- 75-yr-old female, lives alone. Trained as a ballet and modern dancer and loves to dance. Goes dancing at least twice a week.
- Total right hip replacement, was successful but requires left heel lift to remedy leg length disparity. Has chronic left lumbosacral pain from spondylolisthesis, which gets activated when she dances or practices yoga.
- Bunionectomies on left big toe and pinky and right big toe. Had pins put in to help with the correction. Wears spacers to help prevent lateral reversion.
- Had some pancreatic and liver cysts, which were taken out and found benign. Has to go for a follow up soon.
- Has sleep apnea. Was prescribed a C-Pap machine but doesn’t use it because doesn’t like the noise it makes. Suffers from Insomnia. I suggested her to keep a sleep log.
- Diagnosed with Strabismus. Has double vision.
- Mild cervical arthritis. Limited flexion in the neck.
- Has tremor in her left hand which is now spreading to her right hand and causes problem with typing and eating. She’s right-handed.
- Has Scoliosis, right C-curve in lumbar spine. Left shoulder lower than the right. Said that she has had scoliosis since she was little. Growing up in Midwest, the condition was not paid much attention to.
- Has prolapsed organs and uses ring pessary. Says that it doesn’t interfere with her daily life and activities. Has to get up couple of times in the night to use the bathroom.
- Have been practicing yoga since age 25, stopped taking classes when her body couldn’t do what was being taught. Has been practicing on her own for the past 20 years. Says she doesn’t really like yoga but practices because she’s supposed to, to stay healthy.
- Has Osteoporosis in her spine. Told me that she’s been practicing sun salutation, shoulder stand. I asked if she has asked her doctor about that. She hasn’t been to an orthopedic doctor in a while. I asked her to stop doing shoulder stand and explained the reason for it. She says that maybe that’s why her height has reduced by 3”. I encouraged her to go see an orthopedic.
- Gets bouts of Sciatica once in a while on the left side. Twisting to left causes discomfort.
- Doesn’t like to be in a group setting, gets uncomfortable with the noise level. Calls herself a ‘loner’ and ‘introvert’. Says that she ‘likes to observe people than talk to them.’

- Working with Prana Vayu and Apana Vayu. Since she has prolapsed organs, working more with grounding and breath movement from belly to the top.
- Joint freeing movements, gentle pelvic floor strengtheners like bridge pose.
- Using a lot of props like soft blankets, chair, wall to help with scoliosis, osteoporosis and spondylolisthesis.
- Netra Vyayamama and self-massage
- Modified gentler Vinyasa practice with the help of chair and wall.
- Restorative postures like side bends with bolsters to help with the spinal curve.
- Pranayama- extended exhalation, Ujjayi, Nadi Shuddhi and Bhramari.
- Yoga nidra, guided relaxation
- Loving kindness towards herself, moving meditation.
- Practicing with her shoes on with the heel lift to address the leg length disparity.

- Yoga for Scoliosis – book by Elise Miller
- Yoga for Arthritis Teacher training manual
- Adaptive Yoga teacher training manual
- Fishman LM. Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis-A Nonrandomized Control Trial. Glob Adv Health Med. 2021 Feb 24; 10:2164956120988259. doi: 10.1177/2164956120988259. PMID: 33717658; PMCID: PMC7917413. Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis—A Nonrandomized Control Trial - PMC (nih.gov)
- Fishman LM. Yoga and Bone Health. Orthop Nurs. 2021 May-Jun 01;40(3):169-179. doi: 10.1097/NOR.0000000000000757. PMID: 34004616. Yoga and Bone Health - PubMed (nih.gov)
- Bradford DS, Tay BK, Hu SS. Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine (Phila Pa 1976). 1999 Dec 15;24(24):2617-29. doi: 10.1097/00007632-199912150-00009. PMID: 10635525. Adult scoliosis: surgical indications, operative management, complications, and outcomes - PubMed (nih.gov)
- Yoga therapy for scoliosis: an adult case approach | Scoliosis and Spinal Disorders | Full Text (biomedcentral.com)
- Li X, Shen J, Liang J, Zhou X, Yang Y, Wang D, Wang S, Wang L, Wang H, Du Q. Effect of core-based exercise in people with scoliosis: A systematic review and meta-analysis. Clin Rehabil. 2021 May;35(5):669-680. doi: 10.1177/0269215520975105. Epub 2020 Dec 27. PMID: 33356498; PMCID: PMC8076838. Effect of core-based exercise in people with scoliosis: A systematic review and meta-analysis - PMC (nih.gov)

• Yes

Check-in. Seated in chair- Body scan, extended exhalation, Netra Vyayamama, joint freeing movements. By the wall- Sun salutation, lunge, Gentle twist. Lying prone is painful for her, did some backbends like locust, cobra by the wall. Supine stretches like pelvic tilts, figure 4. Can’t stay supine for long.
Restorative shavasana, legs up the chair, blanket underneath the lower back and neck. Progressive relaxation, Breath meditation.
End with Bhramari, asked her to play with different tones. Said that she enjoyed the low pitch, higher pitch made her feel anxious.

Keep practicing sun salutation by the wall, Bhramari, eye exercises and logging her sleep.

Said that she has totally eliminated the shoulder stand from her practice. Said that she has been doing Bhramari and it helps her relax before bed and also when she gets up in the middle of the night. Takes cannabis and alcohol when she “doesn’t want to feel her feelings”. She has a calendar where she checks off when she uses either and puts a ‘star’ when she doesn’t. I asked if she has gone to a therapist. She says “why go to a therapist when I can do it by myself.” Started on a new medication for High BP, still getting the dose adjusted. She started with the sleep log but says “it’s stressful and one more thing to do.”

Since I rent the space once a week, that I see clients in, I realized that I did not have enough props to make her comfortable. So, I decided to have her sessions at my house, where there is abundance of props. That way I can also show her some of the household items that she can use as props for her practice at home.

Try a shavasana in the chair (propped against a wall) with bolsters and blankets.

• Yes

Check-in, Seated in the chair- body scan (eyes, throat, hands and feet), extended exhalation with hand on the belly. Joint freeing movements, breathing from pelvic floor to up towards the crown. Netra Vyayamama- added pendulum and rainbow. Self-massage of the face and neck. Sun salutation by the wall.
Supine – bridge with squeezing a midsize soft exercise ball between her knees, because the blocks caused discomfort to her. I placed a soft blanket underneath her midback to support the curvature of her spine. Side plank by the wall, on the convex side of her C-curve.
Restorative shavasana on the chair by the wall, with two bolsters, her feet propped on another chair and a pillow behind her head.
Progressive relaxation from head to toes and then from toes to the top of the head. Breath meditation. Ending with Bhramari.

Keep practicing Bhramari before bed and whenever she gets up in the middle of the night. Self-massage of the face. Gentle asana practice.

Have been doing sun salutation by the wall, eye exercises, Bhramari before bed, says that she likes the silence that follows and feels at peace. Went dancing on Sunday and danced for more than two hours. She stopped when she started feeling a twinge in the right low back. She did the gentle stretch that we have been working on and Bhramari and says that it went away in the morning. She says she was aware of it while sleeping but it was not painful. Went to her massage therapist which also helped a lot.

Introducing Ujjayi breathing and visualization meditation, restorative side bends keeping in mind her scoliosis curve.

She said that she felt out of breath when she was doing extended exhalation seated in a chair, because of the decreased length of her torso. Next time, will have her standing by the wall and then practicing deeper breaths.

• Yes

Check-in. Standing up with the support of the wall and chair in front of her, started with extended exhalation. She felt that she can breathe deeper like that instead of seated in a chair. I asked her if she would like to try supine. Supine with support underneath her midback, knee and neck- Body scan, extended exhalation, breath awareness. Moved into pelvic tilts with the soft exercise ball between her knees, bridge, cueing back to the intention and breath. Focusing on the ‘fluidity of the breath’.
Seated in a chair- Netra Vyayamama, Joint freeing movements, self-massage.
By the wall- Sun salutation, side plank and gentle twist and side bends.
Supported restorative shavasana in the chair, progressive relaxation, neutral imagery meditation.
Had an emotional release during the meditation, saw herself young and pain-free and with her cat, who passed away in 1992. Said that she felt an immense wave of grief.

Goes for a walk around the neighborhood. Feels self-conscious to try that outdoors. Try moving meditation indoors to get comfortable with it.

Went to a Tai Chi class and saw her Osteopath. He worked on her feet and back. Said that the Tai Chi class was slow but she felt energized and calm after the practice. Sleep has been better, only gets up 2-3 times to pee as compared to 3-4 times. Uses body scan and Bhramari to get back to sleep.
Since it was Valentine’s Day, I asked her to set an intention for the practice. She said she doesn’t like the word ‘love’, feels that it’s been misused and used very freely, doesn’t mean anything, feels ‘childish, immature and self-indulgent. She says that she hasn’t grown up with feeling that emotion or talking about it. I asked about what word does she prefer. She said ‘pay attention’, ‘observe’, ‘become aware’, ‘devotion’. So, we set an intention to “fill your own cup” by ‘becoming aware’ of your body, breath and emotions.

Her reaction to the word ‘love’ was unexpected to me and I felt that I could have handled it a little better. In future, trying to use alternative words would help me make people feel comfortable. I guess, I should ask them in the intake process, if there are any words that cause discomfort, maybe add that question to my intake form?

This was a great learning experience for me. I dug deeper into ‘Vayus’ and how to work with that information. Dove a little into the information on pelvic health and prolapse organs. Listened to a podcast on it and also spoke to a friend, who has been working in this field for a long time, how to work with people having prolapsed organs.

Keep working with pelvic floor and core strengthening. Ways to bring more self-focus. Introduce Ujjayi breath and more calming and balancing practices.