Sometimes, as we end class, we might say, “If you have any questions, please let me know.” Many times when I say this, no one asks but sometimes people do ask a question or two. It’s a great way to gently open the door, so to speak, so people feel encouraged and welcome to bring up a question about their practice. The questions can fall into a few different categories:
How to do a particular pose
How often to practice to get the results one is looking to achieve
How to manage an injury in the context of a yoga practice
Information about an ache, pain or odd sensation in a particular part of the body when one practices yoga.
For today’s post, we’ll focus on the last issue because in my experience, that is the most common kind of question. Â First let’s talk more about what to ASK rather than what to SAY. For instance, when someone approaches me with a question about an ache, pain or other odd sensation in their body when they practice, I ask a few general questions right away:
Where do you feel it? ( ask them to point)
What movements do you do when you feel it? (ask them to show, if possible and since it’s after class, go slowly)
Do you feel this pain at any other time during the day or when you do other movements?Â
If yes, does this pain wake you up at night? Do you take any medications for it? What makes it feel better?
You’re trying here to get an understanding as to if the pain or odd sensation is isolated to movements they are doing on the mat or if they feel it in other activities of daily living. You’re also trying to get an idea of where it is, in terms of the kinds of muscles involved (hip flexors, internal or external rotators of the hip or shoulder, for instance), what movements make it worse or better and if they are in such pain that they are taking medication and waking up at night. If that is the case, I ask if they are already seeing a physician and what kinds of tests or results they have received from these visits ( make sure you are speaking in a low tone and have some privacy).
Once you have this information, then it is possible to proceed with a bit more of an informed approach. Remember, your role is not to treat the person but to confine your suggestions to movements they can take or movements they can avoid if it’s a case of avoiding the pain or minimizing it by simply avoiding those kinds of movements all together. For someone that has lower back pain that is worse in backbends like Bow and Upward Bow (commonly called “Wheel”) ensuring the person has  strong internal rotation at the thigh bones helps and ensuring their Upward Bow, if they take this pose, has an even bend and they are not compressing their lower back or cramming their body up and into their neck and shoulders is important.
For someone with tight hip flexors, providing some supportive, restorative poses that stretch the hip flexors can help along with some active hip stretches, like lunges. The overall goal is to stay focused on what one can do, how one can modify and what might one avoid in order to allow growth without pain.
The other overall thing to remember is that it’s hard to do a “fly by” assessment after class. You usually only have 3-4 minutes with the person before the next class rolls in, unless you can maneuver to a private area outside the room. Even then, sometimes really answering these questions requires a more one on one session. Let the student know that you are available for private sessions and give them your card or contact information so they can reach you to set one up.
The other thing to keep in mind is that in the moment, you may not know how to respond. I had a woman approach me once with a history of migraines. She asked for some tips on poses to do and poses to avoid. In the moment, my thoughts were to keep the head above the heart and to avoid forward bending. I shared this with her but stressed that this was my thought, not based on any specific experience with this condition. I shared that I wanted to do some research and get back to her. I did the research and followed up in the next class and she reported after that one, that she felt great taking the modifications I shared. Never be afraid to let the student know you are not sure, but will get back to them.
Some other general factors to consider and ask about are things like the frequency with which they are coming to class; noting if the pain is worse or better after yoga and suggesting that if it is worse, that they play with cutting back on one class per week for a few weeks to see if that helps. If the feedback is for something pain related or especially if the sensations are more in the area of tingling pain, which can indicate nerve compression, always suggest they seek traditional medical advice.
Our role as yoga teachers is to help people access the best in their bodies and we are part of a whole system of medical and integrative medicine professionals geared towards helping people be strong, get stronger and stay healthy. Our role is not to treat but to suggest, partner with and refer to others in other specialties and in many cases, to work collaboratively with them. Some of my most enjoyable, productive and interesting private clients are those that see me and a Physical Therapist concurrently. We share ideas and watch for progress in each other’s sessions and the client is the beneficiary.
As always, yoga teachers will bring a unique perspective, as we will add in the aspects of mindfulness, especially deep breathing, to the movement practice itself. This is something that our students can readily use at anytime to help restore the body, relax the body and tap into the power of the breath to heal the body in the moment and beyond.