What Pilates has Done For Me!

I recently hit the “50″ mark (ugh, oh-no not me) and had a physical… my blood work came back as if I was in my 30’s, this was great news ! However I had been waking up with back pain (in spite of a “sleep number” bed) and the doctor sent me off for an x-ray… his letter said something to the effect of “your back is older than you look”… I was devastated, I don’t look 50 (at least that is what other kind people have said and most especially as I am a DOER (typically well above others), not a watcher/couch-potato. So off to physical therapy he sent me. PT said that development of my “core” was the best treatment for addressing my “aged” back. They referred me to Pacific NW Pilates.
Though I have not been at Pilates very long, I attribute Pilates to no more back pain in the morning. Proper diet and cardio workouts in a gym had not been enough to address the needs for my back. So even though I’m a “newbie” at Pilates, I am well convinced that I’m going to be a life long Pilates advocate.
Since starting Pilates, the back pain in the morning is gone, I’ve dropped several pounds, reduced my body fat, and am within 10 lbs of my high-school cross-country running days (!), one of my next goals. I’ve been attending great semi-privates, and will be looking to schedule group classes next.
Best regards,
Otto

My Little Pilates Story- Big to Me!

My story is little unless you are me, then it is big!
I’m a pediatric physical therapist, in practice since 1971.  Was never athletic at all, I always preferred to hang out with a book rather than play sports.  But I live an active life and enjoy gardening, hiking, backpacking, x-c skiing, and sea kayaking.  I injured my back gardening in 1979 (SI strain) and had intermittent low back pain ever since.  I tried “crunches” and other basic abdominal strengthening exercises, but could never get strong enough.  At work, my little patients transitioning from crawling to walking always made my back ache, and it was really bad if I had two of them in a day’s work.

I worked out the the gym, doing step aerobics and then spinning.  One day, a fellow spinner told me about Traci’s Pilates class at the downtown Bally’s Total Fitness.  I tried it and I was hooked.  The mind-body training began to make a difference as I learned to get my abdominals to wake up and do their job.  I’ve continued with weekly classes (moving to Pacific NW Pilates with Traci).  I took Melanie’s Pilates for Rehab class at Pacific NW Pilates and that solidified my understanding of the basic principles.  I did not get the certification, but do incorporate the principles and exercises in my work whenever possible.  I also have several “routines” I do at home (with the help of Moira, PJ and others on DVD!), and it is such a fabulous way to start my day.  The good news is that I rarely have low back pain anymore, even after gardening, crawling around after little kids, and doing housework.

I continue to learn about my body and how to keep it happy.  After a spell of very uncomfortable neck pain, followed by PT, home traction, massage, and still residual pain, I had 2 sessions with Melanie.  She “nailed” the source of the aggravation and gave me a great home program.  It is not easy for a 60 year old body to change her posture, but the awareness  of what needs to change, and the tools to work on it are beyond value!  The arthritis won’t go away, but the pain does, and that is life changing.

A happy PS is that my husband and I planned a 5 day kayak trip for our vacation in September.  I was concerned that all that shoulder work would aggravate my neck. The good news is that by stabilizing my shoulders as I held the paddle, my good posture was easy, and I never felt better than when my paddle was in my hands! We had a fabulous week in the Gulf Islands, and I did “my Pilates” on the water, every day.

Thank you to Melanie, Traci and all the folks who keep your studio such an awesome place to be healthy!

Jocelyn Goodall (Physical Therapist)

My Pilates Success!

Is Your Ab Workout Hurting Your Back? Comments about The New York Times Article

There has been alot of “talk” about an article written for The New York Times by Gretchen Reynolds entitled “Is Your Ab Workout Hurting Your Back?”

We thought others might want to join in on the conversation! We welcome your thoughts.

Here’s the original article:

http://well.blogs.nytimes.com/2009/06/17/core-myths/?emc=eta1

Comment #1:

That’s kind of confusing. What is he saying exactly? No transversus/no scoop? Yet, some of the exercises are like what we do. What’s your take?

My take on it is that having a stable trunk is far more complex and integrated then just asking someone merely to pull in their abs and do thousands of crunches a day.

He is not saying that we shouldn’t do them at all but says, “(i)nstead…a core exercise program should emphasize all of the major muscles that girdle the spine, including but not concentrating on the abs.” He points out doing exercises as plank and swimming prep (bird dog)- again exercises that require integrated stability in neutral positions. This supports everything that we already teach at our studio, and our mentors (Melanie, Greta and others) have been expounding for years. As we know, “the core” is comprised of not only the abs, but the deep psoas, multifidis and pelvic floor. The article does not go into these specifics, but instead, points out that “if you concentrate on strengthening only one set of muscles within the core, you can destabilize your spine by pulling it out of alignment.” This idea of balance in fitness is something that I think all of our teaching supports.

The only thing about this that could be bad is that it is not specific enough and some people will now believe that doing ALL pilates and personal training is bad for the them; those people that actually read it, with some knowledge base, that have done work with someone that doesn’t just give thousands of crunches, roll ups and imprinted back exercises sees that good exercise requires balance from all the muscles groups, will see the validity of the article. My take on the “pulling the belly button in” is the fact that most people can’t do this without flattening their back and putting undue stress on their discs.

That’s what I think anyway.

Comment #3

Thank you – this is very interesting. I hope we will have a “Share Pilates” about this and possibly other research and experiences that we are learning about that inform how we exercise.

Comment #4

Thanks, Leslie, for forwarding this article. It was interesting and, for me,affirming that the work we are doing with people is actually focusing on the whole of the body and the whole of the core muscles thruout. Pilates is helping their “abs”, their spines, their joints and their overall body alignment, symmetry, strength and flexibility.

On a positive note, I think there is always a place for modern movement applications and advancements in the understanding of functional anatomy to be incorporated and applied to health and fitness instruction. I would also agree with this author that the oversimplification of the Pilates Method (or others that attempt to address “core support” and functional movement) to simply telling people to do crunches and suck in their abs is one that has the potential to endanger people’s overall posture and make them injury-prone. I would also say too that it reduces and impoverishes the benefits/contributions that Pilates and others attempted to make to overall fitness and wellness.

However, I can’t help but respond to what seems to still be a good bit of nebulous understanding about “the core” that even the writers of this article seem to have….
Here’s a few i.e.’s from the article:

1. Transverse Abdominus is the only/primary core mucsle (leaving out the PF, rest of the deep abs and all the deep spinal muscles)

2. People who are working their core(per article TA) are getting 6-pack abs…that’s Rectus’ domain not the deep abs and, of course, they may hurt their backs that way.

3. Working the core in Pilates-type classes focuses only on the abs (I would agree this is probably the case in the gym format classes and people can get hurt). However, Joseph Pilates says several times that the uniform development of the muscles of the whole body and its balance is primary to his work and to moving well in the world.

There’s my off-the-cuff response to the article. Thanks for contributing to my brain working a bit today,

Comment #5

I had similar feelings…I thought the article was great in some respects, but the fact that some of it was vague would make a less-informed individual assume that all pilates could be bad. I think that the writer or person interviewed could have been more specific about what is considered “the core” too.

Comment #6

I agree with your take as well. Posting the conversations on the blog could be good. Makes me want to respond to the NY Times too.

Do abdominal exercises hurt your back?

Do abdominal exercises make your back hurt? They shouldn’t. If you find that your back is sore after doing a series of abdominal exercises (either immediately after or a day or two later), you may want to check to see if you back is gripping while you are doing them.

Here are several tips for helping you learn how to use your abdominals (instead of other muscles) while doing ab exercises (sometimes called crunches or sit ups)

Step One:

Re-educate your body to learn how to find your abdominals without recruiting other, more dominant, muscle groups.

Often when one has weak abdominal muscles, the hip flexor muscles (the muscles at the front of your hip) and back muscles will overwork. Remove the additional challenge of holding your legs in the air, and instead, cue your hips and back to relax.

To do this, place a thick pillow on the ground in front of you and drape your legs over the pillow (or arc). Then actively tell your back and hip muscles to “let go.” You may notice that your back falls into a slight curve so that there is a space between your back and the floor. See if you can maintain this curve during your sit-up and still keep your back and hips quiet! When you do this correctly, you should feel that your abdominals are working more effectively.

Step Two:

The second step is to see if you can do the same thing with your legs up in the air in a supported position. You could do this by placing your legs over a ball (this will be harder since it is an unstable surface). If you need a surface that provides more stability, put your legs over a coffee table or other surface.

Step Three:

The last step is to see if you apply this to having your legs in the air without support. In this position, your hip flexors will have to work in order to hold your legs up against gravity, and your back may need to be placed firmly on the floor (instead of having a curve in it), but your back should still not be working and, overall, you should feel that there is more balance between your abdominals and hip flexors.

Once you have this skill, you should be able to apply it to other abdominal exercises that require more complex movement with your arms and legs.

Good luck.

Flat abs without back pain

This question was sent and responded to through email, but we thought others might be interested!

Melanie:

What are some good ab exercises that I can do without hurting my back? Do you have research to support these ideas?

Hello,

The most beneficial way to strengthen your abs, flatten your stomach and not hurt your back is to do abdominal exercises that encourage proper recruitment of the spinal and pelvis stabilizing muscles: the pelvic floor and transversus abdominis muscles. To do this, you need to understand how to “recruit” these muscles (in lieu of using other muscles, which is common) and how to tell if they are staying “on” (instead of using those other muscles) while you complete abdominal exercises.
The transversus abdominis is the deepest layer of abdominals. It does not, by design, create movement. Instead, it creates stability for the spine and flattens the abdominals. It is important to make sure that while exercising the transversus abdominis, it is pulling in and flattening sideways (the fibers run horizontally around the trunk like a corset).
These muscles work best when the pelvis and lumbar spine are placed with the natural curve in the lumbar spine (i.e. when the back is not flattened into the mat) and the back muscles are not gripping.

There are several basic exercises one can practice to find the pelvic floor muscles. Since the pelvic floor muscles attach to the underneath side of the pelvis (these are the same muscles that control urination) they are felt easiest by sitting on a ball and gently bouncing up and down or by folding up a small wash cloth and sitting on it. These devices give some feedback for the individual.

To strengthen these muscles, gently connect these muscles by thinking of lifting them upward slightly. (It should feel like the same muscles that work to keep you from urninating.) It is important to be able to gently lift them for a count of 5, hold them on for a count of 5 and release them for a count of 5. They should not be working at 100% but closer to a 25% level.

Transversus should become active just prior to incorporating other muscles. When the transversus abdominis is recruited properly, you see a flattening or drawing in of the lower abdomen without any noticeable movement of the spine or hips.
To get the look of a flat, strong abdomen, you need a variety of different exercises in your routine. Some include:
1) Challenging the spine in neutral (plank, head and shoulders on the ground) ensuring the spine remains as it starts throughout the exercise
a. Toe taps
b. Dead bug series
c. Scissors with head down
d. One leg circle
e. Push ups
f. Leg pull front
2) Flexion routine- ensure that lower abdominals are set prior to and throughout the motion
a. Roll up
b. Obliques with single leg stretch
3) Extension based exercises- keep abdominals lifting up
a. Swan dive
b. Swimming
More info about the transversus abdominis:
1) acts as a corset, drawing in circumferentially as it protects the spine
2) stabilizer of the lumbar spine by virtue of:
- insertion into the thoraco-lumbar fascia, which inserts into the vertebrae,
- its neurological firing pattern (fires before movement begins so that the spine is protected and prepared
- coordinated work with the other stabilizers including the pelvic floor muscles, diaphragm, deep psoas, and multifidus
3) creates motion around the proper axis of motion, and prevents unwanted shearing or translation of the vertebra which can lead to irritation and degeneration of the discs and facet joints
4) provides compression (in a good way) so that the larger muscles have a stable base to pull from
REFERENCES:
1. Lee, Diane: The pelvic Girdle, Third Ed. Edinburgh, Churchill Livingstone, 2004
2. Richardson C, Hodges P, Hides J: Therapeutic Exercise For Lumbopelvic Stabilization: Motor Control Approach to the Treatment and Prevention of Low Back Pain, 2nd edition, Edinburgh, Churchill Livingstone, 2004
3. Vleeming A et al: Movement, Stability and Low Back Pain- The Essential Role of the Pelvis 2nd edition, at press, 2006
Articles
3. Lee, Diane (1998) Stress Urinary Incontinence: A consequence of Failed Load Transfer Through the Pelvis? Proceedings from the Third Interdisciplinary World Congress on low Back and Pelvic Pain. Vienna, Austria www.dianelee.ca <http://www.dianelee.ca>
4. Lee, Diane (2005) Recent Advances in the Assessment and Treatment of the Sacroiliac Joint- Stability & the Role of Motor Control. www.dianelee.ca <http://www.dianelee.ca>
5. Richardson C A, Snijders C J, Hides J A, Pas M S (2002) The Relationship between the Transversely Oriented Abdominal Muscles, SIJ Mechanics and Low Back Pain. Spine 27(4): 399-405
7. Vleeming,A Stoeckart, R, Volkers A C W, Snijders CJ (1990a) Relation between Form and Function in the Sacroiliac Joint, 1: Clinical Anatomical Aspects. Spine 15(2): 130-132
8. Vleeming,A Stoeckart, R, Volkers A C W, Snijders CJ (1990b) Relation between Form and Function in the Sacroiliac Joint, 2:Biomechanical Aspects. Spine 15(2): 133-136