I have a student who has sciatica in her left hip. From closer observation, I notice that her left hip is considerably higher then her right hip and her right hip is twisted forward. Her spine is curved to compensate for hip height difference, and perhaps one disk is starting to think about bulging. (she does feel comfortable in child?s pose). What do you recommend I do with her and is there anything/adjustments that I should do while teaching her in a general yoga class to help her condition? Many Thanks C
In general you want to do postures that improve her alignment in asana as this may help her sciatica. Also of course avoid contraindicated poses for sciatica ? hamstring stretches and emphasize strength of the gluteal region (hip extensors more specifically) in poses such as locust and stretch of its antagonists, the hip flexors in poses such as the runner stretch or lunge. Giving extra relaxation exercises (such as child?s pose) is also helpful as sciatica as a vata imbalance inhibits the ability to relax and sleep. Calming pranayama like the wave breath and concentrating on progressive relaxation is a must.
I will now address the answer to this more explicitly as you are in my Structural Yoga Therapy (SYT) certification course. At this point you have had only 2 of the 12 weekends required for certification, I think others will also benefit from hearing the full scope of this work. I want you to help you utilize my book and my skills more beneficially. Use me by all means, but overtime learn to use me to point to what you cannot get to from referring to my writings. I want you to utilize my response to see how you can utilize your powers of observation and discernment more acutely (being a Sherlock Holmes of body reading assessment) in making future assessments.
There are six levels of assessment information that can be utilized in making a thorough SYT set of recommendations for any given situation.
1 -You began this question well enough showing a closer observation thus utilizing bodyreading skills from chapter 12 of my book. By using this step alone you can create a helpful program of SYT. One solution to your question about what to do can be found in by using my book. It tell you what muscles are contracted making postural changes (see table 3 page 103), another chart shows therapeutic asanas for postural change (table 6, page 266). However this first level of SYT is not very precise.
2 - The second step in the progression to more accurate SYT recommendations is to take and evaluate this body reading in a kinesiological manner. So that is what I will do next I will say the postural imbalances you identified in kinesiological language. For new readers kinesiology is a second level of anatomy studies applied to understanding what muscles are contracting to create movements. Left hip is elevated (thus a contraction of left quadratus lumborum & possibly psoas), right hip is internally rotated (contracting gluteus medius anterior fibers and tensor fascia lata also some of the adductors which are internal rotators too); this implies that the left hip is externally rotated (contracting the gluteus maximus and deep 6 rotators anterior to it - among them is the piriformis infamous for causing sciatica). By considering the antagonists (opposing movers) of these contracted muscles you can discover what muscles are over stretched. A sample list of muscle antagonist pairs is located in table 4 page 122; and another chart shows what asanas strengthen and stretch what muscles (table 5 page 254-255). From this knowledge you can create a more precise set of recommendations that direct the students awareness to feeling the stretch and strength where it is needed.
3 ? The last three steps go beyond the scope of my book covering information only given in my certification training. A step you left out, because you are new to this training, is to do a range of motion (ROM) assessment of the client either following the joint freeing series (JFS) as it is given in chapter 16 ? Anatomy and Mobility Assessment or through a detailed assessment by learning to use the goniometer (sold via my website bookstore) based on our SYT Examination Manual. This manual is available only to students in the training. This provides exact angles of ROM to be more precise than JFS assessment based on guessing the angles of motion. Either manner will tell you what muscles are tight. Then referring to the previously mentioned table 5 you can give yet more helpful recommendations.
4 - Later on you will learn to do a physical therapy based form of muscle testing (MT), also detailed in your SYT Examination Manual, to determine how much a muscle is weakened. With these four assessments - bodyreading, kinesiology understanding, ROM, and MT - then you can utilize your thinking more clearly in giving accurate Structural Yoga Therapy recommendations.
5 ? You can also give recommendations based on an understanding of the condition; in this case sciatica or you could look up that topic (www.yogaforums.com for the archives of such questions). Sciatica can be a mixture of three factors that compress the sciatic nerve ? from its roots at L4-S3 as a result of herniated or degenerated disc; a contraction of the nerve in the gluteals between the piriformis above and the obturator internus below; or tight hamstrings affecting the area where the nerve divides into its two components ? peroneal and tibial nerves. For this precision, the student will need to comprehend the scope of the full 2-year program. A more informed set of recommendations would take into consideration all five factors. In this way by understanding the specific muscles that are imbalanced with her unique sciatica condition, understanding the specific muscles that are imbalanced with her unique sciatica condition can create a more personally tailored program, more pertinent to this woman.
6 ? An Ayurvedic assessment of the condition will also point out what of three approaches is best utilized in giving the above recommendations. This material is given out sparingly in this course until my book Ayurvedic Yoga Therapy is published (hopefully by the end of this year). A training in this method will be given May 16-21 in Zurich, Switzerland.
One also needs to keep in mind the guidelines from my first book, Yoga Sutras of Patanjali, as these guidelines help us to become clear on what is harmful and avoid al such movements that cause himsa (see YS II, 33-35), such as straight leg forward bends. These writings also reveal how we can guide ourselves and students through the progression of Classical Yoga training leading to freedom from all forms of pain and suffering.
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For those wishing to attend the full certification program your last opportunity is coming soon as no new trainings will be started until fall of 2005. The two-year course is still open for those who have had a workshop with me. Deadlines for applications and payment are Pasadena (LA area), CA March 12; Yogaville, VA March 15; and NYC April 2. For the SYT course description go to www.yogatherapycenter.org/structural_yoga_therapy.html For training and workshop dates go to www.yogatherapycener.org/workshops.asp Contact me via phone or email for course applications and payment arrangements.
Namaste Mukunda