How Pilates Has Changed My Life

I started coming to Pacific NW Pilates in January of 2007 on the advice of my doctor. The previous summer I was diagnosed with a problem with my sacroiliac. After months of pain pills, muscle relaxers, massages and physical therapy my doctor prescribed Pilates. He said I needed to have a strong core to support my body. Years of abuse from child birth, including a C-section, and just every day life had taken its toll on my 47 year old body.

I started with a beginner jump start mat class. The pace was a little too fast for me so I tried a gentle Pilates class with Sue. The slower pace of that class is what I needed. The class also had people like me suffering from a variety of different injuries. Eventually I got strong enough to start going to Sue’s beginner mat classes and as her schedule opened up I started doing private lessons with Sue as well. The first year was a slow journey for me. I was afraid of re-injuring my back so I was overly cautious. It also took a long time and lots of private lessons for me to figure out how to correctly get in a proper “neutral” position and stop “tucking.” It took time to get stronger but eventually I did.

The summer of 2007 my family spent two months in Europe. I was not able to go for my Pilates classes.

I was on my own and spending lots of time on trains, buses and airplanes and sleeping in a different bed every week. I continued doing basic Pilates exercises I had learned to keep my core and back strong. I don’t think I would have enjoyed my trip as much as I did without Pilates. Pilates played a big role in keeping me mentally and physically healthier that summer.

Along the way there have been set backs, like the time I was in a hurry and tried pulling my dog out of the car when she wouldn’t budge. That was a month before I was heading to Europe for the summer! But with Pilates basics under my belt recovery was easier and faster. Last December I went sledding and severely sprained my ankle. Again with time and Sue working on my injured ankle, Pilates once again made a huge difference in my recovery.

Rosie Fiallo

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.

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

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

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!

Flat abs without back pain

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

Melanie:

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

Hello,

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

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

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

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