At the beginning of the term last autumn, I decided to teach some twists. Using the concept of vinyasa-krama, that is, work slowly into the postures, I taught some light standing, sitting and lying twists. In general, if you keep the arm work light, the twist moves more into the lumbar spine. Still, I was trying to work into the dorsal spine, so especially worked with the breath. In sitting twists, one can add a krama in the exhale, as the students go into the pose. In lying twists, one can do a dynamic phase followed by some breaths in the pose.
My experience was educational. I discovered that this group is not yet ready for twists. Two students experienced muscle pulls, one in the quadratus lumborum region after a trikonâsana (triangle pose) and one in the intercostal / serratus anterior region after a jatara parivritti (lying twist pose). Another student fell out of trikonâsana. This same student was later told to avoid practising twists after her expander/implant reconstruction. Eight weeks into term, I stopped all but the lying twists, and these I did in their gentlest form.
So, be careful with twists in yoga therapy for breast cancer patients. Here is a workup (vinyasa krama) for the triangle pose (trikonâsana). Legend:
slight bend in the front leg, top arm bent with hand on hip, look down
slight bend in front leg, top arm bent, look up
slight bend in front leg, top arm stretched out and up, look down
slight bend in front leg, top arm stretched up and out, look up.