PILATES FOR SENIORS: HELPING CLIENTS WITH MYOPATHY

Transcription

1 PILATES FOR SENIORS: HELPING CLIENTS WITH MYOPATHY Dara Johnson Physiologic Studio Brooklyn, NY. February

2 Abstract: This paper aims to explore the benefits of Pilates in regards to the senior population. A special focus is given to the condition knows as myopathy. A description of common senior ailments and an analysis of myopathy is followed by a specific case study. Through this man s example and his proposed Pilates exercise routine, it is clear that Pilates represents one of the best methods of exercise for him, and this special population as a whole. 2

3 Table of Contents: Title Page...1 Abstract.. 2 Table of Contents. 3 Anatomy.4 Overview Case Study..7-8 Program.9-11 Conclusion...12 Bibliography.13 3

4 Anatomy: 4

5 Overview: Pilates was invented by a man, Joseph Pilates, with the intention of rehabilitating the ill and injured. Originally called Contrology, Pilates regarded his method as a holistic approach to health, not merely as a form of exercise. Despite the huge population of women that have now gravitated to the practice, it is vital that, while appreciating everyone who wishes to partake, to also not forget the historic roots of the practice. Pilates can benefit everyone. The ten core principles as explained by the BASI method: awareness, balance, breath, control, concentration, center, efficiency, flow, precision, and harmony, can have significance and a positive impact on a wide variety of individuals.. This is one of the most amazing truths of Pilates; that while each exercise has a specific muscle focus, objective, and technique, they can each also be modified or enhanced to a specific individual s needs. Joseph Pilates is quoted as having said, We retire too early and we die too young, our prime of life should be in the 70's and old age should not come until we are almost 100. Unfortunately, this is not the case in current society where seniors (65 and over is the distinguishing age), are often regarded as frail, incapable, and en route to deterioration. According to AgingCare.com, some of the most common conditions affecting seniors include: heart conditions, dementia, including Alzheimer's disease, depression, incontinence, arthritis, osteoporosis, diabetes, breathing problems, frequent falls, which can lead to fractures, Parkinson's disease, cancer, eye problems. In addition, many seniors suffer from various form of myopathy. According to the National Institute of Neurological Disorders and Stroke, myopathies are neuromuscular disorders in which the primary symptom is muscle weakness due to dysfunction of muscle fiber. 5

6 Myopathies can be inherited or acquired. Treatments vary according to the specific type of myopathy but can include: drug therapy, physical therapy, bracing to support weakened muscles, and surgery. Various myopathies often cause a loss of awareness in the hands, feet, and ankles. Pilates, with its barefoot style, offers many exercises to improve strength, awareness, and articulation, especially in the lower extremities As explained by Aliesa George, throughout a traditional Pilates workout, the feet are involved in every exercise. Sometimes pointed, sometimes flexed, and on many exercises moving between these two actions - to stretch, strengthen, and lengthen the calves, improve ankle mobility, and help improve balance. This includes both the intrinsic muscles located within the foot such as flexors (plantar flexors), extensors (dorsiflexors), abductors, and adductors of the toes and the extrinsic muscles, such as the gastrocnemius muscle. Interestingly, though it is regarded as a period of deterioration, the senior years are often a time when many individuals find themselves newly retired from work with more available time to focus on health and vitality. OnSite Fitness summarizes the reasons that make Pilates the ideal physical practice for seniors as it focuses on, optimal musculoskeletal performance strength, flexibility and endurance without risking injury or building bulk and with a focus on core stability, including pelvic and shoulder girdle stabilization, neutral alignment and breathing. The result: a balanced and aligned body that feels revitalized and moves with ease important goals for older clients. The mention of revitalization is huge. Seniors doing Pilates stand to gain from the sense of both physical and mental empowerment which is key for a population often forced to feel incapable. 6

7 Case Study John, was born in As he approaches his 70 th birthday, he is in relatively good health but cognizant of the fact that it is now even more vital to be aware of his physical condition.. John has been active his whole life; however, terms such as core strength, and back extension, are completely foreign. He has never set foot inside a gym, nor done any other official cardio or strength building based exercise. Running a small retail business for more than thirty years, John was constantly tending to the needs of the store; walking constantly, picking up and moving boxes and other heavy objects, and greeting customers. Since retirement, he has maintained his active lifestyle, having recently joined a walking group that takes regular hikes through the local nature preserves. In addition to being very active, John has been lucky to have never sustained any injuries. He occasionally has some general, undiagnosed low back pain which, in his description, usually just eventually goes away. John has several age related, issues including osteoporosis and myopathy. John learned of his apparent myopathy on his most recent visit to the Dr. It is not apparent as to which type of myopathy John has, but it is clear that he has a general loss of feeling in his toes and an overall feeling of muscular weakness, especially in his lower extremity. In regards to the myopathy John is experiencing, it seems that the most effective treatment for him would be an exercise method that focuses on restoring the neuromuscular connection while remaining safe and low impact. Upon assessment, John has several other issues in need of attention. He has some evident kyphosis, giving him a slightly hunched look, and lacks adequate core support.. 7

8 In addition, as walking has been his main form of exercise, he could especially benefit from strength work, especially in his legs and feet. John is also very interested in improving his flexibility. Finally, but perhaps most importantly, John is extremely enthusiastic. While he is somewhat intimidated by a foreign form of exercise, he is greatly motivated to address his physical issues. 8

9 Routine Warm Up Start by rolling feet on ball fascia release to enable more work through feet Roll down assessment of posture, flexibility Pelvic Curl abdominals and hamstrings: spinal articulation, hamstring engagement, pelvic lumbar stabilization (especially good for John s lower back tightness) Spine Twist Supine abdominals with oblique emphasis: oblique strength, spinal rotation, pelvic lumbar stabilization Chest Lift abdominals: abdominal strength, pelvic lumbar stabilization Chest Lift with Rotation abdominals with oblique emphasis: oblique strength, pelvic lumbar stabilization Single Leg Lifts abdominals: hip disassociation, pelvic lumbar stabilization Roll Up with Roll Up Bar (Cadillac) abdominals: abdominal control, trunk stabilization *technically in the abdominal block Footwork Adductor Squeeze hip adductors: adductor strength, pelvic lumbar stabilization (technically part of Legwork block, but hopefully can activate the inner thigh connection before footwork) Parallel Heels hamstrings: hip extensor strength, knee extensor strength Parallel Toes hamstrings and quadriceps: hip extensor strength, knee extensor strength, ankle plantar flexor strength V Position Toes hamstrings and quadriceps: hip extensor strength, knee extensor strength, ankle plantar flexor strength Open V Heels hamstrings and quadriceps: hip extensor strength, knee extensor strength Open V Toes hamstrings and quadriceps: hip extensor strength, knee extensor strength, ankle plantar strength Calf Raises foot plantar flexors: ankle plantar flexor strength Prehensile hamstrings, quadriceps: hip extensor strength, knee extensor strength, ankle plantar flexor strength 9

10 Prances foot plantar flexors: ankle plantar flexor strength Single Leg Heel/ Toe hamstrings, quadriceps, hip extensor strength, knee extensor strength, foot plantar flexor strength Abdominals: Short Box Series Round Back abdominals and back extensors: abdominal strength, pelvic lumbar stabilization Flat Back - abdominals and back extensors: abdominal strength, pelvic lumbar stabilization Tilt abdominals with oblique emphasis: oblique strength, pelvic lumbar stabilization Hinge - abdominals with oblique emphasis: oblique strength, pelvic lumbar stabilization Roundabout if strong enough Hip Work: On Reformer Frog hip adductors: adductor strength, pelvic lumbar stabilization, knee extensor control Down Circles hip adductors and hamstrings: hip adductor strength, hip extensor control, pelvic lumbar stabilization Up Circles - hip adductors and hamstrings: hip adductor strength, hip extensor control, pelvic lumbar stabilization Openings hip adductors: adductor strength, pelvic lumbar stabilization. Spinal Articulation: Begin after first 10 sessions or longer: start with Bottom Lift and Bottom Lift with Extensions Stretches: Standing Lunge hamstrings and hip flexors: hamstring and hip flexor stretch Glutteals glutteal stretch Full Body Integration 1: Sitting Forward abdominals: abdominal strength, hamstring stretch, spinal mobility Side Reach abdominals with oblique emphasis: abdominal strength, oblique stretch, shoulder adductor stretch 10

11 Arm Work: Supine on Reformer: Extension latissimus dorsi : shoulder extensor strength, scapular stabilization Adduction latissimus dorsi: scapular stabilization, shoulder adductor strength Down Circles latissimus dorsi: shoulder adductor strength, shoulder extensor strength, shoulder mobility Up Circles same as down circles Triceps triceps: elbow extensor strength, scapular stabilization Full Body Integration 2: Begin after first 10 sessions start with Elephant, Up Stretch 1 Additional Leg Work: Calf Raises (Wunda Chair) calves, calf strength, hip flexor stretch Lateral Flexion and Rotation: Side lift (Step barrel) abdominals with oblique emphasis: oblique strength, pelvic lumbar stabilization Back Extension: Basic Back Extension (Mat) back extensors: back extensor strength, Rest Position: lumbar stretch Finishing Exercises: Roll Down assessment 11

12 Conclusion: John represents an individual who can benefit greatly from Pilates. He, like many other seniors, is extremely capable of learning a new form of exercise and one that unifies body and mind is particularly advantageous. Pilates can not only help seniors address present conditions, such as myopathy, but can also help combat the onset of ailments that are generally thought to present with age. Pilates can safely be practiced at any age, leading to a complete sense of wellness. As Joseph Pilates said, To achieve the highest accomplishments within the scope of our capabilities in all walks of life we must constantly strive to acquire strong, healthy bodies and develop our minds to the limits of our ability. 12

13 Bibliography: George, Aliesa. Quotes from Joseph Pilates. Centerworks Blog. Centerworks, George, Aliesa. Pilates Exercise Focus: The Benefits of Exercising the Feet Pilates For The People Blog, Levy, Susan. The Most Common Issues of Aging. AgingCare.com. AgingCare, LLC National Institutes of Neurological Diseases and Stroke. Myopathy National Institute of Health, OnSite Fitness. Pilates for Seniors. Merrithew.com. Merrithew Corporation,