Ct walks slowly, left knee pain, larger body. New left foot pain with inversion. She attends yoga classes at the studio 2x/week and goes to the gym 2x/week (working on leg strength and core + elliptical). Dr has advised not to walk on treadmill, and recommends knee replacement when ct is ready mentally/emotionally. Struggles in folding, deep bending poses, as in child’s and DD + walking feet up to the top of the mat towards standing fwd fold.
Describes diet as healthy. Drinks a morning cup of coffee. No other caffeine, occasional alcohol consumption.
Has a sedentary full time WFH job.

Ct reports medium energy level, disrupted sleep, wakes during the night, never feeling rested. Breathes deeply and slowly when prompted, with no raising shoulders. Feels belly inflate/deflate appropriately with inhale/exhale. Experiences 3-part breath.

Ct reports never having a quiet mind, always running scenarios. Reports coming to yoga for peace of mind (but it’s not really working). Has a desk/computer job working from home; worries that she will be required to come back to the office in person. Struggles with self-forgiveness and self-acceptance.
Ct says meditation is hard; spends time in nature just being still and appreciating the beauty.

feels connection to others in a group with shared experience; and in nature, that’s when her mind is still. Takes breaks during the workday to go out in the field and just be. Has a regular prayer life and faith that God is in control and will take care of her.
Introducing the concept of suffering as forgetting our true nature brought tears.

Rather than transcending the reaction to stress, Ct is using her intellect to manufacture stress.

I’m starting with the SMTT manual pp 159-161 on Resilient thinking from Jnana yoga. This Ct is using her intellect to manufacture stress and I believe the teachings of Jnana yoga can help her to reframe and use her intellect to cut through stress.
For example:
“Is it happening right now?”
“I can choose to change my inner experience instead of trying to control things outside myself.”
“I am the witness. As the witness I am always ok.”
+discriminating between what is useful and what is not.
+slokas such as “As you gain control of your mind, with the help of your higher Self, then your mind and ego become your allies. But the uncontrolled mind behaves as an enemy.” Bhagavad Gita, 6.6
+sutra 4.27 which Jaganath Carrera says is the basis for self-forgiveness: “The flow of discriminative discernment may be interrupted now and then by the force of subconscious impressions (samskaras), which cause distracting thoughts to arise.”

I’m working on learning more about knees for this client. She comes to my yoga classes, so I’d like to have some more suggestions to pull out. As I started the research, I had an expectation of finding “safe poses” for knee pain. What I found was that the focus is on strengthening the muscles that support the knee and in talking to this client, that’s exactly what her doctor is telling her to do.

This book has adaptations for asana: pp 70-73.

McGonigle, A. (2021). Supporting Yoga Students with Common Injuries and Conditions: A Handbook for Teachers and Trainees. Singing Dragon.

This book deals with knee pain on pp. 158-168.

Hogan, S. H. (2021). Built from Broken: A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body. Saltwrap.

This is a study on the effectiveness of yoga nidra for sleep) and other cognitive functions)

Datta K, Bhutambare A, V L M, Narawa Y, Srinath R, Kanitkar M. Improved sleep, cognitive processing and enhanced learning and memory task accuracy with Yoga nidra practice in novices. PLoS One. 2023 Dec 13;18(12):e0294678. doi: 10.1371/journal.pone.0294678. PMID: 38091317; PMCID: PMC10718434.

Just a reminder that this was client #1 and I’m filling in the platform with the stuff that was previously approved.

• 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.