Entry TypeAssessment
Client/GroupC.M.Frozen shoulder
Entry CategoryIntended Case Study
Select your mentorSteffany Moonaz
Intake
Assessment
Proposed number of sessions8
Location of sessionsonline
Planned time per session30
Presenting Problemfrozen shoulder
Physical

53 yo male with hx of frozen shoulder 1 year ago, diagnosed by his PT who gave him exercises and 1 month of PT .The pain improved .Now the pain has started again in the same location, his left shoulder.he does not have any other physical complaints..He is not able to bring his arm above shoulder height or hewing his back.No other diagnosis .He does take antihistamine over the counter for allergies as needed.He only exercises occasionally with weights.He likes to go on walks.He leads a mostly sedentary lifestyle.He enjoys reading.

Client/Group goalspain relief
Energetic

He describes his energy level as fair, he is aware that he does not have much endurance.He would like to go on bigger hikes but does not have the energy for it.His breathing is in his chest and not in his diaphragm, but it is not restricted .He will benefit from breathing practices.

Emotional

He had a brief episode of depression and saw an online counselor last fall for 8 sessions when he had a lot of stress at work.His boss was terminated and he did not feel that he had the support at work that he needed.He applied for a promotion and got accepted.This changed the dynamics at work and he got under a different supervisor who was supportive and his mood improved.His current mood is stable and optimistic , he bellies that he is able to improved his pain in his shoulder again , since it also moved with PT last year.

Spiritual orientation and needs

He was raised Catholic. he does not go to church regularly .He is openminded to other religions and enjoys studying them for his intellectual enrichment. He is open and interested in learning more about yogic philosophy.

Intellectual / Sense of self

He is very analytical and self reflected.He has a good sense of self, however in certain circumstances his sense of self is vulnerable ,for example when his boss was terminated he did not feel secure anymore and he started to doubt his own abilities .

Yoga philosophy/wisdom research reference(s)

Non-attachment in Yoga: How To Let Go Without Indifference
is an article
by Maria Kuzmiak :

"The principle refers to putting forth effort without attachment to the results of that effort. The practice of non-attachment gives us more freedom and opportunity to use our gifts, because it allows us to focus on what we can offer now, not the results that may or may not come some time in the future."
I will incorporate the principle of non attachment into my yoga therapy to teach my client that we can work towards a goal, in his case to be pain free with out attachment of how much time will it take and the overall out come.

Tapas, to put in a steady effort with out being attached to the outcome.

Scientific research reference(s), why chosen, how you plan to incorporate 1-3

https://yogainternational.com/article/view/frozen-shoulder-and-yoga/

This article by yoga International gives a good over view of yoga exercises for frozen shoulder.I will incorporate the suggested exercises into my treatment.The article talks about the importance of working on improving the clients alignment in the head and shoulders, woking on core strength and hip mobility.It also talks about several contraindications for example holding postures for an extended time, downward dog, headstand or shoulder stand.
I would offer postures like mountain pose .shoulder rolls, shoulder shrugs, cat cow, table top with leg extension.I would work on improving core strength with leg raises , isometric knee against hands while lying on the back. later work on planks.

I would keep the sessions short but incorporate the breathing practice, postures , visualization and koshas, to make it whole yoga therapy session.

Approval Notice
Your care plan should be approved by your mentor, with any amendments they suggested, prior to your remaining Yoga Therapy sessions.
Questions for Mentor

I was wondering if it is ok to work with him in shorter sessions but with more frequency and repetition, as in his case he should not hold postures for a long time and he would like to do this online during his lunch break.
I am open to any suggestions you have.

Care PlanOutline should be a practice adapted to the needs of that client/group, including:
  • Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
  • balanced pranayama considering contraindications, meditation/centering.
  • Please include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client/group.
  • Over time, we want to see something from each branch, selected, adapted and re-framed appropriately. Tools from each module should be used (not on each client/group – but overall)
The outline should show the sequence of practices as you plan to offer them.
Your care plan proposal should be approved by the mentor before session 2 if possible, or 3 if approval is delayed by mentor.
Session
Session Instructions (Not Mentoring)Your session outline should be a practice adapted to the needs of that client, including:
  • Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
  • Balanced pranayama considering contraindications, meditation/centering.
  • Include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client.
Over time, we want to see something from each branch, selected, adapted and re-framed appropriately.
Tools from each module should be used (not on each client – but overall)
Final Client/Group ReportAfter seeing your client/group (for at least 4 sessions including interactive intake)
Please remember practicum is a learning experience. You’ll learn more from sharing what’s accurate than from what might “look good”. Things you did well, not so well, problems and questions are all valid and useful tools to teach you. We can’t serve you to become the best clinician you can be if you don’t share your challenges and mistakes. Success is anything from which you learn. You can continue to add Session entries after submitting this Final Client/Group Report.
Report briefly on each Kosha belowProgress toward wellness or worsening reported by the client/group or that you observed in the following areas
Additional Information
Personal reflection from doing client/group.
Notify Mentor?Notify Mentor of Updates/Completion