exercise-can-improve-your-health-and-physical-ability
- ↑ Magkos F, Hjorth MF, Astrup A. Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2020 Oct;16(10):545-555. doi: 10.1038/s41574-020-0381-5. Epub 2020 Jul 20. PMID: 32690918.
- ↑ Johns DJ, Hartmann-Boyce J, Jebb SA, Aveyard P; Behavioural Weight Management Review Group. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014 Oct;114(10):1557-68. doi: 10.1016/j.jand.2014.07.005. PMID: 25257365; PMCID: PMC4180002.
- ↑ Ptomey LT, Szabo AN, Willis EA, Gorczyca AM, Greene JL, Danon JC, et al. Changes in cognitive function after a 12-week exercise intervention in adults with Down syndrome. Disabil Heal J. 2019;11(3):486–90.
- ↑ Cattadori G, Segurini C, Picozzi A, Padeletti L, Anzà C. Exercise and heart failure: an update. ESC Hear Fail. 2018;5(2):222–32.
- ↑ Ventura J, McEwen S, Subotnik K, Hellemann G, Ghadiali M, Rahimdel A, et al. Changes in inflammation are related to depression and amount of aerobic exercise in first episode schizophrenia. Early Interv Psychiatry. 2021;15(1):213–6.
- ↑ Sharman JE, La Gerche A, Coombes JS. Exercise and cardiovascular risk in patients with hypertension. Am J Hypertens. 2015;28(2):147–58.
- ↑ Wrench E, Rattley K, Lambert JE, Killick R, Hayes LD, Lauder RM, et al. There is no dose–response relationship between the amount of exercise and improvement in HbA1c in interventions over 12 weeks in patients with type 2 diabetes: a meta-analysis and meta- regression. Acta Diabetol [Internet]. 2022;59(11):1399–415. Available from: https://doi.org/10.1007/s00592-022-01918-8.
- ↑ Collins KA, Ross LM, Piner LW, Fos LB, Slentz CA, Bateman LA, et al. Amount and intensity effects of exercise training alone versus a combined diet and exercise lifestyle intervention on health-related quality of life in the STRRIDE-PD randomized trial. BMJ Open Diabetes Res Care. 2022;10(1):1–10.
- ↑ Dias RM, Moraes ÍAP, Dantas MTAP, Fernani DCGL, Fontes AMGG, Silveira AC, et al. Influence of chronic exposure to exercise on heart rate variability in children and adolescents affected by obesity: A systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(21):1–14.
- ↑ Idorn M, thor Straten P. Exercise and cancer: from “healthy” to “therapeutic”? Cancer Immunol Immunother. 2017;66(5):667–71.
- ↑ Alberts JL, Rosenfeldt AB. The Universal Prescription for Parkinson’s Disease: Exercise. J Parkinsons Dis. 2020;10(s1):S21–7.
- ↑ López-Torres Hidalgo J, Aguilar Salmerón L, Boix Gras C, Campos Rosa M, Escobar Rabadán F, Escolano Vizcaíno C, et al. Effectiveness of physical exercise in the treatment of depression in older adults as an alternative to antidepressant drugs in primary care. BMC Psychiatry. 2019;19(1):1–7.
- ↑ Kerksick CM, Jagim A, Hagele A, Jäger R. Plant proteins and exercise: What role can plant proteins have in promoting adaptations to exercise? Nutrients. 2021;13(6):1–22.