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5 Yoga Pose Variations For Students With Practice-Limiting Conditions From An Instructor With MS

Yoga instructor Morgan Greenwood offers students who might have practice-limiting conditions 5 yoga pose variations that can provide them the same benefits of traditional yoga poses with slight modifications. As an instructor living with MS, she shares her knowledge on practice modifications, what to stay away from, and how to have an encouraging, fulfilling yoga practice. 

Whether you are in your first or fifteenth year of teaching yoga, you know the sweet exhaustion and exhilaration that comes from a class well-taught. When your training, your sequence, and your cues are all flowing. When, from start to savasana, you were fully prepared to deliver a careful and compassionate experience. 

And, regardless of your years of teaching experience, you are probably also familiar with the moments that, despite your training, you feel wholly unequipped for. For instance, when your students come to class with conditions that may significantly impact their practice. It's in these moments that we, as instructors, have the privilege and responsibility to create an inclusive and supportive environment.

Prioritizing student safety while respecting their personal space and privacy is a delicate balance. It’s a task that can be as intimidating as it is rewarding. 

Sometimes we know exactly how to offer a student more comfort. The right words. The right prop. The right variation of an asana. Other times, in true yoga instructor style, we “mellow panic” as we rack our brains for a solution to a body history we have never encountered before.  

In this article, I'll be sharing five specific variations that I have found helpful in my beginner yoga class where students often try yoga for the first time because they are dealing with a quality of life-impacting condition. From vertigo to numbness and tingling, here are a few potential options to help your students in practice. 

KEY TAKEAWAYS:

  • Sweet Exhaustion and Exhilaration: Teaching yoga, regardless of experience level, brings a mix of exhaustion and exhilaration when classes flow smoothly from start to savasana, delivering a compassionate experience.
  • Inclusivity and Support: As instructors, it's vital to create an inclusive and supportive environment, especially when students come with conditions that may affect their practice.
  • Balancing Safety and Privacy: Prioritizing student safety while respecting their privacy is crucial and requires a delicate balance.
  • Adaptability: Being able to adapt sequences and cues based on individual needs and conditions is essential for effective teaching.
  • Communication and Observation: Communication with students and keen observation during class help identify conditions or limitations, allowing for appropriate modifications.
  • Specific Modifications: The article provides specific modifications for various conditions, such as vertigo, knee pain, back pain, sensitive wrists, and numbness/tingling.
  • Collaboration: Effective variations often stem from collaboration between instructor and student, fostering a space of mutual support and empowerment.
  • Continuous Learning: Regardless of experience, instructors will encounter new challenges and conditions, highlighting the importance of continuous learning and adaptation in teaching yoga.

5 Yoga Poses for Practice-Limiting Conditions 

Surya Namaskar A (Sun Salutation A) Variation for Vertigo 

Sometimes, even before class starts, students are willing to share insight on injury, illness, or other body history with us. Other times, we make these discoveries only as we observe how a student moves through the class. Perhaps with gentle questioning, we can learn enough to understand what might be happening on our student’s mat.  

This is how I learned that a first-time student was dealing with a mild case of vertigo. I noticed first that, in Marjaryasana-Bitilasana (Cat-Cow), her gaze was always up toward the ceiling. Even in Cat. My concern was the over-compression of her cervical spine. When she also kept her gaze skyward in Adho Mukha Svanasana (Downward Dog), I kneeled down next to her mat and asked what it might feel like if she were to bring her gaze to the center of her mat. She explained she was recovering from a case of vertigo and that anytime her head was below her heart, she felt dizzy. 

I knew that for her comfort and safety, we needed to avoid Uttanasana (Standing Forward Fold) and Downward Dog, but I still wanted to help her participate in the Vinyasa flow-style class. Here is how we modified Surya Namaskar A. Try it for yourself! 

Step-By-Step How-To: 

  • Begin in Tadasana (Mountain Pose) with your feet about hip distance apart. 
  • Instead of Urdhva Hastasana (Upward Salute), inhale into Parsva Urdhva Hastasana (Upward Salute Side Bend), first on your right, then on your left. 
  • Instead of Standing Forward Fold, sink into Utkatasana (Chair Pose). You may opt to stay in Chair, working your glutes and thighs (this would be while other students move through Ardha Uttanasana (Half-Standing Forward Fold), Plank, Four-Limbed Staff Pose, Upward Dog, Downward Dog, etc.) or you may opt to take a gentle twist to the right, then left while in Chair until all students re-find Mountain Pose. 
  • From Mountain Pose, repeat Upward Salute Side Bend on your right, then your left. 
  • All students refined Mountain Pose.

Extra Variation Note:  

Since Chaturanga Dandasana (Four-Limbed Staff Pose), Urdvha Mukha Svanasana (Upward-Facing Dog), and Downward-Facing Dog can also be tough on tender shoulders, I have since used this same variation for students grappling with shoulder pain or recovering from shoulder surgery. 


Marjaryasana-Bitilasana (Cat-Cow) Variation for Knee Pain  

Knee pain is one of the most common conditions among students in my beginner yoga class. In some cases, having students slide a blanket under their knees in asanas like Bharmanasana (Table Top) or Anjaneyasana (Low Lunge) is enough to alleviate discomfort. In other cases, it isn’t.  

A beginner student of mine arrived early to class to let me know that she had undergone one full and one partial kneecap removal ten months prior. She shared it was difficult for her to put pressure on her knees. I told her I would observe her throughout class, and I demonstrated Balasana (Child’s Pose) describing it as her go-to pose anytime she wanted.  

She bravely attempted Cat-Cow, however, it was noticeable that knee-to-mat contact was painful even with the padding of a blanket. Given that Cat-Cow is a staple for warming up (and cooling down) the spine and the core, I wanted to make sure I could offer her a variation of it. In this case, Seated Cat-Cow was the solution.  

Step-By-Step How-To: 

  • As a first offering to manage knee discomfort, try an elevated version of Seated Cat-Cow by stacking two blocks at their lowest height and taking a seat. 
  • Although this can alleviate direct mat-to-joint pressure on your student’s knees, there is still a deep bend in the knees here. If the bend is too deep - as it was for this particular student - take Sukhasana (Easy Seated Pose). 
  • From there, gently tuck your tailbone under and sit with a straight spine. 
  • Place your hands on the tops of your knees.  
  • On an inhale, slowly drag your hands in toward your hips as you ease your navel forward, coming into a Cow spine. 
  • On an exhale, drag your hands back toward your knees as you gently push your spine toward the back of your mat and tuck your tailbone under for a Cat spine.  
  • Continue for a few more rounds of breath.

Extra Variation Note:  

This variation was also useful to my student dealing with vertigo – and it can be performed in a chair. 

Root-to-Rise Variation for Back Pain 

Whenever I cue “Root-to-Rise” for the first time in a class, I keep close eyes on the room. Because moving from Standing Forward Fold to Mountain Pose with a flat back demands coordination between strong legs, a strong core, and a strong back, it can reveal a lot about what’s happening in a student’s body.  

Traditionally, I encourage all students to widen the distance between their feet and offer a gentle bend in the knees before rooting to rise. For many students, these adjustments aren’t enough to make the migration from folded to upright safe, let alone comfortable. For these students, I offer a wide-stance variation of Chair Pose as a pit-stop between Standing Forward Fold and Mountain Pose.  

Step-By-Step How-To: 

  • From Standing Forward Fold, step your feet apart a little wider than hip-distance. 
  • Bend your knees deep enough so you can easily tent your fingertips on the floor for support. 
  • Sink your hips down until you feel your thighs engage. 
  • Place one hand on one knee and your other hand on your other knee. 
  • Engage your thighs, core, and back.  
  • Keep a straight back as you push through your feet to standing. 
  • Arrive back at Mountain Pose.

Extra Variation Note:  

This variation can also be useful for expecting mothers in any stage of pregnancy when baby’s growing weight might add excessive pressure on mother’s back. 

Adho Mukha Svanasana (Downward-Facing Dog) Variation for Sensitive Wrists 

When a consistent student came to class with wrist braces for the first time, I approached her asking if there was anything in particular I should be looking out for during her practice. She shared she was in the midst of a carpal tunnel flare-up, but really wanted to practice. With a smile, she said, “We’ll see how it goes.” 

As we migrated into the flow portion of class I noticed her wincing in transitionary poses especially Four-Limbed Staff Pose, Upward-Facing Dog, and Downward-Facing Dog. Initially, I offered Child’s Pose as a resting variation to these three often-linked poses. She told me she was hoping for something a bit more challenging. Instead, I offered her a kneeling position with her arms stretched skyward as in Virabhadrasana I (Warrior I). This would act as her version of Adho Mukha Svanasana for the remainder of class. This way she was able to engage her thighs, glute, and core and more comfortably transition between poses. 

Step-By-Step How-To: 

  • From a standing pose such as Mountain Pose, float fold forward to Standing Forward Fold. 
  • Inhale into Half-Standing Forward Fold and bend your knees so deep that you can tent your fingertips onto the ground. 
  • Instead of stepping back into Chaturanga, step back into Table Top. 
  • Sink your hips down toward your heels into Child’s Pose. 
  • Take an inhale in Child’s, then on your exhale, engage your thighs and core so that you can come to a kneeling position. Extend your arms out wide and then overhead.  
  • Throughout class, this kneeling position will act as your version of Downward-Facing Dog. From this position, you can transition into Ajaneyasana (Low Crescent Lunge) by stepping one foot forward. From here, you can transition into a wide variety of standing poses such as Warrior I, Virabhadrasana I (Warrior II), etc. by adjusting your base body.

Extra Variation Note:  

This variation allows your student to participate in a flow without incorporating asanas which can be unsafe or uncomfortable for sensitive wrists. It can also be useful for students dealing with shoulder pain or recovering from shoulder surgery. 

Warrior II Variations for Numbness and Tingling 

On a handful of occasions, students have shared that they are experiencing intermittent numbness in their hands or feet. In these instances, I’ve always asked if there is anything more they can share with me. Some students explain that they are dealing with pinched nerves, poor blood circulation, fibromyalgia, etc. To ensure their safety, I ask them to move slowly through practice and to opt for asana variations that keep their bodies lower to the mat. 

Sometimes, the cause of the numbness and tingling is a mystery to the student and their physicians. One student like this I know very well. It’s me.  

When I began to experience numbness and tingling in my feet due to a flare-up of what, at the time, I didn’t know was multiple sclerosis, I found it difficult to find stability in standing poses. While I knew of many asanas that would keep my center of gravity lower to the mat, some days, you just long for the strength and expanse of Warrior II. It was on one of these days, that I started my chair-based practice.  

Step-By-Step How-To: 

  • Begin seated at the edge of an armless folding chair. 
  • Start to turn to your right and slide your left hip to the left edge of your chair. 
  • Keep a gentle bend in both knees as you begin to open your hips to your left.  
  • Straighten your left leg and keep a bend in your right knee. The outer edge of your left leg should be parallel to the left edge of your chair. 
  • Engage your glutes and press through the back leg and outer edge of your left foot. 
  • Stretch your arms out wide and parallel to the earth. 
  • Keep your gaze over your right fingertips. 
  • Slowly come back to center, and perform on the other side.

Extra Variation Note: 

Both Warrior I and Warrior II can be performed in a chair. 

The Most Effective Variations are Rooted in Collaboration  

Yoga instruction involves not just teaching postures but fostering an environment where each student can explore their practice safely and confidently.  

Regardless of how long we have trained or taught, we will all continue to encounter moments when students bring unique conditions or challenges to the mat. It’s in these moments that our role as instructors must morph into something different. Here, the role of teacher and student must intertwine, maybe so much so that the instructor becomes the primary listener and learner.  

While the desire to “know what to do” is strong and the state of “not knowing what to do” can be intimidating, I encourage my fellow instructors to surrender to these moments as opportunities to collaborate with their students. In my experience, the most creative solutions often arise from the back-and-forth of this union. This gentle and humble dance of making offerings and receiving feedback is where both student and teacher can work together to create a space of mutual support and empowerment. It’s the space where students and teachers mutually enrich each other’s lives.  

Morgan Greenwood
Morgan Greenwood is a Yoga Alliance-registered RYT® 200 instructor trained in Mindfulness-Based Stress Reduction. Using her personal experience managing autoimmune disease, she has created an online yoga and meditation retreat specifically for stress management called The Anxiety Relief Retreat (morgangreenwoodyoga.com/). Based in the Nashville, Tennessee area, Morgan writes freelance with a focus on contributing accessible, action-oriented pieces on health and wellness. Her work has been featured in SELF and Well+Good.