One of the wonderful things about yoga is that the poses can be modified to meet the needs of the practitioner. While some of the common modifications, such as bending knees in forward bends and using straps and blocks are common, there are some other modifications you can try to increase yoga’s accessibility for the elderly, those recovering from injury or those managing disease or disability or other physical challenges.
1. Create a half-Sun Salutations sequence in a chair. Some students can’t tolerate the up and down movements of Sun Salutations and are building the strength and mobility to move from standing to the floor, and back up again. As an alternative, while seated in a chair, move the arms up and overhead several times, and also work the hands up through center and down. Have students look up upon inhaling and straight ahead on the exhale. Ask them to focus on the integrity of the movements, moving slowly, as if pushing their arms through water. Repeat this multiple times, just as you would a Sun Salutation sequence. For the elderly, be sure to check with them to be sure the deep breathing is not creating dizziness.
2. Place hand on the hip versus fully extended for twists. Students with tight shoulder joints and pectoral muscles sometimes experience discomfort in twisting postures, where the arm on the twisting side is fully extended. An alternative position is to have them put the hand on their hip and work the twist and external rotation directly from the shoulder joint. As you shorter the lever of the twisting arm, the student may have better accessibility to the external rotation needed to open up the shoulder. This will also prevent the internal rotation and hunching forward that can sometimes occur.
3. Use a blanket under head to decrease neck extension. Students can come to yoga with hyperextension of the neck that is noticed as they lie flat on the floor. Their chin will jut forward and you’ll see this not only in Savasana but in Bridge pose and any supine twists. Place a blanket under their neck and look for a neutral position, with the chin neither up nor down.
4. Press into a wall for Warrior I and II. Students struggling to balance due to neuropathy, foot injuries or other issues may benefit from bracing up against a wall for Warrior I and Warrior II. For Warrior I, adjust the distance of the body from the wall so the arms are in full extension (or as full as the student can experience). Have the student look straight ahead, relaxing shoulders and breathing deeply. For Warrior II, press one arm into the wall and extend the opposite leg back. If extending the back arm is a struggle, have them place that hand on the hip.
5. Use blocks under wrists for Downward and Upward Dog. Students with repetitive stress injuries, arthritis or other diseases that affect muscles and joints may experience pain and tenderness in Upward Facing Dog Pose and Downward Facing Dog. Using blocks under both hands for both of these postures may give them greater access and decrease some of the pressure on the wrist in Downward Facing Dog, especially. Also, with the increased height off the floor, they may find greater access to the backbend in Upward Dog.
6. Stand behind a chair for balancing postures. In my work in a local nursing home, some students experienced all the postures from a chair but many were able to stand for some. Standing behind a chair, holding onto the chair back, is a great way to for people to practice balancing postures, Warrior poses (one arm on the chair, the other arm extended) and even try a modified Downward Dog. However, be sure the chair is high enough that the person is not hunched forward and be sure it is weighted properly and on stable ground. It is not uncommon, as the student increases the weight on the chair back, that it may slip out from underneath them.
7. Support upper shoulder with blanket in supine twists. Similar to the earlier suggestion to shorter the lever of the arm in a twisting pose, the same holds true as you take students through supine twists on the floor. This might be a Knee Down Twist or could be a position where you hug the knees into the chest and twist over to one side, while extending the opposite arm out to the other. Due to shortening of the pectoral muscles and tight shoulders, as well as a bit of over-zealousness on the part of some students, you may observe the upper shoulder off the floor. Rather than backing off the twist, support the shoulder with a blanket and the arm or hand with a block underneath.
8. Press back against wall for Tree and Eagle Pose. When working with prenatal students or those with balancing challenges, press the body against a wall in Tree, Eagle and even poses like Triangle.
9. Use blocks under hands when pressing up to Warrior I. One of the toughest transitions for new students to make as well as those working with mobility and strength issues is from Downward Facing Dog to Warrior I. Providing extra height off the floor can give the necessary additional room so they can move the leg forward to step it flat on the mat. They can also use one hand to push their foot forward, so their “press up” comes only after the ankle is directly under the knee.
Working with people of all experience levels and physical conditions in yoga is one of the joys of teaching. It is up to us as teachers to be creative, positive and supportive as well as refrain from feeling sorry for our students. We know that the beauty of yoga lies not in perfection but in the unique expression that each person demonstrates as they breathe and move in a pose.