Salah involves continuous gentle muscle contraction and relaxation with perfect harmony and balance. It involves different types of stretching and isometric contraction exercises. These gentle & simple exercises are suitable for all ages & conditions. University of Malaya Medical Centre (UMMC) Cardiology Consultant Specialist Prof Dr Wan Azman Wan Ahmad stated that “12 ‘Rakʿah’ (unit for a set of actions in a prayer) equaled to 30 minutes of light exercises daily as recommended by health experts.” (zurairifm.wordpress.com/2009). Other beneficial activities can be combined with prayer, such as walking to the local mosque. This can help patients achieve the recommended weekly exercise levels of 30 minutes a day, at least five times a week. (Department of Health, 2004). For Muslim populations, higher ROM is required as their religious activities demands greater flexion of the joints in the lower limbs. Muslims need to adopt several postures that require deep flexion of the knee and hip to perform this daily obligation. The various postures of Salah were studied. Range of motion (ROM) were measured by Goniometer (An instrument which measures the available range of motion at a joint)
Prayer’s posture health benefıts
Prayer’s posture health benefıts
Takbir is the beginning of the prayer and starts by raising the hands, keeping the palms open next to both ears, placing the thumbs behind the earlobes, keeping the elbows bent, the Pectoralis muscles stretched gently and the shoulder blades. Raising both hands and placing them on the stomach can expand the chest cavity See Figure 1.
There is an even distribution of weight through both feet throughout the practice of Qayyam posture. This will ease the balance of the body and lower back brought into a neutral position whilst activating the core muscles at the same time. This position aids to straighten the back and improves posture See figures 2,4.
Ibrahim and Siti, (2012) describes that three postures in Salah have been investigated and compared to similar stretching exercises, which were Takbir, bowing and prostration. This suggest that Salah has musculoskeletal effect like stretching
Ruk’u/forward bending: Health benefits
Ruk’u is forward flexion of lumbar spine and flexion at hip joint whereas, knee joint bears load in extension. The American College of Sports Medicine (ACSM) recommends loading exercises (for example weight bearing in Ruk’u) to maintain bone health which helps in minimizing the risk of Osteoporosis. This position stretches the para spinal muscles of lumbar spine, hamstrings, and calves (gastrocnemius & soleus) muscles See figure 3. It strengthens the back, extends the spine and increases the flexibility of hips and hamstrings. It relieve the stiffness at spine, neck, and back and help to improves posture as well as balance and co-ordination. Ruk’u is good for the lower vertebral column, trunk stability and provides a gentle distraction at vertebras. This posture is useful to treat backache and vertebral column related diseases. It reduces the risk of nerve compression and promotes the flexibility of the spine in healthy people.
According to industrial engineering Prof. Muhammad Khasawneh et al, the complex physical movements of the ritual can reduce lower-back pain if performed regularly and properly. He and his interfaith team published their findings in the International Journal of Industrial and Systems Engineering. The maximum compression forces created during prayer postures are much lower than the safety limits set by the US National Institute for Occupational Safety and Health, and the movements can be safely considered a clinical treatment for lower-back pain. In some cases of chronic low back pain, as part of exercise plan, I often advise my Muslim patient to prolong the Ruku’u position every time they Pray for a few more seconds in order get the effective sustain stretch.
Modifications to the bowing posture were studies for individuals with low back pain considering three main factors: back angle, knee angle, and pain level. It was found that all the main factors and one interaction effect (back angle × knee angle) are significant. This can help identify the back and knee angles that minimize the compression force for individuals with low back pain. A Study (a research project carried out by University Malaya’s biomedical engineering department) conducted on patients with regular back pain and pregnant mothers from the Malay, Indian and Chinese communities showed that the ‘rukuk’ and ‘prostration’ positions could be used as therapy as it helped to relax the spinal canal and reduced the risk of pressure on the spinal nerve. NOTE :The Non-Muslim mothers only acted out the positions during therapy sessions. (they showed the improvement within the month).
Jalsa/Tashahhud/Sitting: Health benefits
Jalsa involves sitting on the floor directly on the ground, while both legs are folded in such a manner that the heels touch the gluteal region and the hands are placed on the knees. See figure 6. In this pose muscles at the front of the ankle and foot are stretched. It stretches the tibalis anterior, the extensor hallucis longus (with toe extended), the quads and gluteus muscles (while knees and hips are flexed).
The full inner range of motion on knee joint is achieved and it prevents restricted joint range which is most commonly seen in patients with degenerative knee problems. The knee joint is noted to attain maximum flexion during the sitting posture, which was higher compared to the passive knee ROM. Sitting with lower back in good posture will help to strengthen core muscles. Core strengthening has a strong theoretical basis in treatment and prevention of LBP. Jalsa sitting in kneeling position – not only helps to maintain the good posture but also improves flexibility, and strengthens ligament.
Rising up after Jalsa to continue other Rakʿah involves activities like deep squats as well as full to half kneeling postures. With erect postures more spinal stability is gained See Figure 7.
All these physical activities are therapeutic and merged with a variety of techniques prescribed by physical therapists, can be used to treat joint/muscle injuries and core coordination and balance reeducation.
Sajdah/Sujud/Prostration: Health benefits
The position of maintaining the lower back flexed and forehead resting gently on the floor allows the postural neck muscles to be activated in order to control the neutral head position in lowering down, and while lifting it from the floor. The hands are also stretched out in a manner that allows the forearm as well as the arm muscles to bear weight. Figure 5. The toes, entire vertebral column and upper and lower spinal muscle experiences a stretch. The knees forming a right angle allow abdominal muscles contraction to be activated and prevents flabbiness.
The hip joint was in maximum flexion during the prostration posture, which was much lower than the measured passive ROM. The stretch felt in the length of spine as the individual curls the torso over the legs also creates a space between the dorsal surfaces of the vertebra of the spine and aids spinal distraction as well as allowing neural glides and the lengthening of the nerves. This posture combined with other exercises opens the lower lumbar facet joints may help to reduce the lower back pain and sciatica can be used to treat spinal stenosis and other degenerative disc diseases .
Al- Gazal (2006) and Ayad (2008) stated that prostration is the only position in which the head is in a position lower than the heart and therefore, receives increased blood supply to the brain, stimulates the brain’s frontal cortex. This reduces the chances of brain hemorrhage and headache, helps to reduces high blood pressure, This surge in blood supply also has a positive effect on memory, concentration, psyche and other cognitive abilities. A study investigating the alpha brain activity during prostration has reported increased amplitude in the parietal and occipital regions suggestive of parasympathetic elevation, thus indicating a state of relaxation (Doufesh,2012).
Salaam/Neck Turns: Health benefits
Salam is an excellent form of neck and upper vertebrae exercise. The head performs rotational movements over the cervical vertebra. This improves the range of motion of the neck and whilst stretching the trapezius fibers. It also helps to mobilize the upper back and the thoracic muscles. These gentle neural stretches at cervical rotation are effective and may reduce the symptoms of cervicogenic headache Figures 8,9.
Al- Gazal and Ayad et al. (2008) stated that the neck muscles, in particular, are strengthened such that it is uncommon to find a person offering regular Salah prostrating at least 40 times a day to suffer from cervical spondylosis or myalgias.