• 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. Pratipaksha bhavana – during alternate nostril breathing – inhale positive and exhale negative
2. Deep relaxation after PT/yoga practices. I recorded an 8-minute guided imagery and emailed it to him. I also share Visualization & Guided Imagery for Pain Relief (The Complete Guide) - Pathways that has several records of guided imagery and lay-term explanation on how it benefits pain management. He can choose to use them instead of my recording.
3. Listen to the body and not over doing – He is eager to get better so when the therapists (PT or I) suggest home practices; he tends to overdo it.
4. Non-attachment – He identifies himself as a ‘do-it yourself’ guy. And averse to asking others for help.

Check in
Journaling exercise: ‘I am …..’
Yogic philosophy - klesha
Centering - breath awareness and extended exhalation
Asana –
• Cat and cow
• Arm stretch and down (inhale-exhale)
• Side bend
• Gentle twist - open one arm out and bring the hand to the opposite shoulder, turning the head to follow the hand
• Seated sun salutation,
• seated cris-cross core strengthener (one leg extend to the side, exhale bring the extend leg and opposite elbow to together)
• lion pose
• seated half bow,
• knee to chest,
• leg extension with strap (on a chair)
• puppy pose
• thread the needles
• seated forward bend on the floor – one leg and then both
• supine twist – knee windshield wiper with feet on the floor
• leg up the chair
Deep relaxation: guided imagery – special places -work with all five senses
Pranayama: Alternate nostril breathing – inhale positive thought (opposite of the negative one), exhale negative
Brief meditation

The client has been very diligent in daily practices. He reported that all PT exercises are not as difficult as they used to be. He is getting better at not lifting very high during bridge pose; so, it is not painful as it had been. I suggested to him to hold the pose for 3 to 5 seconds instead of 10 seconds.

However, his eagerness to get better drives him to overdo it. The PT suggested water therapy. So, he went to the gym, but instead of a few minutes of warm up, he did almost 20 minutes of that (reclining bike, treadmills, rolling machine) before getting in the water. It did not go well since he was in pain and felt worse afterward.

He mentioned that his PT did assessment (perhaps a client reported questionnaire), and it does not look like he has made progress in term of pain scale and how it impacts his QOL. We discussed why he thinks that is and how pushing beyond his physical limitation can do more harm than good. I emphasized to him to listen to his body: start small and see how he feels.

We spent a good portion of the session talking about attachment, aversion, and self-awareness. The physical and subtle session went well. He enjoyed the guided imagery; He felt relax and calm. He had pain (overdid with water therapy) when I arrived, but the pain was not there after the session ends.

Check in
Centering – witness practice
Asana –
• Eye movement
• Head and neck
• Shoulder shrugs and stretch
• Side bend
• Cat-cow
• Sun salutation
• Hip/torso circle
• Leg lift
• Seated cobra
• Lunge with one foot on a chair
• Pelvic tilt
• Supine pigeon
• Hamstring stretch
• Supine twist
• Leg up the wall

Deep relaxation
Pranayama: Ujjayi breath, alternate nostril breathing
Meditation
Yogic philosophy –
• Svadhyaya – cultivate self-awareness, pay attention to the body and mind
• Ahimsa – be kind to himself, not pushing through pain.