Pilates and its Effects on Modern Posture Problems
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1 Pilates and its Effects on Modern Posture Problems Brittany Elliott 23 January Costa Mesa
2 Abstract: Modern civilization places increasing demands on the body, which results in minor deviations from neutral spine and can be exacerbated into major problems over time. Problems include pain such as lower back pain or shoulder impingement to deeper problems such as eyestrain, headaches, and nerve inflammation. The benefits of proper alignment include increased positive emotions, increased circulatory processes, and reduction of inflammation and pain. Pilates is an effective tool to counteract imbalances and increase positive effects of a neutral posture in the body. An effective Pilates conditioning program is discussed in regards to a specific case study but the general information regarding choice of exercise is universal. 2
3 Table of Contents: Title Page Pg. 1 Abstract Pg. 2 Anatomical Description Pg. 3-9 Conditioning Program Pg Conclusion Pg. 13 Bibliography Pg. 14 3
4 Introduction: Living in a technologically driven society places unique and increasing demands on the human body. It is practically impossible to get away from computers, whether sitting at a desk working or walking down the street using a smartphone. We are ever increasing the stress on our joints and muscles as daily habits take us further from proper posture. Posture as described by Rael Isacowitz in Study Guide: Comprehensive Course refers to alignment of bony landmarks and joints as well as the balance and function of muscles. (Isacowitz p.41) When referring to posture, there is ideal neutral spine posture and there are minor to major deviations from neutral. To measure posture, we compare a person s posture against a plumb line. While standing, ideal posture is a position in which the head, torso, and pelvis are aligned above one another and above the feet so that ever little muscle activity is required to maintain their position. (Isacowitz & Clippinger p.21) Modern life takes us further from this ideal alignment in turn, causing the body to compensate for additional stress. Some common posture problems include: forward head, rounded shoulders, and a slouched spine. (Friend) These results stem from sitting for prolonged periods of time, looking at screens of desktop and hand held devices, cradling a phone between ear and shoulder, shifting weight to one leg when standing, and standing excessive lengths of time. 4
5 Secondary symptoms include eyestrain, difficulty breathing, poor circulation, and headache. (Friend) Sitting for excessive amounts of time can lead to shortening and tightening of hip flexor muscles which in turn pull on the pelvic complex. This leads to an anterior tilt of the pelvis, evident when standing. The tightness then leads to, decreased neural drive in the glutes and the coupling of these problems can lead to lower back pain. (NASM) Further exacerbation of these issues is associated with slouching in a chair and sticking the bottom out. Sitting at a desk for prolonged periods of time also leads to rounded shoulders. Rounded shoulders result from the tightening of anterior muscles: pectorals major and minor coupled with the stretching and weakening of posterior shoulder complex muscles. This deviated posture can lead to shoulder impingement pain. (NASM) Poking the chin out to stare at a computer screen for prolonged periods of activity leads to a condition known as forward head. Forward head, also known as hunch back or text neck typically goes hand in hand with rounded shoulders and is a result of poor muscular endurance of the cervical stabilizers to resist gravity. (NSAM) Rounding the neck forward causes tightness in the upper Trapezius and Levator scapulae muscles and weakness in the deep cervical 5
6 stabilizers. Over time this posture can lead to neck pain and even headaches. (NASM) It is these muscular imbalances that cause some muscles in the body to be in a constant state of contraction while the opposing muscles over stretch and weaken. (Friend) The body will compensate for these imbalances opening up the possibility of new and worse symptoms not yet discussed, such as fascial tightening. Fascia is important because it is tough connective tissue that supports and lubricates every muscle and organ in the human body. However, if poor posture, trauma, or inflammation is involved, the fascia will bind down and create more fascia in response to stress or demand. When fascia binds down, extra pressure is also being placed on nerves, blood vessels, bones, and organs. [ ] In addition to creating stress on the fascial system, poor posture can also lead to stress on the ligaments and joint capsules. (Friend) Myriads of physical limitations and problems stem from our imbalanced stem (spine) so to speak. Re-aligning the spine and developing supporting muscles can have a profound impact on common symptoms such as lower back pain, eye strain, headaches. It is this reason that Pilates is an effective fitness regime to bring the body back to life. 6
7 Joseph Pilates defined physical fitness as the first requisite of happiness which is maintained by a balanced body. (Pilates 15) He also profoundly states: Physical fitness can neither be acquired by wishful thinking nor by outright purchase. However, it can be gained through performing the daily exercises conceived for this purpose by the founder of Contrology (now Pilates) whose unique methods accomplish this desirable result by successfully counteracting the harmful inherent conditions associated with modern civilization. (Pilates 15) While practicing Pilates as an effective tool to counter act compensations and misalignments in the body, Pilates is also effective in promoting emotional wellbeing and a lifted spirit. A clinical study of students from Ohio State University found that sitting up straight is good for the posture but also gives confidence in ones own thoughts. Researchers found that people who were told to sit up straight were more likely to believe thoughts they wrote down while in that posture concerning whether they were qualified for a job. (Grabmeier) The inverse of this was those who were slumped over their desks were less likely to accept the written down feelings. This research was done in October of 2009 and was published in the European Journal of Social Psychology. Further research was done by the same team in 2003 leading to similar results with head nodding up and down vs. side to side. (Grabmeier) Another study published in Health Psychology set out to determine if slumped and upright posture affect stress responses and the results concluded upright participants reported higher self esteem, more arousal, better mood, lower fear compared to slumped participants. (Nair et al.) Further analysis revealed slumped participants were more negative in emotion words, pronouns, affective process words, sadness words, and fewer positive emotion words and total words in a speech. Upright participants had higher pulse pressure during and after 7
8 the stressor. (Nair et al.) Improving posture has positive impacts in all facets of daily life. Emotional responses, physical pain, eyestrain and headaches, blood flow, to name a few, can all be improved with a more upright and neutral posture. A conditioning program to promote positive postural alignments will be discussed further. Body: In this case study, we will follow the growth and transformation I have found through Pilates and my own physical rehabilitation. I am female, late twenties, and am petite with long legs, and am left-handed. Initial assessment of my body reveals scoliosis of the spine with slight curvature to the right and a slight twist to the right in the spine. In an initial roll down, the left hip is visibly higher than the right and there are muscular imbalances visible both on the coronal and sagittal planes. The muscles on the right side of my trunk are stronger and more developed to compensate and the shoulder girdle on my left is more stable but visibly misaligned. The right shoulder is far less stable and muscularly underdeveloped. The muscles of my left leg are also more developed than the right due to compensation carrying book bags/ laptop bags from my early youth in school though my adult career. Being left handed growing up presented challenges at school with desks. As a result, I constantly rotated my trunk in my seat while keeping the pelvis situated forward, allowing my left arm to rest while writing. There is also compression of the spine from carrying an average of 15lbs in textbooks starting in late elementary school and continuing through college. I was also more invested in scholarly pursuits and did not participate in physical extracurricular activities regularly. I have a slouched neck, internally rotated shoulders, and weak pelvic-lumbar stabilization. The goal of Pilates 8
9 program I have chosen for myself is to: increase stability of the trunk, evening out lateral imbalances; increase pelvic-lumbar stabilization, allowing the spine to strengthen and lengthen; and to stretch the shoulder girdle, releasing built up scar tissue and balancing sides while increasing strength. I am also too flexible so this routine will focus on isometric contractions to stabilize, and isotonic contractions to build strength. Conditioning Program: a 50 minute session with use of mixed apparatus. 1. Warm Up: I chose to stay with mat work primarily to improve fundamental work before switching to an apparatus for assistance. A. Assessment roll down B. Shoulder Stretch 1 & 2 on the Ladder Barrel to open the chest and shoulders before strengthening C. Fundamental BASI warm up: pelvic curl, spine twist supine, chest lift, chest lift w/ rotation, leg lifts/changes, Hundred Prep, and Roll Up. 2. Foot Work: Keeping with the fundamentals, we will transition to the reformer for foot work. The supine position on the carriage is necessary to decompress the spine and find imbalances while heavy spring tension will warm up the legs creating endurance in the lower limbs. Prehensile will help release fascial tissue before switching into single leg where muscular imbalances will become more apparent. A. Parallel Heels B. Parallel Toes C. V-Position Toes D. Open V Heels E. Open V Toes F. Calf Raises G. Prances H. Prehensile I. Single Leg Heel J. Single Leg Toes 9
10 3. Abdominal Work: The warm up focused on abdominal work and the Abdominal block will further activate deep abdominal recruitment. I will be keeping the body in a supine position to release tension along the back and neck but adding a squishy exercise ball below the sacrum to decrease stability on the reformer, requiring increased personal stability. Spring tension is light: 1 red 1 yellow. A. Chest Expansion- to find stability with movement on the ball. B. Hundred Prep C. Hundred D. Coordination E. Lower/lift legs as one unit to increase dynamic abdominal recruitment 4. Hip Work: Removing the exercise ball and adding more spring resistance so that the reformer is on 2 reds. The tension will allow strength building but assisted control with feet in straps. A. Frog B. Circles Down C. Circles Up D. Openings E. A few Frog Extended/ Frog Extended Reverse for coordination 5. Spinal Articulation: Keeping the 2 red springs will allow enough support that stability and strength are both a focus while finding imbalances in the position of the spine. A. Semi Circle- great for spinal articulation and lateral imbalances while requiring the shoulder girdle to stabilize. B. Short Spine Bring the spring tension down to 1Red 1 Blue. 6. Stretches: We worked on stretching the shoulders in warm up so this stretch block will focus on the lower limbs lengthening which will be a relief after heavy footwork and moderate hip work. The spring tension will be a 1 Red 1 Yellow, providing enough stability for me lengthen and stretch the adductors. 10
11 A. Side Split B. Standing Lunge 7. Full Body Integration: We will work in the up stretch group for full body integration to strengthen hip flexors, as well as requiring stability from the trunk and shoulders, helping to open the chest. To start, the spring resistance will be light but over time, slightly more resistance should be added. A. Up Stretch 1 B. Elephant C. Long Stretch 8. Arm Work: The body will stay supine for the first few times with arm work until stability allows for progression. The spring tension will increase to 2 Reds to build upper body strength. Hands will be in short straps but if the tension causes imbalance and compensation, switch to the long straps or drop down to 1 Red 1 Blue, even 1 Red 1 Yellow. A. Chest Expansion B. Adduction C. Circles Up D. Circles Down E. Triceps 9. Leg Work: With the Trunk and legs warmed up and stabilizing more efficiently, we will add a long box and use 1 Red 1 Yellow for springs. Getting into a quadruped position facing the back of the reformer on the long box, one strap on the foot-same side. The Quadruped position allows for necessary abdominal recruitment in an inverse stabilizing position to supine. A. Hip Extension Bent Knee B. Hip Abduction Bent Knee C. Hip Extension Straight Leg 11
12 10. Spinal Extension: Although not in sequential order, spinal extension is done here to keep the flow of the session as well as strengthen the stabilizers in the back before getting into lateral flexion/ rotation. Springs tension will be light: 1 Red and we will stay on the long box facing the back of the reformer. Lying prone on the box allows the body enough support to properly activate muscles necessary for the exercise. A. Pulling Straps 1 B. Pulling Straps Lateral Flexion/Rotation: Finishing with the lateral flexion and rotation on the ladder barrel. The support of the ladder barrel allows for deep stretches and strengthening of the obliques while adding stability to the pelvis. A. Side Over Prep B. Side Overs (1-3 each) Always finishing with a roll down to allow the client to feel improved ROM versus the beginning of the session. 12
13 Conclusion: Pilates is an effective tool to increase the positive postural alignment of the body. Although there is not enough research done to legitimately link Pilates and improved posture, the research of improved posture is universal. Improved posture decreases pain, increases circulatory systems, and increases overall mood. Pilates has been an invaluable tool on my journey to self-discovery, increasing my physical stature, increasing my selfconfidence, and increasing my willingness to face the world head on. Modern civilization exacerbates physical deviances from neutral anatomical positioning as well as increasing our disconnection between mind and body, making Pilates ever more important to counteract these issues. Pilates provides assistance and removes loads off the spine until the body starts to correct itself. I was once told that Pilates never gets any easier, you just become stronger and there is no doubt in my mind that the work of Joseph Pilates truly will bring you back to life. 13
14 Bibliography Friend, Erin M. P.T., DPT, CEAS. Top Three Postural Problems and How to Fix Them. Spine Research Foundation. spinerf.org/poor-posture-and-its-effects-on-the-body/. Accessed 23 January Grabmeier, Jeff. Study: Body Posture Affects Confidence in Your Own Thoughts. Ohio State University Research News. researchnews.osu.edu/archive/posture.htm. Accessed Jan Isacowitz, Rael and Karen Clippinger. Pilates Anatomy. Human Kinetics Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts and Science International, Lucett, Scott. MS, NASM-CPT, PES, CES. National Academy of Sports Medicine. blog.nasm.org/uncategorized/top-three-postural-problems-caused-by-sitting-andhow-to-fix-them/. Accessed 23 January Nair, S. et al. Do slumped and upright postures affect stress response? A randomized trial. PubMED.gov: US National Library of Medicine and National Institutes of Health. ncbi.nlm.nih.gov/pubmed/ Accessed 22 January Pilates, Joseph and William John Miller. Return to Life: Through Contrology. Pilates Method Alliance,
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