Client has a lack of mobility and flexibility in the shoulders, hips, and ankles; the left shoulder is higher than the right; there is kyphosis and stiffness throughout the body. A titanium rod is present in the right tibia due to a spiral fracture, which necessitates gentle rotation of the ankle.
Complains of digestive issues prior to elimination, characterized by sharp pain; the client eats very quickly and barely chews his meals; there is no established eating routine, and diet mainly consists of fast food.
Client states his sleeping habits could improve, no routine, and often stays up late watching TV and using electronics.

Client complains of fatigue throughout the day and is currently managing with ADHD medication.
Chest breathing is shallow, but not rapid.
vapes nicotine; would like to quit but does not know if he can.
Is not currently excercising but trys to walk daily.

The client is experiencing relationship difficulties with his long-distance girlfriend, often resorting to dishonesty to maintain harmony, a behavior he recognizes as a pattern inherited from his parents. He also struggles with his relationship with his mother and father, feeling neglected during his childhood. His father is judgmental, and his mother, who has a lifelong history of mental health issues, can be quite demanding. This occasionally leads to feelings of guilt when he prefers to avoid her company. Additionally, his grandmother, who was his primary caregiver, is now facing early-stage dementia. He also harbors a fear of commitment.

The client was brought up within the Christian tradition but considers himself largely pragmatic; he possesses a spiritual side and is open to exploration.

The client feels a sense of disconnection. He aspires to marry and start a family someday, but he does not believe his current girlfriend is the right partner for this. He spends most of his time working remotely.
Is interested in photography.
He feels a connection to nature and is focusing on purchasing land to farm.
He enjoyed volunteering with the American Red Cross

Yamas: Ahimsa - to self and others - in relation to self: eating/sleeping/vaping.
Yamas: Satya - being truthful with self and others.
Yamas: Bramacharia - harvesting energy. What is using up the energy?
Niyamas: Tapas - strict discipline to create daily routines.
Pratyahara: letting go of the senses and connecting with his true nature.
Sutra 1:33 Four locks and Keys for improvement in his relationship with self and others;
Karma Yoga for comfort.

IY Stress Management Manual - For fatigue and stress reduction: Understanding stress, relaxation and yoga; translating yoga practices into stress management, adapting Hatha yoga practices with consideration to ROM limitation, deep relaxation. Pranayama for comfort and to deepen lung capacity.

IY Healing Relationship Manual - Chosen to start where we are awareness/witness practice; therapeutic relationship - agreement on the goals of therapy and collaboration on the work or tasks of the treatment; modeling self care

IY Therapeutic Yoga Manual - Chosen to support the body and to feel supported.

Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology. 2017 Dec;86:152-168. doi: 10.1016/j.psyneuen.2017.08.008. Epub 2017 Aug 30. PMID: 28963884. https://pubmed.ncbi.nlm.nih.gov/28963884/

Do I need to include additional medical research or is it sufficient to use my course manuals for this client?

• 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.