Tyu-Risk Management

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THE

UNDERGROUND YOGA: RISK MANAGEMENT



The Underground Yoga: Risk


Management

Brigham Young University

Noemi Morales
Maraia Vosaki
Karli Nielson
Jayden Haws

THE UNDERGROUND YOGA: RISK MANAGEMENT



Table of Contents
Overview ............................................................................................................................................... 4
History Of The Organization .............................................................................................................. 4
Mission & Purpose ............................................................................................................................ 4
Personnel ........................................................................................................................................... 5
Who Does TYU Serve ......................................................................................................................... 5
Descriptive Recreation Activities ........................................................................................................... 6
Ashtanga ............................................................................................................................................ 6
Inversion ............................................................................................................................................ 6
Adaptive Yoga .................................................................................................................................... 6
Space & Liability ................................................................................................................................ 6
Current Risk Management Status ......................................................................................................... 7
Guidelines For Workplace Policies ........................................................................................................ 8
Hiring and Termination policies ........................................................................................................ 8
Ashtanga Yoga ..................................................................................................................................... 10
1. Dehydration Reduce ........................................................................................................... 11
2. Re-injury Reduce and Transfer .......................................................................................... 11
3. Overexertion Reduce ......................................................................................................... 12
4. Torn/Strained Muscle Reduce .......................................................................................... 12
5. Sprained joints Reduce ...................................................................................................... 13
6. Head injury Reduce ........................................................................................................... 13
7. Neck Injury Reduce ............................................................................................................ 14
7. Dislocated joints Reduce .................................................................................................... 14
8. Exhaustion Reduce ............................................................................................................. 15
9. Slipping Reduce .................................................................................................................. 16
Inversion Yoga ..................................................................................................................................... 17
1. Dehydration Reduce ........................................................................................................... 18
2. Dizziness Reduce .............................................................................................................. 18
3. Torn/Strained Muscle Reduce .......................................................................................... 19
4. Hernia Reduce .................................................................................................................... 19
5. Head injury Reduce ........................................................................................................... 20
6. Neck Injury Reduce ............................................................................................................ 21
7. Exhaustion Reduce ............................................................................................................ 21
8. High Blood Pressure Reduce ............................................................................................. 22
9. Overexertion Reduce ......................................................................................................... 23
10. Slipping Reduce .............................................................................................................. 23
Outside Studio Yoga ............................................................................................................................ 24
1. Dehydration Reduce ........................................................................................................... 25
2. Knee Injury Reduce ........................................................................................................... 25
3. Lower Back Injury
Reduce and Transfer ........................................................................... 26
4. Re-injury Reduce and Transfer ......................................................................................... 27
5. Sprained hamstrings Reduce ............................................................................................ 27
6. Sprained wrists Reduce .................................................................................................... 28
7. Overexertion Reduce ......................................................................................................... 28
8. Torn/Strained Muscle Reduce ........................................................................................... 29
9. Sprained joints Reduce ...................................................................................................... 29
10. Slipping Reduce .............................................................................................................. 30

THE UNDERGROUND YOGA: RISK MANAGEMENT


3



11. Exhaustion Reduce .......................................................................................................... 30
12. Sexual Harassment Reduce ............................................................................................. 31
13. Head injury Reduce ......................................................................................................... 32
14. Neck Injury Reduce .......................................................................................................... 32
15. Dislocated joints Reduce .................................................................................................. 33
Adaptive Yoga ..................................................................................................................................... 34
1. Fall out of Chair Reduce and Transfer ................................................................................ 35
2. Broken Bones Reduce and Transfer ................................................................................... 35
3. Torn/Strained Muscle Reduce .......................................................................................... 36
Mitigation: ................................................................................................................................... 36
4. Loss of Breath Reduce ........................................................................................................ 36
5. Re-Injure the Spine Reduce ............................................................................................... 37
Mitigation: ................................................................................................................................... 37
6. Dislocated joints Reduce .................................................................................................... 37
14. Neck Injury Reduce .......................................................................................................... 38
Monitoring .......................................................................................................................................... 39
Appendix ............................................................................................................................................. 40
Employee Incident Report ............................................................................................................ 40
Sexual Harassment Plan ................................................................................................................ 41
Disability Policies .......................................................................................................................... 43
Training Employees ....................................................................................................................... 45
Evaluation Form for Classes .......................................................................................................... 47
Incident Report Form .................................................................................................................... 49

THE UNDERGROUND YOGA: RISK MANAGEMENT



Overview

The Yoga Underground teaches a modern, energetic fusion of Ashtanga Yoga, Vinyasa Flow, Pilates, and
any other kick-ass exercise you can think of. The Yoga Undergrounds classes are designed to leave you
feeling strong, open, lighthearted, and optimistic. Bottom line: lifes too short to take yourself too
seriously!

History Of The Organization


Brittany Andrews is the founder of The Yoga Underground (TYU). Andrews was an instructor at 3B
Yoga, in 2009, after working with the 3B organization she left to find a form of yoga that was more true
to her personality. Andrews wanted to be a part of a studio with instructors and participants that were
what she described as, real. Andrews became certified through the yoga alliance and wrote her
certification curriculum. After 2 years of training, Andrews started teaching a few classes. The reason
TYU originally started was when Andrews noticed that the people from the Downtown Provo area
started coming to her lunch hour yoga class. In 2011, Andrews started certifying yoga instructors at TYU.

Mission & Purpose


Life is Delicious.

Founded in 2011, The Yoga Underground was created to fill Utah Valley's need for an open minded,
upbeat, lighthearted, kick-ass yoga studio. TYU welcomes inspiration from wherever it may come.
Seeking mind, body, and spirit refinement through breathing, meditation, and creative Ashtanga
sequencing

THE UNDERGROUND YOGA: RISK MANAGEMENT



Personnel









Instructor:
Stephanie Cirac

Founder & Owner


Brijany Andrews

Instructor:
Angie Miller

Instructor:
Sarah Doe

Instructor:
Antoineje
Gloria

Instructor:
Holly Lambert

Who Does TYU Serve


TYU serves the community of Provo serving as a yoga studio that is light and upbeat. TYU serves all
populations regardless of age, sex, or ability who want to feel strong, open, lighthearted, and
optimistic about life.

THE UNDERGROUND YOGA: RISK MANAGEMENT



Descriptive Recreation Activities


Ashtanga
This type of yoga is a meditative and healing progression of precise movement and deep postures
and is considered to be the most restorative and challenging of all yoga practices. The advanced
series deals with moving deeper into back bending, and twisting.
Inversion
Inverted yoga positions ones heart higher than their head and have been credited with banishing
back pain and improving how well you can breathe on a run. A few inverted yoga poses consist
of headstands, handstands, shoulder stands, and forearm stands. Some of the physical benefits
from doing inversion yoga are the strengthening of the arms, legs, back, and core abdominal
muscles, circulating blood to the brain and to the heart, assisting with the lymphatic flow since
there are a lot of impurities in the lower abdomen, and stimulating the nervous system. Inversion
yoga also develops and improves some psychological functions like balance, concentration, and
perseverance. A few of the prerequisites for getting the most benefit out of inversion yoga
include having a strong neck, back, and abdominal muscles and a capacity to breathe whilst in
the upside down posture.
Adaptive Yoga
Yoga adapted to the needs of each individual participant. In adaptive yoga, the postures or asanas
are presented to match the ability of the participant.
Space & Liability
There are times that instructors teach outside of the studio space. Outdoors, other indoor spaces
and homes.

THE UNDERGROUND YOGA: RISK MANAGEMENT



Current Risk Management Status


TYU does not have any form of a risk management plan that is formally written out. A lot of the
company policies they follow are things that have been stated or things they know they need to follow,
but they do not have documented. As a result, we had a lot of work to do in regards to creating a risk
management plan that will be helpful for the organization. The one thing they do have is a waiver that
every instructor signs when they are hired. In order to receive useful data, we researched policies from
other yoga companies and medical clinics, as well as the unwritten company policies that TYU already
has. Currently teachers are not individually insured.

THE UNDERGROUND YOGA: RISK MANAGEMENT



Guidelines For Workplace Policies


Hiring and Termination policies
1. Hiring

Create a contract to set forth each sides duties and obligations


Set criteria by which the employees performance will be measured
Develop possible reasons for termination
What can result from termination?

2. Breaching the Contract

Know what will happen if either person violates the contract


Typically results in money loss, which is the amount that is needed to restore the injured
party to the
Expected measures of what was compromised

3. Mitigate the Damages

Each side has the responsibility of minimizing the damages


If the relationship deteriorates, be prepared to negotiate a fair settlement

4. Get it all in Writing

Due to fraud, the law limits what is enforceable orally


Set forth the terms, in a memorandum to be enforced
Must be signed by both parties

5. Contract Provisions

Include duties, compensation, type of hire, breach, hiring term, termination, and
covenant not to compete

a. Duties

This describes the employees job or obligations that each side will be
held to
Person must provide services full-time, and state what policies the
employee is expected to follow

b. Compensation

Include the pay, and how often


Say whether it is annual, or pay per class

c. Type of Hire

Need to decide whether the hire will be employee or independent


contractor

THE UNDERGROUND YOGA: RISK MANAGEMENT


9



If person is an employee, you must withhold taxes for the employee
If they are independent, they will be responsible for their own income
tax

d. Breach

Violation of contract
Will terminate the contract

e. Term

At Will employment
Meaning either side can terminate at any given time.
Specify a term if needed
Is this term renewable

f. Termination

Specify the events that can cause a termination


o Include: Sufficient disability, sick days, missing too many classes,
harassment, etc.
Pay all unpaid wages until the date of termination
Severance pay if needed

g. Covenant Not to Compete

Upon termination, and in the contract, specify that the teacher will
refrain from opening own studio to compete with former employee
Know the laws on the non-compete clause, some states do not accept
Be reasonable, ex. 2 year non-compete clause

Examples of Evaluation, Incident and Sexual Harassment form can be found on the Appendix section.

THE UNDERGROUND YOGA: RISK MANAGEMENT



10

Ashtanga Yoga
These risks were ranked on a scale from 1 to 5 with 1 meaning less frequent or severe and 5 meaning
highly frequent or harmfully severe.

Probable Risk

Frequency

Severity

Torn/Strained Muscle

Sprained joints

Dehydration

Slipping

Head injury

Re-injury

Over exertion

Neck Injury

Exhaustion
Dislocated Joints

2
1

1
4

Ashtanga Sca6erplot

Priority List:

1. Dehydration

2. Re-injury
Severity

3. Over Exertion
3

4. Torn/Strained Muscle

5. Sprained Joints

6. Head Injury

0
0

3
Frequency

7. Neck Injury
8. Dislocated Joints
9. Exhaustion

THE UNDERGROUND YOGA: RISK MANAGEMENT



1. Dehydration

11

Reduce

Prevention:

1. Teach proper fluids to have for class


a. Water, Sport Drinks (replace sodium and potassium, lost during perspiration)
b. Avoid alcoholic or caffeinated drinks (coffee, tea, or cola), fruit drinks should also be
avoided (too many carbohydrates).
2. Instruct participants to drink at least 16-20 ounces of fluid one to two hours before activity.
3. Tell them after each class to drink 6-12 ounces of fluid every 10-15 minutes.
4. Instruct them to replace the fluid they have lost (At least another 16-20 ounces).

Mitigation:

1. Provide them with cold water.


2. Tell them to drink sports drinks containing electrolytes or carbohydrate solutions.
3. Tell them to have no salt tablets (can cause hypernatremia dehydration), or carbonated
beverages.
4. Severe Dehydration:
a. Call emergency personnel (ambulance or ER doctor) 1


2. Re-injury

Reduce and Transfer

Prevention:

1.
2.
3.
4.
5.
6.

Proper assessment of past injuries should be done with each participant.


Verbal Participants to teacher communication should be expressed on any past injury.
Avoid painful activities and positions.
Avoid the position and activity that caused the injury.
Know when to encourage immobilization.
Gradually rebuild activities

Mitigation:

1. Evaluate injury
2. R.I.C.E.
3. Seek approval from physician to participate in the activity again2

Cleveland Clinic, Diseases and Conditions, Avoiding Dehydration, Proper Hydration


http://my.clevelandclinic.org/health/diseases_conditions/hic_avoiding_dehydration

2
Yoga Journal, Identify + Heal Your Students Soft Tissue Injuries,http://www.mayoclinic.org/first-aid/first-aid-
sprain/basics/art-20056622

THE UNDERGROUND YOGA: RISK MANAGEMENT



3. Overexertion

12

Reduce

Prevention:

1. Make sure participants are practicing good postures when they are doing the various
positions.
2. Encourage strength training and stretching.
3. Instruct participants to know their body limits and to stick within their experience and
comfort level. 3

Mitigation:

1. Allow the student to excuse him or herself from the class and exit the studio.
2. Provide them with a water bottle on the way out to hydrate him or herself.4


4. Torn/Strained Muscle

Reduce

Prevention:

1. Keep studio at a moderate room temperature between 68-72 degrees.5


2. Instruct participants to warm up and the importance of warming up.
3. Tell participants throughout the class to listen to their bodies and to not push themselves
past their experience or comfort level.
4. Tell the participants throughout the class that they can ask any questions if they are unsure
of a position.6

Mitigation:

1.
2.
3.
4.

Allow them to sit down and rest.


Have ice in freezer at all time. Go grab them some ice.
Provide an Ace wrap to compress the injury.
Lastly, provide them with something to elevate where needed while they are waiting for
someone to come and pick them up.7

Healthline, The Understated Injury: Excertion, http://www.healthline.com/health/understated-injury-


overexertion
4
AZ Central, Heat Exhaustion Symptoms http://healthyliving.azcentral.com/heat-exhaustion-symptoms-
bikram-yoga-6858.html
5
According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.
http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html
6
Ortho Info, Yoga Injury Prevention http://orthoinfo.aaos.org/topic.cfm?topic=A00063
7
Mayo Clinic, Torn Muscle http://www.mayoclinic.org/diseases-conditions/sprains-and-
strains/basics/definition/con-20020958

THE UNDERGROUND YOGA: RISK MANAGEMENT



5. Sprained joints

13

Reduce

Prevention:

1.
2.
3.
4.

Avoid doing too much too soon


Maintain strength in the surrounding muscles.
Do not skip warm up or cool down
Teach proper technique when involving repeat motions

Mitigation:

1.
2.
3.
4.

Rest: Immobilize that are that is hurting for at least 48 hours, braces and splints can be used.
Ice: Use a cold pack or ice as soon as possible. Ice for 15 minutes, four to eight times per day
Compression: Use an elastic wrap or bandage on the swollen area.
Elevation: Get the injured limb above the heart whenever it is possible to do so. 8


6. Head injury

Reduce

Prevention:

1. Instruct participants to stretch properly.


2. Inform the participant to stop when their limit has been reached.
3. Have the participant aware of their surroundings and make sure they are not near any walls
or obstacles they may cause collision with the head

Mitigation:

1. Remove the participant from the activity immediately and do not allow them to resume.
2. Monitor for worsening symptoms and/or focal neurologic deficits including weakness and
sensory change, every 15 to 30 minutes during the first several hours after injury.
3. If symptoms worsen, the participant should be transported to an emergency department for
further evaluation, because changes may suggest an injury more serious than a concussion, such
as intracranial hemorrhage.
4. If symptoms remain stable or improve, the participant can be sent home if an adult caregiver is
present. The caregiver is given a list of symptoms to be aware of and that would warrant a trip
to an emergency department, and the athlete is not allowed to drive.
5. Place the participant on physical (no sports, running, jumping, or weightlifting, for example) and
cognitive (no school, studying, or video games, for example) rest to minimize stress on the brain,
Cranio Sacral Therapy. 9

8
9

Mayo Clinic, Sprain: First Aid,http://www.mayoclinic.org/first-aid/first-aid-sprain/basics/art-20056622


Mayo Clinic, Diagnosing and Treating Sports-Related Concussion http://www.mayoclinic.org/medical-
professionals/clinical-updates/general-medical/diagnosing-treating-sports-related-concussion

THE UNDERGROUND YOGA: RISK MANAGEMENT



7. Neck Injury

14

Reduce

Prevention:

1.
2.
3.
4.
5.
6.

Stretch properly
Avoid heat
Elude from anything that causes neck traction
Avoid deep tissue massages and chiropractic adjustments
Inform the participant to stop when their limit has been reached
Elude from sleeping on your belly

Mitigation:

1. Breathing
a. Make sure diaphragm is being used to inhale and the neck muscles are not
contracting to help.
b. Do supine with neck roll, so the cervical curve is supported.
2. Neck support: Wrap a folded dishtowel around the neck as a support when at home.
3. Ice: Put ice on and around your neck for as much as once an hour.
4. Neck retraction: Keep the neck over, and not forward, the rest of the spine. Isometrically
pressing the back of the head into a wall or the car seat is beneficial. It is important to do
this when sitting or standing.
5. Sleeping in good alignment
a. If you are a side sleeper, make sure the pillow is thick enough to cover the space
between the ear and the outer edge of the shoulder.
b. If you sleep on your back, only use enough of a pillow to support your cervical
curve.10

7. Dislocated joints

Reduce

Prevention:

1.
2.
3.
4.

Proper warm up exercises.


Focus on strengthening and stretching all muscles before moving into deeper moves.
Verbal communication with participant about even distribution of weight on feet and wrist.
Listen to your body.





10

Yoga Connection, Common Injuries in Yoga: Neck Strain http://the-yoga-connection.com/well-


being/common-injuries-in-yoga-neck-strain/

THE UNDERGROUND YOGA: RISK MANAGEMENT



15

Mitigation:

1. Don't delay medical care. Get medical help immediately.
2. Don't move the joint. Until you receive help, splint the affected joint into its fixed position.
3. Don't try to move a dislocated joint or force it back into place. This can damage the joint and
its surrounding muscles, ligaments, nerves or blood vessels.
4. Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding
and the buildup of fluids in and around the injured joint.11


8. Exhaustion

Reduce

Prevention:

1. Keep studio at a moderate room temperature between 68-72 degrees.12


2. Tell Participants to listen to their body and not push themselves past their experience or
comfort levels.
3. Make sure participants are keeping hydrated and drinking plenty of liquids. Provide a
drinking fountain nearby.
4. Instruct participants to listen to their bodies. If they feel any exhaustion instruct them to
take a break. If it persists instruct them to talk with their doctor. 13

Mitigation:

1. Allow the student to excuse him/herself from the class and exit the studio.
2. Provide them with a water bottle on the way out to hydrate himself or herself.
3. Instruct them to take a 5- or 10-minute break to give their body time to cool down again.14

11

http://www.mayoclinic.org/first-aid/first-aid-dislocation/basics/art-20056693
According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.
http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html
13
Ortho Info, Yoga Injury Prevention http://orthoinfo.aaos.org/topic.cfm?topic=A00063
14
AZ Central, Heat Exhaustion Symptoms http://healthyliving.azcentral.com/heat-exhaustion-symptoms-
12

bikram-yoga-6858.html

THE UNDERGROUND YOGA: RISK MANAGEMENT



16

9. Slipping Reduce

Prevention:

Assessment of individual participants needs or concerns before class starts.


Address and encourage skid free matts and absorbent towels for continual practice.
Keep studio at a moderate room temperature between 68-72 degrees.15
Have dry paper towels or terry cloth towels available for participants in active fitness area.
Let participants know they can take a break to readjust and wipe down before workout to
avoid slipping.

Mitigation:

Immediately attend to participant.


Verbally attend and evaluate the situation
Treat any injury according to assessment.


15

According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.
http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html

THE UNDERGROUND YOGA: RISK MANAGEMENT



17

Inversion Yoga
These risks were ranked on a scale from 1 to 5 with 1 meaning less frequent or severe and 5 meaning
highly frequent or harmfully severe.


Probable Risk
Torn/Strained Muscle
Slipping
Dehydration
Dizziness
Head injury
Hernia
Over Exertion
Neck Injury
Exhaustion
High Blood Pressure

Frequency

Severity
3
2
5
5
1
2
3
1
4
3

Inversion Yoga
6

3
1
3
1
5
4
1
5
1
2


Priority List:
1. Dehydration

2. Dizziness
5

3. Torn/Strained Muscle

Severity

4. Hernia

5. Head Injury

6. Neck Injury

7. Exhaustion
8. High Blood Pressure

0
0

3
Frequency

9. Over Exertion
10. Slipping

THE UNDERGROUND YOGA: RISK MANAGEMENT



1. Dehydration

18

Reduce

Prevention:

1. Teach proper fluids to have for class
a. Water, Sport Drinks (replace sodium and potassium, lost during perspiration)
b. Avoid alcoholic or caffeinated drinks (coffee, tea, or cola), fruit drinks should also be
avoided( too many carbohydrates
1. Instruct participants to drink at least 16-20 ounces of fluid one to two hours before activity.
2. Tell them after each class to drink 6-12 ounces of fluid every 10-15 minutes.
3. Instruct them to replace the fluid they have lost (At least another 16-20 ounces).

Mitigation:

1. Provide them with cold water.


2. Tell them to drink sports drinks containing electrolytes or carbohydrate solutions.
3. Tell them to have no salt tablets (can cause hypernatremia dehydration), or carbonated
beverages.
4. Severe Dehydration: Call emergency personnel (ambulance or ER doctor) 16


2. Dizziness

Reduce

Prevention:

1.
2.
3.
4.

Ensure you are not practicing at the wrong time with regard to your eating cycle.
Hydrate to a reasonable level before you begin.
For women, be cautious of what moves are done during your menstrual cycle.
In regards to backbends, work at continuing to open the hips and shoulders with standing
17
poses and seated twists and concentrate on relaxing the participants neck.

Mitigation:

1. Contract the calf and thigh muscles strongly to squeeze blood from leg veins toward the
heart. Start this action before you start to come up and continue while coming up and after
you are upright.
2. Come up slowly to give reflexes time to respond.
3. Inhale while coming up. This lowers pressure in the chest, thereby helping blood flow into
18
the heart.

16

Cleveland Clinic, Diseases and Conditions, Avoiding Dehydration, Proper Hydration


http://my.clevelandclinic.org/health/diseases_conditions/hic_avoiding_dehydration

17
Yoga Journal, Dizzy Spells, http://www.yogajournal.com/article/practice-section/dizzy-spells/
18
Yoga Journal, What to do about dizziness during yoga, http://www.yogajournal.com/article/practice-section/what-to-
do-about-dizziness-during-yoga/

THE UNDERGROUND YOGA: RISK MANAGEMENT



3. Torn/Strained Muscle

19

Reduce

Prevention:

1. Keep studio at a moderate room temperature between 68-72 degrees.19


2. Instruct participants to warm up and the importance of warming up.
3. Tell participants throughout the class to listen to their bodies and to not push themselves
past their experience or comfort level.
4. Tell the participants throughout the class that they can ask any questions if they are unsure
of a position.20

Mitigation:

1.
2.
3.
4.

Allow them to sit down and rest.


Have ice in freezer at all time. Go grab them some ice.
Provide an Ace wrap to compress the injury.
Lastly, provide them with something to elevate where needed while they are waiting for
someone to come and pick them up.21


4. Hernia

Reduce

Prevention:

1.
2.
3.
4.

Warm up thoroughly
Dont try positions beyond your experience
Keep hydrated
22
If youre experiencing exhaustion or pain, take a break

Mitigation:
Nonsurgical treatment:
1. Rest for 7-10 days while putting ice or wrapping the bulging area.
2. Two weeks after the injury, you may do physical therapy exercises to improve strength and
flexibility in your abdominal and inner thigh muscles
3. A doctor may recommend non-steroidal anti-inflammatory medicines (ibuprofen and
naproxen) to reduce swelling and pain.



19

According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.
http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html
20
Ortho Info, Yoga Injury Prevention, http://orthoinfo.aaos.org/topic.cfm?topic=A00063
21
Mayo Clinic, Torn Muscle, http://www.mayoclinic.org/diseases-conditions/sprains-and-strains/basics/definition/con-
20020958
22
OrthoInfo, Yoga Injury Prevention, http://orthoinfo.aaos.org/topic.cfm?topic=A00063

THE UNDERGROUND YOGA: RISK MANAGEMENT




Surgical Treatment

20

1. Endoscopic procedure - the surgeon makes smaller skin incisions and uses a small camera,
called an endoscope, to see inside the abdomen.
2. Inguinal neurectomy - requires the cutting of a small nerve in the groin (inguinal nerve)
23
during the surgery to relieve the patient's pain.


5. Head injury

Reduce

Prevention:

1. Instruct participants to stretch properly.
2. Inform the participant to stop when their limit has been reached.
4. Have the participant aware of their surroundings and make sure they are not near any walls
or obstacles they may cause collision with the head

Mitigation:

1. Remove the participant from the activity immediately and do not allow them to resume.
2. Monitor for worsening symptoms and/or focal neurologic deficits including weakness and
sensory change, every 15 to 30 minutes during the first several hours after injury.
3. If symptoms worsen, the participant should be transported to an emergency department for
further evaluation, because changes may suggest an injury more serious than a concussion,
such as intracranial hemorrhage.
5. If symptoms remain stable or improve, the participant can be sent home if an adult
caregiver is present. The caregiver is given a list of symptoms to be aware of and that would
warrant a trip to an emergency department, and the athlete is not allowed to drive.
6. Place the participant on physical (no sports, running, jumping, or weightlifting, for example)
and cognitive (no school, studying, or video games, for example) rest to minimize stress on
the brain, Cranio Sacral Therapy. 24


23

OrthoInfo, Sports Hernia (Athletic Pubalgia), http://orthoinfo.aaos.org/topic.cfm?topic=A00573


Mayo Clinic, Diagnosing and Treating Sports-Related Concussion http://www.mayoclinic.org/medical-
professionals/clinical-updates/general-medical/diagnosing-treating-sports-related-concussion

24

THE UNDERGROUND YOGA: RISK MANAGEMENT



6. Neck Injury

21

Reduce

Prevention:

1.
2.
3.
4.
5.
7.

Stretch properly
Avoid heat
Elude from anything that causes neck traction
Avoid deep tissue massages and chiropractic adjustments
Inform the participant to stop when their limit has been reached
Elude from sleeping on your belly

Mitigation:

1. Breathing
a. Make sure diaphragm is being used to inhale and the neck muscles are not contracting
to help.
b. Do supine with neck roll, so the cervical curve is supported.
3. Neck support: Wrap a folded dishtowel around the neck as a support when at home.
4. Ice: Put ice on and around your neck for as much as once an hour.
5. Neck retraction: Keep the neck over, and not forward, the rest of the spine. Isometrically
pressing the back of the head into a wall or the car seat is beneficial. It is important to do
this when sitting or standing.
6. Sleeping in good alignment
a. If you are a side sleeper, make sure the pillow is thick enough to cover the space
between the ear and the outer edge of the shoulder.
b. If you sleep on your back, only use enough of a pillow to support your cervical
curve.25

7. Exhaustion

Reduce

Prevention:

1. Keep studio at a moderate room temperature between 68-72 degrees.26


2. Tell Participants to listen to their body and not push themselves past their experience or
comfort levels.
3. Make sure participants are keeping hydrated and drinking plenty of liquids. Provide a
drinking fountain nearby.
4. Instruct participants to listen to their bodies. If they feel any exhaustion instruct them to
take a break. If it persists instruct them to talk with their doctor. 27

25

Yoga Connection, Common Injuries in Yoga: Neck Strain http://the-yoga-connection.com/well-


being/common-injuries-in-yoga-neck-strain/
26
According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.
http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html
27

Ortho Info, Yoga Injury Prevention

THE UNDERGROUND YOGA: RISK MANAGEMENT



22

Mitigation:

1. Allow the student to excuse him/herself from the class and exit the studio.
2. Provide them with a water bottle on the way out to hydrate him or herself.
3. Instruct them to take a 5- or 10-minute break to give their body time to cool down again.28



8. High Blood Pressure

Reduce

Prevention:

1. Be cautious of what the body can handle. Take breaks if needed.


2. Dont strain the body too much.
3. Participant may only pick from the list of provided moves:
a. Downward facing dog
b. Feathered peacock pose
c. Fish pose
d. Handstand
e. Intense side stretch pose
f. Pigeon pose
g. Plow pose
h. Supported handstand
i. Supported shoulder stand
29
j. Upward bow (wheel) pose

Mitigation:

1. Practice regularly
2. Eat healthy and stay hydrated
30
3. Reduce your stress and meditate


http://orthoinfo.aaos.org/topic.cfm?topic=A00063

28

AZ Central, Heat Exhaustion Symptoms


http://healthyliving.azcentral.com/heat-exhaustion-symptoms-bikram-yoga-6858.html
29
Yoga Journal, High Blood Pressure Contraindications,
http://www.yogajournal.com/category/poses/contraindications-modifications/high-blood-pressure-
contraindications-modifications/
30
Mayo Clinic, High blood pressure, http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-
depth/high-blood-pressure/art-20046974?pg=2

THE UNDERGROUND YOGA: RISK MANAGEMENT



9. Overexertion

23

Reduce

Prevention:

1. Make sure participants are practicing good postures when they are doing the various
positions.
2. Encourage strength training and stretching.
3. Instruct participants to know their body limits and to stick within their experience and
comfort level. 31

Mitigation:

1. Allow the student to excuse him or herself from the class and exit the studio.
2. Provide them with a water bottle on the way out to hydrate him or herself.32


10. Slipping

Reduce


Prevention:

1.
2.
3.
4.
5.

Assessment of individual participants needs or concerns before class starts.


Address and encourage skid free matts and absorbent towels for continual practice.
Keep studio at a moderate room temperature between 68-72 degrees.33
Have dry paper towels or terry cloth towels available for participants in active fitness area.
Let participants know they can take a break to readjust and wipe down before workout to
avoid slipping.

Mitigation:

1. Immediately attend to participant.


2. Verbally attend and evaluate the situation
3. Treat any injury according to assessment.






31

Healthline, The Understated Injury: Excertion, http://www.healthline.com/health/understated-injury-overexertion


AZ Central, Heat Exhaustion Symptoms
http://healthyliving.azcentral.com/heat-exhaustion-symptoms-bikram-yoga-6858.html
33
According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.
http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html
32

THE UNDERGROUND YOGA: RISK MANAGEMENT



24

Outside Studio Yoga


These risks were ranked on a scale from 1 to 5 with 1 meaning less frequent or severe and 5 meaning
highly frequent or harmfully severe. Currently teachers are not individually insured. This is
recommendation that should be implemented to avoid lawsuits because the studio liability does not
cover each instructor outside of the studio. 34


Frequency

Probable Risk
Torn/Strained Muscle
Sprained joints
Dehydration
Slipping
Head injury
Re-injury
Over exertion
Neck Injury
Exhaustion
Dislocated Joints
Knee Injuries
Lower Back
Ham String Pulls
Wrist Sprains
Sexual Harassment

3
3
5
2
1
4
5
1
2
1
5
5
5
5
1

Outside Studio Injuries


6

Severity

4
3
Risks

2
1
0
0

4
Frequency


34

Severity

Priority List
1. Dehydration
2. Knee Injuries
3. Lower Back
4. Re-injury
5. Ham String Pulls
6. Wrist Sprains
7. Over exertion
8. Torn/Strained Muscle
9. Sprained joints
10. Slipping
11. Exhaustion
12. Sexual Harassment
13. Head injury
14. Neck Injury
15. Dislocated Joints

Benefits Plus Insurance. http://www.yogajournal.com/benefitsplus/faq.html

3
3
3
1
5
3
1
5
1
4
3
3
2
2
5

THE UNDERGROUND YOGA: RISK MANAGEMENT



1. Dehydration

25

Reduce

Prevention:

1. Teach proper fluids to have for class
a. Water, Sport Drinks (replace sodium and potassium, lost during perspiration)
b. Avoid alcoholic or caffeinated drinks (coffee, tea, or cola), fruit drinks should also be
avoided (too many carbohydrates
2. Instruct participants to drink at least 16-20 ounces of fluid one to two hours before activity.
3. Tell them after each class to drink 6-12 ounces of fluid every 10-15 minutes.
4. Instruct them to replace the fluid they have lost (At least another 16-20 ounces).

Mitigation:

1. Provide them with cold water.
2. Tell them to drink sports drinks containing electrolytes or carbohydrate solutions.
3. Tell them to have no salt tablets (can cause hypernatremia dehydration), or carbonated
beverages.
4. Severe Dehydration: Call emergency personnel (ambulance or ER doctor) 35

2. Knee Injury

Reduce

Prevention:

1. Instruct participants to warm up and the importance of warming up.
2. Make participants aware to always keep the knee directly over the ankleor closer to the
bodyin any weight-bearing, bent-knee poses.
3. Never bend the knee so deeply that it aligns over the toes.
4. Engage the outer thigh muscles to keep knee aligned with the hip and ankle, which helps to
36
bear our weight.
5. Tell participants throughout the class to listen to their bodies and to not push themselves
past their experience or comfort level.
6. Tell the participants throughout the class that they can ask any questions if they are unsure
of a position.37
7. Allow easy access of blocks and wraps for modified movements.


35

Cleveland Clinic, Diseases and Conditions, Avoiding Dehydration, Proper Hydration


http://my.clevelandclinic.org/health/diseases_conditions/hic_avoiding_dehydration

36
http://www.yogabasics.com/connect/yoga-blog/how-to-avoid-common-vinyasa-yoga-injuries/
37
Ortho Info, Yoga Injury Prevention
http://orthoinfo.aaos.org/topic.cfm?topic=A00063

THE UNDERGROUND YOGA: RISK MANAGEMENT



26

Mitigation:
1.
2.
3.
4.
5.


Allow them to sit down and rest.
Have ice in freezer at all time. Go grab them some ice.
Provide an Ace wrap to compress the injury.
Lastly, provide them with something to elevate where needed while they are waiting for
someone to come and pick them up.38
Transfer Injury to health care provider to assess and approve when and if participant can
return to regular yoga routine.

3. Lower Back Injury

Reduce and Transfer

Prevention:

1. Instruct participants to warm up and the importance of warming up.
2. Make participants aware in just about every pose, we want to visualize a long low back. This
does not mean to tuck the tailbone by squeezing the buttocks.
3. Visualize the tailbone lengthening towards the heels and the belly button gently drawing in
and up, towards the front plane of the spine. By doing this, we engage the lower abdominal
muscles to support the low back and strengthen the group of muscles designed to
4. Be sure to engage the strength of your quadriceps and chest muscles, your back should not
be doing all of the work.
5. Make participants know to avoid crouching back positions.
6. Tell participants throughout the class to listen to their bodies and to not push themselves
past their experience or comfort level.
7. Tell the participants throughout the class that they can ask any questions if they are unsure
of a position.39
8. Allow easy access of blocks, mats and wraps for modified movements.

Mitigation:

1. Don't delay medical care. Get medical help immediately.
2. Don't move the joint. Until you receive help, splint the affected joint into its fixed position.
Don't try to move a dislocated joint or force it back into place. This can damage the joint and
its surrounding muscles, ligaments, nerves or blood vessels.
3. Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding
and the buildup of fluids in and around the injured joint.40
4. Transfer Injury to health care provider to assess and approve when and if participant can
return to regular yoga routine.

38

Mayo Clinic, Torn Muscle http://www.mayoclinic.org/diseases-conditions/sprains-and-


strains/basics/definition/con-20020958
39
Ortho Info, Yoga Injury Prevention
http://orthoinfo.aaos.org/topic.cfm?topic=A00063
40
http://www.mayoclinic.org/first-aid/first-aid-dislocation/basics/art-20056693

THE UNDERGROUND YOGA: RISK MANAGEMENT



4. Re-injury

27

Reduce and Transfer

Prevention:

1.
2.
3.
4.
5.
6.

Proper assessment of past injuries should be done with each participant.


Verbal Participants to teacher communication should be expressed on any past injury.
Avoid painful activities and positions.
Avoid the position and activity that caused the injury.
Know when to encourage immobilization.
Gradually rebuild activities

Mitigation:

1. Evaluate injury
2. R.I.C.E.
3. Seek approval from physician to participate in the activity again41


5. Sprained hamstrings

Reduce

Prevention:
1.
2.
3.
4.
5.


Avoid doing too much too soon
Maintain strength in the surrounding muscles.
Do not skip warm up or cool down
Teach proper technique when involving repeat motions
Try laying off poses that extend through the back of the body and legs until the injury heals.

Mitigation:
1.
2.
3.
4.


Rest: Immobilize that are that is hurting for at least 48 hours, braces and splints can be used.
Ice: Use a cold pack or ice as soon as possible. Ice for 15 minutes, four to eight times per day
Compression: Use an elastic wrap or bandage on the swollen area.
Elevation: Get the injured limb above the heart whenever it is possible to do so. 42


41

Yoga Journal, Identify + Heal Your Students Soft Tissue Injuries,


http://www.mayoclinic.org/first-
aid/first-aid-sprain/basics/art-20056622
42
Mayo Clinic, Sprain: First Aid, http://www.mayoclinic.org/first-aid/first-aid-sprain/basics/art-20056622

THE UNDERGROUND YOGA: RISK MANAGEMENT



6. Sprained wrists

28

Reduce

Prevention:

1. Avoid doing too much too soon.
2. Do not skip warm up or cool down
3. Your hands bare weight, check to make sure that your fingers are pointed towards the front
of your mat.
4. Check the weight distribution in your hands. All ten fingers should feel as though they are
sinking into the mat, without any room for air to pass between the mat and your fingers.
5. Instruct students to focus on the area of the palm that lies between the index finger and the
thumb. If you can, press this area into the mat while externally rotating the arm bones (or
visualize rotating the elbows towards each other).
6. Teach proper technique when involving repeat motions

Mitigation:
1.
2.
3.
4.


Rest: Immobilize that are that is hurting for at least 48 hours, braces and splints can be used.
Ice: Use a cold pack or ice as soon as possible. Ice for 15 minutes, four to eight times per day
Compression: Use an elastic wrap or bandage on the swollen area.
Elevation: Get the injured limb above the heart whenever it is possible to do so. 43

7. Overexertion

Reduce

Prevention

1. Make sure participants are practicing good postures when they are doing the various
positions.
2. Encourage strength training and stretching.
3. Instruct participants to know their body limits and to stick within their experience and
comfort level. 44

Mitigation:
4. Allow the student to excuse him or herself from the class and exit the studio.
5. Provide them with a water bottle on the way out to hydrate him or herself.45



43
Mayo Clinic, Sprain: First Aid,
http://www.mayoclinic.org/first-aid/first-aid-sprain/basics/art-20056622
Healthline, The Understated Injury: Excertion, http://www.healthline.com/health/understated-injury-
overexertion
45
AZ Central, Heat Exhaustion Symptoms
http://healthyliving.azcentral.com/heat-exhaustion-symptoms-bikram-yoga-6858.html
44

THE UNDERGROUND YOGA: RISK MANAGEMENT



29


8. Torn/Strained Muscle R educe

Prevention:
1.
2.
3.
4.


Keep studio at a moderate room temperature between 68-72 degrees.46
Instruct participants to warm up and the importance of warming up.
Tell participants throughout the class to listen to their bodies and to not push themselves
past their experience or comfort level.
Tell the participants throughout the class that they can ask any questions if they are unsure
of a position.47

Mitigation:
1.
2.
3.
4.


Allow them to sit down and rest.
Have ice in freezer at all time. Go grab them some ice.
Provide an Ace wrap to compress the injury.
Lastly, provide them with something to elevate where needed while they are waiting for
someone to come and pick them up.48

9. Sprained joints

Reduce

Prevention:
1.
2.
3.
4.


Avoid doing too much too soon
Maintain strength in the surrounding muscles.
Do not skip warm up or cool down
Teach proper technique when involving repeat motions

Mitigation:
1.
2.
3.
4.


Rest: Immobilize that are that is hurting for at least 48 hours, braces and splints can be used.
Ice: Use a cold pack or ice as soon as possible. Ice for 15 minutes, four to eight times per day
Compression: Use an elastic wrap or bandage on the swollen area.
Elevation: Get the injured limb above the heart whenever it is possible to do so. 49


46

According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.
http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html
47
Ortho Info, Yoga Injury Prevention
http://orthoinfo.aaos.org/topic.cfm?topic=A00063
48
Mayo Clinic, Torn Muscle http://www.mayoclinic.org/diseases-conditions/sprains-and-
strains/basics/definition/con-20020958
49
Mayo Clinic, Sprain: First Aid,
http://www.mayoclinic.org/first-aid/first-aid-sprain/basics/art-20056622

THE UNDERGROUND YOGA: RISK MANAGEMENT



10. Slipping

30

Reduce

Prevention
1.
2.
3.
4.
5.


Assessment of individual participants needs or concerns before class starts.
Address and encourage skid free matts and absorbent towels for continual practice.
Keep studio at a moderate room temperature between 68-72 degrees.50
Have dry paper towels or terry cloth towels available for participants in active fitness area.
Let participants know they can take a break to readjust and wipe down before workout to
avoid slipping.

Mitigation:

1. Immediately attend to participant.
2. Verbally attend and evaluate the situation
3. Treat any injury according to assessment.

11. Exhaustion

Reduce

Prevention:
1.
2.
3.
4.


Keep studio at a moderate room temperature between 68-72 degrees.51
Tell Participants to listen to their body and not push themselves past their experience or
comfort levels.
Make sure participants are keeping hydrated and drinking plenty of liquids. Provide a
drinking fountain nearby.
Instruct participants to listen to their bodies. If they feel any exhaustion instruct them to
take a break. If it persists instruct them to talk with their doctor. 52

Mitigation:

1. Allow the student to excuse him/herself from the class and exit the studio.
2. Provide them with a water bottle on the way out to hydrate himself or herself.
3. Instruct them to take a 5- or 10-minute break to give their body time to cool down again.53


50

According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.
http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html


51

According to the American College of Sports Medicine's Health/Fitness Facility Standards and Guidelines.

http://www.ihrsa.org/home/2009/8/10/is-there-a-standard-temperature-in-a-club.html
Ortho Info, Yoga Injury Prevention
http://orthoinfo.aaos.org/topic.cfm?topic=A00063
53
AZ Central, Heat Exhaustion Symptoms
http://healthyliving.azcentral.com/heat-exhaustion-symptoms-bikram-yoga-6858.html
52

THE UNDERGROUND YOGA: RISK MANAGEMENT



31

12. Sexual Harassment Reduce

Prevention:
1.
2.
3.
4.
5.
6.

7.
8.


Referrer to participant by name.
Have a third part present during one-on-one session. 54
Avoid unwelcome touching.
Demonstrate a technique or exercise first, then, if necessary, ask the participants if its okay
to touch him or her to further explain the training goal.
Assess how comfortable the client is in talking about his or her body, assess participants
comfort level.
Ask participants verbal consent to help with adjustments, assess nonverbal communication
in addition to what a client tells you. Some indicators include pulling away from the
[trainer]; failure to meet the [trainers] gaze; and fidgeting or signs of physical tension,
55
particularly in the clients face. Nervous laughter might also be a clue.
Stray clear of offensive remarks about a persons sex or gender.
Use proper body part terms.

Mitigation:

Speak up! Take this seriously.
Make notes or audio record what was done from both parties.
Present opportunities where the perpetuator to meet with the accuser face to face.
Talk with participant on how to change the set up in order for them to feel more
comfortable.
5. Cite your sexual harassment policy, explaining the unethical nature of sexual conduct
between a trainer and current client.
6. File and store any and all incidents of sexual harassment.
1.
2.
3.
4.

Trainer feels sexually harassed by participant.



1.
2.
3.
4.

Speak up! Take this seriously.


Make notes or audio record what was done from both parties.
Present opportunities where the perpetuator to meet with the accuser face to face.
Talk with participant on how to change the set up in order for them to feel more
comfortable.
5. Say that she or he needs to keep business and personal matters separate [for the sake of]
her or his job.
6. If that doesnt end the unwanted behavior, consider discontinuing the relationship with that
client.
7. File and store any and all incidents of sexual harassment.


54

JESSICA HARRELSON V. SEUNG HEUN LEE AND DOES 1 TO 100, INCLUSIVE.


All suggested prevention and mitigation methods were described in IDEA Health and Fitness Association.

55

THE UNDERGROUND YOGA: RISK MANAGEMENT



32

13. Head injury

Reduce

Prevention:

1. Instruct participants to stretch properly.
2. Inform the participant to stop when their limit has been reached.
3. Have the participant aware of their surroundings and make sure they are not near any walls
or obstacles they may cause collision with the head

Mitigation:
1.
2.
3.
4.
5.

6.


Remove the participant from the activity immediately and do not allow them to resume.
Monitor for worsening symptoms and/or focal neurologic deficits including weakness and
sensory change, every 15 to 30 minutes during the first several hours after injury.
If symptoms worsen, the participant should be transported to an emergency
Department for further evaluation, because changes may suggest an injury more serious
than a concussion, such as intracranial hemorrhage.
If symptoms remain stable or improve, the participant can be sent home if an adult
caregiver is present. The caregiver is given a list of symptoms to be aware of and that would
warrant a trip to an emergency department, and the athlete is not allowed to drive.
Place the participant on physical (no sports, running, jumping, or weightlifting, for example)
and cognitive (no school, studying, or video games, for example) rest to minimize stress on
the brain, Cranio Sacral Therapy. 56

14. Neck Injury

Reduce

Prevention:
1.
2.
3.
4.
5.
7.

Stretch properly
Avoid heat
Elude from anything that causes neck traction
Avoid deep tissue massages and chiropractic adjustments
Inform the participant to stop when their limit has been reached
Elude from sleeping on your belly


56
Mayo Clinic, Diagnosing and Treating Sports-Related Concussion http://www.mayoclinic.org/medical-
professionals/clinical-updates/general-medical/diagnosing-treating-sports-related-concussion

THE UNDERGROUND YOGA: RISK MANAGEMENT



33

Mitigation:
1. Breathing
a. Make sure diaphragm is being used to inhale and the neck muscles are not
contracting to help.
b. Do supine with neck roll, so the cervical curve is supported.
2. Neck support: Wrap a folded dishtowel around the neck as a support when at home.
3. Ice: Put ice on and around your neck for as much as once an hour.
4. Neck retraction: Keep the neck over, and not forward, the rest of the spine. Isometric
pressing the back of the head into a wall or the car seat is beneficial. It is important to do
this when sitting or standing.
5. Sleeping in good alignment
a. If you are a side sleeper, make sure the pillow is thick enough to cover the space
between the ear and the outer edge of the shoulder.
b. If you sleep on your back, only use enough of a pillow to support your cervical
curve.57

15. Dislocated joints

Reduce

Prevention:
1.
2.
3.
4.

Proper warm up exercises.


Focus on strengthening and stretching all muscles before moving into deeper moves.
Verbal communication with participant about even distribution of weight on feet and wrist.
Listen to your body.

Mitigation:
1. Don't delay medical care. Get medical help immediately.
2. Don't move the joint. Until you receive help, splint the affected joint into its fixed position.
3. Don't try to move a dislocated joint or force it back into place. This can damage the joint and
its surrounding muscles, ligaments, nerves or blood vessels.
4. Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding
and the buildup of fluids in and around the injured joint.58


57

Yoga Connection, Common Injuries in Yoga: Neck Strain http://the-yoga-connection.com/well-


being/common-injuries-in-yoga-neck-strain/
58
http://www.mayoclinic.org/first-aid/first-aid-dislocation/basics/art-20056693

THE UNDERGROUND YOGA: RISK MANAGEMENT



34

Adaptive Yoga
These risks were ranked on a scale from 1 to 5 with 1 meaning less frequent or severe and 5 meaning
highly frequent or harmfully severe.

Probable Risk

Frequency

Severity

Re-Injure the spine

Fall out of Chair

Loss of breath

Broken bones

Torn Muscles

Neck Injury

Dislocation


Priority List:

AdapEve Yoga
6

1. Fall out of Chair

Severyity

2. Broken Bones

3. Torn Muscles
3
Adappve Yoga

4. Loss of Breath
5. Re-Injure the Spine

1
0
0

Frequency

6. Dislocation
7. Neck Injury

THE UNDERGROUND YOGA: RISK MANAGEMENT



1. Fall out of Chair

35

Reduce and Transfer

Prevention:

1. Teach the proper steps in staying in the chair


2. For elderly: Find the proper chair and evaluate whether the class will be okay for them to
take
3. For disability: Check and talk about a safety harness that attaches to the chair
4. Provide option to buy or rent harnesses, also have a few on hand

Mitigation:

1. Have a waiver for the people, so that they know the risks of taking the class. Make sure it is
a class that they are ready for the class.
2. Check on the customers and make sure that there are no immediate problems.
3. If mild, make sure to tell the patient to rest and get ice on the area that is hurt
4. If severe, do not move the patient. Call medical response team, and let them take care of
the patient


2. Broken Bones

Reduce and Transfer

Prevention:

1. Make sure that the customers are loose and limber.
2. Let people know that there are limitations
a. With some members of the class having disabilities, they may not have feeling in
there legs are arms if they are quadriplegics.
3. Have the people not to push themselves
4. Train the employees that will be helping with the class, they must know how to help people
that do not have feeling.

Mitigation:

1.
2.
3.
4.

Stop any bleeding if there is any; apply direct pressure


Immobilize the broken area; do not attempt to re-align the bone
Apply ice to the area; this will help relieve the pain, and reduce swelling
Treat for shock
a. If breathing is short or they feel faint, have the person lie down and tilt
b. Head back to allow for breathing
5. Call ER or medical response

THE UNDERGROUND YOGA: RISK MANAGEMENT



3. Torn/Strained Muscle

36

Reduce

Prevention:

1. Keep studio at a moderate room temperature between 68-72 degrees.


2. Instruct participants to warm up and the importance of warming up.
3. Tell participants throughout the class to listen to their bodies and to not push themselves
past their experience or comfort level.
4. Tell the participants throughout the class that they can ask any questions if they are unsure
of a position.

Mitigation:

1.
2.
3.
4.

Allow them to sit down and rest.


Have ice in freezer at all time. Go grab them some ice.
Provide an Ace wrap to compress the injury.
Lastly, provide them with something to elevate where needed while they are waiting for
someone to come and pick them up.


4. Loss of Breath

Reduce

Prevention:
1. Do not have customer perform positions that are hard for them
2. Controlling the breathing is important for the yoga customers because all the power comes
from being in control
3. Give appropriate time for rest

Mitigation:

1. Sitting:
a. Rest feet flat on the floor, lean chest slightly forward, rest your elbows
b. On knees, and relax neck and shoulder muscles
2. Standing
a. Stand with feet shoulder width apart, lean hips against the wall, and lean letting
your arms dangle

THE UNDERGROUND YOGA: RISK MANAGEMENT



5. Re-Injure the Spine

Reduce

37

Prevention:
1.
2.
3.
4.

Seek for approval from doctor to make sure that the customer can participate in the activity
Perform positions that can help strengthen a person's muscles in the back
Do not allow positions that could re-injure the spine, or could cause stress on spine area
Train employees on how to properly remove people from their wheelchair so that there are
no complication or issues with the customer

Mitigation:
1. Do not attempt to move the person
2. Get the doctor on the phone
3. Call the medical response and get an ambulance

6. Dislocated joints

Reduce

Prevention:

1.
2.
3.
4.

Proper warm up exercises.


Focus on strengthening and stretching all muscles before moving into deeper moves.
Verbal communication with participant about even distribution of weight on feet and wrist.
Listen to your body.

Mitigation:

1. Don't delay medical care. Get medical help immediately.
2. Don't move the joint. Until you receive help, splint the affected joint into its fixed position.
3. Don't try to move a dislocated joint or force it back into place. This can damage the joint and
its surrounding muscles, ligaments, nerves or blood vessels.
4. Put ice on the injured joint. This can help reduce swelling by controlling internal bleeding
and the buildup of fluids in and around the injured joint.

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14. Neck Injury

38

Reduce

Prevention:
1.
2.
3.
4.
5.
8.

Stretch properly
Avoid heat
Elude from anything that causes neck traction
Avoid deep tissue massages and chiropractic adjustments
Inform the participant to stop when their limit has been reached
Elude from sleeping on your belly

Mitigation:
1. Breathing
a. Make sure diaphragm is being used to inhale and the neck muscles are not
contracting to help.
b. Do supine with neck roll, so the cervical curve is supported.
2. Neck support: Wrap a folded dishtowel around the neck as a support when at home.
3. Ice: Put ice on and around your neck for as much as once an hour.
4. Neck retraction: Keep the neck over, and not forward, the rest of the spine. Isometric
pressing the back of the head into a wall or the car seat is beneficial. It is important to do
this when sitting or standing.
5. Sleeping in good alignment
a. If you are a side sleeper, make sure the pillow is thick enough to cover the space
between the ear and the outer edge of the shoulder.
b. If you sleep on your back, only use enough of a pillow to support your cervical
curve.59


59

Yoga Connection, Common Injuries in Yoga: Neck Strain http://the-yoga-connection.com/well-


being/common-injuries-in-yoga-neck-strain/

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39

Monitoring
As part of the implementation of the Risk Management plan, we suggest doing a yearly review with
all employees. The purpose of the meeting is to go over all the incident reports that have been filed
when an accident has occurred. Reviewing the incident report will allow for open communication on
what the most frequent accident/incidents that occur and evaluate if the proper prevention and
mitigation steps are being implemented and If there are better prevention and mitigation steps that
could be updated.
The meeting will provide a designated time and place to go over instructors certifications and
insurance forms and what steps need to be taken to have all insurance policies and certifications up to
date.

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40

Appendix

Employee Incident Report


Date:
Name:
Occurrence:
ACTION TAKEN:
[] COACHING
[] VERBAL
WARNING

[] WRITTEN
WARNING
[] TERMINATION

Dept.:

[] SUSPENSION ___
day(s)
[] OTHER
______________

(DEPENDING ON THE NATURE OF THE OFFENSE, ADVANTAGE RN RESERVES THE RIGHT TO SKIP ANY STEPS AT ITS DISCRETION.)

[]
[]
[]
[] FINAL
FIRST SECOND THIRD
WARNING
DESCRIPTION OF ISSUE:
[]
[] VIOLATION
[] OTHER ______________
ABSENCE
[]
[] POLICY VIOLATION
TARDINESS
[]
[] PERFORMANCE
CONDUCT

Goals/Corrective Behavior:
SHOULD YOUR RECORD CONTINUE TO BE UNACCEPTABLE IN THE ABOVE AREA(S), THE COMPANY
WILL FIND IT NECESSARY TO TAKE THE FOLLOWING DISCIPLINARY ACTION (OR MORE DEPENDING ON
THE SITUATION):
[] WRITTEN
[] FINAL
[] SUSPENSION ___
WARNING
WARNING
day(s)
[] TERMINATION
[] OTHER potential pay decrease
Employee Comments:
________________________________________________________________________
__________________________________________________________________________________
________

YOU ARE FORMALLY BEING WARNED TO BRING TO YOUR ATTENTION THE SEVERITY OF THIS SITUATION. FAILURE TO CORRECT THIS BEHAVIOR AND/OR
FURTHER VIOLATION OF COMPANY POLICY WILL RESULT IN ADDITIONAL DISCIPLINARY ACTION UP TO AND INCLUDING DISCHARGE. BY SIGNING BELOW YOU
ACKNOWLEDGE THAT YOU HAVE RECEIVED THIS NOTICE.

Employee:
Date:
__________________________________________________
__________
Supervisor:
Date:
__________________________________________________
__________
Owner: ________________________________________________
Date:
__________

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Sexual Harassment Plan


The Yoga Underground is committed to providing a workplace that is free from sexual harassment.
Sexual harassment in the workplace is against the law and will not be tolerated. When the company
determines that an allegation of sexual harassment is credible, it will take prompt and appropriate
corrective action.

Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual
nature constitute sexual harassment when:
1. An employment decision affecting that individual is made because the individual submitted
to or rejected the unwelcome conduct; or
2. The unwelcome conduct unreasonably interferes with an individual's work performance or
creates an intimidating, hostile, or abusive work environment.

Unwelcome actions such as the following are inappropriate and, depending on the circumstances, may
in and of themselves meet the definition of sexual harassment or contribute to a hostile work
environment:
Sexual pranks, or repeated sexual teasing, jokes, or innuendo, in person or via e-mail;
Verbal abuse of a sexual nature;
Touching or grabbing of a sexual nature;
Repeatedly standing too close to or brushing up against a person;
Repeatedly asking a person to socialize during off-duty hours when the person has said no
or has indicated he or she is not interested (supervisors in particular should be careful not to
pressure their employees to socialize);
Giving gifts or leaving objects that are sexually suggestive;
Repeatedly making sexually suggestive gestures;
Making or posting sexually demeaning or offensive pictures, cartoons or other materials in
the workplace;
Off-duty, unwelcome conduct of a sexual nature that affects the work environment.

Responsibility Under Policy

If The Yoga Underground receives an allegation of sexual harassment, or has reason to believe sexual
harassment is occurring, it will take the necessary steps to ensure that the matter is promptly
investigated and addressed. If the allegation is determined to be credible, the Department will take
immediate and effective measures to end the unwelcome behavior. The Yoga Underground is

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42



committed to take action if it learns of possible sexual harassment, even if the individual does not wish
to file a formal complaint.

Yoga will seek to protect the identities of the alleged victim and harasser, except as reasonably
necessary (for example, to complete an investigation successfully). The company will also take the
necessary steps to protect from retaliation those employees who in good faith report incidents of
potential sexual harassment. It is a violation of both federal law and this policy to retaliate against
someone who has reported possible sexual harassment. Violators may be subject to discipline.

Employee Rights and Responsibilities

Any employee who believes he or she has been the target of sexual harassment is encouraged to inform
the offending person orally or in writing that such conduct is unwelcome and offensive and must stop.

If the employee does not wish to communicate directly with the offending person, or if such
communication has been ineffective, the employee can take the problem to the owner.

Sexual Harassment Documentation Form


Persons involved:

Witnesses:

Date incident was reported: Reported by:

Date of incident:

What occurred:

Disciplinary actions taken:

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43

Disability Policies
According to ADA Title 1: Employment, employers with less than 15 employees are not required to
comply with ADA standards. However, Company ACME will still put forth effort to accommodate
those with disabilities. Also, there is a possibility that Company ACME will grow and employ more
people, so the following policies have been put in place.

Diversity Training
Learn as much as you can from books on the subject, as well as exposure to people who are different
from you

Investigate video series on managing diversity


Consider public programs

Policy
The Yoga Underground is committed to the principle of equal opportunity in employment. The Yoga
Underground prohibits discrimination against and harassment of any clients, employee, applicant for
employment, third party or community member because of race; color; national or ethnic origin; age;
religion; disability; sex; sexual orientation; gender; gender identity and expression; including a
transgender identity; genetics; veteran status; retaliation; and any other characteristic protected
under applicable federal or state law, herein called protected categories. The University expects all
employees, and community members to join with and uphold this commitment. The Yoga
Underground also prohibits retaliation based on a protected activity, such as the filing of a complaint
of discrimination or participation in the investigation of such a claim. Any witness, complainant or
respondent involved in an investigation ought not to be retaliated against for their participation in the
fact-finding process.

In the employment context, discrimination may begin with an adverse employment action, which is
something an employer has done that is unfair to an employee (for example: terminating the employee
or not selecting him or her for hire or a promotion, harassing the employee, denying the employee's
request for a reasonable accommodation, etc.).

Personality differences or conflicts, general mistreatment not based on the above-protected categories,
or a response to poor performance are usually employee relationship issues, not discrimination matters.
Please call the owner to discuss any problems.

Rights and Responsibilities

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44



Here at The Yoga Underground you have the right to work in an environment free from discrimination
Rights and Responsibilities include:

1.
2.
3.
4.

Duty to Report
Duty to Cooperate
Freedom from Retaliation
Confidentiality

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45

Training Employees
All instructors must have completed at least a 200-hour training program with the Yoga Alliance,
or a program that is associated with it.
The Yoga Underground is proud to offer a unique, Yoga Alliance Certified, 200-hour Ashtanga
teacher training program that is not available anywhere else! The program will be taught using
an experiential philosophy: a majority of the training will take place outdoors, in Utahs beautiful
Provo Canyon. This is a daily, full-immersion program designed to create the best learning and
discovering atmosphere possible.
If the class is taken at The Yoga Underground, the owner will teach the minimum 200 hours, and
another 180 with Primary ERYT. Including 100 hours of asana practice, 30 hours of the philosophies
that surround yoga and 25 hours anatomy and physiology

Re-Training Current Employees

Every three years starting from the initial date of registration with Yoga Alliance, all RYTs must
submit a minimum of:
45 hours of yoga teaching and

30 hours of yoga training


o At least 10 training hours must be Contact Hours.
o No more than 20 training hours may be Non-Contact Hours.
o All hours must be directly related to one of the Yoga Alliance Educational
Categories.
Contact Hours

These are in-person classroom hours in the physical presence of a qualified Continuing Education
Provider. One Contact Hour of Continuing Education is earned by completing one hour of any of the
following activities:

Yoga teacher training


Workshops (single session or ongoing series)
Courses at a college or university
Discussion or study groups

Non-contact Hours
Non-Contact Hours consist of informal or self-directed study which occurs outside of the classroom,
without a teacher or trainer present. A Non-Contact Hour of Continuing Education is earned by
completing one hour of any of the following activities:

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46



Reading a book or article, or watching a video that deepens your yoga practice and/or
understanding
Being a student participant in a webinar or taking an online or correspondence course
Receiving remote mentoring
Authoring yoga books, articles, videos or other media for public dissemination (e.g., in
newsletters, CDs, DVDs, newspapers, magazines, online, etc.)
Creating class materials for distribution to students

Registered Yoga Teachers are encouraged to submit a written reflection or evaluation of each
activity, to demonstrate what was learned and how it relates to the Educational Categories and
Continuing Education requirements.

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47

Evaluation Form for Classes


1. How long have you been taking classes at The Yoga Underground?
a. 6 + months
b. 1-3 month
c. 3-6 months
d. less than
2. On average, about how many classes do you take each week at The Yoga Underground?
a. 4+
b. 3
c. 2
d. 1
e. 0
3. Thinking about the instructors at Kate Yoga, whose classes meet your needs best? Whose classes are
you most likely to come back for?
a. Stephanie C
b. Antoinette G
c. Sarah Doe
d. Angie M
e. Holly Lambert
f. Brittany
4. Which classes are you most likely to attend at The Yoga Underground. Please select all that apply.
a. Yoga Recycled
b. Primary Series
c. Lunch Time Yoga
d. Rock Asana
e. Kick Asana
f. Sunday Funday
g. Come Fly with me
h. Freedom Friday
5. Thinking of your schedule, what are the best days of the week for you to practice yoga?
a. Monday
b. Tuesday
c. Wednesday
d. Thursday
e. Friday
f. Saturday
g. Sunday
6. Again, thinking about your schedule, what is the best time of day for you to take a class at The Yoga
Underground?
a. 6am-9am
b. 9am-12pm
c. 12pm-3pm
d. 3pm-6pm
e. 6pm-9pm
7. What is the primary benefit you looking for at The Yoga Underground?
a. Exercise and Fitness
b. Calm and peace

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48



c. Strength
d. Challenge
8. When compared to other yoga classes in the area, do you think The Yoga Undergrounds prices are:

a. Less expensive
b. About the same
c. More expensive
d. Other:
9. Why did you choose The Yoga Underground? What keeps you coming back? (If you haven't been in
lately, what would bring you back?)




10.
What can we do to make The Yoga Underground better for you?

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49

Incident Report Form

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