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!

Osteiitis Pubis

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

 

Response from Melanie Byford-Young:

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

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

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!

What, exactly, is “the core?”

It’s surprising to me how common the term, “the core”, has become. I hear people talk about it all the time. “I’m going to pilates to work on my core,” or “I think my core is really weak.” But, what exactly is “the core?”

Specifically, “the core” is describing the joints (articulation of two bones), ligaments and muscles that stabilize the rib cage, middle and lower spine, sacrum and pelvic region. When we exercise, “the core” refers primarily to the muscles that control or stabilize this region.

Imagine your trunk, specifically the region from your ribcage to your pubic bone, as a three-dimensional cylinder. If you wrap a large sheet of paper around your trunk, you would have the sides of the cylinder. Then imagine, if you could put a top on the cylinder just under your rib cage and a bottom on the cylinder underneath your sit bones and pubic bone (as if you were sitting on it.) This is the area that is your core.

The core muscles around this region need to co-activiate in order to create and maintain intra-abdominal pressure. That’s seems technical, but mostly what it is saying is that all the muscles in this region that are close to the bones need to work together to create the right amount of pressure to create stability in the trunk. This stability is important because without it your joints and discs are allowed to move too much. Too much movement at any particular joint will create unwanted sheering and will not allow the loads of weight bearing and movement to be transferred between the trunk, pelvis and legs effectively.

Now, imagine you are a long distance runner and every time you move your legs to take a stride, one or two parts of your spine move more than the other parts. In essence, you “give” too much at one or two joints thus creating a lot of friction and sheering at these regions. Over time, these joints will begin to break down, and you may end up with spinal degeneration (i.e. facet syndrome, spinal stenosis, degenerative disc disease).

The primary muscles of your core (that make up the imaginary cylinder) are the pelvic floor (the bottom of the cylinder), the transversus abdominis (the front and sides of the cylinder), the diaphragm (the top of the cylinder), the multifidis (the back of the cylinder) and some of the deep fibers of the psoas muscle.

Learning how to use these muscles correctly during exercise will help develop your core strength and minimize injuries to your spine and pelvis. Cool, huh?

Stay tuned for more information about core stabilization and exercises that help you strengthen it most effectively!

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