Finding a movement/fitness practice is hard for all. It is especially more difficult for those suffering from an injury or neurological disease. Traditional exercise does not always address how to create a fitness practice when the body is not well. How the mind influences the body can determine better function for most.
Traditional exercise has an emphasis on the loading of muscles, repetitions and sweat. This is important in the end result of good healthy fitness. The process for finding fitness should be different when the body is not well.
A lot of classes and fitness are too fast and/or too much exertion for the person who does not feel well. Sometimes the body will go to the muscles that are already overworked when the load/exertion is too much. For instance, abdominal and bridging exercises are important in back care. Many complain of back pain in these kinds of exercises. What is happening here?
The brain is giving the wrong feedback to the body.
Instead of initiating the movement from the abdominals in the crunch,
the brain goes to the back muscles to start the work. How do you make change?
You retrain how the mind thinks about movement. This is a practice in itself. These techniques are used by athletes, dancers and gymnasts.
Essential tools are:
Breath Imagery
Better understanding of functional anatomy
Cueing
Mental rehearsals
Relaxation techniques
We are going to look at how to train the abdominals and the legs using new tools. Breath is your road to deeper concentration, relaxation and core support. For further in depth practice see my podcast on breath. One can also used breath as imagery to assist in change. When you blow up a balloon, it swells up into a moldable shape. When you allow a balloon to let out the air out, the balloon releases back to its original shape.
Focus your breath to an area of tightness in your body.
Imagine the breath expanding that area like a balloon with the inhale.
As that area expands, feel how the muscles lengthen, widen and release.
On the exhale, imagine the muscles falling softer towards the ground.
Breath can be a great tool when the body is fatigued or in pain.
Let’s say you are in a class and you have reached a place of fatigued.
Instead of leaving class, go back as the class workout to the breath. Only join back into the class when you feel well.
ANATOMICAL IMAGERY
Understanding how the body works can really help one find new connections and a preventive measure from re-injury. We are going to look at the Bartenieff Fundamental, the thigh lift. This is a underlying concept how the thighbone moves in the hip socket. It is essential for a movements of the legs such as walking and level changes such as getting up from a chair.
When someone comes in with a back injury,
I look at how they do a thigh lift.
When the thighbone is not gliding well in the hip socket,
the pelvis will unleveled to lift the leg.
This repetitive motion can lead to more discomfort in the back, hips and legs.
Here(see above podcast) is the thighbone placed into the hip socket. Notice how it is a deep round socket for the head of the femur bone. When the leg is lifted, there is an opposition of movement of the two distal points of the femur bone; one where the knee is and the other, the femur head in the hip socket. In the thigh lift, the head of the femur will glide in the opposite direction of the knee. The higher the knee is lifted, the head of the femur will roll and glide lower in the socket towards the sitz bones.
Image the bone gliding down in the hip socket as you do the thigh lift.
Feel how the back lengthens with the bone gliding well in the hip socket.
When you understand how the body is designed, you will have better movement. As Eric Franklin says “Embodied anatomy improves function”. When the thigh lift is done correctly, the correct muscles will be invited to work. The Bartenieff Fundamental, the thigh lift is the underlying concept in all abdominal work and movements of the legs.
(See my podcast on Pilates Basics: Enhancing the core)
Mental Rehearsal
This is a technique used by musicians, dancers and athletes. You review the movement in your head like it is a film. You image the movement with complete success, expression and enjoyment. We are going to look at the Bartenieff Fundamental, the pelvic shift forward. This can be a great exercise to get the legs stronger and stabilized the spine. Sometimes when the legs are weak, the back wants to overcompensate. This can be painful for many.
Visualize yourself doing a pelvic shift forward.
Press down on your feet feeling equal pressure on the inside and outside lane of the feet.
Feel the hamstrings engaged against your thighbone
Using your leg muscles rise the pelvis forward towards your feet.
Your relaxed spine rises up in one piece.
Your back is relaxed and the legs are doing the work
Imagine your legs are like an elevator that carries the load of the spine up and down.
Slowly descend your spine down with your spine in neutral. Your spine should come down in one piece.
Practice this a few times and then try to do a real Pelvic technique.
Mental rehearsal is great to use when you are fatigued or in pain. Research has shown through biofeedback that muscles are charged even with mental rehearsal.
Relaxation techniques
Sometimes to get to the correct muscles usage, one needs to release the overcompensating muscles. Stretching can be positive for some; for others over-stretching can put a muscle in spasm. Constructive rest position is a practice of lying on your back to release unnecessary tension in your body.
Lie on your back
Have your legs bent with your feet on the floor or on a stool/chair. A belt can help keep the legs together. This can help diminish tension.
Observe how your spine feels on the floor.
What areas of the spine lay well on the floor?
How is tension in your body affects how you lie on the floor?
Use breath and image of the balloon to create new releases in your spine.
Special pilates group sessions Movements Afoot would love to set up special classes for special needs. We would love to bring pilates movement to people who would love a Pilates class designed at the pace and needs of their present health. Please give us a call if you and your organization would like to set this up.
Possible Special Pilates classes:
MS
Arthritis
Back care
Fibromylia
Chronic fatigue
Parkinson’s
Other resources Somatic/body therapies:
Alexander technique
Bartenieff Fundamentals
BodyMind centering
Feldendrais
Franklin Method
Hanna Somatics
Pilates
Restorative yoga
For further information about constructive rest:
Andre Bernard
Eric Franklin
Restorative yoga
Another great book about release techniques Paul Escosque Pain-Free
Here’s my client question: 43 year old former dancer (ballet) and gymnast Runner in her late 20’s until recently when she has been sidetracked by hip bursitis. She spoke with her Doctor and Physical Therapist before starting with me. They said that she can do any type of movement provided it doesn’t cause her pain.They would prefer we don’t do extreme hip rotation.
In my visual assessment, I caught right away that she is bow-legged with hyper-extended knees and her parallel stance is not strong as she prefers turn out. Today, was our first session and we spent a lot of time on the Tower with Roll Down, Push Thru Seated Front and Circle Saw as I wanted to see core strength, rotation ability/mobility and articulation. When I got to Footwork (Bend & Stretch) I found a pattern that surprised me. I expected her to pattern her movement like I used to since I began with bow legs and hyper extended knees. But, instead of her knees splaying out, they come in and almost knock when she corrects her feet to parallel. So, we moved to Reformer Footwork and it was the same, when she pushes the carriage away, if I apply gentle pressure to her heels to “swing” them parallel, her knees “knock” inward. I put the Franklin ball between her knees to keep them apart (when, in my case, I use the ball to keep my knees more together). We then moved to bridging where I discovered the lack of hamstring strength. I focused on the hamstring connection for a while, did some pulling straps/swan and finished with mermaid. Can you offer me any suggestions? Am I on the right path? I do feel that we need to get her hamstrings stronger but will this help with the knock knee/footwork issue? Should I use something bigger than a ball, like maybe a yoga block between her knees?
Or between her ankles? H-E-L-P!! As always, thanks for you insight! Cheri
by Lesley Powell
How a client organizes in a static position can be different when moving. Watch how she organizes her body to stand on one leg. As she stands on one leg, look at the bone rhythms of the legs.
Does the foot remain stable, supinated or pronated?
Does the shins rotate inward or outward?
Does the femur rotate inward or outward?
What happens to the pelvis and spine?
She might have been doing some compensation patterns in standing to appear not knocked knee. Your working with her on creating balance in the legs is great. Be careful about pushing parallel if she can not maintain it on her own. She has been working on this pattern for awhile.
Sometimes with knocked knees, putting a block/ball between the femurs can be a poor cue. They should not be squeezing the block hard. It might be better to use a theraband tied around their thighs. The tightness of the theraband should be enough to get them to parallel not beyond.
Strengthening the abductors/rotators is important. Since her PT’s do not want her to do extreme range, keep the movements small.
Rotators – lie on the side with knees bent. Only lift knee a inch off the other leg. Or with theraband tied around thighs tightly lying on the back. Move one knee again in tiny range of motion.
Abductors – range of motion on side should not be higher than her hip
Standing – Can she stand on one leg without letting the knee knocking in?
Working on balance of all the leg muscles is important. Since she is not allowed to do range of motion, I would also teach some release techniques for lateral rotators, abductors and adductors, and feet as well.
I had worked with Physical therapists Ruth Teitel and Nicola Weiner with their experience with clients who had Parkinsons. The workout should include mobility, stretching, strengthening the extensors, and improving one’s gait. With some clients with Parkinson, there is a bent spine.
From the website; www. Parkinson.org, the reasons for a stooped posture is unknown. Some think the rigidity of the muscles are the cause. This posture affects the movements of the hip, thigh and back muscles.
Try it: Stand up and bent at your waist with your spine in a “c” curve.
Now walk and see how it affects your walk.
Suggestions for Parkinson included the following;
Work in seated and prone positions as supine often increases rigidity and flexed posturing
Emphaze trunk, lower and upper extremity extension as well as rotation
Encourage slow and rhythmic movement once moving has been initiated for a specific sequence.
Use rhythmic and auditory cuing to help establish movement
Avoid fatigue.
Especially with kyphotic postures work on mobilizing the spine, with emphasis on extension, rotation, and side bending. Also include exercises that include back and hip extension, improving hand-scapula relationship and hip mobility.
“What about ankles? My friend has old ankle injuries and has had little luck fixing them via surgery. I know alignment and muscle use can make a huge difference. Would it help him? Where should he start? “
Yes alignment and muscle balance can make a difference. Sometimes when there is an injury, you need to look above or below the problem. For instance, knocked-knees (valgus) usually puts the weight on the inside of the ankle. The ankle, knee and hips have to organize around this disfunction.
I have a Pilates client who has a pin in her ankle from a terrible fall. Because of the pin, she no longer has much range of motion in the ankle. I still train her feet, legs and work on alignment. Her gaining strength has made a big difference in her posture. When the foundation is weak, the entire body compensates.
A lot of bunion surgery is unsuccessful. What was not addressed is the movement patterns that caused the bunions. I highly recommend training like Pilates, yoga especially the standing poses to help build strength in the legs and torso to help with standing and walking. A good teacher can work with the limitations of an injury and help a client gain the necessary support for better function. Of course, certain injuries, such as my client with the ankle pin, will never return back to normal function. By improving overall tone, alignment and flexibility, my client has made incredible changes in function.
“One of the dirty secrets of the fitness world is that for all the talk about the importance of stretching, many athletes and other fit people don’t bother with it. It’s hard to gauge the benefits, and it seems as if the time could be better spent running, lifting weights, or perfecting sports skills. This sentiment is expressed by Dr. Bob Arnot in the foreword to “The Whartons’ Stretch Book,” and he says that the Whartons changed his mind. He went to them with a stiffened hip that he thought needed surgery, but after a regimen using the active-isolated stretching technique, his flexibility in that hip had increased 40 percent.
Active-isolated stretching is very different from what your high-school gym teacher made you do. Rather than holding a stretch for a half-minute, you hold it for just two seconds. This prevents the muscle from activating an instinctual braking device to keep itself from overstretching. Traditional stretching forces that braking to occur, and the Whartons think that’s not only counterproductive, but dangerous. If you force too deep a stretch while the muscle is doing all it can to keep itself from being stretched, something’s got to give. And a torn muscle will repair itself with scar tissue, ultimately making that muscle less flexible.”
This is a series that I learned when I was doing the Franklin Method training. Eric Franklin’s Books
Rolling on the balls is like giving yourself a massage. Tight muscles are poorly functioning muscles. Tight muscles hold the bones in positions that are not always the design of how the body works. Getting bones to move in their normal range is another way to release tight muscles.
They’re back… two December workshops with two great teachers.
John Chanik & Lisa Love return to teach at Movements Afoot this December.
Lisa Love returns with a workshop about assessment. Learning how to assess is about the art of seeing. Lisa Love, Ed.M., R.M.T., has an Advanced Master of Education in Motor Learning from the Department of Movement Sciences & Education, Teachers College, Columbia University with additional graduate studies in biomechanics and clinical
kinesiology at NYU. She has taught movement reeducation for over 20 years, and maintains a private practice in Pilates in NYC. She has been researching and working with MS clients for 15 years.
John taught this wonderful workshop 2 years ago about the spine. John brings his expertise as a trainer and a personal injury to his back lifting a dancer in his dance career. The Spine workshop this 12/18 is about understanding the function of the spine and the newest research about stabilization. 2 years ago we had a variety of students from those with back problems and teachers. I still use the material in all of my sessions with my clients.
When teaching clients with hip replacements, it is important to find out what kind of hip replacement did they have. At the moment, there are 2 different type of surgeries: the incisions are in front of the hip or in the back. Because of the incisions, this leaves the hip vulnerable to displacement due to weakness and the incision. I highly recommend that you and the client talk with their Doctor about their surgery and contraindications for training. With new advances in hip replacement, things are changing.
For instance, surgery from the back, movements of deep hip flexion is contraindicated. That means not to push hamstring flexibility by trying to bring the leg close to the body. Training the posterior hip is very important. Building strength of all the muscles of the hip and legs is important. In Pilates, diminished range of leg circles are great. Full short spine is not recommended. (Some of range of motion depends on their fitness before the surgery. Dancers have a unique range of motion.)
The most important thing to remember with hip replacements is not to push extreme range in the hip. Building dynamic strength is essential. Some clients, who tried to avoid surgery, developed compensation habits around the painful hip. Part of your teaching might be teaching your clients better function of using their legs.
One of my top teachers, Doris Pasteleur Hall, had gone through many surgeries for her breast cancer. Doris is very articulate about how her body changed and the process of getting back to shape. I had a woman client with similar surgeries, to the breast and abdominals. She kept getting injured with back, hip and foot pain. I learned a lot from Doris’ experience in how to train clients with similar issues.
Scar tissue and the affects of the drugs, chemo and radiation has affects on the body’s movement. I went back to basics, retraining of the pelvic floor, multifidus and abdominals. I also worked on a gentle range of motion, but I didn’t push range. Remember, when a muscles thinks that it is going to be overstretch, it will contract to protect itself. Scar tissues brings a different quality of tone/flexibility.
Also Doris and those women, who work with a massage therapist specializing in scar tissue, made more progress in fitness and relief from discomfort.
Without being dramatic, I can honestly say that Pilates has changed my life, both literally and figuratively. Nine years ago I had a very serious accident. As a result, I incurred three injuries to my cervical spine, four injuries to my lumbar spin, carpal tunnel, cubical tunnel and fibromyalgia. I received, acupuncture, physical therapy and chiropractic care for seven years to manage the pain. I felt my condition was hopeless, until my doctor found a therapy center that offered pilates sessions twice a week.
After six months, I had gained flexibility, strength and endurance. In fact, there was such a marked improvement in my physical condition through out that year, that it was clear, Pilates was going to be a life practice for me. I gained a fuller range of motion and learned how my body had compensated for my injury. Then as my stability and strength grew, I learned how to correct my balance and work on improving my alignment. With the new knowledge of my body mechanics and the consistency of my practice, I regained movement that I thought I’d lost forever. My doctor was so impressed with my results that he began prescribing pilates to all his injured patients. He also began practicing pilates as part of his health maintainence routine.
My injury humbled me and pilates has helped me to heal. It has given me a greater sense of control and respect for my body. My practice has developed and with it came a greater understanding of the necessity of self knowledge and individual responsibility for good health practices.
After three years of practice I became certified as a teacher. Having been a teacher all my life, I love learning. Therefore, it was a natural next step to bring my passion and profession to a new level. My intention was to learn even more and I have. I have learned to care for and respect this unique body that each of us is given for this lifetime. I continue to learn and love sharing that knowledge.
My teaching Bartenieff Fundamentals™(BF) led me to Pilates. I was teaching classes and private sessions based on BF and conditioning to injured clients at Dr. Backrach’s Center for Osteopathic Medicine in 1987. Teaching Bartenieff Fundamentals™ to an injured population taught me the power of this work. My colleagues in my certificate Laban/ Bartenieff program were such great movers that I did not understand the importance of BF. Working with clients led me deeper into the concepts of BF and their potential in assisting neurological repatterning.
Because of my success with working with clients, I was invited and paid to learn how to teach Pilates at JRW Physical Therapy in 1990. The physical therapists at that time were having difficulties with traditional Pilates teachers working with an injured population.
A majority of the cases of the clientele of the physical therapy practice were suffering from repetitive stress disorder. Most were journalists who spent long hours in front of the computer. Because their arms/hands were in trauma, a lot of the Pilates exercises were contraindicated. Bearing weight on their hands especially on the footbar was painful.
Within my Pilates sessions, I would work with the clients on the fundamentals of the hand-scapula relationship. First goal was to get ease of motion of the scapula and then slowly adding resistance. The beauty of the Pilates machines is the feedback proprioceptively that they can give the client. I would keep the load light with springs until the client could work pain free.
I am going to take the thigh lift and how it can change the Pilates workout. The thigh lift is an important action of all movement: gait and dance/sports activities. It is the dancer’s passé, the initiation of the kick in sports, yoga, fitness and most importantly our walking. The ability to move our legs and move us through space is essential for everyday activities. The freedom of the thighbone in the hip socket with the strength of the leg and torso muscles take us into standing, walking and more complex movement actions. A lot of problems of back, hip and knee pain can be a cause of poor patterning how the thighbone moves in the hip socket, pelvic stability and lifted to propel us in space.
A poor thigh lift disconnects to the deep use of the abdominals and the psoas will be lost. Other muscles will have to take over for the lack of this connection. In the Pilates repertory, the thigh lift fundamental will teach the differential of the thighbone from the pelvis.
Teaching the principles of the pre and thigh lift is a wonderful link to the single leg stretch of the Pilates mat. The thigh lift is an important principle to understand for all abdominal training and the Pilates mat. One must stabilize the pelvis to connect to the correct mobility of the femur. The psoas alone will flex the hip. Without the counterbalance of the abdominals, the pelvis is pulled to an anterior tilt and/or unleveling. A short psoas will also bring the pelvis in an anterior tilt. A tucked pelvis will make the psoas lax. Stabilization is about finding quietness in the spine with length as you mobilize the legs.
Let’s now look at footwork and the relationship to the thigh lift on the reformer. In Footwork, one lies supine on the carriage with the feet pressing on the foot bar. The carriage glides in and out with flexion and extension of the legs. Footwork taught well is a wonderful link to gait. In traditional Pilates, the tucked pelvis can kick out the hip extensors when the legs are extended.
With teaching of the thigh lift fundamental with footwork, the client gets a better connection to the legs. The femoral fold is soft while the correct sequencing of the quadriceps and hamstrings come into play to move the carriage with the legs. If there is a contraction around this fold, one could be overusing other muscles such as rectus femoris, some certain fibers of the adductors and even the back muscles. When the back becomes involved, this gives the appearance of the hips hiking, anterior/posterior tilt (depends on the client) and/or rotating.
Leg springs or modified short spine takes the pre- and thigh lift to a fuller range of motion. The springs or straps give a wonderful spatial intent in counter balance to the hollowing and the spine lengthening in the opposite direction. With pelvic stability and this counter tension, the legs mobilize with a different connection in the hip sockets.
New research is coming out now of the importance of the pelvic floor, transverse abdominus and multifidus. Irmgard Bartenieff was revolutionary. In the section about the fundamentals in her book, Coping with The Environment, she was already addressing these concepts. This book was published in 1972. It is possible to have ease of motion and dynamic strength in the Pilates repertory.
BF and Pilates is about connections. BF can enrich Pilates not only in biomechanical principles but taking the repertory in new spatial demands.