With the popularity that yoga has achieved over the past five years, newly trained yoga teachers will find themselves faced with an array of students requiring special attention for a variety of structural and physiological limitations. The definition of therapeutic yoga, to which I will respond in this article, is yoga with the intent of giving relief from physical pain and improving joint and organ functions. This perspective on yoga is related to, yet different from a yoga practice that stretches, opens and relaxes a person in general.
In order to meet the needs of yoga students, it is important to have an understanding of the anatomy of muscles, joints, and organs, as well as of human physiology, and how all these things are affected by the yoga poses.
Some styles of yoga are more applicable therapeutically than others. Whatever style of yoga rings your bell, a solid foundation in the Iyengar method will offer you the best preparation for a therapeutic understanding of the poses. Understanding proper alignment in the poses can help balance joint instability as well as decompress the organ systems, leading to improved function and an increase in life force, or prana. Knowledge of various disease processes will also be helpful. With spinal injuries or disorders, an understanding of the difference between a pinched nerve, a ruptured disk, spondylolysis or osteoporosis will help to guide the yoga poses recommended and the details of their execution. For example, with neurological disorders such as multiple sclerosis (MS) there is a tendency for the nervous system to overwork, generating heat and fatigue. Depending on the progression of the disease, challenges with balance and joint pain may also need to be considered when helping the student develop an effective yoga practice.
Yoga teachers need to discipline themselves to inquire about the needs and limitations of every new student. When faced with a condition that is unfamiliar, a teacher must be open to feedback from the student in order to find poses and that are helpful and non-injurious.
Once a new teacher has gained a working knowledge of alignment, anatomy, and various disease processes, the next challenge is learning the art of "seeing." Different body shapes, sizes and proportions tend to throw a new teacher off. If you focus your vision to the level of the bones, you can watch the skeleton articulate, which reflects both good and bad alignment and reveals insights regarding the compression or expansion of the various joints and organs. With neuromuscular problems such as low back or neck and shoulder pain, adjusting the alignment of the bones in the yoga poses will relieve stress in the joints and help bring about muscular balance. Good alignment and the appropriate sequencing of poses are the keys for creating a positive change in the neuromuscular system.
With neurological or physiological disorders, a new teacher needs to learn to track the energy, or prana. In order to learn to "see" with students whose condition limits their range of motion and possibilities for alignment, practice squinting your eyes to narrow your vision and track the energy moving through the core of the limbs. Students should be guided to synchronize each extension with their breath, while maintaining their best alignment. Being able to see the energy move or not move as a teacher, or feel it as a student, is a learned perception and will come with practice. When we utilize conscious intent to extend and activate the nervous system we stimulate and improve its function, reaping many positive benefits.
Additionally, the teacher needs to assist the student in addressing their pain thresholds. Learning to work with the pain, not against it, is an important factor in the healing process. Following the lead of John Cabot Zinn (see reference books below), there is a simple formula you can utilize: 1) don't resist the resistance; 2) suspend judgment; 3) breathe deeply; 4) watch and wait for a change.
To pass on the guidance of my teacher, B.K.S. Iyengar, never work on an injured area directly, rather open and strengthen the surrounding areas first to indirectly bring about positive change in the effected area. In the case of neuromuscular problems, choose a minimum of three poses based on balanced anatomical movements for your preliminary sequence. Once the muscles that are contracted and weak are released, it is then safe for the teacher to guide the student into poses that create muscle tone. To begin to strengthen muscles, choose poses that engage them within their range of motion. For example; Marichasana, fish pose, can be effective in the strengthening the upper back and neck even if the student can only lift their upper back one inch off the floor. There are many ways to learn yoga and to teach it. Many programs teach the basics of teaching yoga poses; however, choosing an effective sequence of poses for the specialized needs of individual students is an art.

Lillah Schwartz, RYT, is a Certified Iyengar instructor and founding director of the Lighten Up Yoga Teacher Training Institute, R.Y.A.(200 & 500 hr) in Asheville, N. C. She can be contacted at 828-254-7756 or on the web at lightenupyoga.com.

REFERENCE BOOKS
Anatomy of Movement, Blandine Calais-Germain
Anatomy of Hatha Yoga, David Coulter
The Path to Holistic Health, BKS Iyengar
Full Catastrophy Living, John Cabot Zinn

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