Knee Stability Post Surgery

We just got this question emailed to us from a student:

This is Christi Tuck from Colorado Springs YMCA. I am a certified STOTT PILATES instructor and I have a question.
I have an inquiry from a possible student regarding some knee issues and if the reformer would be beneficial and are their any concerns. Basically they had surgery recently and the doctor informed them they have no cartilage around the knee. I believe they had the meniscus repaired.
My guess is the reformer would be helpful to strengthen the surrounding muscles and that starting at light resistance would be best. I welcome any comments or suggestions.

Hi Christi-
Thanks so much for your question. As far as your client’s issues are concerned; yes, the reformer would be very beneficial to her recovery. Doing footwork starting with lighter resistance is a great start. I would also do single leg pulses in a variety of positions–laterally rotated, parallel and medially rotated. Make sure when she is doing footwork or single leg that she is really using her quads to draw the kneecap up as she straightens the leg. VMO (vastus medialis oblique) is especially important for knee stabilization and it tends to be weak for many women. I find I really feel the VMO muscle more when doing lateral knee pulses, but that may vary from person to person, so check in with her to see if she is feeling that muscle. Strengthening the posterior leg muscles will also help to stabilize the knees, so make sure you are doing some glute and hamstring work as well.
Melanie Byford-Young has a great workshop on Knee Stabilization if you ever get a chance to take it! She created an exercise where you are sitting on the reformer carriage with no springs attached. One foot is on the floor between the rails and the other leg is lifted up supported by the hands or with a flexband around the thigh. If you have a rotational disc, place the foot on top of the disc and keep the ankle, knee and hip tracking as they slowly move the carriage out and in. This helps to stimulate and strengthen the popliteus muscle which is another deep knee stabilizer.
The more those stabilizing muscles are activated and strengthened, the less wear and tear will occur to the knee and the remaining cartilage. Eventually, you can increase the resistance as those muscles get stronger, but at the beginning we don’t want to overload those stabilizing muscles.
Let me know how things go or if you have any other questions.

Osteiitis Pubis

Hi Melanie
Sorry to seek your assistance so soon again.  If you can find the time to give me some help on this client would again be very grateful.
 
One of my clients has  has osteitis pubis.  She has now had this for 2 years, bought on in her second pregnancy.  She played hockey upto 14/15 weeks of this pregnancy.  She had no pain at that time, but did in the later stages of her pregnancy.  Unfortunately, she didn’t say anything about the pain to her midwife and no pelvic support was used.  After the birth, she pushed herself quite early, and has suffered since.  She saw a PT for quite a long time, but found that she was worse after these sessions so has stopped.  I have seen her 4 times.  I am only doing half hour sessions with her as she tires quickly. I have been working with her to not overdo her lift and contraction of pelvic floor and TA.  Initially, at times, 20% would cause pull in the area, so we dropped it back to 10%.  Now that shearing/pull doesn’t hit until 30-40%, so we are working at about the 20%.  I have been doing supine, sitting, sidelying and today some standing work with her.
 
Supine – very small lateral leg openings with flex band behind leg, also medial leg mvmts, foot on toning ball, scap isolations, light adductor with mini ball, focus on left/right side pc
Side lying – small ext hip rotation, scap isolations
Sitting – I have some gliding discs – on raised mat, small sgl leg presses, then dbl leg presses and today small alt/reciprocal mvts, arm raises and today small swimming arm mvts (at chest height)
Standing – Cadillac push through bar – sgl lat pull and dbl then with roll down bar(small mvmt just until she felt core connection
 
She saw a specialist at the hospital this week who has suggested surgery.  She is not keen to undertake this option and was disappointed they offered her nothing else.  Am I heading in the right direction with Rachel?  What else should I do.
 
My other client with TMJ is currently off on school hols so I will let you know how we get on in a few weeks.
 
Thank you so much
Sonia, Progressive Pilates, New Zealand

Response from Melanie Byford-Young:

Hi sonia!
Great question. Osteiitis pubis can be very debilitating and hard to figure out. You are doing good exercises already.
Essentially you have to imagine that the pubic symphysis can get pulled apart very easily, even just via the contraction of the hip adductors. Your goal is to try to work the myofascial slings to hold her together- the anterior and posterior slings. You need to get the external control adn the internal control of the local stabilizers.
There are several other things you can try
1) breathing- see if she can tolerate breathing like she is sucking in through a straw, and gently lifts the pelvic floor as she does (i.e. uses the breathe to lift the pelvic floor) instead of focusing on contracting the pelvic floor (PF) muscles specifically. It can be a more gentle way and uses the diaphragm with the PF. If she can, use this technique then have her hold the PF up while she exhales. If this works, repeat hourly through the day.
2) swimming prep on hands and knees to get the posterior oblique sling supporting the pelvis and spine
3) footwork on teh reformer- probably 2 springs starting with the stopper out at position 6. Progress range first then weight and rhythm. Running can be very effective at beginning to tolerate weight shifting. Then, progress to shifting weight from on leg to the other.
4) sleeper on the reformer/ V2Max with the  spring from above (flexband supporting the leg)
5) standing arm work on the rotational discs, bosu or just on the floor. Light to moderate weight, bilateral first then unilateral. Eventually you want to do it standing on one leg.
6) sitting on a stability ball and doing imprint  and release, arm circles, spine twist etc. Vary her leg positions as able.
That should keep you busy.
Let us know how it goes!
Melanie

Herniated Disc Injury

This was emailed to us and we thought others might be interested!

Hi,
I wanted to ask about herniated disks. I have a client who has a herniated disk between L4 & L5, she does not currently have pain. Is it correct to not do any kind of lumbar flexion with thorasic rotation(i.e. short box round back with twist or mat obliques roll back), just rotation of thorasic with lumbar in neutral to avoid any further herniation?
Thanks,
Deanna Murray

Response from Leslie Braverman:

Hello Deanna:
Thanks for emailing. When the disc ruptures or herniates, a portion of the spinal disc pushes outside its normal boundary. When a herniated disc bulges out from between the vertebrae, the spinal nerves and/or spinal cord can become compressed. So depending on where this is happening will determine which movements to avoid. Typically, it is recommended that people avoid spinal flexion and rotation, because the disc most frequently herniates posterior-laterally and flexion and rotation would exacerbate the problem and/or create pain. To be perfectly sure which movements are to be avoided, it is best to speak with a physician or physical therapist that has worked with your client and has seen the notes from an MRI and knows exactly where the bulge is occurring. Unfortunately, as a pilates teacher, it is often hard to get this information.

If your client were still having a lot of pain, I would suggest that he/she consult with a doctor and, ideally, work with a physical therapist before doing pilates.

Since your client is no longer having pain it is possible that the disc problem has been resolved and the annulus is no longer irritable and pushing on the nerves. In this case, you can progress your client through all exercises and use her symptoms as a guide. Initially, be cautious of lumbar flexion and rotation. On the other hand, your client may have lost a lot of disc height and have too much segmental mobility and/or  instability where the disc was herniated. Progress slowly and be cautious of too much flexion load on her lumbar spine. Be very conscious of her ability to sit in neutral lumbar position. Most likely,  your client will need to sit on a box or cushion to have a proper position without stressing the lumbar area.

I would recommend that you focus your programming on work that encourages your client to become very stable in neutral positions. Really monitor what is happening at L4-L5. You may need to place your hand on her back to really be sure that she is not flexion or extending, even minutely, at this level. Often people with L4-L5 herniations will not know how to sit properly in neutral position, so really check that her lumbar and sacrum are absolutely correct.

Giving your client lots of exercising that challenge stability in neutral positions will be key to her avoiding future herniations or other deterioration of the spine. Here are some examples. Use these ideas with discretion-depending on the clients level and innate strength at this time- use your professional judgment:

1.) Cat position exercises- all variations to build stability in neutral:
-picking up one hand at a time
-sliding one leg out at at time
-alternating opposite arms and legs (i.e. swimming prep on hands and knees)

2.) Shoulder Bridges- Glut strength is paramount for people that have lower back instability
-advance to picking one leg up at a time
Make sure she is getting Glut medius and deep fibers of Glut Max- not just her deep rotators and hamstrings- watch she doesn’t tuck her sacrum under. Keep your hand on L4-L5 to maintain neutral.

3.) Leg Pull Front Prep

4.) Reformer- Footwork- keep your hand on L4-L5- maintain neutral

5.) Short Box- Straight back
You could do this on the reformer too with the arm straps (like roll back with a straight back) add bicep curls if able

6.) In kneeling positions, make sure that her hips are open enough to get head of femur over the knee so her spine can stay neutral. Her hips may be tight and not allow her to do this.

7.) Extension work is great- my guess is that it was a posterior herniation- if there is any pain avoid it. You can definitely do things like breast stroke that encourage upper back extension. If things like Swan Dive feel good, then do them. As usual, check that she is not hyper-extending at any one spinal level.

8.) Lateral flexion- watch alignment is excellent.

Hopefully, this gives you some good ideas. Challenge her in standing, kneeling and sitting positions- as long as there is no pain. Add upper body and lower body resistances to challenge her ability to stabilize her back against rotational pulls. Side lying work would be great too.

Then, once she is really strong this way, I would begin to introduce more flexion and rotation. Make sure that she is getting movement in all segments of the spine, and she is distributing and translating movement throughout the spine and not giving in at one level.

Some clients will fully recover from disc issues and some will always have a degree of vulnerability. You will have to find out slowly over time and with thoughtful progressions. When in doubt, be open to consult with your clients’ other health advisors and clinicians.

I hope this helps!

Best, Leslie Braverman

Scoliosis & Winging Scapula

This question was emailed to us from Mila in NYC:

I have long s-shaped thoracolumbar scoliosis. I looked at a post on your website and realized you spoke to someone about a client that had a shoulder blade that tips foward. My left shoulder blade, which has been described as a “winged scapula” is tipped foward to the point where it looks like I am slouching. I have a thoracic scoliosis with convexity to the right.

I often feel “tired” on the left side of my upper body. Do you know of any exercises to help with this or with aesthetic apperance of the scapula? I failed to mention that I am 21 years old.  Also, I know you are not a doctor but I was just wondering if you know whether my condition can worsen with time. I happen to be left-handed. Could that have contributed to scoliosis as well? Also, can an abnormality in the shoulder blade (such as winging or rotation) cause scoliosis?

Jean’s response:

Winging scapulas are not an uncommon occurrence when you have a thoracic scoliosis. If it is feeling tipped forward as well as winged then it would help to strengthen the mid and lower segments of the trapezius muscle as well as serratus anterior. STOTT PILATES has a variety of exercises that can help target those muscles. However, based on the curvature of your spine that scapula may not ever be able to lie perfectly flat on your ribcage. We should be able to decrease the amount of winging and help it to stablize in a more neutral position.
As far as feeling “tired” or less connected to your left side, it might help to focus on breathing into that side more. Most of us have a somewhat assymetrical breathing pattern and a scoliosis increases the odds of that happening. Lying over the spine corrector or an arc barrel or large pillow on your right side will help to open up the ribcage on your left side. Imagine the ribs opening and closing like an accordian to increase the oxygenation to that side. Breathing can create some amazing changes in the body just by bringing awareness and increased blood flow to that area.
I have included some photographs of  winging and tipped scapula as well as a good  exercise to strengthen the scapula stabilzing muscles below.

Melanie’s response:

Thank you for writing to us. Indeed there is alot that you can do to help relieve the fatigue you feel in your spine. Whether or not you can change the appearance of your scapula depends on whether there is a myofascial component causing the winging, or if the scapula position is determined solely by your scoliosis.

There is some great research by Paul Hodges that talks about the differences in muscle type and function on either side of the curve. As Jean wrote, combining breathe and movement is one of the very most effective ways to change scoliosis and optimize function.

A couple of exercises that you could start with:
Arm scissors and arms overhead: focus on the motion of the left scapula and clavicle. The clavicle must rotate posteriorly to achieve full elevation and to bring the scapula in contact with the rib cage. Keep your posterior rib cage down as you slowly create the proper mechanics at the SC joint and clavicle. You can use your inhale to try to elongate the pectoralis minor which is frequently is a cause of winging.

Mermaid- Do this to both sides but have a different focus for each side: side bending to the right with the left arm in elevation: focus your inhale into the pectoralis minor region and try to get elongation through the lateral muscles of your trunk and scapula. Really focus on reaching up and over as you side bend right. On the side, after side bending to the left, really focus on your return to vertical. Developing the the multifidus and erector spinae should help with the fatigue.

Spinal rotation with scapula isolation: focus on spiraling through the rotation. Usually we will allow the pelvis to move instead of maintaining the initial stacked position due to the scoliosis.

Spine stretch forward with hands on a stability ball- exhale as you roll forward focusing on keeping your scapulae centered and with no gripping; inhale in your flexed position focusing on not gripping around your scapular and neck muscles; then exhale as you re-stack your spine. After having done a couple of repetitions, add an additional challenge to your spine; after stacking up your spine perfectly, maintain your spine and lift both arms off the ball without shifting or rotating.

Start with those and let us know how it goes. Naturally every exercise can be adapted for your scoliosis and scapular issue.

A good example of winging and anteriorly tipped  scapulae.

Shrugging the shoulders up and then sliding them part way down is a good way to find a more neutral alignment.

Once you have your shoulder blades as neutral as possible, (i.e. flat against the ribcage) then try some wall push-ups, trying to maintain the scapula in this stable position while you are bending and straightening the elbows. You should not let the shoulder blades move while you do the push-up.

Keep the body in one straight line as you do the push-ups. The heels can come off the floor as needed.

Pilates & Gardening: Or how to hoe without hurting

This question was emailed to us:

Hi all!  I have a great client who struggles with on and off lower back sensitivity.  She is concerned that her issues will put a damper on her gardening this spring (we live in Chicago, and we take our warm-weather activities very seriously!)

Can you recommend some postural suggestions that might allow her to continue gardening, pain-free?  Also, we would appreciate exercise recommendations to prepare her for the beautiful summer garden months?

Many thanks.

Salle Huber

Hi Salle-
Thanks so much for your inquiry. Here are some suggestions for your client:

1. Work in neutral spine as much as possible. Often what irritates our back from a gardening session is the constant bending over or staying in a flexed spine position for too long. When weeding or preparing the soil, try to squat down as low as possible while maintaining a neutral spine and pelvis. If squatting is uncomfortable, buy a kneeling pad, but again try to work with a neutral spine while on the knees.
2. Vary your activities. There is always a lot of work to be done at the beginning of the gardening season. Tilling the soil or adding compost or fertilizer to the soil. Weeding or removing old plants to get ready for the new. etc. Instead of spending two hours preparing a plot, spend 30 minutes doing that and then switch to another activity like pruning trees or watering. Then go back to the more labor intensive activity. Often, we get so involved in whatever activity we are doing that we spend too much time in one position and that will irritate the back.

In terms of exercise ideas, definitely working the core muscles, (abs, glutes, spinal muscles etc) will allow your client to remain more pain free during her gardening activities. Try adding in some squats or some waiters bows to see if she is able to maintain a neutral spine in a squat position. Waiters bow is a core exercise where you sit on the edge of the cadillac or a couple of reformer boxes (in other words a slightly higher seat than a normal chair) The feet should be firmly planted on the floor though. Have your client hinge forward from the hips maintaining a neutral spine.

Certification student, Patricia Sinclair, demonstrates the waiters bow

The arms can reach forward slightly as the spine hinges forward. Once there is

Standing upright, before hinging to return to bench

enough weight in the feet, the client should be able to stand up. Then reverse the waiter’s bow to sit back on the edge of the cadillac or the boxes. These movements should be performed slowly with control so that no momentum is necessary and there should be no change in the spinal alignment as the client shifts from sitting to standing. Using the pelvic floor, transverse abdominals and multifidus muscles are essential to doing this exercise with control and fluidity.
Using a squat to get down close to the ground or to lift plants or heavy objects can help prevent strain to the back muscles. Again, make sure the abdominals are engaged and use an exhale to perform the lift or the difficult part of the movement. Check out some other great exercises in this article by Leslie Braverman; Pilates and Posture

Patricia demonstrates a good neutral spine while squatting to lift a pot.

Taking periodic breaks to stretch is also a great way to check in on your body and make sure you are not over doing things. Gardening can be a true delight, but it is important to gage your strength and endurance so that you can enjoy your garden throughout the growing season!

Job shadowing a pilates instructor

This was emailed to us, but we thought others might be interested!

My name is Hannah Walker and I’m a high school Junior interested in talking with you about teaching, your training, and your experiences owning a studio, to find out a little more about working as a Pilates instructor.

I am planning on coming to your studio for my Pilates certification and would like to learn more about your instructors as well as your thoughts on the STOTT PILATES method versus other teaching styles.

A little background about myself. I was a serious ballet dancer from age 4 until 15 and discovered Pilates through my dance studios. I stopped dancing ballet but have enjoyed taking some modern classes since then and I still continue with Pilates at Pilates Plus Northwest as well as Gyrotonic and Gyrokinesis at Center Gyrotonic. My objective is to obtain my Pilates certification before I graduate high school, and eventually obtain my Gyrotonic and Gyrokinesis certifications as well.

I know you are very busy, and don’t always have the time to meet with people. I thought that perhaps it would be more convenient if I emailed you some of my questions, and you can get back to me at your leisure.

Hi Hannah:

Actually, I didn’t choose STOTT PILATES, it chose me, and I am feel very fortunate about that. I decided to begin taking pilates classes after acquiring a dance injury (a stress fracture to my left tibia) that wouldn’t heal. It is a long story, but, in essence, I ended up missing nearly a year of my dance career while I was at Oregon Ballet Theatre. During that time, one of my co-workers (another dancer) suggested that I go with her to do pilates. The instructor had also been a dancer and she was a certified STOTT PILATES Instructor Trainer. Well, I had studied pilates in New York City many years before, so this particular style was unfamiliar to me, but as soon as we started going to classes, I fell in love it. I especially liked how anatomically- based it was. My teacher had been educated to work with injuries, and she worked very specifically with me on my imbalances and weaknesses; I began to realize that many of which may have instigated my injury. After I finally returned to dancing after being off for months, I was shocked at the amount of strength and over-all control I had gained. Even my co-workers were amazed.

It is difficult to find positions available that offer full-time work and benefits for pilates teaching only. Typically, in the United States, pilates instructors are self-employed. Nevertheless, those jobs do exist. At large gyms, clubs or resorts, you can find salaried or set hourly positions like this. Sometimes workers have multiple roles to acquire this employee status. For example, you may be a pilates instructor at a large gym and also do personal training or administrative work. At any rate, I think one of the benefits of pilates is that it can be taught in your own home. Because the equipment and initial investment is relatively low, compared to many start up businesses, a certified instructor can do really well. Also, many studios rent space and equipment to certified pilates instructors to run their own business within.

Depending on where you live, pilates can be very competitive or relatively unknown. Certainly, it is more popular than ten years ago, but that can also work to a new instructors advantage; the public does not need to be educated about what pilates is or its benefits like teachers had to do a decade ago. I think an instructor that is considering a career in pilates should do some homework about the region that they intend to work in prior to acquiring their certification. He or she should look seriously that the region’s demographics and if it can support a teacher. Also, I have seen excellent pilates teachers thrive in areas that are not typically supportive of a business like pilates, but because of the individual’s personality, talents and skills as a teacher he or she excels anyway.

Income varies widely depending on the region in which you live. An instructor that I know in Los Angeles makes over $80,000 per year. She doesn’t work at a studio but instead has built a business catering to the affluent people in that region. She requires her students to purchase STOTT PILATES equipment, and she teaches them in their homes. She is an excellent instructor and uses word-of-mouth referrals to gain new students.

I am not sure that this same kind of business could thrive in a city the size of Portland. There are people in this city with this same level of affluence, but compared to population there are fewer. Also, the Portland mind-set is completely different than L.A.

In a city like Portland, an excellent, hard-working, full time teacher (30-35 hours per week) can probably earn about $45,000-$60,000 per year, depending on their circumstances (if they are a business owner and how many hours they work.)

I think an Exercise Science Degree could be helpful to someone interested in pursuing a career in pilates. In fact, I have met many college students getting a degree in Exercise Science or Physical Therapy pursue the pilates training as a means to be employed while in school. Because of the ability to have a flexible schedule and be self-employed as a pilates instructor, it is a great job option that is complementary to their academic pursuits.
Business courses are definitely helpful to individuals considering opening a studio.

Yes, word-of-mouth referrals are the primary way that we acquire new students. Initially, when we opened our studio, we had to invest money into print advertising, conventions, and offer ongoing specials and discounts etc. After about four years in business, we found that most of our clients were finding us through referrals and on the internet. After seven years, we discontinued all of our print advertising. Having excellent instructors and keeping our clientele happy has been the best way to build loyalty and a consistently positive reputation in our area.

Thanks, again, Hannah, for contacting us. I wish you the best of luck, and I look forward to meeting you one day.

Thanks much,
Leslie

Pila-tease. It’s not easy!

This past week I worked at Pacific NW Pilates with several new students and each of them remarked, in their own way, about how difficult pilates was for them to do. I hear people comment about this frequently, and I can assure you, after teaching for over ten years, that it is quite normal to find Pilates difficult to do well.

This is primarily because Pilates requires attention. It is not a mindless exercise. You can’t do Pilates while doing something else, like reading a book or watching television, and if someone tells you that they do, they are fooling themselves.

Deep at the heart of the this technique is the principle that quality of movement is far superior to the quantity of movement. So, at any given time, a student may be thinking about their body alignment, the way in which they move a limb, sensing if the movement is being generated from the appropriate group of muscles, and many other personal corrections that he or she needs to think about to conduct the exercise in a more coordinated and balanced fashion.

In order to make profound change using an exercise technique such as Pilates as the channel, one must learn new movements or “motor skills.” A motor skill, is a highly coordinated movement that allows for investigation and interaction with the physical and social environment (O’ Sullivan & Schmitt 1994 in Motor Control).

Motor skill involves learning new strategies for sensing as well as moving. Generally, there are three stages to learning a new motor skill: understanding what change has to be made, experiencing what adjustments have to be made to implement a change, and making the change automatic.Learning new motor skills takes time and, in most cases, requires guidance through each stage.

A qualified pilates instructor should be able to direct you through each of these phases in order to help you reach many of your exercise goals. Tools that your instructor will use to help you with motor change will include helping you understand how your body moves, improving your attention and awareness skills and providing you with feedback.

Adequate practice time is also needed to build new motor skills. Each time a signal passes through a series of synapses, the synapses become more capable of transmitting the same signal in the future. If pathways are facilitated enough, memory of that signal is created and can be recalled to program future movements (Gyton 1981).

So, real change through exercise, like pilates, requires getting correct information in order to facilitate a desirable change, building new movement patterns by becoming more aware (this occurs by getting consistent feedback), and having enough time to practice the new movement pattern.

So, next time you think to yourself, “Pilates is hard!” You will know why.

Pilates and Posture: Kyphosis-Lordisis

One of the classic postural types is called Kyphosis-Lordosis. Characteristically, Kyphosis-Lordosis is a posture in which all the natural curves of the spine are exaggerated.

As seen above, the figure on the left side has increased the curve in the neck (hyper-extension), displacing his head into a forward position; notice the figure’s chin on the left is forward of his sternum, unlike the figure on the right where the head is erect and the chin is in-line with the sternum. In addition, the curve of the upper back (thoracic spine) on the left is more pronounced (increased kyphosis) and the shoulders are rounded forward. Likewise, the curve of the lower back (lumbar spine) is also exaggerated (hyper-lordodic). The exaggerated curve of the lumbar spine is accompanied by a tipped pelvis (anteriorly tipped).

In this set of pictures below, you can see the shape of the bones more clearly. Although the figures are facing the other direction from the figures above, you can compare the curves of the spine and position of the head and pelvis more clearly here. The figure on the right displays the ideal curves while the figure on the left displays Kyphois-Lordosis

So, what can be done in pilates to help offset this particular postural alignment?

First, you must understand what muscular imbalances are associated with this posture.

Because of the position of the head and neck, a small pad or other prop may need to be place behind his or her head during all exercises that are conducted on their back (supine). This will help to keep the head and neck in a more ideal posture. In addition, the individual may need to work in an imprinted position more frequently than in neutral. He or she may be able to eventually work in a neutral position as they become stronger.

Take a look, again, at the curve in the lower back. Notice how the muscles of the lower spine are shortened and the muscles on the front side (the abdominals are lengthened.) This individual will need exercises that encourage he or she to lengthen the tight lower back muscles and recruit the weak abdominals.

It is imperative that a student with lordosis of the lumbar spine, learn to use their abdominals to support their back instead of their hip flexors or hip extensors. In other words, often new students with a lordodic tendency (hyper-extension of the lumbar spine) try to use gluts (bum) or muscles in the front the hip to control their back. Because of this tendency to recruit the wrong muscles, they tend to remain unable to control their back even after years of trying to do “abdominal specific” work.

Here are a few exercises you can do to promote good balance of the abdominals, hip flexors and gluts and lengthen the lumbar spine.

First, Practice lengthening the lumbar spine correctly. Here the student is lying on their back with her legs relaxed over a pillow. She is gently elongating her back into the mat (you can slightly see how the purple waist band is tipped toward her belly button in the second photo), so that the curve in her lower back diminishes (i.e more of her low back touches the mat) . It is important to make sure that your abdominals are moving your back instead of your legs. Any gripping in your back muscles or legs indicates that you may not be finding your core muscles correctly.

sit-up:

Now, try to go into a sit-up position without gripping your legs and back. You are trying to keep your back from moving into a bigger curve (i.e. arch away from the floor.) Your movement may be very small. It is important that you train you abdominal muscles to bring your upper body off the floor instead of changing your lower back or using your legs.

Dead Bug:

Finally, see if you can keep your lower back lengthened on the mat (using your abdominals, like you did in the first exercise) and pick one foot of the ground without arching your back away from the floor. If this is too hard, imprint. Alternate legs.

It is also important to teach the upper back muscles (erector spinae) to learn how to extend the upper back. Take a look at the picture of the skeleton above. Notice how the upper back is rounded, this prolonged posture makes the upper back muscles very weak and the muscles on the front side of the chest very tight (the pecs). So, it is important that this individual learns how to move their back out of this curve, open their chest and work the weak upper back muscles.

Here are a few exercises you can do to promote extension of the upper back without creating unwanted hyperextension of lumbar spine:

Turtle:

Finally, because of the way the pelvis tips, the muscles in the front of the hip can become really short and tight. Conversely, the muscles on the opposite side (the bum and hamstrings) are really weak. Take a look at the little girl’s stance below. Because of the angle of her pelvis, you can see the distance between the front of her hip bone and thigh is very short.

Here is a good exercise to open the hip and, simultaneously, use the gluts and hamstrings:

Bridge

All of these exercises are best done under the supervision of a certified pilates expert.

When is massage a necessity, not just an indulgence?

I don’t know anyone who doesn’t like a good massage, but most of the people I know, including myself, only get an occasional massage–either when things are really out of wack, or if someone gives us a gift certificate or something like that. As a pilates instructor, I work with muscle imbalances all the time and I am highly aware when someone has an abnormal degree of myofascial tightness. I can devise and teach a lot of exercises that will help to create more mobility and muscle balance, but I often advise clients to seek out additional body care to address these specific issues and resolve them more quickly. But do I follow my own advice? Rarely!

This weekend, I treated myself to a great massage with a couple of friends. It was designed to be a treat for a friend who has had some serious health issues, but I realized about half way through the massage, how much my body needed this. Places that are chronically tight, become less proprioceptive. The body shuts down some of the feedback mechanisms otherwise we would be bombarded with pain messages throughout the day. As this area becomes less “aware”, it also becomes less “intelligent”. It doesn’t move as well as it should because we have shut off communication to those tight spots. What a good massage does, is bring much needed stimulation and blood flow to these affected muscles. The massage will also help to lengthen and stretch the tight areas and restore a better range of motion to those muscle groups. Suddenly we are able to move with more freedom and control and we wonder why we don’t do this more often!

I can’t afford to get a massage every week or even every month, but I do resolve to get one more often. It’s not a luxury–it’s a necessity!

Pilates for Equestrians

Pilates and Posture: What is ideal?

Yesterday, one of my new students asked me if I thought Pilates could help their posture, and I told her that over the last ten years, I have seen countless numbers of students radically improve their posture through pilates. So, she asked me to analyze her posture and suggest exercises that would be most beneficial for her to do. Of course, I did this for her, and she was able to leave the lesson with five or six things that she could focus on while working in group classes and on her own.

Later, I realized that this would be a great topic to focus on for our blog. So, here is my first entry about Pilates and Posture. Today, I will talk about what is commonly considered “Ideal Posture.” An ideal posture (or standard posture) is something that we strive for.

In general, ”good posture” is one that promotes overall balance for all the joints and organs and minimizes stress and strain throughout the body. Good posture allows joints to glide and move as they were meant to, minimizing unwanted grinding or sheering. Good posture also is “conducive to good alignment of the abdomen and trunk, so that the chest and upper back are in a position that favors optimal function of the respiratory organs” (Florence Peterson Kendall, PT)

As seen in the profile picture below, the spine has its’ normal curves, the pelvis is level (the two hip bones in the front (ASIS) are on the same plane as the pubic bone), the hip joint is centered in the socket and the thigh bones are stacked directly over the bones of the lower leg (tibia and fibula) and the head sits balanced on the spine so that there is a slight (lordodic) curve in the neck and the chin sits in line with the sternum.

The back view of an ideal posture, seen to the right, shows the head balanced (neither tilted or rotated), a straight neck, level shoulders and shoulder blades, a straight spine (right and left sides of the trunk are symmetrical), level pelvis and neutral hip joint and knees. The toes are pointing slightly outward.

 Since there is a direct coorelation between the static alignment of the bones and the balance of the muscles which attach to them, pilates exercise can be used as means to change posture. In order to do this effectively, one’s posture should first be analyzed for deviations that appear different from the standard posture. Then, a qualified instructor should be able to select exercises that help to lengthen or strengthen muscles that contribute to the postural deviation. In addition, the instructor needs to be able to successfully guide the student through the exercises, using props or modifications as needed, in order to ensure that the student is effectively changing their habitual movement pattern and using the correct muscle groups throughout.

Stay tuned for more entries about posture and learn about the three classic postural types and which pilates exercises may be most beneficial to focus on in each case.

Happy hamstrings: What is the best way to stretch?

Having good hamstring length is important for all athletic endeavors and to comfortably do regular every day activities; to bend over to tie your shoes you will need elongated hamstrings. Without lengthened hamstrings, undue stress and strain may occur in the back, hips and knees.

Commonly, people know static stretches to build passive hamstring length. An example of static hamstring stretching would include lying your back while your instructor holds your leg in the air.

This photo illustrates a static stretch for the hamstrings using a wall to support the leg rather than a person

Static stretching will encourage the muscles to relax in order to create elongation, however, because the stretch is done passively, it may create an imbalance with the opposing muscle groups, make the muscle less sensitive to neural messages sent to the it by the brain, which diminishes its’ ability to generate force, and reduce blood flow in the stretched muscle. Therefore, static stretching is not considered a wise way to stretch prior to strenuous activity; a static stretch should only be held for 6-30 seconds, and should be done only preceding a gentle activity.

A dynamic hamstring stretch, conversely, involves actively taking the muscle in and out of a stretch. Since good flexibility is specific to body position and speed, a dynamic hamstring stretch will lengthen the muscle, but also prepare it for quick, ballistic and/or explosive activity. Consider when a soccer player kicks a ball or a martial artist kicks an opponent, he or she requires long muscles that can respond quickly in a variety of positions. In addition, since dynamic stretching increases blood flow to the muscles, it is an ideal way of stretching to prepare the muscles to be able to lengthen during a variety of situations- from playing sports and to doing other daily activities as gardening or picking up heavy objects. Training your hamstrings to stretch dynamically can greatly diminish the risk of tears and other injuries.

There are numerous exercises on the pilates reformer that can be used to dynamically lengthen the hamstrings. Here are three great exercises that can help you create long, strong and responsive hamstrings.

Feet in straps:

The back is stable against the carriage using the abdominal muscles, and all the muscles of the legs are active (gluts, hamstrings and quadriceps) to maintain the extension of the knees and to create resistance against the straps. When the legs are brought towards the body, the hamstrings are elongated, but the opposing muscle groups are active and the spine and pelvis are stable. This exercise begins slowly and can progress to a faster pace (still with control), 8-10 times.

Elephant:

During elephant, the gluts and hamstrings actively work to press the carriage out, simultaneously, the spine is supported in a neutral position. Then, the carriage is pulled in by using the hip flexor muscles. Notice that the upper body remains completely stable while the movement occurs at the hip joint, as if it were a hinge. This exercise begins slowly and may progress to a quicker pace (still with control), 8-10 times.

Front Splits standing on the floor:

In this exercise, the front leg is straightening to push the carriage out and bending to pull the carriage back in. The quadriceps are working to straighten the knee creating a hamstring stretch, then the hamstrings are working to pull the carriage back in. This exercise begins slowly and can progress to a quicker pace (still with control), 5-8 times.

All of these pilates exercises should be executed under the guidance of a certified pilates instructor.

Anatomy of the Pilates Reformer

The pilates reformer is an amazing piece of equipment. The design is simple and, yet, it is extremely versatile, enabling one one to do hundreds of different exercises that strengthen and/or stretch the arms, legs and trunk.

There is a carriage in which one can sit, kneel or stand on and which glides back and forth. On the underneath side of the carriage or wheels which allow it to glide and 5 different springs which create resistance to work against.

Resistance can be created for the arms or legs in various positions by either placing the hands or feet on the footbar (the bar at the front) or by putting the hands or feet into the straps. Depending on the exercise, all parts of the body can be used to either move the carriage or to stabilize the body against resistance that is very light or very heavy.

 In this particular exercise, the student is rotating her spine against resistance when she turns to the left, using her obliques, to create the rotation.

 The focus of an exercise, muscularly, can change depending on the amount of resistance (number of springs). For example, In this next exercise (pictured below), the student is pushing the carriage in and out with her arms. If the weight is lighter, then it takes more effort to control the position of her back to maintain a plank position, if it is heavier than it becomes more challenging for her upper body.

    This remarkable piece of equipment also allows you to use the straps to work the upper body and legs while, simultaneously, working the abdominals to create length of the spine. Seen here, the arms are working but also the spine is rounding into a deep curve.

The reformer also allows you to build strength and flexiblity by controlling the carriage in a standing postion. Imagine trying to keep the carriage pressed out and bending forward (as seen below) on very light spring weight! This exercise is a great workout for the muscles on the inside of our legs and challenges flexibility of the hamstrings, coordination and balance!

What’s the difference between yoga and pilates?

Frequently, people ask me what the difference is between yoga and pilates and if they should practice one versus the other. While there are differences, there are many elements of pilates and yoga that complement each other.

Yoga which means “union,” is a highly sophisticated system of whole-body integration. It has a physical component, the asana (postures or poses) that promote toning and strengthening muscles, flexibility and range of motion, balance and relaxation. It generates motion without causing strain or imbalance in the body. It also asks for a full union of body, mind and spirit, so you can’t be distracted while doing yoga–you need to be fully present. Yoga is a spiritual practice, providing tools to help quiet the mind, become more grounded, and live in harmony and tranquility.

Pilates, on the other hand, is an exercise form developed by Joseph H. Pilates during World War I. The Pilates method emphasizes building strength and improving posture, balance, coordination and stamina. The exercises can be done on the floor (mat-based Pilates) and on specialized equipment. Designed to strengthen, stretch, and stabilize muscles without building bulk, Pilates can benefit anyone. In Pilates, emphasis is placed on ensuring that the movement is done fluidly, but, accurately: The quality of the movement is more important than the number of repetitions completed.

So, what are the similarities between the two methods?

• Both methods facilitate deep concentration and integration of the whole body. Often described as the mind-body connection, this leads one to be fully present and in the moment
• Both improve alignment and posture and create a sense of balance in the body.
• Both forms are excellent for injury prevention. Both promote healing and help facilitate recovery from injury.
• Both are interested in creating a sense of energetic flow through the body, facilitating grace, poise and coordination.
• Both forms have been “tried and tested.” They aren’t just some new fitness fad.

What are some of the main differences?

• Yoga adds a spiritual element to the mix. The Indian sage Patanjali wrote the yoga sutras thousands of years ago, describing the spiritual and philosophical path of yoga.
• Yoga takes a holistic approach to the body, while Pilates focuses on a specific area called “The Powerhouse.”
• Pilates improves flexibility by fluidly moving the limbs in their full range of motion against a stable base of support, while yoga improves flexibility by lengthening muscles during dynamic poses (asanas).
• Yoga offers tools to aid in relaxation, relieving stress, and meditation.
• Breathing is very important in both forms, but the technique is different.

Why is the combination so beneficial?

• The concentration required in a Pilates workout really helps build the focus that is required for doing the yoga asanas (poses), pranayama (breathing techniques), and meditation.
• The focus on precision and movement technique, emphasized in Pilates, assists the yoga student to work more correctly.
• The asana in yoga give the Pilates student a broader scope of practice to apply stability and good technique.
• The stronger core body developed in Pilates, gives the student confidence to go more deeply into their yoga practice, more safely.

Practicing both Pilates and Yoga, gives a student more tools for developing a whole body that is vital, aware and adaptable.

How to do quality pilates when you’re on a budget

Given the current economic climate, it is not surprising that people are having to cut back on their pilates lessons. It’s also not surprising that gyms with pilates programs are having to cut back on their programming. So, what can you do to keep in pilates shape and watch your wallet?

You could select a DVD or find a workout online that you like, but the problem with that is you don’t receive any feedback about how you are doing the exercises and with pilates, feedback is paramount!

Instead, find a reputable instructor in your area (see my recent blog about finding a good pilates intructor) and ask he or she to select a Pilates DVD that is appropriate for your fitness level. Then purchase a small package of private lessons with that instructor in order to work on the exercises highlighted int he DVD. Especially if you have an injury or other special condition, it may be really important to make sure that your pilates technique is being evaluated; in some cases, your instructor may suggest that you omit certain exercises that are taught on the DVD.

Over the last several months, some of my students have chosen this option when they didn’t have the financial means to come to the studio every week. This method has also worked well for students that travel alot. In some cases, these students have continued to supplement their training with group classes while others have simply worked at home and then come in once a month to get their routine changed and their technique reassessed.

This solution requires discipline, but it can be an excellent alternative to getting out of shape or losing interest in your workouts when money is tight. Ask your instructor to provide challenges for you to meet and things for you to work on by the next appointment.

Another idea is to look for studios in your area that offer lessons with Pilates apprentices. These are pilates teachers-in-training that have completed all their course hours but have not completed their examination. In many cases, these students will teach you privately at a highly discounted rate, and they are often observed by a seasoned professional. Check out pilates centers in your area that train students to become certified instructors and offer this as an option.

Here is a link to STOTT PILATES Licensing Centers located throughout the world:

http://www.stottpilates.com/education/centers.html

Each of these locations has an Instructor Trainer available. Licensing centers train students to become STOTT PILATES teachers, so these are some of the most elite studios in the industry, and many of them offer discounted lessons with apprentices.

If none of these locations are convenient for you, check out the Instructor Finder search for other certified STOTT PILATES instructors that are near your area at:

http://www.stottpilates.com/finder/infosearch/infocustomerconfirm.lasso

Good luck!

Next Page »