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Karen Ingall CS1 R

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Karen Ingall CS1 R • Teaching Homework 21 Case Study 1 M is a 28 year old teacher. He has no previous experience of yoga but has an anatomical knowledge of the body from doing a physiotherapy degree. He plays football and goes to the gym regularly and he cycles to and from work. He is fit with a strong upper body from weight training. Medication and outstanding health issues; None M is committed to a strenuous gym programme but is also aware of the danger of overdeveloping tight muscles and of training without alignment. He would like to establish a yoga practice but is realistic about the time he can commit with this present work and family commitments (20minutes each day and a 1 hour lesson per week) He identified the following areas which he hoped a yoga practice would improve: • He has Achilles tendinitis which is particularly painful after football. • He suffers from tight calf muscles the day after football • He has neck pain and earache on occasions and tension headaches • He found driving created a lot of tension in his back, neck and shoulders. I observed M in standing and his natural stance was with the feet tuned out and pronated. He found dorsal and plantar flexion of the foot painful, in fact, the ankle was stiff in all directions. We talked about how that put a strain on the Achilles tendon while playing football in particular. The position of the feet may be a factor in a lordosis in the lumbar spine with a reciprocal curve in the cervical spine. The head was carried forward and he often circled his head as if to relieve tension. These were my observations but M could identify these things for himself. I did not want or feel qualified to “prescribe” poses but wanted to have these things in mind when I devised a practice. M was happy with this and we agreed on collaborative approach where M’s physiotherapy training would marry with my yoga training. We would try, not to ”treat” a condition but to embark on a process of discovery, within the yoga practice, trusting that learning with awareness would produce desirable results. Karen Ingall_CS1 Lesson 1 Learning Intentions Yoga poses should be “comfortable and steady”: Pantanjali Yoga Sutras 11.46 Increase proprioception by creating body maps for painful, numb areas of the body by mindful, co-ordinated, exploratory movements and body scanning Become aware of the breath and the body in gravity. Know what it is to ground. Body Scan in semi-supine bringing awareness to the breath, by putting hands on lower ribs and then the upper chest . Then follow the 12point mediation on the body outlined in Reginald Ray’s Meditation on the body. Particular focus for M on the weight travelling from the knee to the centre of the heel. 5mins Warm-up for ankles and feet. Inhale in extension and exhale in flexion. Stand and roll through the foot to dorsiflex and plantar flex; evert and invert the foot . Then press all the balls of one foot into the ground and rotate the foot clockwise and ant-clockwise. Do each movement 3x on each side gently, mindfully and slowly. Sit one leg in front and one behind (pinwheel) and gently bend each toe back from the metatarsal joint towards the sole of the foot. On the same side pull each of the toes away from the floor (lateral stretch). Then stand and observe difference in feeling of feet before doing the other side 10mins. I put a cushion under M’s foot and he could not extend his foot comfortably. Tadasana: Standing with a focus on how to reverse the pronation by focusing on pulling in below the ankle bone and feeling how doing this with a passive big toe and the focus on weight in the centre of the heel (standing on the talus) let him feel gravity sending force through the leg into the ankle and down through the heel. Uttanasana, Trikonasansa, (Modified by using chair seat) 10mins Child’s Pose: M needed a cushion under the hips and feet. He first stretched with his hands on a chair seat, moving from the hips to stretch the spine away from the arms. We then softened the pose and put a third cushion between the thighs and belly and spent time with omnidirectional breathing (Seated cell exploration) (How Life Moves, McHose and Frank) 10mins Supine Twist ,-cushion under the legs. 5 mins Seated Breathing (Ujaayi breath) 5 mins Savasana 5 mins Karen Ingall_CS1 Feedback: M felt relaxed and felt more contact with the floor in standing. He felt he had some tools to relax and align the foot and lower leg and would do the ankle exercises daily. Lesson 2 Learning Intention: to bring awareness to lengthening through the front of the spine. To continue work on opening the hinges of the feet. Body Scan : as before. Breath focus in feeling the torso as a cylinder –Inhale-. The chest expands in all directions and as the diaphragm moves down the belly relaxes Exhale – the reverse and watch the breath till the end of the exhale and then a bit more as the lower ribs relax down. Allow the inhale to happen. (5 mins) Ankle foot and toe exercises as before. Prepare for Virasana by sitting in a chair and bending the lower leg back and stretching the front of the foot, toes pointing away. Then in kneeling turn the toes under (runners toes) and stretch them back. (5mins) Walking: with the awareness of all the toes and rolling through the foot and pushing of through the toes with awareness with the big toe. Done very slowly and gently. Also introduced the idea of pointing the knees in the direction you want to travel. Michael walked in an exaggerated form of his usual walk (rigid ankle, hard heel strike and toes out and then returned to the “aware” walk to observed the differences.(5mins) Tadasana- focus on feeling the ground and aligning the feet. He did this without my cues. Wall hang (preparation for Uttanasana and Adho Mukha Svanasana and Utthita Trikonasa Buttocks, shoulders and head resting against wall. Feet aligned 12” from wall. Focus on relaxation of face and jaw and peeling from the wall, head shoulders, lower spine, hips. Breathing regular and deep. Bend knees in order to reverse process to come up. Once standing stretch arms up the wall and then come back to Tadasana. Repeat slower and mindfully (3 mins) Adho Mukha Savasana –From hands and knees, allow hands to spread and ground, keeping arms straight and pits of elbows facing each other lift knees and straighten legs a little and then come down. Repeat and keeping bent knees lift the sit bones. Transfer weight from foot to foot, noting connection to hip joint and pelvis but keep knees bent to prevent hands taking all the weight and still allowing the spine to stretch (2mins) Utthita Trikonasa (hand on chair) (2 mins). Supta Padangusthasana: Use belt in both hands. Open chest and relaxed shoulders and straight leg aligned and sole of the foot aligned against the wall. Lift leg only insofar as it does not disturb the spine. Variations: leg to the side and across the body (5 mins) Viparita Karani – Hips on a bolster (5 mins) Savasana Karen Ingall_CS1 Feedback: A sense that his feet were beginning to open across the major hinges (ankles, heels and metatarsals) and that this was giving him a feeling of his legs being more vertical in relation to the ground. He had a sense of standing more on the centre of the heel. Lesson 3; Learning Intention Awareness of the connection between the thoracic spine and the pelvis. Keeping the connection between the lower ribs and the hip bones. To twist from this centre not using head and arms to pull oneself around Opening. Body Scan. Focus on area between pubic bone and navel drawing in and lower ribs drawing in on the exhale and how this affects lumbar spine. Activating the transverse abdominus 10 mins Experience the four actions of the spine: 1) extension in setu bandhasana (bridge), 2) flexion in uttanasana, 3) rotation in Sage and 4) lateral flexion in parighasana (gate) (15 mins) Focus on Parighasana: M did the variation standing sideways one arm’s length away from the wall and placing hand at shoulder height fingers pointing towards the ceiling. Move from the hips to move the body away from the wall. Lengthen entire side of body as you push the wall away. Bring head towards the wall to increase the stretch. Don’t let ribs push out and with awareness of the alignment of the feet, grounding and breath. (10 mins) Parivitta Parvakonasana Focus on turning the heart and making the torso strong even if the turn is small rather than turning the head and the body following. (2mins) Janu sirsasana (3 mins) Reclining spinal twist. Do this slowly. Start with both legs standing and allow one knee to open to the side. Observe the point where the other knee has to follow. Gently turn the head the other way Supta virasana using a two bolsters for the back and blanket under ankles. (10 mins) Sirvasana (5 mins) Feedback: M now doing the ankle and foot sequence each day. He feels that he is aware of his feet during the day and often goes through the sequence at work. At the end of this practice he observed how spanning the hands from the hip joints to the lower ribs gave his a sense of strength.
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