This sequence helps open the shoulders, stretch the pecs, and improve humeral scapular rhythm to avoid pain in the shoulder joint. Enjoy!
How to be Friends with your Client's Physical Therapist
Many of my teacher trainers have mentioned to me that sometimes they feel nervous when their clients start appointments with a physical therapist. They feel like their client might prefer the physical therapy to Pilates and eventually drop their Pilates classes. In my experience, the opposite is true. A talented physical therapist can effectively communicate the unique needs your client has so you can personalize their workouts. With subtle adjustments, based on feedback from the physical therapist, you can help your client get stronger and avoid injury. But how do you do this?
#1 Understand your Role
Unless you have additional training, Pilates instructors are not physical therapists. We work in studios, not clinics. (Even when my husband asks me a question about a nagging injury, I preface my response with “I’m not a doctor.” “I know you’re not a doctor,” he says, “I would know if we’re paying back loans to medical school!”) So yeah, I have a habit of letting my clients know the limit of my knowledge. I’ll say things like “In the past, I’ve worked with (fill in the blank injury or condition)” or “in my experience, that can indicate a (tight muscle or condition), but a doctor would know for sure.” Lying or misleading a client to make them think you have experience you don’t have is never a good idea. Googling a condition does not mean you have experience with a medial condition. I’ve found the more upfront I am with what I know, the more a client with respect and want to work with you. Your reputation is your calling card, and being honest with your certification is of the upmost importance.
#2 Use the Physical Therapist’s Secret Power to your Advantage
Physical therapist have a secret power that Pilates instructors don't have: They have training in diagnosis of injuries. If I have a client with pain in their ankle, I’m not sure it it’s coming from ankle instability or hip tightness (I’ll look at both). But a physical therapist, with the medical training they have, will be able to correctly diagnosis what is causing the pain. I can then use that information to help the client get better.
#3 Know the only question you’ll ever have to ask a Physical Therapist
Physical therapists are busy people. They see people everyday like Pilates instructors, but also have to dedicate time to charting as well. All physical therapists I’ve reached out to have taken the time to help me make sure what we’re doing at the Pilates studio also follows their protocols and recommendations, and I try to make sure they know I value their time by only asking one question: “What muscles do we stretch and what muscles do we strengthen?” It’s so simple, and will only take them a few minutes to jot down a few notes or send quick email. Sometimes I tell my clients to ask that question and have the physical therapist write the answer down. I’ve found this is often how a physical therapist will plan a client’s protocol, and if you know the answer to this question, you can easily work their recommendations into a session (even following the traditional order). For example, for knee injuries, it is commonly recommended to strengthen the lateral muscles of the hip and stretch the IT band and Hamstrings. I now know a basic Reformer Class would be:
Footwork (with the O-ring in parallel or the Power Circle on the outside of the legs to work the lateral muscles)
100 (Keep the ring)
Front and Leg Circles (add IT band and Hamstring stretches)
Stomach Massage (add band or ring)
Short box (cue lateral muscles to hold the strap, add IT and Hamstring stretches after Tree)
Long Stretch Series (no contraindications)
Kneeling Knee Stretches (cue lateral muscles)
Running in Place (band works here, Power Circle not so much)
Pelvic Lift (could narrow foot stance to add band or circle)
****Recommendations only, I am not a doctor :)
****Notice I also used my super power as a Pilates instructor: I worked the entire body, not just the injury.
That specialized lesson for my client took no time at all. I didn’t google exercises I’m not trained to teach. I didn’t pretend to have knowledge I didn’t. I simply took the Physical Therapist recommendations and translated it into my existing base of knowledge. The client will make more progress, work out safer, and make more progress. Meet my new best friend: the physical therapist! We’re part of the same village, making our client stronger!
Posture Exercises for Standing
I was a guest blogger at GetCorrectPosture! My clients often tell me that they have standing desks (because sitting is the new smoking) but standing with bad posture isn't that much better for you than sitting. Check out my tips and why I love the Power Circle so much at the link above.
And if you want more Power Circle, check out my abs and glutes video here.
P.S. credit to my son for the photo :)
Top Five Differences Between Pilates and Yoga
So what is better? Yoga or Pilates? That is a difficult question to answer, and it does depend on your workout goals. Keep in mind, too, that there are many different types of yoga and even different styles of Pilates, so these are general guidelines.
The goal of yoga is spiritual enlightenment. That does not mean that Pilates cannot be a spiritual practice, and it does not mean that yoga is not a workout. It does mean that at the heart of a yoga practice is a spiritual component, and that usually involves mediation or other techniques to quiet your mind. I consider my Pilates practice a moving meditation, but I don’t spend time meditating as a component of my practice. I do meditate, but it is separate from my Pilates work.
The goal of all Pilates exercises is the strengthening of the Powerhouse. This is true no matter what style of Pilates you practice. The Powerhouse is a centering concept, but it is also a physical place. It is the two inch band that runs above and below your navel. Every exercise in Pilates is trying to connect you to this part of your body and tone and strengthen this area. This does not mean that yoga does not work your core or that Pilates does not work and tone other parts of your body. It means that Pilates exercises are always focused on this area, no matter what else is working.
Pilates was made for the modern body. Joseph Pilates created his system of exercises between 1912-1967, and moved to New York City in approximately 1933. That means he knew what concrete was, and cars, and buses and chairs. His work cannot help but be influenced by the wear and tear and stress these modern conveniences place on our bodies. The development of yoga is over 5,000 years old. It was not made for a mainly sedentary population. Most people 5,000 years ago walked everywhere, much more than we do now and sat on the floor. They got more movement preparing their food than some of us get in an entire day. That is a different body than Joseph designed his work around. This does not mean that yoga has never been updated or that Pilates does not tap into ancient wisdom. It means that Pilates was created for people who live in the modern world because it is a modern invention itself.
Pilates was not made for a yoga mat. Hey, even yoga wasn’t made for a yoga mat (see the 5,000 year old practice mentioned above). But Mr. Pilates made his own mats, and they are way thicker than your average yoga mat. They usually were a raised platform with much more cushioning for your spine. They had extra boxes at the sides to place your legs wider than a yoga mat. They had straps for your feet to help keep your feet stationary as you rolled and poles to help stabilize your shoulder girdle for inversions or open your chest for extensions. If you’re doing Pilates, you should at least double your mat to cushion your spine. Pilates has more spinal articulation and rolling (see the focus on the Powerhouse listed above) so if you’re doing Pilates at a health club, please find a thicker mat or hack one yourself to protect your spine.
Pilates has equipment. I’m not talking props like bands or bolsters. I’m talking about the Reformer, Cadillac, Barrels, Chairs…. Mr. Pilates saw the mat as the foundation to his work, but without the support and aid of the equipment, it’s really hard to progress in your Pilates practice. Equipment and mat really are meant to go together (see also Mat vs. Equipment Pilates). The Reformer and the mat are the cornerstones to the Pilates work, and Mr. Pilates always intended for his students to do both. The stretch, support, and resistance work on the Pilates equipment with the springs really has no equal in any exercise format. It combines open and closed chain work, tempo variations, and deep stretches you cannot find if you only have a mat alone.
What are your thoughts? Do you teach yoga and Pilates? How do you think they compare?
Top Eight Tips for Working with Pilates and Osteoporosis (the Condensed Version)
So many of us are working with Goldeners (the Active Aging Population) that I thought it would be helpful to list a few of the Dos and Don’ts of working with Osteoporosis, especially as it concerns Pilates. (Disclaimer: I am not a doctor, and this list is not medical advice, nor should it be used as such), but I weeded through a few studies so that you don’t have too.
****The most important tip is first
Don’t use spinal flexion. Yes, that is a lot of the Pilates repertoire, but flexion puts pressure on the anterior surface of the vertebral bodies, and that is usually the weakened part of the bone. Flexion increased the risk of fracture in 89% of osteoporosis cases in this study.
2. Do use spinal extension. The posterior vertebral bodies have a higher degree of cortical bone and are at less risk of fracture. A study found that stronger spinal extensors led to increased bone density and less occurrence of spinal fractures.
3. Don’t side bend. Pressure on the vertebra are also excessive during side bending.
4. Do teach a hip hinge instead of flexion. It is imperative osteoporosis clients know the difference between spine and hip flexion (see #1 above).
5. Don’t twist. Again, excessive pressure on the vertebra.
6. Do teach isometric work. This is one of the best ways to get strong (and by now, you may be asking, “What can I do with a client with osteoporosis?”). Most of the isometric work can be found in the Pilates Fundamentals and are great for teaching control and strength in the core so clients don’t accidentally do little tiny twists or other contraindicated movement when moving their legs to the front or side.
7. Don’t work with a client if they can’t tell you their T-Score. Clients who have taken a Bone Mineral Density Test should be able to tell you their T-Score. A Standard Deviation of -1 to -2.5 indicates osteopenia, and -2.5 or more indicates osteoporosis. Why is this important to know? For every one point below the mean, fracture risk doubles.
8. Do teach these clients to stand and balance. They need to be weight bearing if possible. Standing weights, standing power circle, standing leg swings, and single balance work on one leg is very important. If these clients fall, they are likely to fracture, so they need to be taught how to stand tall.
Working with someone with osteoporosis can be a bit scary (and when in doubt, refer out), but it can be safely done with a knowledgeable Pilates instructor. The extension work, chest openers, standing series and the ease of adding weights to our work makes it a natural fit for the osteoporosis client. Remember, it is a silent disease, so your clients won’t have symptoms, but don’t let that stop you from following safety guidelines. Some clients like flexion because it feels good, but you need to be firm in your knowledge and confidence to tell them why that movement needs to be avoided.
Leave any additional questions in the comments below. I’ve been working with clients with osteoporosis for years and would love to help. Its a population that needs Pilates!