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.

Teaching in Bangalore, India

I arrived in Bangalore on December 1st, after finishing an Intensive Reformer training in Mumbai. I was scheduled to start teaching an Intensive Mat Plus course at the Zone Mind and Body Studio in Bangalore the next day. It was a long drive in from the airport to the hotel and the traffic was intense! This city has grown by leaps and bounds over the last decade, but the roads have yet to catch up with the increased traffic! I was staying in a very nice condo hotel that was an easy walk to the studio. My hosts, Anjali and Sharat Sareen picked me up the next day and took me to their beautiful studio. This was an oasis of calm and beauty after the noisy atmosphere of the Gold’s Gym in Mumbai. I enjoyed hanging out in the lounge or on one of the open air balconies before and after the training.

Most of the students in the IMP course had been training with Anjali and Sharat for a couple of years. It really helped to have some experienced students in the group and of course to have Anjali co-teaching with me. That was a first for me and it took me a while to get used to having someone else there to teach. Anjali made it very easy though and we had a great time together.
They were also extremely generous in taking me out to dinner several times and of course on our whirlwind shopping extravaganza! I had such a great time that day and really found some gorgeous things to take home with me! I only wish there had been more time for seeing some of the area around Bangalore. This was a whirlwind trip in more ways than one! The course went by so quickly that in no time we were at the end of the course, practicing those difficult intermediate exercises!

Fortunately, this was not on the day when we went out to eat the giant paper dosas! What a delicious food this is, but as you can see, it is not small in size!

I had such fun working with this group. I hope they continue to practice and improve their teaching skills. It is fortunate that most of them have Anjali and Sharat to observe and work with while they prepare for their exams.

Mumbai Impressions-A Pilates Instructors First Trip to India

I arrived in Mumbai around 2am on Friday November 20th after leaving Portland at 8:45am on November 18th. Once our plane had landed in Mumbai we were shuffled from one line to another to go through customs and through a special Swine Flu checkpoint. Then began a very long wait for our luggage. It seemed to trickle out one bag at a time and by the time my bag finally turned up it was close to 4am. I almost missed finding Samir who was hosting the course and had been outside waiting for me for 2 ½ hours. Fortunately, we finally made the connection and he drove me to my hotel in the Malabar Hill area of Mumbai.
After a good 7 hours of sleep I awoke and ordered the vegetarian “sumo” meal from the hotel restaurant.

It was delicious, and “sumo” enough to last me for two meals! Samir picked me up later and took me the few blocks to Gold’s Gym where the Intensive Reformer course would be held. We finished assembling the SPX reformers before heading back to the hotel. I discovered that the hotel was “dry” which is fairly common in India. Fortunately there was a “bottle shop” just down the street where I could get a beer when needed! It took me several days to get over the jet lag and I think I would have recovered sooner if I’d been able to get to sleep earlier on my arrival. As it was, I would come back from the course every day around 4pm and be utterly exhausted and would then take a short nap. This was a terrible idea as I would then wake up each morning around 3am and be unable to go to sleep again. I finally broke that cycle, but it took almost a week to feel completely adjusted.
The Gold’s Gym was just a few blocks from the hotel, so after a nice buffet breakfast I would walk down there each morning to do a little workout/warmup before the class started at 10am. Malabar Hill is a very prestigious neighborhood that was originally developed by the British.

Since it is up on a hill it tends to get more breezes and be slightly cooler than the lower parts of the city. If Malabar Hill was the coolest spot in Mumbai, I wasn’t looking forward to venturing out from there! The temperatures during my first week in Mumbai hovered between 92 – 94 degrees and the humidity was intense. I can’t imagine what the city would be like during the hot monsoon season!
I had seven students in the IR course and they were all new to pilates for the most part. A few had done some mat classes, but I was really starting from the ground level with all of them. The first day we went through the principles of STOTT PILATES and learned how to set up and use the SPX reformers. At the beginning with a group like this I always feel that it is going to be a real uphill battle to get through all the elements of the course and really get them to understand the subtleties of the pilates repertory. As we progressed though, things got better.

Everyone really worked hard to learn these new concepts and movements. I always want to have more time too, and it is hard to let go and leave them to practice on their own. I hope that they will keep in touch with me as they continue their pilates training.

A hard thing to get used to in Mumbai is the abrupt contrast between the well to do and the very poor. Even in an affluent neighborhood like Malabar Hill there are constant reminders of extreme poverty. Unlike the US, which tends to keep it’s wealthiest areas quite distanced from any sign of poverty, India mixes everything together. A billionaire’s home will have a squatters hut built on the outskirts of the estate. One side of a road will be filled with wealthy mansions and condos and the other side will be filled with shacks made of corrugated tin. What is even more bizarre is that no one seems to notice this dichotomy.

Mumbai is filled with these contradictions. It is what makes the city such a crazy, adrenaline filled circus! After a few days here, your rhythm changes and you start to feel the honking, screeching, tabla beat of the city get inside of you. Whatever you do here, don’t miss the thrill ride of taking a taxi or a autorickshaw around town!

How Has This Changed my Life?

Can Pilates help women facing hysterectomies or other abdominal/pelvic surgeries? Can people move with strength and ease after 50? I am living proof. Recently, I faced two pelvic/abdominal surgeries, only five months apart, to combat the latest effects from my history with stage 4 endometriosis. Each surgery creates new scar tissue, which can create new pain and limitations in my movement and ability to live a normal life. Needless to say, two surgeries so close together (I’ve had 4 all together including a total hysterectomy 5 years ago) was a double whammy for me to recover from and I worried if I’d ever feel well again.

I work in a physical therapy practice as a Rehab Pilates specialist, and so preparing for surgery included what I would recommend for any client – plenty of core work and moving my body safely for strength and stability in all planes of motion. I chose STOTT PILATES for my instructor training because of the emphasis in anatomy, rehabilitation, and adapting the work to fit each unique body’s needs. Setting aside time for Pilates prior to surgery was a chance to experience my body as capable, not helpless, and to feel joy in movement as the springs on the equipment helped me move and soar as I otherwise did not have the strength to do. I literally was doing Pilates in the pre-op little room on my hospital gurney as I waited for them to take me into surgery. My husband laughed, but I knew it would be my last chance to help my abdominal and pelvic muscles be strong and ready to face recovery, and also, it was a welcome distraction from the stress of the moment. Doing Pilates gave me something positive I could do for myself and my healing.

After the surgery, I was able to use what Pilates has taught me to focus the mind with my body… to isolate and relax muscles more easily, use breath to cope with pain, and literally went through the entire recovery without ANY pain meds other than a couple of regular strength Tylenol! My first day back at work, I turned to two women physical therapist co-workers, both extremely athletic young women in their 20’s, and said “ok gals, I need your help in getting me back into shape… let’s do an abs workout.” Imagine my surprise when I, a woman 51 years old, with a total of 4 surgeries to her gut, found I was kicking these younger women’s butts! I thought they were actually going easy on me as we worked out together doing a variety of abdominally challenging Pilates exercises. No, as it turns out, the muscles do have memory and the body does indeed want to return to wellness if you give it the tools. Because Pilates addresses all my muscles, not just the surface ones, my recovery was faster and my power returned quickly. My surgeons were shocked at how fast I bounced back – yet again!

Now at nearly 52, I see each day that age is not a big determiner for wellness. Neither is past surgical trauma. Breathing and moving well is! Each day I move, in all directions and with the stability and strength required to do so safely. At my age, despite having had osteoporosis diagnosed since I was 40, am just as tall and straight as ever. My ribs expand to allow easy full breaths, and my body actually craves the feeling of moving/stretching. Perhaps next time, if there is a next surgery, I won’t be so lucky. I can’t help that, but I can celebrate each day the best I can by moving and challenging my body in ways that feel healthy. It is my best chance at facing whatever life has in store for me with grace and joy.

The thought of advancing age… of possible future illness… none of that scares me anymore. Whatever life brings, I know that my Pilates practice will adapt along with my changing needs, keeping me flexible in mind and body for the whole of my life.

I often think how fortunate I am to have chosen to formally study Pilates at Pacific NW Pilates over all the many choices out there. The level of training and commitment to quality at PNWP is simply heads above the rest! They taught me how to make Pilates relevant for even the most challenging of health situations.

Thank You!
Renata Marsal

My Pilates Success!

Home Workout Workshops

Each of these workshops involves a unique piece of equipment that will either provide resistance, challenge your balance or help release tension. Check out the listings below:

1. Wobble Cushion Workout with Melanie! June 27th 12pm-1:15pm
   $35 which includes the wobble cushion or $25 for just the workshop (must bring your own wobble cushion)
2. Flexband to the Max with Traci! July 25th 2pm-3pm
   $35 which includes flexband and STOTT PILATES DVD, or $25 for the workshop and bring your own flexband.
3. Yamuna Body Rolling Balls with Jean! Aug. 15th 12pm-1pm
   $35 which includes the Yamuna calf rolling ball, or $25 for the workshop and bring your own Yamuna Calf Ball.
4. Travel Workout with Tubing Kits with Leslie! Nov. 7th 12pm-1pm
   $60 which includes the J-Fit Tubing Travel Kit, or $25 for the workshop and bring your own kit.

Call the studio for more information and to sign-up.

Pilates Poem

From one of our lovely students, Lois Brooks. Thanks, Lois!

Thank you for the cards on my birthday

They helped me have a very special day

Thanks for all the help over the years

You all deserve big rousing cheers

My first Pilates teacher was our own Miss Jean

It’s a nasty rumour that she is the queen of mean

Jean taught me the power of breath

While waiting for me to learn she could have read Macbeth

Leslie had me in group classes for a long time

Because of her, my abs are fine

Ms  Melanie is from my province of birth

When we get together there is lots of mirth

Carole helps me any time any way

About her assistance I could write an essay

Lisa is a bright morning glory

The fun in her class is a lengthy story

So this little poem is for my favorite Pilates team

You all definitely reign supreme

Costochonritis

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

Me again. In this line of work, I get to meet so many different kinds of people with so many unique challenges. Thank goodness I’m a jazz singer too (so I can think on my feet!)

Anyway, I have a new client coming who suffers from costochondritis. I do not know any specifics yet, but wondered if this is something of which you have heard or tackled. I looked it up online, and it appears there are different aspects of the condition, and even different ways you can “contract” it…viral, bacterial, over-use of the chest musculature, or even a physical force or accident.

Just let me know.

Thanks!

Salle

ps, I was reading the blog response about singing and pilates. I do not use the same breath for singing…I get better depth of sound and endurance if I let my abs forcefully expand and hold them out there while I’m singing.

But my pilates training has helped tremendously because it has allowed me to control my breathing for the activity at hand . For instance, in pilates we lift the pelvic floor for stability…in music, I drop the pelvic floor to reach my high notes. It gives me grounding so that my voice can reach high.

Response from Melanie:

Mel

Response from Jean:

I found this definition from the mayo clinic:
http://www.mayoclinic.com/health/costochondritis/DS00626
I had never heard of it either. My recommendations would be to try to get some gentle thoracic spine movement in all the different planes and work on improving posture and core stability.
Jean

A First Hand Account of a Priceless Experience

This was emailed to us by Lindsay Dilworth:

Over the past five weeks, I have been involved in the apprenticeship program for aspiring teachers at Pacific NW Pilates. Saying that I learned a lot would be an understatement. The experience of working directly with clients on a one on one and group basis was priceless, and my only regret was that the program was not every day of the week. Jean Leavenworth, one of the instructor trainers at Pacific NW Pilates, was on watch at all times to be the eyes, ears, and hands of knowledge. Her many years of experience were the major piece of the puzzle that was missing from my practice teaching at home and at the homes of my friends and family.

The program involved a one- hour “Quickstart” session in which five fresh participants came to learn the basics of STOTT PILATES. The majority of these clients had no experience in Pilates and, being able to watch them progress from learning how to breathe to moving through the side leg series with ease, was such a joy. There was a definite feeling of pride surrounding myself and the other two apprentice teachers as we assisted Jean in teaching this class. It is hard not to smile when you watch someone finally able to stabilize their spine in imprint and perform an open chain movement with their legs. That sense of control and confidence reminded me of the day that I finally felt new things in my own body; it still excites me to think about it.

The second part of the program consisted of a one- hour private session with clients of several different ability levels. This was where Cheri, Kate, and I took the reigns and guided each of our clients through a series of workouts that we put together on our own. We were given their history and the level that they had achieved so far and we were challenged to push them to new heights in their workouts. Each of the three clients brought something exciting and challenging for us to work with. One client was extremely controlled and very focused on improving her already strong core. Another client was brand new to the studio and brought the challenge of teaching the basic principles in different ways that she might be able to understand it in her own body. The third client brought a wonderful sense of fun and energy to every day we spent with her, as well as the challenge of working with someone living with Muscular Dystrophy.

I could not praise this program enough for what it has given me. I have reached a new found confidence level in my skills as a teacher. If I wasn’t in love with Pilates before, I know that I am now and that I would never be able to turn my back on it. Like many people, I struggled with depression for several years and had lost touch with my previously fine- tuned dancer body. Rediscovering Pilates at Pacific NW Pilates has changed my world and my outlook on life. The teachers that I have had the privilege of working with have all been so wonderful and given me so much.

I would recommend the Pacific NW Pilates Apprenticeship Program to every aspiring teacher. It took my awkward cueing and low self confidence completely away and helped me to break out of my shell. Although I will be moving soon to San Luis Obispo in beautiful, sunny California, I will always consider Pacific NW Pilates a home of mine and a place where I will always come back to learn more. I have also made the promise to myself to always be a student. I learn new ways to control my muscles using my mind every day and I could not do that without the time and energy I have devoted to studying the material I have learned at Pacific NW Pilates.

Thank you so much to everyone who has been a part of this first phase of my Pilates journey.

How to work with prenatal clients

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

Hello ladies!

I am beginning to teach both mat and reformer to a woman 6 weeks pregnant. With her last child she did not do any physical exercise because she was afraid of miscarrying. However, she would like to try Pilates once a week throughout this pregnancy. Can you give me some tips to use when working with her? Also, she hasn’t done Pilates for the last month and is worried that since she has been “out of practice”, starting up again will be like starting a new exercise program–which is not recommended in prenatal books. I assured her that this would not be a problem, but she would like the official word from the experts at PNWP.

Thanks so much!

Answer from Jean Leavenworth:

Hi there-
I am curious why she stopped exercising completely during her first pregnancy. Was she at risk for miscarrying? That is something to find out as it could still be an issue, and I would highly recommend that she is released by her physician to work with you during this pregnancy and that she is given permission to work with you through each trimester; the first trimester has the highest risk of miscarriage, so it is important that she has been cleared for exercise.

General contraindications during pregancy:

1.) no inverted exercises e.g. rollovers, short spine, etc

2.) no extreme stretching due to lax ligaments, especially side splits!

3.) Prone exercises may be uncomfortable due to breast tenderness and after the first trimester will need to be replaced by a quadruped position.
after 20 weeks, work in an inclined plane instead of supine (use arc barrel, spine supporter or similar device to keep upper body elevated)
be cautious about over-exertion or letting the body get over heated. Strengthening the core muscles will be very helpful to prevent excess lordosis during the pregnancy and it may help during the delivery process too.

4.) Pelvic floor exercises are great, but emphasis should also be placed on learning how to relax and release the pelvic floor too.

5.) side lying leg work is great to strengthen the abductors–use a pillow under belly as pregnancy progresses.

6.) arm work and upper body strength is important to prepare the new mom for carrying the baby around and all the other heavy baby stuff!

7.) Check for any changes in the diastus recti. If it separates during pregnancy, then extra care will need to be taken post-partum to avoid increasing separation of the rectus muscle. Flexion should be avoided or any other exercise that causes the diastus to increase. Strengthening the TA while keeping the spine neutral is optimal for healing the herniation.

Let me know if that makes sense!
Best wishes-
Jean