A few case studies with names, some details and identifiers changed to protect privacy.
Fiona: 69 years old, retired lawyer
Fiona asked for help managing an increasing ‘hunch’ on her upper back, which was accompanied by neck and upper back pain in addition to ‘stiffness’ in her right hip and pelvic region, especially in the morning.
These problems became more obvious after completing a successful round of chemotherapy for bowel cancer a few years ago and Fiona rightly suggested were likely worsened by her many hours of seated work on computers.
Her enjoyment of regular activities like swimming and photography were being affected and she was keen to maintain her active lifestyle.
During the initial assessment, Fiona mentioned she’d been treated for asthma for many years and that it was getting slowly worse, despite being attentive to her medication regime.
Otherwise well, Fiona was open to trying a yoga therapy practice at home with her beautiful, gentle dog as her constant companion!
On physical assessment a Kyphosis (rounding) of the upper back was noted and Fiona’s chest area was subsequently reduced, in part because of her posture and breath constriction, due to asthma. We tried some hip-opening and gentle back-lengthening and strengthening postures, both static and dynamic, to open her chest area and improve breath awareness. Added to these movements were some simple chants and breathing techniques, or Pranayama and this became the basis of an energising morning and relaxing evening practice, designed to help Fiona to increase her strength and range of motion without pain and to counteract her forward-bending posture, opening her chest and breath.
In follow up sessions, Fiona reduced the evening practice and increased her morning practice.
Fiona quickly noticed physical improvements in all areas and particularly over time in her breathing, which means she has been able to reduce her asthma medicine usage.
“I especially love the breath work, which feels great and is so easy to use any time of the day,” said Fiona, “…And my dog enjoys lying beside my mat while I do my practice!”
Joseph: 27 years old, private trainer
Physically fit and an athlete, Joseph retired from representing his state in a number of sports at 24 years of age and started his own business as a personal trainer of high-achieving professionals, who were focused, short on time and wanted to maintain their fitness and productivity.
His work requires travelling around the city to various indoor and outdoor venues, for intense 30-45 minute training sessions with clients, before completing his own daily workout and 10km run.
Joseph came with a niggling right knee injury (some swelling and heat was apparent) and low back pain that had been troubling him off and on for many years. He had seen medical specialists in Sydney, Melbourne and London who variously proposed steroid injections, surgery and retirement, none of which Joseph was willing to take on believing there “must be a better way”.
A chance encounter a year before with a Yoga teacher who recommended Yoga Therapy had been in his mind for some time prior to making contact to see if Yoga could help.
Joseph’s body was unsurprisingly strong and he was practiced at ignoring and pushing through pain, but found identifying the point between comfort and pain challenging. His conversation was sprinkled with adages like ‘no pain no gain’ and ‘believe you can and you’re halfway there’.
Although physical postures were relatively easy for Joseph, resting and relaxing his mind were almost impossible and he struggled to understand how these could help him with his physical problems. We spent time talking about the importance of rest and awareness in recuperation and recent research on the connection between body and mind, which he understood in connection to motivation rather than recovery.
The practice we designed was less physical and much more restful and mindful, although for Joseph especially demanding.
Subsequent sessions were about growing Joseph’s sense of his internal body and the process of interpreting that information into different ways of responding to pain.
Since commencing Yoga Therapy, Joseph has adjusted his exercise regime to better protect his knee, which has decreased in swelling and heat. He replaced his daily run three times a week with a cycle to the beach and a surf and he has noted a marked reduction in his knee and lower back pain after only a few weeks of regular practice.
We’re still working on a more mindful rather than a cardio-focused cycle ride and on a regular Meditation practice with breath work at its heart.
Joseph is also thinking about how he can bring some lessons from Yoga Therapy into his professional training sessions.
Mason: 62 years old, retired transport worker
Always active and strong, Mason has used his physical and mental strength in both work and play all his life.
Early physical injuries and fractures were part and parcel of motor biking, parachuting, cycling and running, but he was shocked to discover that ongoing compression fractures in his spine and ribs during his mid-50s were a result of Osteoporosis rather than Arthritis or ‘just pulling a muscle’. Heeding his specialist doctor’s advice, Mason started a regime of medicines and changed his diet to lose weight and halt the progress of chronic bone degeneration.
Over the years and despite chronic pain, he’s succeeded in reducing his fracture rate and manages his fitness with swimming, some strength training, massage, diet and medication to maintain his bone integrity. His move, a couple of years ago to the South Coast of NSW, coincided with the sale of his business and some much-anticipated free time.
On a recent visit to Sydney he complained of the exhaustion and low mood caused by chronic, low-grade pain in his right shoulder, knee and mid and lower back. His back and knee restrictions meant he was unable to sit without discomfort for even a few minutes and his ability to swim and lift were limited by his shoulder. We talked more about how Yoga Therapy might help and he agreed he’d “do anything!” to resolve the pain that was getting him down and restricting his sense of joy.
On assessment, it was evident he had lost height and there was a marked spinal scoliosis (lateral curve) to the right. His spine appeared quite rigid and limitations in joint movements were noted in both shoulders, neck, knees and in forward bending.
We agreed that Mason’s goals were to gradually improve the flexibility of his neck, spine, shoulders, hip and knees and to build strength around those joints to better support their functionality. A breath practice, or Pranayama, to help manage his osteoporosis, pain and to relax his body, which was chronically tense, became an important tool he could learn and use whenever he needed.
Mason’s motivation was high, so a simple practice designed to increase his joint flexibility and strength were combined with simple chants or mantras to start the day and a quietening evening practice of around 15 minutes before bed. Relaxation and focused visualisations of light and spaciousness in the main joints of the body added to better sensitise his body awareness. Our ability to notice changes and signals from our body means that we can respond quickly to prevent further injury.
Although Mason struggled to complete his end of day practice, his dedication to a daily late morning practice resulted in mood improvements related to pain-free movement within weeks. While aware that the practice needs to be continued to ensure he’s able to move with freedom, he was last seen moving more freely and enjoying a beer and a laugh in his local pub.