Using spinal extension and pranayama to counter-act desk job, where a pain has developed under area of xiphoid process. Refer to doctor to rule out any serious conditions and get clearance for activity.

Meet with client and assess areas of discomfort and assess spine, ribs, neck and shoulder area.
Assess effect of breath on pain.

Diminish discomfort in area of pain.

Female 32 no diagnosed health condition, chronic anemia iron deficiency. Hx heavy menses, no childhood dz. Working, computers desk job 8 plus years. Lives with partner, no kids, one dog.
Eats healthy, exercise 2 x week walking. some trauma as kid, Since COVID has had swelling in thyroid.

Assess her symptoms and general health. With that information I referred her to a doctor for a physical and any further testing needed before we proceeded to the plan.
Concern is her posture at a desk for many hours a day leading to thoracic flexion, leading to compacted area in frontal chest area. she has shallow breathing and little awareness of breathing into the whole chest or using her diaphragm. The pain is in the constricted area at the bottom of the frontal area of ribs.
Second go through the treatment plan with her, taking her through it 3 times and verifying she knows what to do at home on a daily basis.
Review progress in 3 days, then 1 week. If needed a 3rd visit for questions, further assessment and additions to treatment plan.

In this class our focus was on the physical body. In this plan I used primarily asana and pranayama which fall under hatha. This person has a stressful job mentally and physically, sitting most of the day at a computer answering questions and maintaining a professional countenance. Service to the clinic as well as though clients who call and walk through the door every day. Enabling her to provide that service with less physical pain is one goal. Another is to enhance her respiration so that she feels a sense of energy from within versus the coffee. Taking the time to daily practice is service to herself because everyday she is practicing Karma for others with a cheery attitude. In her practice I am asking her to examine her breath and how she feels svadhyaya, a part of Raja yoga. In the future I might add a chant to her exhales with her asanas which would add a bit of japa.

Assessment: Her concerns were directed to pain management and doing her job with more ease and vitality. Discussed meeting withreferral provider.
Review the goal of plan -diminish her pain and create better postural balance and breath with greater depth and ease.
Established an upright posture in a chair. She felt that her hands placed palms up on thighs and placed just in front of the hip crease was most efficacious for her to feel her front body most “open”. Breath Awareness followed by being guided to increase and feel depth of breath etc . Client had a great response to learning about her breath. We added movement by using virabhdrasana with inhale raising arms, spinal extension, and bending front knee and exhaling back to neutral. 6 x each side. 2nd asana was bhujangasana followed by ardha salabhasana all going up on inhale emphasizing use of upper back muscles.

I suggested the client do these exercises in the morning for 6 repetitions of each asana Virabhadrasana , bhjanghasana and ardha salbhasana. Focus on breath being deep and full of equal length. In evening after work I suggested bhujanghasana and airplane like counter poses to her work day. At least 4-6 repetitions of each, lengthening the exhale, enhancing the relaxation effect for the end of day.
In future sessions I would add a series of neck and shoulder rolls, bridge with arm movements and suggest lying with a lengthwise blanket or pillow under spine supine and relax with extended exhale, taking deep shorter full inhales.
In her weightlifting she can work on trapezius, rhomboids as well as loosening up with shaking and moving limbs to off set tightness of lifting. A standing desk or a stool with a screen ay eye level would be advantageous.

The meeting with client went well, she was eager to get started. Even as she began the breathing exercises she felt different. I felt the goal was met. I had developed an easy brief plan that she could execute and even learning the plan she had relief. The goal was achieved, less pain, more vital energy and more comfort with her breath. Her explanation was hard for her to explain in words, ease and comfort was what she felt.

For this client I did not need to adapt anything. She is vital and eager, excited to learn. I learned that even easy plans can bring comfort quite quickly. Many people especially women suffer a multitude of maladies from sitting all day, even when you can get up every so often. It is common for middle age women to have chest pain and breathing issues from sitting all day. And other research shows a list of maladies more common in women who sit for 6 hours or more a day.
Associations between sitting time and a range of symptoms in mid-age women
GMEE (Geeske) Peeters a b, Nicola W. Burton a, Wendy J. Brown The University of Queensland, School of Human Movement Studies, St Lucia Queensland 4072, Australia The University of Queensland, School of Population Health, Herston Road, Herston Queensland 4006, Australia
19 December 2012.

Berkowitz, Bonnie & Clark, Patterson. "The Health Hazards of Sitting." The Washington Post 20 Jan. 2014. 27 Feb. 2016 .
Every clients’ circumstances and presenting history is different. I might tweek this protocol for others, depending on their yoga knowledge, concomitant complaints and history. For example, a person with more pranayama knowledge may be ready for deeper breathing techniques such as short retentions. If this person had pain related to eating, then I would advise 3 deep breaths prior to eating and watching the size of the meal. Maybe they have been eating fast on their break so they may need to negotiate a longer lunch period.
Many people have this desk issue and it can be addressed on a corporate level. Also small business' could be more open to their workers needs by offering stand up desks or stools that accommodate standing or sitting. This was one person who easily was able to gain the knowledge and skill to change her pain, increase her energy and generally feel better at work by taking 20-30 min a day to do her practice.