The Yoga Flow This PT Teaches To Enhance Mobility & Prevent Injury
I have spent the last few decades teaching therapeutic yoga practices to as many people as possible. I've worked with elders at different stages of their life, all the way up to their 90s.
One of the challenges that I notice my elderly clients face as they grow older is the fear of falling and fracturing a hip. If you get a group of elders talking, it is inevitable that one will bring up a story of someone that they know who has had a serious medical issue or died as a result of falling.
Why we should all practice getting up and down off the floor
As a young physical therapist in the ‘90s, I learned that falls were one of the leading complications that could lead to severe injury or even death in the elderly population. I was trained early on how to help my patients learn how to get up off the floor. In some cases, I taught them how to fall more effectively to reduce the risk of head trauma and fractures.
Things have not changed in the last few decades. The CDC reports that falls continue to be the source of health complications1 for elders 65 years and older. More than one out of four older people falls each year.
Over the course of 27 years, I've developed methods to help thousands of people get up and down safely in my therapeutic yoga practice.
Since we do yoga primarily on the floor, that means that each student of mine has had to get some experience moving down to and up off the floor independently. I like to make sure that every person that I work with can move down to the floor and then get up off the floor with as much grace as possible.
The most effective method that I use to do so is called the Therapeutic Sun Salutation©. I teach it to everyone—young and old, fit or frail. Everyone that I encounter gets their own version of this important practice.
I especially love this practice because once a client learns how to use it, they can reduce their risk of being stuck on the floor in the event of an accidental fall. They can also use it to check in with their body and do a self-assessment of how well they are moving and functioning in that moment.
The warmup practice (to be done standing)
Here is a gentle introduction to the First Half of the Therapeutic Sun Salutation© that almost anyone can do. Doing these movements can help prepare you mentally and physically for the complete salutation. You can use it when you want to warm the body and focus the mind, but you are not ready, able, or willing to get down onto the floor.
Before you begin, take a moment to read through the directions completely to make certain that each step makes sense. For even more fun and possibly better results, try the following activities with a friend or loved one. Therapeutic yoga is more fun when done with others!
- Begin in standing mountain posture with your hands at heart center and your feet parallel and hip distance apart. Check in to feel the weight even between both feet and keep the weight even between the ball of the foot and the heel on both sides. Lift your toes to begin to engage the muscles that support the structural arch in the feet. Then stretch the toes and relax them to rest on the mat. During this and every activity, do the best that you can to breathe through your nose, with your mouth closed.
- Practicing gratitude: Focus your attention on something that you are grateful for today.
- Inhale and each your arms out to the side and over your head. Exhale and bring your hands down and back to your heart. Repeat three times.
- Inhale and reach your arms out to the side and over your head. Exhale and bring your hands down and back to your heart while you bend your knees and sit your bottom back as if moving to sit into a chair. Repeat three times.
- Inhale and reach up. Exhale and bring the hands to the thighs. Repeat three times.
- Inhale and reach up. Exhale and bring the hands to the thighs and hold them there. Stay in the knees-bent-with-spine-neutral position.
- Inhale and extend the spine. Exhale and flex and round through the spine. Repeat three times.
- Inhale and sweep your arms out to the sides and overhead while you straighten your knees to come back to upright standing.
- Exhale and bring your hands to your heart center to return to a standing mountain pose.
The complete sequence
The complete method prepares the body to have mobility and strength that will make getting down to and then up off the floor easier. “Easy” is in the body of the beholder when it comes to getting off the floor. This does take consistent practice—but it's worth it.
You don’t have to be on the floor to get started with this practice. You can work on the first three steps to help develop your upper body and core strength when you are lying on a firm, preferably wide bed. This will allow you to practice the components and improve your strength and proficiency, while staying in an easy-to-maneuver and accessible position on the bed. If you can get out of bed safely, then you can do this beginning practice.
Remember, safety first! Make sure to keep breathing smoothly through your nose while you do these activities. Your breath will tell you how you are doing. If you are holding your breath, you are doing more than your body is ready for. Take rest and then try again later.
- If you are lying on your back, bend your knees, roll onto your side, and then onto your stomach. Breathe while you are doing this.
- Come up onto your elbows and see how that feels. Push into your elbows and hands to lift your hips off the floor and move onto your hands and knees. Breathe.
- Push into the mat/floor using the strength of your arms and hands (with your palms flat and fingers wide). Keep breathing.
- Curl your toes under to help your feet move into position to make it easier to lift the knees off the mat. Press up into downward-facing dog. Breathe.
- Widen the stance of your feet as you begin to walk your feet closer to your hands on the mat. Bend your knees and move your feet towards your hands until your feet are completely in solid contact on the mat. Breathe.
- Bring your hands to your thighs. Breathe.
- Bring your torso to level with the earth, almost like a tabletop. Hold here and breathe to help get your blood pressure to level out.
- Then, slowly begin to push through the strength of your legs to straighten your body up back to the standing position. Keep your eyes on a point of reference, a focal point to improve balance. Breathe.
- Congratulations, you made it off the floor!
Getting up off the floor is harder than it looks to the casual observer and more important than most people realize. If you end up on the floor and you can’t get up, it could lead to serious health complications and even an untimely death. We can help to reduce these complications by keeping our bodies mobile and strong enough to do my Therapeutic Sun Salutation© on a regular basis. Now, get to practicing.
Adapted from an excerpt of Therapeutic Yoga Works: A Gentle Approach to Eliminating Back Pain and Improving Functional Mobility for Life, Nydia’s first book set for publishing in the Fall of 2023.
Nydia Tijerina Darby is a Doctor of Physical Therapy, Therapeutic Yoga Research Specialist, Certified Yoga Therapist, published author of therapeutic yoga research, and owner and creative director of the Open Hand Institute and Nydia’s Yoga Therapy Studio in San Antonio, Texas. Nydia is currently writing her first book, "Therapeutic Yoga Works: A Gentle Approach to Eliminating Back Pain and Improving Functional Mobility for Life"—to be published early fall 2023.
Nydia received a bachelor’s and then a master’s in physical therapy from Texas Woman’s University in ’90 and ’91. She completed a doctorate in physical therapy from the University of the Incarnate Word in 2014. She has dedicated her life toward practicing what she preaches and supports her clients on their journeys toward mind, body, and spirit wholeness in the integrative physical therapy and therapeutic yoga practices that she shares.