In meeting this client the core teaching concept are annamaya kosha as well as the pranayama kosha.

To begin working with this client we will be begin with an assessment of his breath and do a few minutes of breath work followed by a 30 minute asana practice. I will also be looking closely at his range of motion as well as strength in his elbow. These sessions will be in person twice a week over the next 8 weeks.

This is a 54 year old male that just had an elbow injury/ surgery 6 weeks ago. He is a personal trainer and is used to daily exercise. He came looking for yoga therapy not just for the elbow but for tension in his whole body and also anxiety after the surgery from the healing time and lack of movement that he is used to. He is in very good shape but has a very shallow breath and feels pain throughout his body in his muscles. He had stage 4 Lymphoma 5 years ago and is now cancer free.

My plan is to begin with breath work to so a few minutes of nadi sodhana followed by a buzz breath and moving into some breath with some spinal flection and extension. The asana practice will be 2 rounds of a sun salutation followed by a restorative practice with some hip openers and forward folds using props followed by a yoga nidra.

We focused mostly on the heath branch of yoga and added a Jnana yoga meditation with the yoga nidra. The Hatha yoga embodies the body and the breath which is were his focus of healing was. The Jnana meditation was to aid in the understanding that the pain doesn't define him. He is not the pain within his body.

This client was never really interested in yoga but realized he needed help to heal from the elbow surgery and the other physical issues that came along with it. He knows how stretching the body helps his own clients but needed more to be able to do this on his own.

After working with this client for 8 weeks twice a week for 30 minutes he decided to also take a yoga class regularly. We also decided to continue a 30 minute session once a week indefinitely. There is still work with the elbow healing but the pain and tension in the muscles was a huge improvement. I suggested some breath work if/when the anxious feeling arise using the alternate nostril breath.

With resistance on the breath work and meditation I was met with I believe the goal was achieved. We only had 30 minutes to work so I think that time relieved the client and helped him be more open knowing it wasn't a longer period of time. Over the weeks we kept the breath work, asana and nidra the same so he knew what to expect and feel the improvement. To prepare for this client I went to the Cleveland Clinic for elbow replacement knowledge as well as Intergrative Medicine's for pain. Attached are a few of the articles that I found helpful.

Originally I wasn't going to do the nidra with the Jnana meditation but during the intake and the first session I realized how much he defined himself to his physical body and to the pain he was having. Keeping it short and simple but was able to see the client relax more and more through each session.
It's a good lesson to always add some mediation to fit the client and sometimes you have to meet them first to know what it is.

This was a unique case having many different areas to work on with this client. If I had the same situation I would keep the 30 minute session a few days a week because it relived stress in the body while allowing willingness for the breath and deep relaxation. The asana practice was designed for opening the body and to free the pain in the muscles while supporting the elbow which is still weak. That has to be individualized with each different person's physical needs and form. But overall wouldn't change the practice/sessions in this situation because of the growth in the client.

• Integrative-Medicine-What-Is-It-Types-Risks-Benefits.pdf
• Elbow-Replacement-Surgery.pdf