Posted in Yoga School Rishikesh

Case Study

yoga courses in rishikesh

AYM 300 HR Yoga Therapy TTC                 JUNE 2015

ANNAMAYA KOSHA: Gross Physical Body Level


  • Name:
  • Email:yoga teacher training in rishikesh
  • Telephone number:
  • Age: 38
  • Date and Place of Birth: 16 December 1976 – Hampshire, UK
  • Sex: Female
  • Children: None
  • Nationality: British (white Caucasian)
  • Heart Rate (BPM): 74 BPM
  • Respiration Rate (RR): first rate 21 – second 18 – third 16-17   – tends to breathe through the chest although now is more conscious through the diaphragm and belly.
  • Blood Pressure: normal 110 over 80
  • Weight 1 year ago: just over 8 stone
  • Weight 6 months ago: 8 ½ stone
  • Current weight: 9 stones
  • Weight you would like to be? More muscle tone, not bothered about the weight
  • Height: 5”5
  • Body Type: Small Bones
  • Navel Position: normal – in middle
  • Prakriti: unknown



  • Marital Status: Single
  • Do you have children, if so how many? None
  • Are you religious or spiritual? Spiritual
  • Is this an important part of your daily life? Yes
  • Where do you currently live? Moving to England from Thailand
  • Occupation? Most recently an English teacher in Thailand which involved a lot of sitting. Previously a beauty therapist which involved a lot of standing.
  • How stressful is it out of 10? 5 or 6



  • Main health concerns: Back – middle back by the spinal area. Pinching sensation. When she moves the right leg, bend the right leg/ hip up – it pinches.
  • Other concerns or goals? Be more healthy and work on muscle tone.
  • Do you get headaches: No, very rarely. When she gets a headache she knows something is wrong (tension)
  • Do you smoke? If so how much? No
  • Do you drink? If so. How much? Rarely – on social occasions only.
  • Do you take any drugs for recreational purposes? In the past smoked.
  • Any serious illnesses/ hospitalisation or injuries? In 2013, 2 years away, she was getting into a car and hit her head on the doorframe. When this happened, head hurt and pain travelled to the back and down to the knee. She went to the doctor, he asked her to bend over to check spine flexibility. He diagnosed no condition – all well.

She then went to a chiropractor, he clicked her back but pain came back after a few days. Stiffness and awkwardnewss. Feels it in the hips – right one is tight.

Depression in 2012 – and before. Was on medication on and off. Doesn’t want to be on the medication. Prozac. She came off them in one go, without getting doctors’ advise, as she just felt numb all the time, and no longer wanted to be on them as it didn’t feel right.

  • At what point in your life did you feel at your best physically and mentally? In 2009-2010 when you were dancing (physically) – Mentally would be around now, but is nervous about the future – anxiety.
  • How is the health of your mother and father? Mother – polymyalgia (muscle hurts all the time, and is on a combination of medication). She practices yoga.
  • How does this affect you? She would like her mum to be happy and healthy.
  • Sleep Pattern: Busy mind at times can affect sleep, difficulty in getting to sleep.
  • How many hours do you sleep: Need 8 hours’ sleep . Always been a night owl.
  • Do you wake up at night? Rarely .
  • Do you take rest during the day, if so when and how? No, except on this TTC course. Afternoon nap.
  • Do you have any pain, stiffness or swelling anywhere in your body? Middle back otherwise no.
  • Do you have any constipation, diarrhoea, gas? Normally, bowel movement is good and regular. During the TTC, upset stomach for a week.
  • Any allergies or sensitivities? Used to get hayfever – not anymore. It started when she was in high school. Stopped a couple of years ago when she started using Jala Neti.
  • Do you exercise – if so, how long and how regular? Walk at least 30 mins a day. Yoga almost every day + exercise bike.
  • What is your energy level when you exercise? High
  • How often do you practice yoga, meditation and other relaxation techniques? Every day
  • How does it make you feel? Great


  • Are you on any medication? No
  • Do you have any diseases? If so what has been diagnosed? No
  • What was it caused by? n/a
  • Any help, healing or therapies you currently participate in? n/a



  • What type of food did you eat as a child? Meat and veg – balanced and healthy. Granma used to cook. No junk food.
  • What are your eating patterns? Healthy with occasional sweet and savoury treats.
  • Vegetarian/ Vegan/ Raw Food/ Pescatarian/ Non-Veg/ Halal/ Kosher? Vegetarian and no dairy.
  • What is your daily food intake look like – breakfast, lunch, dinner, snacks?

Vegetable juice (green), muesli

Pad Thai (in Thailand)

Steamed / Vegetables + brown rice– not after 6pm

Some chocolate and nuts

  • Do you crave for sugar, coffee, cigarettes or others? Chocolate – sugar.


Flexibility: Spine flexibility: Cannot touch her toes, but nearly. Tight hamstrings.

Shoulder flexibility: Good – right shoulder tight.


PRANAMAYA KOSHA: Pranic Body Level


  • Energy Levels on a daily basis: Wishes she has more energy on a daily basis. yoga teacher training in indiaSluggish upon waking. At night feels quite restless. Which is why she sometimes falls into feeling tired and napping during the day, which makes her feel awake during the evening.

MANOMAYA KOSHA: Mind, thoughts and emotions level


The pain and sensations really gets to her, feels like nails scratching down. Which in turn upsets and frustrates her, and gives her fear to move. It used to happen when she got dressed, which really got her down, and irritated her. The acute pain lasted a few days, couple of weeks. Since then, just the niggling pain.

When it happened had some depression, and since then has worked through it and now manages depression.

Has taken reiki, and meditation – meditates daily.

Pretty good emotional state, bounces back quickly from negativities. And always tried to see the positive and the good in people. Does not judge people.


Advised patient to get an x-ray and another full check- up with a specialist (doctor and spine specialist) when she gets back to the UK.

Semispinalis area – possible area of tightness. Possibly liquid or nerve damage?

Overthinking and overanalysis may affect the pain threshold, though she does not believe she does so. She did mention she is worried about the future, and the health of her mum. From talking more at length with her, the past depression and being underweight at high school (not eating) , certainly has long term effects and worried about how other people think of her is an issue.

Back pain may in this case be psychosomatic.

Middle back pain can have an emotional meaning – guilt from the past.


Tight hips + hamstrings, and middle back stiffness.

Annamaya Kosha Level: Suxma Vyayam warm up muscles , hamstring flexors, hip openers, back traction then strengthening + neck tractions.

Pranyama Koshal Level: and kriyas – brahmari, anulom vilom

Manomaya Kosha Level : Discussion about her past, her anxiety and worries about her mum, going back home to live with her mum, the future, relationships and so on.

Vijanmaya Kosha Meditation and focusing on the positive and breathing into the bell. She has seen a counselleor/ therapist in the past for her depression. Self-study as well, of spiritual books.

Anandamaya Kosha: Going deeper into the self-study and focusing on total bliss and consciousness.

Day 1:

Suxma Vyayama: Lower body warm up and stretches. Ankle and toe pumps, quads, squats, side stretch.

Assisted hamstring and hip openers. .

These can be repeated on her own using a strap.

Assisted Cobra

Lower Back release

Rope – spine traction and neck traction.

Lenghthening the spine, and finished with a neck traction.

Followed with neck and shoulder massage. Savasana then bhramari for a feel-good, and balancing of emotions pranayama.


Next dayFeedback: She managed to practice yoga later in the day without experiencing any pain or pinching sensation in the back.

Day 2: Focus middle back

  • 3 rounds of anulom vilom
  • Warm- up – calf raises/ leg circles / indian squats/ spine flexion and lateral flexion/ shoulder rolls and arm lifts

Supported Triangle                     Supported Shoulder Stand and Back bend

Supta Vajrasana

Spine traction on the rope

These can be done on her own at home or whilst travelling. Whenever she feels a middle back pain again, advised her to gently warm up muscles – or do a hatha yoga class or hatha flow – then finish with these – once every 3 -4 days . Not to overstretch the back.


Day 3: Focus hip, shoulders and middle back


Feedback: Slept well, no pain. As she was getting dressed this morning, a pinching sensation all the down to right – as she was bending the right leg forward.

Today, during therapy, felt a twinge when she had the right leg on the wall, and when she was in dandasana during the warm up, when she bent the right leg in to her chest.

Day 4: Self – practice – meditation

Arms balances and inversions asana workshop.

Short meditation during supported supta vajrasana.

She later used the ropes for downward dog and supported headstand.

Day 5: Focus hips and lower back

Feedback: Didn’t sleep well last night because she was stressed and overthinking. Anxious about her return to the UK. Friends asking her what her plans are, and she gets anxious.

This morning, her back twinged about 10 times. Didn’t practice ashtanga this morning because she was too tired. Also as she lifted her legs up to get over the window, her back hurt. Sitting against the wall on a cushion, back hurt.

Today at lunch she walking up and down the hill, and went to the pool and this was good for her.

Didn’t manage to focus on her breath, abdominal breathing, as I had suggested. Her mind is still agitated.


Today for therapy – focus on hips and lower back.

Warm up – suxma vyama lower body, hips, arms and shoulders.

Assisted hamstrings and hip stetches.

Assisted lower back release.

Assisted pawanmuktasana .

Assisted child pose stretch.

Spinal twist.




Final stats on day 6

Respiration Rate: 18

Heart Rate: 80 bpm


She has continued doing some of the suxma vyayama as well as some stretches. However her awereness on her breathing has yet to be managed, chest breathing keeping the abdomen in is still a habit, which I believe is the reason her heart rate and respiration rate are on the higher normal scale. This may be due to the anxiety of going back to the UK and the end of her journey in Asia.

Upon her return to the UK, she will get her back checked with an x-ray, though the reason for her occasional pinching sensation may be due to emotional imbalances, anxiety and worry. With past depression bouts, I think this need to be monitored, as she now thinks that all is well, and she has no worries. Anxiety and worrying about what others think can be disturbing to the peace of mind.

I would certainly suggest taken up again some therapy such as life coaching, a life therapy to help give her direction to her life, and upcoming 40s which can be daunting in itself.

On the vijanamaya kosha level, besides some more holistic therapy, laughter therapy may be a good way to have her express herself, and laugh which is the best medicine at times.


Picture Source:


A national yoga organization of india offers yoga courses and retreat in Rishikesh

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