Tests of our aims of exercising Tests of our aims of exercising
The following sections suggest a selection of tests,
with an emphasis on the close relation between test-
ing and exercising. Results can be documented in
different ways according to individual preference.
For example, measurements can be taken, or draw-
ings, photographs, verbal descriptions, or a combi-
nation of any of these can be used. In this way the
patient’s success rate can be observed over a period
of time. The baseline indicates where the patient
was at the beginning.The meaning of mindfulness
As explained in Chapter 2, mindfulness is a fun-
damental aspect of the ancient eastern paths of
meditation. Applying this principle to the physi-
cal practice of the yoga path leads to the following
reflective aspects:
• observing the body’s signals
• cultivating inner awareness from the center to
the periphery of the body
• observing and feeling: where awareness can go,
which parts of the body can be penetrated with
the mind, how long this awareness can last, how
long you can be calm in a posture.
In mindfulness the exercise path is entered from
both directions. It is a basis for measuring the
improvement in all objectives as well as the qual-
ity of exercise and the boundary of movements. It
is enhanced through continued practice. Improving
mindfulness is not restricted by most conditions,
nor by aging. Iyengar (2005) emphasizes that we
have the capacity to refine our awareness as we get
older. It is worth cultivating this. Mindfulness is a
strong diagnostic tool that can be applied to all exer-
cises and can constantly be honed.Mobility and stability
For a successful exercise prescription it is important
to consider hypomobility as well as hypermobility
and the possible relationship between the two. It is
particularly important to understand hypermobility
in order to protect the relevant areas and avoid injury
through overexercising. We need to distinguish between pathological instability and hypermobility
(Magee 1997).
Pathological instability is an excess of the small
accessory movements in the joints, such as trans-
lation or anterior/posterior shift. A small amount
of this joint play is important for painless, good
joint function; it is not under voluntary control.
Pathological hypermobility is an excess of gross
anatomical movements, such as flexion, extension,
side-bending, rotation, and circumduction. It is very
individual, and is dependent on age, gender, and
many other factors. Hypomobility and hypermo-
bility can be generalized or local. Hypermobility is
often adjacent to a restricted area and a consequence
of it.
Clinical instability of the lumbar spine is frequently
discussed (Richardson et al. 1999, Panjabi 2003 ).
When the practitioner can see more pronounced
deviations from natural curves during active exami-
nation, showing hypermobile segments, the patient
often experiences pain. This is an important connec-
tion between the testing done by the therapist and
the patient. These hypermobile segments also need
special care during exercise. If movements at these
segments are causing pain, this area may be over-
worked. The movements should remain in the pain-
free range or come back to this range if performed
too far.
Patients and yoga students who are generally
hypermobile are often admired and envied for
their abilities and impressive performance of yoga
āsanas. Nevertheless, they tend to have pain that
does not improve, and sometimes is even worsen-
ing despite their regular, beautiful practice. Their
muscles, tendons, and ligaments are often over-
stretched and irritated. They should not go to the
limit of their mobility; rather they need to adjust
their postures so that the muscles are strengthened
and work together in a balanced way. For hypermo-
bile individuals precise alignment is very important.
The muscles should be used sufficiently to finetune
the movements of the joints and to protect the vul-
nerable joints. The instructions for both the āsanas
and the basic exercises are designed to fulfill this.
Very mobile people may need to come away from
their limits of movement and use props to sup-
port stability first. Details need to be decided on a
case-by-case basis.