• 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.

1. Morning - deep breathing 5 min followed by 5 min meditation on something that he is grateful for.
2. Make small goals for the day - considering his energy and how he feels. Pay attention to his physical body and try not to overdo it. I suggest him to keep activity log and take a note on how he is feeling each day.
3. Incorporate pelvic tilt, heel slide, tabletop with knee(s) lift) and hamstring stretch (with a strap) into his routine exercises. And remember to breathe with movements.

Check in - the client did yardwork this week (riding mow and weed whacking); however, I think he over did it. He did not feel good afterward. He did two of the four home practices (deep breathing and cat-cat cow). I assessed pain level using PEG Pain Screening Tool and Global well-being using PROMIS-10. The client mentioned that the PT instructed him to do two sets of bridge, 10 repetitions each and he found that it was painful. I suggested him to talk to his PT about this.

Asana - joint movements on a chair, mountain pose with arms stretch and forward bend, knee-to-chest, pelvic tilt, circle the knees, reclined hand to big toes (with strap), heel slide, tabletop with lifted knee(s) and savasana (integral yoga template).

Pranayama (deep breathing) and meditation were done while the client lying down. I asked the client to focus on something that he is grateful for during meditation.

We discussed homework. - we discussed making small goals and not attach to what he did for fun (being outdoor, hiking, caving etc.) in the past and find other activities that also bring him joy, e.g., volunteering at a senior center (he is doing it and love it), going for a drive in the countryside, picnic etc.

Total session time: 1 hour and 20 minutes

This is the first session, therefore, there is no progress yet. I used PEG Pain Screening Tool and PROMIS-10 to assess the pain and well-being of the patient, respectively.

I planned to do several standing poses, including downward dog, triangle, locust during the session. However, the client felt pain on his back and left leg during mountain pose and forward bend. So, I got him to lay down and just focused on supine poses that would help with the back pain. I did not plan to do pelvic tilt but thought that it would be good to ease the pain. So, I included it, and it did help.

The client felt tingling on his right leg when we did side stretch on the left side (while on a chair). I reminded him to go slow and back off from the pose if the discomfort started to creep in. I think that cultivate body awareness will be helpful for this client.

Since he had difficulty with standing poses, I will focus on doing poses on a chair or on the floor.

After savasana, the client seemed relaxed and I did not want to ask him to sit up; so, I decided to do pranayama and meditation lying down.

I will check with him on how he is doing with home practices; especially sticking to small goals and not overexert himself. I will teach witness practice and will add nadi suddhi to the practice. We will continue to discuss non-attachment and contentment. Asanas will be done on a chair or a floor (sitting or lying down).