how to teach students with special conditionsBy Dr. Paul Jerard, E-RYT 500

Students with special conditions can be a challenge for new Yoga teachers. Below is a question and answer session in regard to teaching a private Yoga lesson to a student with more than one serious ailment. When possible, encourage your students to get a physician’s approval, before practicing Yoga, with pre-existing ailments.

Q: “I have a private student to work with who has had her heart Mitral Valve replaced two years ago, and has a little restriction with her Acromioclavicular ligaments, due to aggressive gym work. She has already been practicing Yoga in the last few years, and has a basic knowledge of asanas. What would be your recommendations for both the Mitral Valve, as well as the AC ligaments?

A: Both situations are uniquely different, as mitral valve replacement is a pre-existing condition within the heart. In regard to the acromioclavicular ligaments – if this student has wear and tear on both sides, the shoulder joints have been pushed to their limits.  Her physician’s approval is very important, in order to responsibly design a customized lesson plan.

The mitral valve is the valve that separates the two chambers on the left side of the heart. It is a two part, dual-flapped valve in the heart that lies between the left atrium (LA) and the left ventricle (LV). The left ventricle pushes blood forward into the body. The mitral valve prevents blood from flowing backwards, into the upper heart chambers, during a cardiac contraction.

Generally speaking, inversions should be approached with extreme caution or eliminated altogether. The same can be said for severe twists. Open twists, such as Triangle pose (Trikonasana), should be fine. However, her family physician, or cardiologist, should be consulted. Please remember that twists can compress the heart, so do not take chances.

With regard to the Acromioclavicular ligament – it is located within the shoulder and is part of the acromioclavicular joint. Acromioclavicular ligament injury can lead to unusual biomechanics within the shoulder joint, which can also cause injury to the soft tissue within the shoulder.

During shoulder movements, such as lifting, some muscles help move the shoulder, while other muscle groups work to stabilize the shoulder. Much of the stability within the shoulder is provided by muscular coordination.

Needless to say, hand stand, downward facing dog, dolphin, and any similar asanas, which put similar stress on the shoulder, to lifting movements, should be eliminated from your Yoga lesson plan. Flowing movements should be approached with caution. Sequences with plank posture might also have to be eliminated, or modified, with the use of blocks, stools, or chairs.

Limitations depend on the amount of discomfort your student has. Your student needs to be honest and avoid pushing herself through pain. Your student also needs to become mindful of discomfort, when practicing asanas. For this reason, I would design a program where she holds postures long enough to be mindful of them, and gives you accurate feedback, in regard to modifications.

© Copyright 2010 – Paul Jerard / Aura Publications

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