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.

Pilates is A Part of My Healing

I was originally referred to PNW Pilates by my PT of over 25 years in putting me back together after several car accidents, recurring SI dysfunction and a couple of falls!! All of the above cooperate too well in leaving me uncomfortable at best, and unable to move at worst.

27 years ago when I had just arrived in Portland my left SI did its usual slipping out and I was hosptialized at Saint vinnie’s for two weeks, and put into traction on valium and codeine for two more months at home. I worked from my home setup with an old-fashioned traction device. I was not given any PT after being released from the hospital, and told to remain in bed for as long as it took to reduce the muscle spasm. 12 months after this episode, I gave birth to my first child(and had been confined to bed for the last 3 months of my pregnancy due to the threat of an early birth–which didn’t happen) You can just imagine what poor physical shape I was in for that event!!

Several years later, the same thing happened, and this time I was given a half inch lift to wear in my right shoe–which I did for about 6 years, and sent back to my PT, whom I had met through my first child’s pediatrician, who sent me there for a crik in the neck from long middle of the night feedings, and continued Si dysfunction.) I continued to have episodes; when the orthopedist who put in the lift sent me away in the middle of one such crippling episode (now I was home with 2 little ones, and my husband was travelling!!!)I turned to a friend , a DO, who set me up for x-ray studies of leg length and cranial sacral treatments with a colleague.

Fast forward through MANY cranial treatments(several practitioners), acupuncture, 3 car accidents and 2 surgeries, and PT: About 1 1/2 years ago, my PT sent me to Melanie after several attempts on my part to undertake exercise programs on my own. After several sessions with Mel, she turned me over to dear Janet, and I have been happy ever since.

Last winter I suffered round of a frozen shoulder; the previous episode had me stopping all activity , including walking, because of the pain. Janet urged me to continue with the pilates, and modified the workouts according to whatever shape I was in at the time. She is patient, cheerful and very supportive, skillfully reading my readiness for her routine at any given moment, and adapting them on the spot to my ability on a given day. This past summer I went through another period of frequent “slips” in my pelvis, which were, I believe held in abeyance by Janet’s skill in straightening me out, literally, in a session. She encouraged me to supplement with visits to the chiropractor if I asked for her opinion.

Unfortunately, due to financial difficulties at home, I have had to postpone my next round of 10 sessions. I am having major jaw surgery in November, and have every intention of coming back asap, as I believe that working with Janet will speed my recovery from that major event. I will be back for her professional and personal touches in my “healing process”, and can absolutely attest to the success that one-on-one pilates has brought to my long-standing skeletal problems. Janet has given me some exercises to continue at home (without the reformer, which I will sorely miss) and has convinced me of the utility of one-on-one instruction for my circumstances. I am not ready to “take a class” and am suspicious of the many venues where people are teaching “pilates” just by saying so (indeed, I have the same opinion about many yoga classes), and have developed a good understanding and respect for, under Janet’s care, just how much training goes into a good instructor of pilates. She is always caring and professional.

I hope to be back in the studio very soon. I will miss my weekly dose of Janet’s enthusiasm and skill for the next little bit—

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)

The Importance and Necessity of Pilates

Pilates have been a tremendously important and essential part in my pain management.

I have had back pain for thirty-four years. This resulted from two ruptured discs at age 21 which required surgery. The pain stopped, but after about a year, it reoccurred. I have tried acupuncture, massage therapy, naturopathic herbs, and water aerobics. Nothing helped. I started falling down on a regular basis and was in almost constant pain. I went to a doctor at Kaiser Permanente and was told that I had ataxia and that I would most likely end up in a wheelchair. In 2005, I was introduced to Pilates after talking with Melanie. Before long, my balance improved immensely and keeps improving with each visit. The days of my falling have ended. Even though I occasionally have a flare-up, usually I am pain-free. Prior to being introduced to Pilates, I often had to remain stationary for extended periods of time.

Thus far, I have only taken private lessons. My goal is to get strong enough to be able to take one of Traci’s group classes.

Now I find that Pilates allow me to maintain an active lifestyle.

Jeannie Tenney

My Success Story! Teaching in Dublin, Ireland

Success as I see it is arriving safely in Dublin, making it to my bed and breakfast, remembering that people do speak English here and that I actually should understand what they are saying, getting a bus to town and back! That is success. I think I should be entered into the contest. My challenge was arriving and finding out that I am teaching one more day than I knew about (it was discussed but not confirmed to my knowledge, and now I lose my travel time with Kevin. The extra day was on my confirmation notice but I missed it….. did not start my day well).

Melanie

My Pilates Success!

Hip Perthes

Howdy Leslie and Melanie and All,

Hope the summer has been fab for yous all, mine has been busier!! Along with my clients, I have been working hard at my own rehab. It is coming slowly, but correctly!! My question regards a male client, mid 50’s, with hip perthes. I have done some research and understand the basic of the disease. He has come in several times with it “out” which gives him a leg length difference of 1/2 to 1″. He is in very good muscular shape but lots of disfunction throughout his spine and scapula. Are there any exercises or positions that would be an absolute no-no, or is this a problem that can be worked in any position as long as there is no pain?

Thanks for being available for these type of things! I had never even heard of this disease before!

Happy Still Summer,

James

Response from Melanie Byford-Young:

Legg Calves Perthes disease is when the growth plate at the head/ neck of the femur (the capitol epiphysis) slips, and thus the orientation of the femur is irregular. In order to know what the precautions are, you would have to know what the shape of the hip is, whether or not the socket is a normal depth, and any other dysplasia. Your client or his therapist should know some of this information. In the absence of all of this information, follow the range of motion your client has and do not push it. The neutral position is most likely not symmetrical, so again find the best position and always follow the ease of movement.

Melanie

Home Workout Workshops

Every year, students ask us to create some workshops that can be done at home, on vacation or during the holidays. So, we have finally done it! Here are a list of 1 hour workshop give you the tools and the techniques for a great workout at home or on the road! 

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.

The Pilates “V”: Vital Exercise Tool or Pilates Dogma?

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

Hi Leslie,
I recently had an instructor teach me as part of an interview process & i try to be open to other schools but in every exercise that was open chain i had to be in the Pilates v,so i asked why?The response was stated with attitude that inner thighs help activate the corset,& it was  said as if a scientific fact.I know partly this is true,but parrallel add & abd with a ball between the legs helps activate adductors & inner thighs,but they kept repeating on & on about Pilates v as if it was the most effective or the only way that worked.
I did not want to get into a battle or even sound as if i was correcting them,but could you let me know how you would have responded as i would be interested in your thoughts!
Best regards

Lucy Garcia

Response from Leslie Braverman:

Leslie

Lower Extremity Workshops with Melanie Byford-Young

Two weeks ago, several of us were lucky enough to take a three day STOTT PILATES® intensive workshop with Melanie Byford-Young on the Hip, Knee, Ankle, Foot and the mechanisms of gait.

For those of us who took all three days of workshops it was an intense, but exhilarating experience! A lot of information was received, but we were also given plenty of time to experiment with each other and make actual change happen! From a personal perspective, I was able to change my wobbly gait pattern (due to a rigid right midfoot issue) and start getting my center of gravity over that foot in a much better way.  I still have a lot of homework to do, but the changes to my whole alignment from ankle to spine have been truly amazing!

It has also been very interesting to me to see how many clients have come in over the last two weeks with ankle, knee or hip issues! How exciting to have some really cool exercises to try on them and to see some of the same changes happen to them as I and many others experienced  over the weekend! Not all of these changes happen in one session, but I feel very empowered having more tools to address these issues with clients.

I am looking forward to hearing how others in the workshops have been using the information they received. What kinds of success stories can you share with us? Questions? Bring em on!

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.

Ankle Plantar Flexion Challenges!

This question was sent to us from Tresa Sauer, and we though others might be interested too!

I have two (2) clients who have difficulty with ankle plantar flexion.  Geez – usually it’s the other way around and I gotta bark about their quads and knees, but with both of these cases, the insufficiency is nearly debilitating.  One woman’s plantar flexion is so poor that during tower class, I show her to the Stability Chair for Ankle Exercise so she doesn’t come crashing down during Push Through with Feet on the push-thru bar (yeah, I know she can keep her knees slightly bent, but I have 4 other people to worry about). When she does Ankle Exercise, I can see that she’s sliding her knee up and down on the edge of the chair to make the movement, but also – her calves seem TIGHT. Tight and weak. Hmm… My other client, during Lift and Lower footwork, actually levitates her pelvis off the reformer!  We scream with laughter and I suppose her gastroc and soleus are weaker than weak, but why the pelvic levitation?  Dynamically, what’s going on?!? Both of them do a lot of BIKING!

Response from Melanie:

Hi Tresa!!!
How are you doing, wonderful? And how is your son managing with his brace and exercise? I still listen to your DVD regularly and love it! I  thought I had replied to you already about the dreaded lack of plantar flexion, but as I cannot find it, here goes!

Crazy that these two clients lack PF to such an extreme. I love the levitation visual! There is hope! I suspect a couple of things: First I expect that they grip with their toes constantly; Secondly, I suspect that they have significant rigidity of the midfoot joints in association with their cycling; finally I suspect that their postures are such that the pelvis is not centered over their feet habitually, and that they are likely slightly flexed at the hips with tight/ dominant hip flexors.
Here are a couple of suggestions:
1. Have they come to class  a little early and mobilize/ roll  their feet on a half tennis ball or full tennis ball. Have them step on the ball at various points of their feet, roll their feet up and down on the ball, and rock their feet side to side  and in circles.
2. Try footwork initially with the midfoot on the bar; this will help to open up the muscles and joints of the midfoot, and may help some of the tension they have to plantar flex against. Then progress so that you help her up into plantar flexion (you do the concentric work and reduce the load she is pushing), then have the client lower the heels down eccentrically. Repeat that several times and then see how much plantar flexion she can achieve.
3. Try footwork with the jump board and toning balls. Place the toning balls under their heels and have their metatarsal heads on the board. In this way they are being supported in plantar flexion. Cue them to relax their feet and push the carriage out with their legs.
4. Try Lower and Lift with the knees bent. This may help stop the levitation, and target the deeper plantar flexors including the tibialis posterior and soleus. So this both supine and in side lying (sleeper)
5. Try side lying (sleeper on the reformer, and side lying leg springs on the V2Max/ cadillac). I hope this will help them open up the front of the hip joint, and use the hip abductors and peroneals (which are plantar flexors)
6. Try Elephant in as much plantar flexion as they can tolerate. Focus on the work coming from the abs, hip flexors and hip adductors instead of gripping with the feet.
See how these go and please report back. I will come up with another series of ideas if these do not help to restore some power and range of plantar flexion.
Say hi to everyone at the club!!!
Melanie

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

Pilates and Obesity; How can I be an effective instructor?

This question was sent as an email, but we thought others might be interested!

Hi Leslie/Melanie,

I love your Pilates Blog, and I have learned lots from it. I have attended Melanie’s workshop in Toronto; she is a great and skillful instructor trainer.
I have a few obese clients that come to take Pilates. What kind of cues or images would you give to them for engaging their Pelvic Floor muscles & Tranversus Abdominis? For clients with soft tissues around the waistline, would you be using imprint position most of the times for them to engage abdominal muscles?
I would like to hear your advice & comments.

Thanks
Jeff

Response from Melanie and Leslie

Hi Jeff:

Thanks for your great question. Melanie sent me some of her best cues, and I have added a few of my own. Here it goes:

When working with obese clients, it is important (as with all students) to give them lots of visual and sensory feedback. They can visualize drawing their abs and pelvic floor muscles in to a point in the center of their pelvic bowl or a couple of inches in front of the sacrum (S2). Advise your client that they should not feel any gripping or rigidity when they recruit their abs properly.

When first teaching them how to find and recruit the pelvic floor, try having the student sit on a stability ball. This way they may be able to feel the muscles of their pelvic floor in contact with something. In this position, they can lean slightly forward or back to feel either the anterior or poster muscles of the pelvic floor working more. This may be a good place to start them out. If the ball is too unstable, have them just sit on a chair and do the same thing.

In addition, you may be more successful sensing if they are, indeed, finding their pelvic floor and transversus abdominis by having them work in a four point (cat stretch, starting position). If you are able (and the client is comfortable), you can place your hands just on the inside of their hip bones (ASIS) to see if they are drawing those muscles inwards and flat. Because gravity is helping you to see if they are drawing up their abdominals when they are in a four point, cat stretch position, this may be a more successful way for you to help give them feedback and “see” what they are doing. They may put their elbows on a box if this is better for their wrists. Because of their own weight, often finding pelvic floor and transversus abdominis in supine is too difficult; the cat (four point) position will help you see (and feel) what their back is doing and help you determine if their muscles are working (i.e. if you see them lift toward their spine, away from the pull of gravity.)

The timing of recruitment is important. You may wish for them to completely relax (allowing their abdominals to “let go”). Then, cue them gently lift their pelvic floor (teach them how to do this sitting on the ball first, as mentioned before). You should see no change in their spine, pelvis or sacrum when they engage their pelvic floor. In addition, you should not feel their back get rigid. Also, when they engage their pelvic floor, ideally, you should see or feel (if you are able to palpate) that the lower abs gently lift in and flatten in the direction of the fibers. If they are very weak, you may, in fact, have to cue them to also think about gently using their tranversus abdominis– often it will fire properly if their pelvic floor is working. Check to make sure that they are not recruiting their obliques prior to their transversus abdomins by noticing if their back gets rigid or if you see them “cinch in” at the waist prior to flattening their lower abs.

Also, keep in mind that doing things in a closed chain position may really help. Give your student more feedback by having them do abdominal work while their arms are pulling down against resistance (i.e. midback work on the cadillac with their legs over an arc). This will do two things; help close the chain, and pre-tension their transversus abdominis to fire. Because the latissimus dorsi, obliques and tranversus abdominis all feed into the thoracolumbar fascia, this can be a great way to “trick” the abdominals into working. You can either have them pull the arm springs down as they do ab prep, for example, or just have them hold tension on the strap (hover arms above the mat with tension) while doing ab work. It is even a great way to have them pick one foot off the mat at a time with their head down, do hip release, do hip rolls etc. If the arm springs are too heavy, you can also tie the flexband around the cadillic upright bars instead.

As always, keep in mind that you will need to be very encouraging to these clients. Refer to the alignment of their bones when correcting them and try to give them a mental image of what by showing them pictures of the muscles and bones or showing them a skeleton. We find that students that are overweight often appreciate being educated about what is happening at an anatomical level. You will have to be aware certain cues may make them feel uncomfortable or seem insulting. For example, constantly telling them to just “pull their abdominals in” when they really don’t feel what you are talking about at a muscular level and, perhaps, already have a complex about their weight, will be very discouraging to them. I expect you are already keen to this, since you are working to find other ways to cue.

We hope these few ideas will be helpful! Thanks for reading our blog; we love the great questions and look forward to hearing if others have any great ideas too!

Thanks, Leslie and Mel

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