Maintaining range of motion and building strength while adapting a yoga practice for an aging body

Sessions with Maggie: (Her name has been changed to protect her privacy)

Maggie is 86 years old. I’ve worked with her once a week since 2006. For the last two years we have worked virtually as I moved out of New York City during the pandemic.

When I started working with Maggie she informed me that she had had both hips replaced, had dealt with breast cancer and gone through a mastectomy. She regularly reported not sleeping well, often reported a dull and aching pain on the tops of her feet, and had very limited range of motion in her right hip following her hip replacement surgery. Maggie is a deeply intellectual woman, a voracious reader, a mother of 3, and spends much of her time seated. She lives alone and this has always been a huge consideration for me in our work. She must be strong enough to push herself up from a chair and also from the floor, in the event of a fall, in order to continue living solo. She is a writer and a researcher and continued to work full-time into her mid-eighties and still works as a consultant at 86.

Physically, Maggie has a mildly flattened thoracic curve and some limited range of motion in her hips, pronated feet, and some scar tissue restriction on the right side of her chest following a mastectomy.

Our regular weekly practice has focused largely on improving her range of motion through  building and maintaining strength, and on improving her breathing capacity. A new challenge is helping Maggie navigate the fact that she has started falling more. This has happened a couple of times at home, as well as out on the street when getting in and out of cars. She reports feeling some weakness and a sensation of ‘giving out’ in her right leg. My goal with Maggie has always been to keep her moving, to keep her tissues hydrated and supple, to help her move her body in ways that she is not utilizing in her daily life and to help her remain strong and sufficiently capable to live alone. In every weekly session for 15 years I have asked Maggie to get down on the floor, spend some time on her hands and knees, be prone, be supine, and side lying, and to push herself up from a kneeling position in order to sit in a chair in which to close class.

What has worked well with Maggie in general:

Simple movements

Holding space for Maggie to express her current emotional, physical, and energetic state knowing that she will be heard and the class content adjusted for her present reality.

Lots of repetition with minor progressions

Time to rest, not too much of one thing

Ball rolling, self massage

Supported back bends

Body scan

Breath work

Below is an example of the type of session that Maggie and I do together which I feel would be a very useful and adaptable session for any student in their 80’s who is capable of getting down on the floor and who is interested in maintaining and increasing range of motion, strength, and balance work.

Standing work:

Foot rolling

Heel raises, heel rocks

Calf stretching

Standing arches in/arches out

Arm swings

Arm circles

Block between feet, reach up, unilateral, bilateral

Weight transfer—gait pattern weight shift mid-stride practice

Lunging with hands on counter or chair

Downward dog with hands on counter

Chest rolling with ball and block at wall

Chest stretch at wall

Arm stretch up wall reaching block up the wall

Hands against wall downward dog

Chest work:

Rolling out her chest with a therapy ball and a block at the wall to increase blood flow and circulation to the area around her chest.

Chest stretches using a wall

Side body stretches reaching up the wall

Foot and ankle work:

Foot rolling to increase blood flow and hydration to the plantar fascia and to create more foot and ankle mobility.

Seated with a block between the feet, isometric holds of the block between the ankles

Calf stretching

Heel raises and heel rocks

Balance work:

Standing facing the kitchen counter with a block between her thighs, practicing shifting weight into one leg at a time and minimizing reliance on her hands and the counter for support

Lunges

Box squats in and out of the chair

Chair work:

Seated lunges with a gentle side bend

Shoulder stretches

Exercises with a yoga strap and a theraband to increase shoulder range of motion and strengthen her upper body.

Neck stretches

Twists

Floor work:

Modified cat/cow

Quadruped reaching one leg back

Prone thoracic extension

Supine hip massage work with therapy balls

Feldenkrais lower body exercises

Pelvic bridging with a block between her knees

Windshield wipers

Hamstring stretches

Hip flexor stretches

Knee to chest stretch

Side lying:

Clamshells

Lateral leg raises

Twist

Arm circles

Constructive Rest