"The most significant difference between regular asana and restorative poses is that in restorative poses, the body is completely supported by props. The body and mind feel safe. They can relax and let go. Poses can be held longer, w/o strain, allowing the benefit of the asana to be sustained and go deeper" Restorative TT Manual p.7

Daily practice of Supported Breathing Pose (Supta Baddha Konasana variations, Lasater p.19-24) will "open the chest, especially the lower chest" an area w/ significant physical tension & scar tissue still healing on multiple levels. Possible outcomes include: Improved breathing & ROM & trust, less fatigue & frustration w/progress client can notice.

Male identifying, PHYSICALLY ACTIVE 77 year young human with history of cancer, glaucoma, vertigo, and spontaneous mitral value prolapse. Is recovering from open heart surgery (9+ months ago) and is not "all better yet." Chief complaint is fatigue and frustration with progress; he is "only walking 4 miles a day and requires daily naps". His surgeon, cardiologist, general practitioner, AND consulting neuropsychologist have ruled out alternate explanations for fatigue and conclude "it's being 77."

Session #1: Intro. to & education Re: benefits of RY. Client enjoys learning about how the Nervous System works & how we can intervene via tools of yoga (pranayama, gentle mindful movement) so RY was introduced as “one more tool.” Client learns best by “doing” so the plan was to briefly discuss What/Why & then spend the remainder practicing How, noticing any/all effects. (Details in next section).
Goal: find shape every day/10 min. w/Client understanding EITHER variation was acceptable. While in shape, client is encouraged to notice his breath & practice slow easeful breaths.
Check-In (Booster) Sessions: Invite client to use this shape for his “end of class Savasana” so I can check-in on his set-up over time (he attends 3 classes/wk).
Session #2: 3 to 4 weeks after Session #1, meet & re-assess fatigue, shoulder range of motion, attitude RE: Restorative, attitude toward continuing.

1) Hatha: Restorative Yoga: In general, RY practices offer our body a chance to guide our brain toward peace. Supta Baddha Konasana (SBK) helps by bringing the chin into flexion (slightly lower than forehead) stimulating the PNS & the relaxation response (Lasater, p.6). Maintaining a position that is in-between laying down & sitting up by “Propping the head in ‘straight ahead’ position will help you relax w/o going to sleep” (Lasater, p. 7). For this client, given his chief complaint is fatigue, propping spine to 45-degree angle is critical for obtaining the benefits of relaxation while remaining comfortably alert.
Uncertain whether the client would feel better w/SBK variation 1(feet flat on mat knees hips distance apart) or 2(soles of feet together, knees open like a butterfly) (Lasater p.19-27 (see nxt. box).

2) Hatha: Pranayama: Guided Breath Awareness leading to Dirga Pranayama

Check-In revealed that along w/fatigue, client feels frustration & worry. His doctors are running tests to understand the fatigue, yet are also quick to remind him that he is 77 so “slowing down” is to be expected. Client sees fatigue as not only keeping him from things he needs/wants to do but also as a potential sign that something is not right. Although tests suggest all is well, he is left uncertain.
Initial set up for RY made use of what Client had on hand (Base Set Up Photo 1 & 2). We brainstormed other solutions based on what he has at home & I sent images of a “Prop Rich” set-up that he could replicate with tools on hand. We discussed key principles for setting up 2 variations of SBK & emphasized how RY is similar to & yet different from his Hatha practice. It was during this session that I realized FREQUENT check-ins to review set-up/address questions would be a good idea.

One point I’ve emphasized is that RY (like all yoga) takes time. While client has had a yoga practice for nearly 5 years Restorative Yoga is a new way of approaching things & may take practice before benefits arrive. Suggestion: Find ways to practice that are already part of his routine. For example: we agreed that he could try SBK as his Savasana in class (option NOT requirement). Adapting the shape (while maintaining the spirit) proved essential: Once he adapted it, he found a version where his muscles “weren’t working so hard” & that he enjoys. He was able to then translate that to the mat version & set up with greater attention to “real comfort.”
RY over Zoom means the Client has a much larger role in building the comfort. While this may mean it takes longer to get “there,” now that he grasps it, I am certain it’s truly embodied.

Branches cont’d:
I planned to introduce both V1&2 since both serve our goals.
Per Lasater, in addition to optimal awareness, both variations of SBK reduce coughing (that may come w/laying flat) & open the chest* V1 opens lower chest while V2 opens upper chest.
*not using this language w/ client due to open heart surgery b/c I am not a monster

Yes, applied the plan. Yes, goal was met (some).
Client diligently practices savasana every day already BUT typically finds it laying flat in bed for 10 to 15 minutes following a post-run/walk shower. Setting this up on the floor and finding it each day proved challenging so he adapted (see box below)!
His initial set up (see Base Photo 1 & 2) was enhanced by tilting the blocks (flat portion on thigh). He has LARGE blocks that supported the bolster well. At 2 weeks of daily practice he reported energy level feels about the same.

Client continues to practice & has found a version of the shape where his “muscles aren’t working as hard.” Although we discussed at length (& during follow up check-ins that Restorative = NO work for the muscles, he admits that this is the hardest part for him to grasp. During Week 2 he developed an adapted version of V2 using his recliner as the base. Using a bolster with blankets to support spine and head (similar to mat set up) he then uses the padded arms of the chair for support for his knees. In his words “It’s perfect & I now know what relaxed while awake can feel like.” At 77, this is huge. While fatigue continues, he is pleased his shoulder range of motion has improved noticeably (by me) by him “It’s easier to move my shoulders (retraction/protraction).” Eagle Arms are significantly more available. (Wk 1 vs. Wk3) (See nxt. box for lessons learned).

Yes (Went well/would repeat).
I’d be sure to incl. frequent check-ins. During 1st wk., we reviewed/refined practice/deepened understanding of RY. “Release, relax, let go” = foreign concepts to a person who is independent/used to being in charge.
To enhance sense of control, Client had SBK options, encouragement to adapt shape (while keeping its spirit) & option to stop at any time.
Making peace w/your body post-cancer is a life-long quest. Cardiac event notwithstanding, Client will likely always interpret physical sx. 1st via the “Is it cancer/recurrence?” filter. This alone can be anxiety/fatigue producing. A full YT program could address this via Raja Yoga to compliment the RY, e.g., YS 1.11 “The act of memory is to store a sensory experience in our memory” ; possible contemplation: “Can I train my memory to serve my growth/happiness?” (Bachman, 2021).
His 2 most significant health events came “out of nowhere” both beginning w/fatigue. Doctors stating fatigue is “part of being 77” did nothing for sx. (& undermined the healing relationship). In contrast, we put fatigue front & center. In his words: “While it’s not better, it’s not worse & that’s something.” This = high praise.