Pilates For the 9-5iver with Neck & Shoulder Issues

Transcription

1 Pilates For the 9-5iver with Neck & Shoulder Issues Maeve McKnight August 2017 The Pilates Clinic Wimbledon, UK 1

2 ABSTRACT In today s society, it is evident that we are entering a new phase of body issues relating to the way we live. Shoulder and neck pain and ailments are on the rise, not from the typical excessive use through sport or specific activity, but from the way we sit throughout the day. For the average person in an office, the 9-5iver, this is being in a sedentary position at the desk in front of a computer and/or on the phone squeezed between the ear and the upper trapezius, often with the neck and shoulders curved forward and hanging out of alignment. This paper will explore the strain caused on the shoulder and neck in a male office worker due to stress, tiredness and lack of movement, how pilates can assist in changing/alleviating the level of stress on the body, along with several other lifestyle changes. 2

3 Table of Contents Abstract 2 Table of Contents 3 Introduction 4 Case Study 5 Anatomy of the Neck & Shoulder 6 Program 7 Conclusion 9 Bibliography 10 3

4 Introduction Office workers in the UK are presenting with increased physical ailments compared to the generations before now. This is due to several factors, working longer hours, often without a break, increased use in electronics to complete all tasks, leading to increased hours sitting in the same position, and as a result, more significant physical issues, especially issues related to repetitive strain on specific areas. This is is different to repetitive strain in sports injuries, as it does not always involve movement of the muscle but the constant positioning of a muscle. 4

5 Case Study David, is a 45 year old male who suffers from moderate to severe neck and shoulder pain. He currently works in an office for up to 11 hours a day, and frequently has to travel to Europe, Asia and the United States for work. He tries to exercise as often as possible, so some weeks he will do 5 days and other weeks he may only get 2 sessions of exercise. During these sessions, he will vary his exercise between running, cycling, rowing, weight training and HIIT. He has 4 young children, all under the age of 7 years, 3 of whom do not attend school yet. This is an important factor and contributor to David s excessive tiredness, stress and possibly adding to the forward rolling shoulders. He suffered a minor injury several years back, in his left shoulder (this is his dominant side as he is lefthanded). He had severely strained the Deltoid (anterior) muscle during exercise, and this was treated by a physiotherapist for almost 6 months. It has rectified itself to the point of no longer requiring treatment from the professional, although David continues to use the various stretching exercises he was given by the physiotherapist. It was also recommended that he add exercise that increases tone and incorporates stretching. This is why David sought out Pilates and has had previous experience in Pilates, but took a long break from it and is now returning. 5

6 Anatomy of the Neck and Shoulder The Neck and Shoulder are comprised of several muscle groups, all of whom play an important role in keeping the upper extremity stable. The neck is comprised of a section of the spinal column (attached to the skull), called the Cervical (vertebrae). The shoulder is a ball-and-socket-joint and has a wide rang of movement, although can be unstable due to the lack of bone of ligament support. Unlike other areas of the body, this can be a particularly vulnerable set of muscles and without the correct mechanics, it can quickly lead to injury, strain or overuse of other muscles, as they try to compensate for any weakness. This may take the form of tendinitis, muscle tear, dislocation or simply overuse of other muscle groups such as the upper trapezius, which in turn can lead to neck and shoulder tension. (BASI, 2017). 6

7 BASI Pilates Program (1-10 sessions) BASI Block Apparatus Exercise Notes Warm Up Mat Roll down Pelvic Curl Spine Twist Supine Chest Lift Chest Lift w/ Rotation Due to time passed since David last did Pilates, the basic foundation will be re-introduced, with a goal to progress to the Intermediate warm up when appropriate. Footwork Reformer or Wunda Chair (after 8wks of sessions) Footwork: Parallel Heels Parallel Toes V position Toes Open V Heels Open V Toes Calf Raises Prances Single Leg Heels Single Leg Toes Focusing on the feet and legs, while keeping the upper body in check, engaging abdominals, and ensuring that the trapezius do not take over. Abdominals Reformer Hundred Prep Hundred Co-ordination Hipwork Reformer Supine Leg Series: Frog Circles Down Circles Up Openings Building abdominal strength is the key goal. This was a difficult exercise as David found it difficult to not activate from the neck first. On these occasions, we did not use the straps and focused on the exercise with the extra tension. To focus on the stability in the pelvis and increase flexibility in the hip flexors. Hamstring tightness meant the range was small in the first few sessions, as we were focusing on keeping the tailbone on the mat. 7

8 Spinal Articulation Reformer Bottom lift Increasing the thoracic extension and opening up the back. With tight hamstrings, this exercise was broken down into steps and built up in the first 10wks. Stretches Mat (on the Ball) Reformer Ladder Barrel Pole Series Kneeling Lunge Shoulder Stretch 1 & 2 Emphasis on opening the shoulder, and allowing lateral flexion/rotation without the neck and shoulders overtaking the exercise. Kneeling lunge was introduced slowly and Shoulder Stretch 1&2 was brought in from session 7 onwards. FBI n/a n/a This was introduced after the initial 10 sessions, and in a gradual process. Reformer work will need to build awareness of activating the back extensors, and drawing the shoulder blades away from the ears. Arm Work Reformer & Cadillac (8-10 sessions) Arms Supine Series: Extension Adduction Circles Up Circles Down Triceps To ensure the body was engaged and ready for the exercise, teaching David to draw down the Scapulae and, opening the collarbone and wrapping the lats before moving the arms. This position is a good place to start for clients who struggle to let go of their shoulders and neck when doing any type of arm work. Leg Work Wunda Chair Leg Press Standing To focus on posture, balance, in addition to activation and controlling the Gluteal muscles. Lateral Flexion/Rotation Reformer Mermaid To focus on increasing abdominal oblique strength and progress in the rotation of the thoracic without allowing the neck or shoulders to take over. 8

9 Back Extension Wunda Chair Step Barrel Swan Basic Swan Prep Using either of these exercises to increase back extensor strength, abdominal control and scapulae stabilisation. Conclusion A BASI program was introduced and it was observed that David was very strong in the upper body, chest, shoulders, and biceps. His rhomboids were active but not as strong and difficult to activate in certain exercises, they also fatigued faster than the other upper body muscles. David s neck was overactive in nearly all the exercises to begin with but this significantly improved as he participated more and more in Pilates. David has been involved in the program for 14 weeks, and there has been significant change to his general posture and overall flexibility in the whole body. During these 14 weeks, David also acquired a standing desk at work to prevent further injury and to alleviate his back pain. He has worked hard to have a regular sleep pattern but on days when he was sleep deprived, there was an obvious return to the neck being overactive during regular exercises. On these days, more time was spent stretching and slowing down the warm up, with an emphasis on the breathing and this appeared to help. David has himself seen a difference since starting the program and is committed to continuing Pilates. He has reduced neck and shoulder pain and has even commented that he feels a reduction of tightness in his face (that he had not been aware of before this). 9

10 Bibliography Book Isacowitz, Rael & Clippinger, Karen. Pilates Anatomy. Champaign, Illinois: Human Kinetics, 2011 BASI, Isacowitz, Rael. Study Guide Comprehensive Course. California: Body Arts and Science International, 2017 Websites Anatomy of the Neck & Shoulders, 10