I teach Yin Yoga to an elderly lady who has an Hernia in her diaphragm. What Yin poses should she avoid doing and which ones do you recommend for her?
Thank you in advance.
Very interesting question. I do not know much about this condition and I am not a doctor, but I do know that a true diaphragmatic hernia is very dangerous. This is not the same as a hiatal hernia, where the stomach starts to push up through the hiatus between the stomach and the esophagus. A diaphragmatic hernia is the abdominal organs passing upward through an opening or tear in the diaphragm and endangering the lungs. It usually happens in new born babies, but can happen to adults after a trauma. I assume your student does not currently have a diaphragmatic hernia, but rather she had one and it was surgically repaired.
If your student does currently have a diaphragmatic hernia, she should get to her doctor right away, but most likely it was her doctor who told she has it…so the real question is … “what does her doctor say?” Are there some movements or positions that she recommends avoiding? Since you and I are not doctors, any suggestions we can offer are just guesses: best to hear from the experts.
My suspicions would be 1) your student doesn’t currently have a diaphragmatic hernia but she did have one that was repaired; 2) the site of the repair may be the weak link in the integrity of the diaphragm; 3) care must be taken to ensure the student does not over stress the diaphragm; 4) the best approach for the student is to slowly strengthen the diaphragm and abdominal/core muscles.
Given all this, Yin Yoga is not going to strengthen her core. For that she needs yang exercises but not the traditional sit-ups or crunches, which could make her problem worse. Instead I would suggest the McGill Big 3 core exercises, which I have described here and here. Her doctor may have already suggested some strengthening exercises which may be incorporated into a yang yoga practice.
Yin Yoga is probably benign, but I would suggest avoiding any postures that put pressure on the belly: avoid Sphinx, Seal and Snail postures. Go slow: start with shorter holds and teach her how to pay attention to sensations. Any sign of pain or discomfort in the core areas means to come out right away. She should also notice how she feels after she has come out of the pose and even over the next day or two. Over time, she will learn what is okay and what doesn’t work for her.
Good luck, and let us know how it goes.