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 has been my saving grace in so many ways.   After having a 10.5 lb baby boy a couple of years ago, my small framed body and alignment was a wreck! I had hip and lower back pain with walking and I began to worry that it would be a lifelong problem.  After a series of visits to the chiropractor with no relief in sight, and after X-rays and MRI, the chiropractor said she could not help me.   She strongly recommended pilates because of it’s ability to alleviate my alignment issues and build core strength where I needed it.    My first visit to Ishbel for my postural analysis was a very humble one as I was not even stable enough to try the leg stirrups.    Each visit was better and better, and I added “homework” prescribed by Isbhel consisting of 3 specific pilates exercises at home -slowly, after about six months, the pain in my lower back and hip subsided.  It was a gradual improvement but one that I am forever grateful for.  Walking with pain is never something I could imagine having to just live with.   Now, about 18 mos. after my first introduction to Pilates, I am enjoying taking reformer classes, jumpboard plus, a mat class here and there, and the occasional pilates seminar.    Thank you to all of you at Pilates NW for caring so much and helping me become active and fit again.

Tonya

]]> http://www.pacificnwpilates.com/blog/how-pilates-has-changed-my-life/feed/ 0 http://www.pacificnwpilates.com/blog/happy-hamstrings-what-is-the-best-way-to-stretch/ http://www.pacificnwpilates.com/blog/happy-hamstrings-what-is-the-best-way-to-stretch/#comments Sat, 17 Jan 2009 04:00:38 +0000 Leslie Braverman http://www.pacificnwpilates.com/blog/?p=399 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.

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!

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!

Hi All-Knowing Pilates Instructors-

Hi Lulu!
How are you doing? Snowed- in? This is just WRONG in Portland.

Anyhow…as you know the new V2 Max Plus™ is awesome! The all- in- one unit is definitely great for a small space. That said, the STOTT PILATES® cadillac is a great piece of equipment too. Here are a few things to consider:

The V2 Max Plus, overall, is a little bit bigger than the Cadillac. (30 in. wide x 97 in long x 16 tall- from the floor) versus the cadillac (36 inches wide x 89 in long x 25.5 tall-from the floor).

You gain many new exercise options with the V2 Max Plus that you couldn’t, otherwise, do with just the Cadillac and STOTT PILATES Reformer. Also, I believe, many of these exercises are more functional then the Cadillac exercises that you will be missing.

You can do the majority of the Cadillac exercises on the V2 Max Plus minus the hanging exercises and the trapeze work. Keep in mind, the hanging exercises (walkover, for example) cannot be executed without high ceilings. Overall, I think you would find that you can do many more V2 Max exercises with ALL your clients then the Cadillac exercises that use the hanging bars.

So, I guess if it were me, I would purchase the V2 Max Plus and another Reformer instead of 2 Reformer and a cadillac.

Hope that helps. Let us know when you are purchasing equipment, we may be able to get you a better price. Carole can help you with the order. Also, let me know if you would mind if I posted your question to our blog- I think others might find it helpful- thanks.

Response from Lulu Blake:

Leslie,

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

Hello,
I am a Peak Pilates Certified Trainer in Bradenton, Florida. I have a client that has severe lymphedema and I would like to train her. Her arm is always swolen and she generally has 2-3 infections per year. I am not able to attend you Breast Cancer class but would be interested in purchasing the materials, perhaps. I look forward to hearing from you.

Patty McIntosh

Answer from Melanie Byford-Young:

Hi Patty!
Pilates can be an excellent approach to help her general health and lymphedema. There are several main things that you need to know and keep in mind.
1) Make sure you get clearance from your client’s physician before beginning any exercise program.

2.) wearing her compression garment is a great idea, especially at the beginning, or until you know how she is going to react to the activity.
3.) Diaphragmatic breathing can help stimulates the pumping of the lymphatic system, which will hopefully help with her swelling. Adding lymph massage throughout the session can be very useful if she or you know how to do that.
4.) You do NOT want to overwork the arm! It is suggested that you begin with breathing and some abdominal work to help stimulate the lymph system, then do some leg work; then start some arm work moving the proximal muscles/ joints first, then progressing to the more distal muscles and joints, and then to return to the proximal/ shoulder muscles to help get blood and lymph moving and clearing from the arm. Follow this up with more abdominal and breath work. You can repeat these steps throughout the workout. Minimally, start with the trunk, and then alternate between leg and arm work so as to not overtax the affected arm.
5.) In the past, women with lymphedema were told to never lift anything heavier than 10 pounds. This advice has changed recently, and experts suggest beginning with very light resistance and progressing very slowly. There is a great website www.lymphnotes.com where you can do some more reading on the topic.
6.) You always must consider whether your client has osteoporosis because of her treatments. If there is any concern that she may have decreased bone density, avoid all inverted positions, avoid thoracic flexion and avoid combined flexion and rotation. If she has osteoporosis in her hips, avoid full compression of the hip in a flexed position. If her wrists are involved, then avoid weight bearing through the wrists. Make sure that you include balance work to help prevent falls and fall related fractures. Again, make sure her physician has given her approval and that there are no special exercise modifications to take into consideration.
I cannot take the credit for putting together the STOTT PILATES® Breast Cancer workshops and DVDs, another team created them. The mat and equipment DVDs are excellent and provide a very good introductory preamble,as well as a well balanced exercise program. You can order them on line at www.stottpilates.com or call 1-800-910-0001.
I hope this helps you out. Good luck to you !

I have made an interesting discovery lately with two of my students. I thought others might have had similar experiences, and I would love to hear more about what you think!

I work with one gal that has a clockwise pelvic rotation. She has a history of left knee pain and burning along the peroneal nerve on the same side. In addition, her left femur is medially rotated. She believes that some or all of this may be attributed to a ski accident over 20 years ago.

At any rate, over the last month, we (she and I) have made an interesting discovery. It seems that most of the rotation and pain in that leg is due to the fact that she constantly grips her left TFL (tensor fascia latae) and possibly iliacus.

So, we discovered that whilst pushing out in from the bar in footwork she grips in her hip (thus medially rotating her hip and causing the clockwise rotation) instead of using her adductors or quadriceps on that leg. It is really interesting. Even when lying supine with her knees bent and a fitness circle or ball between her knees, she uses these muscles instead of her adductors! As soon as she stops doing it, her pelvis looks symmetrical.

Then, I realized that I had another student that was doing the same thing, and believe it or not, the same results occured. It is really exciting.

I would love to hear if anyone else has had a similar experience.

Leslie

Moon setting over Deer Creek Valley.

Cody and Jake explore the terrain.

Working on knee stretches in Sun Valley.

Relaxing at the end of the course.

Lisa has a beautiful studio in Hailey in the Gateway Building. It was fun working in such a beautiful space with such great students too. Everyone worked really hard, but also had a lot of fun!

Melanie

From Jeff to Pacific NW Pilates:

Jeff Ong

From Leslie Braverman

Hi Jeff:
Thanks for your questions; I’m so glad you like the blog and will be attending some of Melanie’s upcoming courses and workshops; she is really the expert in this area, but I thought I would put in my two cents. I know she will have some comments for you to consider too.

This question about asthma as related to the principles of breathing is an interesting one; I don’t think I can recall being asked about it before. At any rate, I have not read a lot about the subject. That said, there are some interesting books out about the topic that you may want to look into. Alexandra Hough has written a book called “Physiotherapy in Respiratory Care” that talks about not only asthma but many other mild and chronic respiratory conditions.
She also has a whole section about breathing techniques for asthma.

To summarize, she says that certain breathing techniques can be used to diminish stress and anxiety (some of the triggers of asthma- although there are many, many others), aid in giving a person a feeling of control, promote relaxation and improve the efficiency of breathing. She emphasizes that the individual should find a comfortable way of breathing, it should be gentle (not deep or forced), encourage breath awareness and diminish residual tension (do these things sound familiar?!) She uses these techniques with patients and encourages them to do them regularly and, particularly, if they feel an attack coming on. I would love to hear if others, with asthma, have felt any changes, positively or negatively, from practicing pilates on a regular basis.

With regard to osteoarthritis (vs. rheumatoid) and degenerative disc disease, the first is a degenerative process in which cartilage around a joint wears away and the second is progressive structural degeneration of the intervertebral disc. Generally speaking, compressive, sheering forces at their respective locations will contribute to both conditions. Therefore, localized joint stability will be really important and, since we are speaking, specifically, about neutral versus imprinted spine and which is better for an individual presenting with spinal osteoarthritis and/or DDD, I would suggest that working in the spine’s neutral position will be most beneficial to individuals with these issues. Working in the spine’s neutral zone with support from the pelvic floor, transversus abdominis and multifidis will be vital to your client’s spinal health, and it will be important that they are cued to avoid bracing, overuse of their erector spinae and/or substituting other superficial muscles for these deep local stabilizers.

I know Melanie will have a ton more information for you about this topic. Diane Lee has also done some amazing studies about neutral spine and lumbopelvic stability; she is worth checking out.

Thanks for your note. Would you mind if I post this, along with our answers, to our blog? I think others will be interested in these topics too, and I would like to hear what others have to say. Let me know.

Thanks.
–
Leslie

Answer from Melanie Byford-Young

I arrived at the back stage of the amphitheater around 5:15 pm, signed in and heard the rules (no autographs, no photos, no personal questions, no throwing myself on him during the workout, no pinching his bum and squealing….the regular stuff). I was told that if we were working well together, the session may be an hour; if he wasn’t liking the workout, the session may be over in 15 minutes!!!! I was told to make it a difficult advanced workout, and not to be too nit picky.

(Imagine STING doing side splits on the reformer with his guitar!!- OMG!)

So at around 6pm, STING’s assistant went to ask him IF he would like to do STOTT PILATES®. He arrived at the door, we shook hands (as he gazed into my eyes and told me that I was one of the most beautiful women he had ever seen and that the reputation of Pacific Northwest Pilates proceeded my visit…oops, that is the fantasy version! Back to reality). So down to business.

I started with breathing side on the spine corrector and it was a nightmare!!! I swear I though he may stand up a walk out on me!!!! I ended up demonstrating one rep and from there on things went much better, thank goodness. I did some difficult stuff on the spine corrector and skipped over any other exercises with too many complicated steps/ cues.

From there, I went to the reformer and worked his legs really hard with footwork, sleeper and the jumpboard. From there, we continued with backrowing, long stretch and a series of advanced exercises like tendon stretch. STING does not talk much during the session, so it was funny when I asked if he was feeling the ab work and he barely squeked a “yes’ out of his mouth. When he was doing the side lying feet in straps work, he felt a huge adductor pull, let out a little yelp and said he would be hitting the high notes at the concert! He he he.

So I got to work with him for an hour, and when he said it was time to finish up, I said something like ‘ bummer’ and then got to do two more exercises! I had at least 12 more exercise planned!

STING is incredibly strong and flexible! Very focused and disciplined!

The highlight was after the session, we shook hands and he said something to the effect of ” well now I have to go and cancel the concert, and you have to go tell everyone”.

After that, I went out and met Carole, my husband Kevin, Daphna and her husband and several other friends. Needless to say, I was still flying and talking a mile a minute!!!! The concert was awesome, especially with Stings sweat on my finger tips!!! I got t touch STINGS bum!!

So there is the story! I did not get to meet any of the other band members nor his wife. I did not get a back stage pass, or an invitation to the villa in Tuscany (yet). Unfortunately, I tried to get Leslie or Daphna to be able to work with him the next night in the Gorge, but his people hired someone from Seattle who he had already worked with. Next time hopefully.

This week I am going to take my midweek madness course through the ‘Sweat like STING” workout. We are talking of posting it on our newsletter so you too can teach the STING workout.

Thanks to everyone for running with my energy and making this whole experience a reality and so much fun! You have now seen me at almost my highest energy level! Watch out if he comes back!

You guys are the best!

Wednesday group class….. watch out!
Melanie