To work with clients who have movement challenges requires a more creative approach to traditional asanas. With adaptive yoga, many physical postures become accessible to a greater number of practitioners. This way everyone who breathes can enjoy the benefits of yoga.
Ref.: Adaptive Yoga Manual; Eisenberg, Mindy. Adaptive Yoga Moves Any Body.

To develop flexibility and lessen her pain, my client will practice 3 asanas, pranayama, and Yoga Nidra (30 min). At the beginning and end of the session, we'll measure pain levels (1-10). The goal is to gradually strengthen and stretch the hamstrings using props, adapting the asanas to her body and relaxing her mind, opening to healing.

My client is a female, 67 years old, mother, retired teacher, living alone. She meditates every day and practices yoga sometimes. She has pain on her right leg and sits bones. Her right leg is externally rotated, her pelvis is moving forward and she has a partial tear of the hamstring tendon, at the level of the ischial tuberosity, which gives her pain when she sits for too long. She is already seeing a chiropractor. She wants more flexibility in the body and positive thoughts in the mind.

She will work with asanas and breath awareness 3x a week, 2 sessions, using props and adapting the asanas to empower her healing process.
1. Warm-up (5min) – pavana muktasana on the mat(5-10x). First, she warms up to prepare her whole body, mainly the hamstring muscles.
2. Legs up the wall-3 min with a folded blanket, to stretch her hip flexors.
3. Supta padangustasana- resistance training to strengthen the hamstring muscles (5 -10x each side) Isometrically work trains the muscle to hold and stabilize. Wrap the strap around the right foot. Inhale extend the leg up, left leg extended on the floor. Exhale, bend the knee and pull gently the tight toward the chest with a strap while she pushes her feet upward into the strap creating resistance.
4.Bridge with a block under the sacrum -10 breaths. Strengthens the core abdominals necessary for controlling pelvic tilt.
5.Relaxation-savasana

1. Raja yoga helps the client to understand that pranayama can eliminate the root cause of suffering. Through pranayama, the veil that obscures the inner light dissipates. (2.52) Carrera, Rev Jaganath.
Raja Yoga tells us we are “Happiness personified” (R. Y. TT manual). But we cannot reach that state because we are searching for temporary happiness outside. Pranayama takes us inside where our true Self resides, which is SAT CHIT ANANDA (ever Existent, ever Conscious, ever new Joy).
2. Hatha yoga: asanas and pranayama. First, we work the physical body (annamaya kosha) with warm-ups and then energy body (pranomaya) to enter in savasana to access the higher koshas.
Hatha yoga Pradipika states I chapter I, v.67 that the purpose of practicing Hatha Yoga is to attain Raja.

During the session, I asked about pain and suggested that she needed to be comfortable in the asana and pay attention to the breath, working breath, and movement. Because she had yoga for so many years, she has a pretty good body awareness. She gave me the idea to practice the pashimotanasana flexing and extending the feet but not forcing her big right toe because when she forces it she feels pain in the glute area. She also suggested adding an upward dog to stretch the hip flexors. In the end, she felt great with the relaxation, relaxing every part of the body and sending healing to those parts.
After the session, she said she had no pain. She said stretches help and that she needs to do more stretches. The next day after the practice, she felt soared but two days later she felt great.

I suggested she go to the doctor and maybe get an image screening of her hip and sacrum area to have a better approach to her treatment. She was afraid of going to the doctor because of some trauma she suffered with doctors in the past. But because of the talk we had, she went to the doctor and she will have an X-ray. Her pain subsided at this point and she thinks it is related to trauma.
Adaptive yoga is not just adapting props to the body but also adapting the thoughts and lifestyle. I suggested she embrace the moment and breathe through the pain. Investigate the pain as a child who is curious about something they never seen before. When we push pain away, we increase it. The body wants to communicate with us and pain is a form of communication. I suggested she learn to accept the changes in the body, be playful, and present, and invite healing.

I had to adapt the intended plan. I left space for her to suggest what was the best in her body. She practiced yoga for many years and has a very good body awareness, then I could give her this space for her adaptation. She practiced what I suggested and added the flexing and extending of the feet in pashimotanasana. She feels that this can work better for the fascia in that region. She also suggested adding an upward dog to stretch the hip flexors.
And because of her travels and my travels, we could not have a second meeting. However, the goal was achieved because she has much less pain and is willing to continue with her treatment.

Like it's explained above, I had to adapt the intended plan.
I learned some interesting lessons:
- Do not stick to the plan. Adapt, adjust, accommodate!
- When there's a problem in the physical body, check the mental body too. This one I knew before, but in this case was very evident.
- Adaptive is not only about props and the physical body but also about the mind and lifestyle.
- Create a safe space for the client to express themselves.

Yes, I would approach it the same way because it worked, her pain subsided. I'm not talking about using the same asanas, but about creating space for the client to blossom their body and breath awareness.
Adaptive yoga “is designed to cultivate your own healing power with a sense of playfulness and empowerment” (Eisenberg). The breath awareness is very important in adaptive yoga, “Without attention to the breath, the poses are simply positions of the body and do not reflect the true potential of yoga to connect the mind, body, and spirit.” Then the yoga asanas, the attention to the breath, and the playfulness that was created in the session, helped in her healing process.
Mindy Eisenberg writes in her book "Adaptive Yoga Moves Any Body: Created for individuals with MS and neuromuscular conditions":
"A conscious breathing practice connects with mindful movement for a heightened sense of peace and well-being. The more you become self-aware, the more readily you can listen to what your body needs on any given day. Think of yourself as a musician and your body as your instrument. Yoga will help you tune that instrument so it plays harmoniously."