Having worked with PTs, trainers and a chiropractor, client clearly understands her appropriate Range of Motion. She stays active and fit with 5-to 8-mile hikes, Pilates and workouts 7 days per week.
She prides herself for being in excellent physical condition for her age while managing chronic pain, which she said was a 4 (scale of 1 to 10) during our session. When I asked about the principle of Rest & Recovery, she said her chiropractor had also mentioned that, then winced at the idea of taking a day off from her active routine.
With this in mind, I believe that the client will benefit by starting with a floor-based sequence of 4 to 5 gentle asanas (see pg. 2) integrated with breath awareness to deepen connection with her body, as she safely stretches her back and lower body to ease stress, manage pain and maintain mobility. As the client consciously incorporates each movement with inhales and exhales, I trust, in time, she’ll find herself doing the same throughout her day. I’ll also offer one chair pose: on the inhale, ground and visualize spine lengthening from coccyx to crown – breathing space and light in between each vertebra, exhaling to soften and relax. Repeat 3 to 5 times.

See above.

Client has an obvious undercurrent of anxiety. She described her stress level as ‘Moderate’, which she manages with hiking, workouts and Pilates. The teaching of Ahimsa is relevant due to the fact that she exercises vigorously 7 days per week, which keeps her in a Rajasic state and a probable Vata Imbalance. I also sense there’s some resistance to being still and connecting with her feelings and chronic pain.
With this in mind, I believe a mindfulness practice of sitting 3- to 5-minutes (2 to 3 days per week) with hands on heart and belly and 3-Part Breath will be beneficial with stress reduction as well as gradually opening to her awareness of feelings and discomfort within. Some additional stress management techniques I’ll recommend over time include Mantra and Gardening: cultivating awareness and connection – breathing as she connects with the soil and
IYT Assignment #1 – Care Plan
earth leaning in with wonder and awe at the inherent, regenerative knowledge and interconnection of plants with nature and the 5 Elements.

Client considers Nature to be her church. The 5-4-3-2-1 Grounding Technique would be an enjoyable and relaxing way to tune into her surroundings and physical body through her 5 senses while on a hike.

Client has a strong sense of self. I do see that she is dismissive of her feelings - allows her thinking to override her sensitivities and is obviously averse to owning her anxiety.

The Yamas & Niyamas by Deborah Adele
I appreciate Adele's insights and stories regarding Ahimsa. I’d discuss this with my client relative to self-care and lovingkindness with all things including herself in spite of her condition. I’d use this as an opportunity to discuss healthy aging and appreciating one’s body as it changes and all it can still do in spite of her condition.

SPINE JOURNAL: The Effect of a Stretch and Strength-Based Yoga Exercise Program on Patients with Neuropathic Pain due to Lumbar Disc Herniation
This article is based upon a randomized control trial of 48 patients due to Lumbar Disc Herniation (LDH), which can present as Spondylolisthesis. The study’s hypothesis being that yoga can improve LDH and related pain by increasing mobilization, core strength and spinal and hamstring flexibility.
The study’s results showed a significant improvement in patients who practiced carefully selected asanas pointing to a promising treatment option for pain management.
Based upon the findings of this trial, I plan to present a gentle and intentional 4- to 5-Asana sequence with breath awareness to support client in maintaining mobility and flexibility of back and lower body and lubricating joints, while helping to ease chronic pain.
Asana Sequence w/ Breath Awareness – Reclining Hand-to-Big-Toe Pose w/ Strap - hamstrings | Reclining Pigeon - hips| Happy Baby – movement & massage | Legs Up the Wall – hamstrings & stress reduction | Child’s Pose - lower back

N/A

• 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.