PILATES AND OSTEOPOROSIS

Transcription

1 PILATES AND OSTEOPOROSIS NATALIE GILLOT 20 th July THE PILATES CLINIC WIMBLEDON UK

2 ABSTRACT SUMMARY Osteoporosis is a prevalent condition, most commonly occurring in women, but also occurring in men to a lesser degree. As it s a condition that can both be prevented and improved by exercise, it seems to me crucial that we as teachers of exercise understand the condition and more importantly know how we can safely and effectively create programs for our clients in this population. Pilates students, at least at the moment are predominantly female, and we see perhaps a proportionally higher number in the over 50 s age category than traditional gyms. It is therefore highly likely that we will be teaching people with an Osteoporosis. I therefore wanted to research the condition so that I can confidently create and teach my clients who are presenting with the condition. 2.

3 CONTENTS 1. TITLE PAGE 2. ABSTRACT SUMMARY 3. CONTENTS PAGE 4. ANATOMICAL DIAGRAMS 5. WHAT IS OSTEOPOROSIS 6. WHAT IS OSTEOPOROSIS CONT 7. WHAT IS OSTEOPOROSIT CONT 8. CASE STUDY 9. PILATES WORKOUT PLAN UTILISING THE BASI SYTEM 10. CONCLUSION 11. BIBLIOGRAPHY 3.

4 ANATOMICAL REFERENCES Comparison of healthy bone to osteporotic bone Common fracture sites Effects of osteoporosis on the spine 4.

5 WHAT IS OSTEOPOROSIS? During my research I was genuinely shocked to learn that in the U.K. 1 in 2 Women and 1 in 5 men will suffer a fracture, typically in the hip (neck of femur) spine (lumbar or thoracic vertebra) or wrist (distal radius) due to Osteoporosis. Osteoporosis is defined as loss of bone density. The problem occurs when bone resorption outpaces bone deposition. In large part this is due to depletion of calcium from the body more calcium is lost is urine, feces and sweat than is absorbed from the diet. This can be due to a number of factors, the main reason being the decline in oestrogen after the menopause in women. Both the main hormones Oestrogen in women and Testosterone in men stimulate osteoblast activity and synthesis of bone matrix, so a drop has a direct effect on bone health. There are many other possible reasons why somebody may develop osteoporosis included long term use of some medication or having a specific health condition such as Hyperthyroidism. A sedentary lifestyle and a poor diet also are factors, as well as genetics, smoking and alcohol consumption. Medical experts advise a diet providing adequate calcium and regular weight bearing exercise. Although it is clear that this will be far more beneficial when adopted as young women that drugs later on. Prevention is definitely better than cure! 5.

6 Osteoporosis is a silent, often painless disease. The first indication that somebody may actually have the condition is when a bone is broken after what seems like a fairly innocuous incident. A subsequent bone density scan may reveal that bone density has been lost. After a first fracture a second is highly likely. A fracture of the hip is serious and always leads to hospitalization, a reduction in normal activity and can cause prolonged or permanent disability or even death. A fracture of the spinal vertebra will result in loss of height, nerve entrapment, severe back pain and deformity thoracic kyphosis. It is therefore important to focus on prevention of falls in a Pilates program for those Students who have been diagnosed with the condition, in fact balance work is an important part of any Pilates program but specifically for Osteoporosis sufferers, for whom the results of a fall could be devastating. The psychological impact of a fracture mustn t be overlooked. An active 60 year old who fractures a wrist and then discovers she has osteoporosis will suddenly feel very old. She will temporarily lose independence, be unable to drive, and do all the things she enjoys. Prevention is always the goal but we may also see clients who are post fracture who will need reassurance that they can take part in an exercise programme safely without further injuries. It is also quite possible that if we are teaching older clients that osteoporosis is already present. There maybe indications such as pain, loss of height, or 6.

7 kyphosis that we recommend that these clients talk to their doctor as we could be giving them unsuitable exercises, putting them at risk of fracture. The Pilates method is an ideal option for osteoporosis sufferers as it encompasses weight bearing resistance training, in a very safe environment under the guidance of a teacher. Movements which should be avoided, include flexion and flexion with extension. Flexion can increase pressure on the anterior portion of the vertebral bodies where they are weakest. Loaded lateral flexion should also be used with caution and any abrupt or explosive movements avoided. Extension exercises will help bone increase bone density with the added advantage of improving posture by strengthening the muscles of the posterior chain. The posterior portion of the vertebra is stronger and denser than the anterior portion, making extension a safe option. Encouraging axial elongation will help to create space between the vertebrae. 7.

8 CASE STUDY I have been teaching a lovely lady, Kate for about 5 years. She is 57 years old, very active and fit, in fact she was once a fitness teacher. Over the last 5 years she has been coming to my group mat classes regularly. She has had several regular episodes of low back pain over the years since I have known her. There have been a few acute episodes when she has been unable to attend classes due to back pain. Usually a visit to her osteopath helps. She has had M.R.I scans and X-Rays showing age related degeneration in the lumbar spine. Recently she has also been experiencing hip pain. During class the only limitation Kate has shown is experiencing discomfort during a spine curl, so I advise her to avoid the rolling up and down and rather going up and down with a straight lumbar spine. She is a very capable student and has very good body awareness and performs exercises with excellent form. About a month ago Kate had a bone density scan during a routine medical assessment under her health scheme. Osteoporosis was diagnosed, and Kate is quite upset as she has always exercised and eaten a good healthy diet. She feels her body has let her down! We have agreed that she will start to come to private studio classes. I can then integrate the use of the reformer, chair and tower to create an appropriate osteoporosis safe plan. Kate is otherwise in good health, walks her dogs for about an hour every day and has no other health issues. 8.

9 OSTEOPOROSIS SAFE PLAN UTILISING THE BASI BLOCK SYSTEM BLOCK Warm up EQUIPEME NT Cadillac as a mat SPRINGS EXERCISE NOTES Pelvic curls Leg Circles Only mobilizing lumbar spine Teach and remind principles of lateral breathing, neutral spine, hip dissociation, axial elongation and abdominal muscle activation at the warm up part of the session. Bent knee to modify Spine Twist Supine Single Leg changes Footwork Reformer 3 Red All Footwork Positions Double leg Single Leg Abdominals Reformer 1 red or 1 Hundred Prep red + 1 head down blue Co-ordination Hips Reformer or 1 red + 1 blue head down Supine Leg Series Feet down to modify Head down Add spring to increase challenge Progress to hundred if good pelvic stabilization. Head down Only if good pelvic stabilization Encourage good pelvic stabilization 2 long Cadillac yellow Spinal Reformer 2 red + 1 Bottom Lift Add extension after a number of Articulation blue sessions Stretches Reformer 1 blue Standing Lunge Encourage lifted torso Hamstring Encourage flat back stretch Full Body Reformer 1 red + 1 Knee Stretch Integration blue Flat Back Reformer 2 red + 1 Stomach Only if a flat back can be maintained blue Massage Flat Cadillac RUB 2 short yellow Arms Cadillac Arm springs 2 yellow Back Thigh Stretch Arm series omitting Butterfly Full Body Reformer 1 red Balance *Only with a very capable student

10 Integration Advanced Control Front Legs Cadillac Yellow springs Squats Chair Light /med Leg press standing Lateral Chair Light Side Kneeling Flexion / spring stretch Rotation Extension Reformer 1 blue Pulling straps 1 Foam roller Pulling straps 2 Spinal extension over a roller or rolled up towel who can perform a front support well on the mat. Wrist weight bearing very important. Encouraging lifted chest Balance work is important to reduce fall risk. Watch for any forward flexing A useful home exercise to teach clients 9.

11 CONCLUSION As Pilates Teachers we are perfectly placed to help the many people, men and women who have had a diagnose of Osteoporosis by providing a safe, supportive environment where they can feel confident that they are working positively towards improving their bone health. They will also be gaining many other benefits through regular practice, such as increased flexibility, a stronger core, better functional movement and improved balance. We can also teach our clients how to safely carry out daily activities, lifting, bending, even sneezing and coughing! Teach them to move well, using the principles that they learn in class during their daily life! It is always good practice to build a network of practitioners of other disciplines. We will then be able to refer our Students on to Osteopaths, Nutritionists, Acupuncturists and Podiatrists for specialist treatment to support our work. We can also educate our younger students on prevention of this debilitation Disease. 10.

12 BIBLIOGRAPHY Books: Isacowitz Rael. Pilates your complete guide to matwork and apparatus exercises. Human Kinetics 2006 Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, CA: Body and Arts Science International, Isacowitz, Rael. Mat Analysis Workbook. Costa Mesa, CA: Body Arts and Sciences International, Body Arts and Science International Isacowitz, Rael. Reformer Movement Analysis Workbook. Costa Mesa, CA: Body Arts and Sciences International, Sherri R Betz Osteoporosis Exercise Book: Building better bones. Osteo Physical Therapy Principles of Anatomy and Physiology - Tortora and Derrickson. John Wiley and Sons Inc Websites: / Web searches Sherri Betz April National Osteoporosis Society 11.