Yoga teaching, and spinal injuries. What Auntie taught me.

As I mentioned, today’s post is inspired by my short time teaching “Auntie”, a temporary resident at the Children’s Home I volunteered at. Auntie was the mother of Hari, the house manager, and staying with her son while she recuperated from spinal surgery. The details of her injury are not exact, but Auntie was very intent on telling me all about it in Nepali. Some of the kids were very helpful and willing to act as translators, others more content to watch me and Auntie struggle it out in smiles, nods and hand gestures. Auntie had, around 10 years previously, had fallen off a ladder whilst picking some fruit. Now according to what I was told, Auntie severed her spinal cord and was confined to a wheelchair for the ten years, paralysed from what I am guessing was some where in the low thoracic spine down judging by the hella impressive scars she showed me. One of the kids explained to me that this stroke of bad luck (and maybe one or two illnesses along the way) painted Auntie in a bad light in her community, as superstitions are still rife in Nepal and so she had become somewhat more outcast that she had previously been in life (frankly I have no idea to what extent, but given Nepali infrastructure, I can imagine it’s pretty shite being in a wheelchair there, never mind being shunned in the community on top of this).

I’m no doctor, what little I know of spinal injuries is fairly removed. But I do know that depending on the degree of the severance and the position of the injury can be a determining factor as to whether you will or won’t recover. Auntie’s injury must have been in the recovery range, and I’m guessing accessibility to treatment may have been a big factor in her recovery. Auntie lived in Lumbini, the birthplace of Gautama Buddha (and incidentally somewhere I want to visit when I go back). This year, she underwent major surgery to her spine, inserting metal rods along her back, leaving her with humongous scars. And, after ten years, the ability to walk again. Most of this was translated to me by Luna (and sometimes Raju trying to help) one sunny afternoon. I was sitting in agnistambhasana, taking advantage of the warm weather to loosen up my stiff hips, and Auntie made some attempts to tease me for how I was sitting. Then she mentioned yoga… and well we went from there. She was so keen to take advantage of me being in the house, joining in with the kids classes. However I realised straight away that this was not an option. Auntie still uses crutches and her balance is slowly but surely returning. So whilst the kids wanted something fast paced and challenging to occupy their minds and bodies, this wasn’t an option for Auntie, or me as a teacher. Visions of a crutch slipping or some other catastrophe floated about my head. It’s all well and good explaining a modification in english, or explaining why someone shouldn’t do a move, but in a completely different language with kids who are focussing on their own thing… well that’s another story isn’t it? So the plan formed. Sunita, one of the kids in the home has C.P, and was struggling to keep up with the other kids too. So I asked her to tell Auntie that I would teach a class just for the two of them, which would give me time to prepare something more appropriate.

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So I thought I would share our class early one morning on the roof. We were surprisingly joined by two others – Anoushka, Hari and Susmita’s 20 month old child who is a tiny genius, and Cheena, one of the down syndrome kids. First things first… when teaching someone with mobility issues, the best thing I found is to keep standing poses and floor poses (i.e sitting and kneeling) completely separate. Whilst the end game is to get there, this is super tricky at the start when muscles aren’t built up for this kind of transition. And with that – muscles! Working with someone who has been chair bound for 10 years obviously has lost massive muscle tone (Auntie picked her foot up several time and let it flop down to demonstrate her weakness) – so lots of strengthening rather than stretching was on the menu. Last but not least – props! Belts (or whatever can be used as a belt), stable surfaces to lean on and against, and cushions! We had no mats, so thin cushions were integral to all kneeling and seated poses.

Warm Up

Standing side stretches, (very) gentle supported standing ustrasana (camel pose), and ardha utanasana (half forward fold) – hands on thighs, back straight. Repeat x5

Surya Namaskar A

The flow of the movements in surya namaskar A were accessible to Auntie, so we went for it nice and slow, taking the knees chest chin route down. Repeat x3

Surya Namaskar B

This was trickier – with Virabhadrasana A rearing its head. However, moving slowly into the pose with a dropped back knee, Auntie nailed it. This was one where balance became really obvious – and something I take so much for granted. Repeat x3

Standing poses

Here is we get creative! On the roof we had a nice waist height wall to hold onto/ lean on to aid balance. Not all of these are yoga moves for sure, but inspired by!

  1. Leg abductions/adductions: Standing side on to the wall, extend the outside leg outwards away from the midline of the body (abduction) as high as is comfortable, without effecting the posture. The wall can be used for stability. Carefully move the leg back in, crossing over the midline of the body and out the opposite side as far as can be (adduction). Repeat x15 each side – this, in theory will assist with balance working towards utthita parsvasahita. On the final move on each side, hold for 3 breaths, rotate clockwise for 3 breaths and anti clockwise for 3 breaths before returning the foot to the floor.

    utthita-parsvasahita-variation
    Leg abductions and adductions
  2. Modified utthita padangusthasana: Back to the wall, hold the knee to the torso. Root down through the standing foot and hold for 3 breaths. Release the leg, but do not return to the floor – keep elevated at a 90 degree angle from the hip. Hold for 5 breaths. Extend the leg fully, keeping the foot off the ground. The aim here is not for height but strengthening the leg muscles. Hold for a further 5x breaths. Repeat x3 times on each side.
    Utthita Padangusthasana Variation.png
    Utthita Padangusthasana Variation

     

  3. Toe extensions: Back to the wall, lift the leg slightly and point the toe on an inhale, exhale flex the foot, toes pointing towards the knee. Repeat 15x on each side.
  4. Utkatasana: Of course this lil nugget of joy makes an appearance. We held for 5 breaths, sank a little deeper and held for 2 more breaths.

Intermediary poses

Slow vinyasa, taking the right foot forward after downward dog and opening slowly and with care into utthita parsvokanasana, extended side angle pose, resting the arm on the knee. Hold for 5 breaths before planting the hands and taking a slow vinyasa. Repeat on the left side, plant the hands and move into a table top position.

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Utthita Parsvokanasana

 

 

Table top/ kneeling poses

A good back is only as strong as the core muscles that supports it!

We started off with some cat/cow rolls with our breath, before moving into dandayamna bharmanasana (balancing table) poses. I kept my eye on Auntie through this as I wasn’t entirely sure of her strength but I needn’t have worried – she nailed it. We extended with our inhales and on the exhale took the extended limbs in towards the core, arching the spine as in cat, and kept flowing between the two with long steady breaths. Repeat x8 each side, and round off with a few breaths in balasana (childs pose), hands out in front.

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Dandayamna Bharmanasana Variation

From balasana move back up on to the knees and move into a very gentle ustrasana, supporting the back with the hands (or if necessary other props could be used for support, like a chair stacked with cushions). At this point I was gesticulating at my abs trying to indicate this is where Auntie should be feeling things, not her back. Luckily Sunita was on hand to help with translating! Take 5 breaths in the ustrasana variation, inhale back up, exhale to balasana and repeat one more time. (Somewhere around this point Anoushka got tired of emulating us and I had to run back downstairs with her)

At this point, we begin to wind down taking some stretches on our knees/ all fours, starting with a modified parighasana  (keeping the bending to a min and focusing on posture and the extended leg) for 3 breaths on each side, and a gentle parsva balasana (threading the needle) on each side for 3 breaths.

Finishing

Normally my finishing sequence is littered with navasana poses but with no idea of the extent and exact location of Aunties injury I thought it best to limit this.

1. Paschimottanasana: keeping our backs as straight as a poker and letting our hands fall where they will – hold for five breaths.

  1. Janu Sirsasana:  Like paschimottanasana, and we exaggerated aligning our torso and leg. 5 breaths on each side.
  2. Modified navasana: feet on the floor. For this I stayed with Auntie to make sure her spine was straight – 5 breaths.
  3. Modified ardha matsyandrasana: Leg extended, with a very gentle twist.
  4. Agnistambhasana: Like many nepalis, Auntie has spent every meal seated in a cross legged position on the floor. Needless to say she kicked my arse at this, both knees resting gracefully on the respective ankle whilst my right knee floated up to near shoulder height (ok mild exaggeration, but certainly above hip height).
  5. Gomhukasana: Likewise, Aunties hips happily sat square on the floor, but she had trouble with the arms for this, so I handed her one of my socks as a belt. Improvisation is king.
  6. Modified viparita karani: Legs up the wall, with a thin cushion under the lower back – 15 breaths
  7. SAVASANA – 3 mins

Meditation

Auntie is big on meditation 🙂 As soon as we came out of savasana she looked at me, crossed her legs and said OM, as if to say this part now please! We closed our eyes, and used the mantra Lokah Samasta Sukhino Bhavanthu, taking eleven rounds. Then we did some lovely lovely lovely nadi shodhanna breathing, before sitting in silent meditation. Until cheeky Cheena decided she’d had enough and decided to pull my hair.

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Lovely Meditation

Auntie taught me quite a lot in a short time. Don’t underestimate your students ability, even if they are recovering from an injury – don’t be afraid to try things, within reason. Read their body language and know the signs of someone who is struggling or in discomfort and ASK them what the problem is, or straight up back off the movement. With severe injuries like Aunties, recovery is a long progress so keep the class slow and steady, so that students have time to find their way into the poses in their own time. They do not need to be rushed and ideally will be able to move in and out of poses without assistance – that said stay alert, and be ready to help if you see that they are having problems. Learn as much as you can about their injury! This was by far the most difficult part for me – given the language barrier. Once you know their history, do some research online. This too was not an option for me as there was no internet where we were, so my class was made to run a bit trial and error – but Auntie was able for everything once it was broken down slowly. And last of all – the gratitude. It was overwhelming – Auntie is a kind soul regardless, but once our classes started her gratitude towards me was humbling. So much love in her smiles, and when I left giving me a hug and insisting we get a photo together.

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Auntie and I on my last day
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