Bolsters and props help us to feel supported and elicit a relaxation response.
Chapter 13: Clinicians applying yoga principles and practices in pain care an evidence informed approach
by Shelly Prosko and Matthew Taylor.

Client is experiencing low back pain when she is in a stressful situation and feels anxious and out of balance. I plan to have her in a supported frog pose with the help of a bolster and blanket for 5 minutes. I will have to have her rate her pain on a scale of 0 to 10 before and after our yoga therapy session.

58 yo female who is generally healthy but states that when she is under stress she will have somatic pain in her lower back. She states that she feeling well and visiting her family in Europe when the war in Ukraine started in February. She states that since then she has low back pain and she had a massage session which help a little but she continues to feel tense in her lower back. She states that she and her family are not in any acute danger but she is very sensitive to suffering of others.

This client is very aware that in stressful situations she gets very tense and she will have pain in her lower back. I wanted to bring her into a supported pose that creates more flexibility in the hip and back. The pose also increases circulation in the pelvic and abdominal region. With the pose being in a prone position it increases the awareness of the in and out breath, this in turn can make it easier to feel into the breath and helps to to bring a sense of calm. A restorative pose when held with the least amount of effort can help us feel supported and elicit a relaxation response and therefore release tension which a lot of people hold in their lower back. Before having her come into the pose I instructed the client to do some Tibetan hip circles to help warm up the hip joint and promote lubrication of the joint so the client can hold the position longer to get the full response.

I used the IY branch of Hatha yoga such as asana and breath awareness to to encourage the client to release anxiety and stress to achieve a state of balance and inner peace.

I met with the client over zoom. I instructed her to have 2 or 3 blankets and one bolsters. After a short centering, I asked her to rate her pain. She states it was a 3. I instructed her to come into a table top position and started out with Tibetan hip circles in both directions to warm up her hips. I showed her how to position the blanket and the bolster. To have one blanket above the bolster to rest her head and to have one blanket on the other end of the bolster for her knees, we made sure that she was in a comfortable position so she would be able to hold the position for a while. After she came into the pose I had her focus on the her in and exhalation. I also talked about the benefits on the pose and made sure she felt comfortable. She was able to have her body sink into the pose. She felt feel very calm and was able to stay in the pose for 5 minutes.

She had a very positive response to the yoga session. She states that she felt very comfortable and relaxed in the pose and she states that in this moment she did not feel any pain. She states that she is ware that she is very sensitive to other peoples suffering and we talked about the importance of good self care and that this is not a selfish act that we are only able to help people when we take care of ourself first and that is is ok to rest and relax .She thanked me for reminding her of this she states that she was feeling so helpless when she saw the intense suffering of people and all she was able to do was to donate some money to the red Cross. I suggested to her to have a gratitude journal to bring her awareness to what she is grateful for and to realize the things she does to help other people.

Yes, I did apply the plan as intended. I did consider to have the client stay in the pose for less than 5 minutes, if she was uncomfortable in the pose. I did anticipate adjustments for example, I could have added a second bolster on top of the first one or have her cover herself with a blanket if she felt vulnerable in the pose. She stated that she feel comfortable she liked that I had her focus on the breath and had her imagine the breath flowing up the spine on inhalation and down the spine on exhalation. She feel that with each exhalation she was able to let go a bit more and sink into the support of the bolster.

No, I did not have to adapt anything, but I was prepared to do so and also to use a different pose, for example modified child pose. At the end of our session when she told me that she did not feel the pain anymore, I was very happy and surprised, honestly I did not expect this response from the client. I was hoping to ease her pain but I did not expect it to be gone. It was a very nice for me to experience the healing power of yoga first hand. It is one thing to read about it in an article and quite another to experience it with a client. This brought me great pleasure and happiness. We were able to reflex on the importance of self care and journaling and she was very grateful to the reminder how important self care is and while we might not be able to solve the problems of the world, we are able to make thinks a little better for us and the people around us.

Yes I would approach it again in the same way, as long as I keep in mind and remind the client that it is very important to let me know if she feels uncomfortable so I can make adjustments if needed. I did not make changes because the client was comfortable, she was able to trust the support of the bolster and she was able to relax the tension in her back and came out of the session reporting that she did not feel pain. We where able to reflect together the importance of self care and that this is not selfish because it helps us to rejuvenate and have more energy to be helpful to other people. As I mentioned before was surprised myself how powerful yoga is when it comes to relaxation and reliving the tension to the body. Reading all the supporting documents and research, maybe I should not be so surprised but being a new teacher it was a very powerful and meaningful experience for me.