Adaptation Principles

Lesson Overview

In this lesson, we lay the foundation for approaching the complex subject of adapting for individual needs.

Objective

Understand the difference between adaptation vs. generic teachings vs. therapeutics and become aware of adaptation principles that can serve as a foundation from which to base your decisions.

Description

Explain what is meant by “adaptation principles” and how this subject is similar and different from therapeutics. Provide examples of a yoga teacher using adaptation principles in teaching. Name topics to become familiar with as background knowledge before considering how to approach an individual situation. Explain why it’s important to know if a student is taking pain medication. Describe six principles that can guide a general approach when addressing an individual situation and five foundations upon which adaptive practice relies. Describe you might help students to experience an injury as their teacher.

Adaptation vs. Generic vs. Therapeutics

In the sections below we share powerful “adaptive principles.” But first we explain what we mean by that term.

Adaptation vs. Therapy or Therapeutics

In the past, we’ve used the word “therapeutic” to differentiate the process of adapting for individuals vs. “generic” teachings that are used universally with “healthy” students in an unrestricted yoga class.

But as yoga TEACHING and yoga THERAPY have evolved in the West, there has come to be a more clear distinction between the two professions.

The term “therapeutics” is now best reserved for referring to yoga therapy whereby the therapist works individually with a client to design an individual plan.

The terms “adaptive” and “adaptation” better describe the expectations of a yoga teacher in a group class. (In the past, we wrote, “We acknowledge that the words ‘generic’ and ‘therapeutic’ may not be ideal but they are the clearest words we could find for now.” And, as time has gone on, “adaptive” is now a better word than “therapeutic.”)

Here’s how representatives of the central organizations representing yoga therapists (IAYT) and yoga teachers (YA) have noted this increasing distinction:

It makes sense for the YA to distinguish what they do from what IAYT does, since neither YA’s standards nor their mission are designed to support yoga therapy as an emerging field distinct from yoga teaching… it is timely to more carefully identify the distinguishing characteristics and develop distinct credentials. – John Kepner

And the following is an excerpt from the Yoga Alliance Q&A that addresses their 2016 change in policy as it relates to yoga therapy. We give more details here.

A training module that educates its trainees in how to teach yoga to someone with a medical condition without hurting them is [appropriate]. Teaching about contraindications when instructing students with disabilities or medical conditions falls within the Registry’s educational categories. We encourage RYSs to teach their trainees how to safely conduct a yoga class with these populations… In contrast, modules that focus on treating symptoms or diagnosing medical conditions do not fall within the Registry’s Standards and would not count towards the minimum training hours.

Adaptation

  1. In contrast to “generic” teachings, adaptive principles involve some level of customization of teachings. In fact, customization or individualizing could be other words for adaptation.
  2. Adaptation implies the teachings are chosen, varied or applied to respond to a particular situation — typically an injury or condition.
  3. This may be a response to one student who has unique needs compared to the class at large, such as a pregnant student in a drop-in class.
  4. Or it can be the development of a class plan for a specialized class, such as yoga for seniors or students with scoliosis, anxiety or chronic pain.

Thus, a sequence or philosophy teaching that will be used with all students in a drop-in class would be “generic” teachings.

Advising a pregnant student about poses to avoid or teaching a sequence designed for students with knee issues would be “adapted,” “customized,” “individualized,” or “applied” teachings.

General Adaptation Approach

Background Knowledge

  1. Of fundamental importance is knowing When & How to Refer Students Out for Diagnosis or Individual Assessment.*
  2. Next, be sure you are familiar with trauma-sensitive teachings in order to support the psychological and emotional safety of all student populations.
  3. It’s also very important to know how to work with pain, particularly as it relates to the different needs arising from chronic vs. acute pain.
  4. And then when it comes to approaching individual situations, you’ll need a strong foundation in anatomy.

*Please note that students taking pain meds may be unable to gauge when a movement increases pain and thus should be referred to a yoga therapist or other expert.

First Priority

  • As with yoga in general, adaptation is a process of self-exploration and empowerment.
  • That is, yoga teachers do not diagnose or endeavor to “treat” a condition. Rather, they guide the student in a process of discovery, whereby the student may recover her sense of wholeness / balance / integrity.

General Approach

  1. Focus more on what a student can do than what she can’t do.
  2. Address and integrate the person’s various aspects or koshas.
  3. Determine the energetic need (langhana or brahmana) to guide choice of practices.
  4. Draw from many yoga techniques beyond asana including breathwork, visualization and meditation, chanting and philosophy.
  5. Encourage students to become aware of daily life patterns that contribute to or exacerbate imbalances.

Specific Example

In the YogaUOnline article, Create a Potent Practice for Every Individual: The Art and Science of Yoga Sequencing, Olga Kabel gives three specific examples of using the same poses but producing an entirely different result to meet the varying needs of three different students. Please see the article for details.

We go deeper into many of these principles below.

Wholeness & The “Can Do” Bias

Yoga therapy sees each person as an expression and reflection of the infinite possibilities and intelligence of the source energy. – Joseph LePage 

Inherent Worthiness & Wholeness

  • In this modern world that has lost sight of so many things, a most revolutionary and invaluable foundation of yoga is the explicit principle that every person is a perfect and whole expression of the one infinite source. Everything starts from the person’s inherent worthiness and wholeness just as she is.
  • While a person may be experiencing pain or severe disability, it is understood that beneath these qualities of experience is the whole and perfect Self who is never damaged.
  • From awareness of her inherent worthiness and wholeness, the student embarks on a journey. The journey itself comes to be experienced as “a homecoming to a place of inner balance, awareness, and wholeness.”
  • The tools of yoga are used on the journey “to open the appropriate doorway to the student’s own potential for health, healing, and awakening, all of which is already present.” (Joseph LePage)
  • It is understood that the journey may lead to any number of outcomes, such as healing underlying imbalance, relief from symptoms, or more tranquility in living with a chronic condition.

The Can-Do Bias

  • A powerful and beautiful offering is a focus on what a student can do more than what she can’t do.
  • If a student cannot safely raise her arms above her head, or cannot practice forward bends that compress the belly, such knowledge is fundamental to know and guide the practice. But once such limitations are acknowledged, the focus then turns to all the yoga tools that are safe and useful.
  • Teachers can help their students enjoy a rich and satisfying practice full of mindfully-chosen asana, visualization, pranayama, chanting, meditation, and so on.
  • Students may have heard that injury can be a great teacher. Teachers can help students to experience this powerful lesson through encouraging a perspective of curiosity. Injuries invite more self-awareness plus increasing knowledge of such things as the contraindications and purpose of some poses. With this growing knowledge, the student becomes more empowered as she learns to choose and adapt practices.
  • This focus on experiencing and honoring all that the student can do to bring restoration and balance may be a powerful antidote to the typical negativity surrounding injury and condition.

Empowerment vs. Prescription

My goal is not to correct, fix, or change something. Instead, I am collaborating with and supporting you with… empowerment teaching elements. – Michelle Pitman

  • As you know, yoga teachers and therapists are not qualified to diagnose conditions or prescribe treatment.
  • But the reason that yoga teachers do not act as “prescribers” goes beyond just their scope of practice. The entire perspective of yoga is different; with an intent of Self-realization, it approaches practice and healing in a different way.
  • Of course, that is not to discount the value of a diagnosis and treatment plan from a healthcare provider. Rather, the point here is about yoga’s approach. Yoga works fine as an adjunct treatment with western medicine but itself does not use a prescriptive approach.
  • The process begins by helping the student to see herself as the whole person she is, in body, mind and spirit. And from there, the journey she is invited on includes “helping you realize yourself as a self-governing expert of your own life and issues.” (Michelle Pitman)
  • The process invites curiosity, exploration and self-empowerment. Michelle Pitman’s article quoted above offers an inspirational and practical teaching on this vital topic.

Practicing with Injury

When an injury is not severe, you can find a range of motion within the yoga poses that can help you heal from your injury and rebuild your practice. Even if an injury prevents you from doing the full posture, this does not matter. Minimizing yoga poses while still understanding their general direction of movement is a significant practice… Obviously there are injuries that are so severe you have no choice but to rest the injured area. But this does not mean that you have to give up yoga completely. In these times, practicing through visualization, working with your breath, practicing restorative poses, and meditating are all very beneficial. – Rodney Yee

Yogic Toolbox + Integration of Learning

A Vast Yogic Toolbox

A holistic approach uses many yoga techniques beyond asana including breathwork, visualization and meditation, chanting and philosophy.

Many More Tools than Asana

My desire for all those who have only been exposed to the asana part of yoga is that they have an opportunity to appreciate the depth and breadth of this great tradition. When you have a life-threatening or serious condition, you can’t rely on what you could rely on before. Yoga is like a raft that can help you go through these things. But in my case it wasn’t asana. It wasn’t even breathing. It was attitude, prayer. – Gary Kraftsow 

The Cultivation of Positive Qualities

What I’ve discovered in more than 20 years of working in yoga therapy is that while yoga techniques, such as asana and pranayama, are a key part of the healing process, the deepest and truest healing comes from the cultivation of positive qualities, called bhavanas. – Joseph LePage

Integration of Learning

  • Becoming aware of daily life patterns that contribute to imbalance is a central part of the healing journey. Posture, stress management techniques and other such aspects of daily life often hold the key to continued and lasting balance and health.
  • In addition, incorporating daily maintenance practices is a common technique for helping students to experience and maintain desired states of health.

Practice Foundations

Overview

  1. Stress and the nervous system are a key component of virtually every situation. It’s essential that teacher and student have a very clear understanding of the vital role of the nervous system and how it can relate to the manifestation and relief of symptoms and conditions.
  2. Repetitive, simple movement in pain-free range of movement is a fundamental tactic in many therapeutic approaches that can be applied in most adaptive situations as well. More movement is introduced gradually as pain diminishes.
  3. Students will naturally tend to compensate in a way that lessens the challenge to the targeted area (particularly as it relates to spinal curves). Thus, teachers need to stay observant to see how a targeted action is practiced.
  4. Joint health is related to the healthy functioning of surrounding muscles.

Langhana & Brahamana

  • The fundamental Ayurvedic principle of aiming to bring balance teaches that when there is excess heat, we endeavor to cool; when there is restriction, we strive to release tension; when too mobile, we stabilize, and so on.
  • Thus, a fundamental consideration when working individually is to determine a need for langhana or brahmana.

Langhana vs.Brahmana

The basic orientation of any treatment is either that of reduction or purification (langhana) or that of tonification or building (brahmana). Reduction therapy is called for when there is some kind of excess in the system that must be reduced: excess weight, toxicity, hyperactivity or anxiety. Tonification therapy works to nourish the system. This is useful in conditions such as general weakness, low energy, specific debilities or lack of confidence. – Gary Kraftsow

Movement Guidelines

  • In addition to watching for the tendency to compensate, teachers will want to keep in mind is the relationship between joint health and muscular balance. The following recommendations come from A G Mohan in Yoga Therapy 2004, pgs 172-173:
  • Know whether movement increases or decreases pain.
  • At first, avoid movements and positions that place stress on affected body part. As student progresses and pain diminishes, movements can be introduced gradually.
  • Dynamic movements that alternately bend and stretch can help with stiffness and avoid stress sometimes caused by static positions.
  • Start from where the person is. Mohan reminds us that classical asanas arose in a culture where people sat on the floor in a cross-legged or squat position for several hours per day. Using the same asana with people who have completely different lifestyle and habits “can aggravate or even cause structural problems.”

Interconnection Leads to Compensation

Due to the relationship of spinal curves and the tendency to compensate, we must be mindful of how a targeted action is practiced… It is important to realize that conditions in the upper back and lower back are interconnected. If one spinal curve increases, the other usually increases to compensate… Both the lower back and the neck and shoulders can function as release valves for stress in the upper back. We must remember that in working to flatten the curve of the upper back, there is a great tendency to simply increase the curve of the lower back. And if we are successful in blocking the curve of the lower back, we must be careful not to bring too much stress to the neck and shoulders. – Gary Kraftsow

A Joint is only as Healthy as the Muscles Surrounding It

[Joint] complexity is one reason they’re particularly vulnerable to injury. A joint is only as healthy as the muscles surrounding it. Relaxed, flexible muscles lead to a more mobile joint. – Larry Payne