Adolescent Idiopathic Scoliosis, A Case Study

Size: px
Start display at page:

Download "Adolescent Idiopathic Scoliosis, A Case Study"

Transcription

1 Adolescent Idiopathic Scoliosis, A Case Study Rhonda Wilkinson Sept 2013 Course Year July Rituel Studio, Paris, France

2 Scoliosis refers to a lateral curvature of the spine and a corresponding rotation of the spine, which involves muscle imbalances associated not only with those muscles responsible for movement of the spine itself, due to the shortening and tightening of muscles on the concave side, and lengthening and stretching of the muscles on the convex side, but also muscles associated with the ribcage and the scapulae, the rectus abdominus, the chest, the hip flexors and extensors and the hip abductors and adductors. There may also be leg length discrepancy and a rotated and/or tilted pelvis. The rotational element of the spine can have a negative effect on the normal kyphotic and lordotic curves. In Adolescent Idiopathic Scoliosis (AIS) the individual is still growing, and the curve may also be increasing. Thus the aim of the exercise program is to improve and restore muscle balance, mobility and function, and develop habits which will help her feel in control of her body.

3 Table of Contents: o Title page Page 1 o Abstract Page; description and purpose of study Page 2 o Table of Contents Page 3 o Anatomical description of a spine with scoliosis Page 4-5 o Introduction to Adolescent Idiopathic Scoliosis (AIS) Page 6 o Case study: Hayley Dawson Page 6-7 o Medical Diagnosis Page 6 o List of visible asymmetrical symptoms of AIS Page 7 o X- ray of Hayley s back Page 8 o Assessment Page 9 o Considerations when planning a program for Hayley Page 10 o Program Page 11, 12 o Conclusion Page 13 o Bibliography Page 14

4 Anatomical Description of a Spine with Scoliosis The spine, when observed from the posterior view, should be a straight vertical line, from the 5 cervical vertebrae, through the 12 thoracic vertebrae, through the 5 lumbar vertebrae, and finally the sacrum and coccyx. When lateral curves appear in the thoracic and /or lumbar region, the spine is considered to have the condition known as scoliosis. The lateral curvature(s) of the spine result from deformities in the bones, muscles, and ligaments. The bones of the spine actually twist on each other, forming a C curve, and there may be a continuing curvature in the thoracic and lumbar region, or an S shape. The curvatures can be relatively more or less pronounced in the thoracic or lumbar regions. The curvatures are created by deformities within and between the vertebrae, and are associated with a rotation of one or two vertebrae at the point of curvature. The vertebral bodies rotate towards the convex side of the curve, and the spinous processes rotate away from the convex side of the curve. Subsequently, the orientation and mechanics of the associated muscles and connective tissue are affected. The orientation of the ribs and sternum will also be affected. On the convex side the ribs and intercostal muscles between them move sideways, spread apart and rotate backwards with the spine. On the concave side the intercostals muscles are under- developed and the ribs are compressed. Because of the rotation of the spine, these ribs are pushed forward. The sternum can be pulled towards the convexity. In severe cases there can be negative effects on ribcage mobility, meaning that breathing efficiency can be compromised. The orientation of the scapulae might be affected due to the ribcage deformity. It may be

5 abducted, rotated upward, winging or tilting. The deformities can also affect the length and tone of the trunk muscles, with those on the concave side tending to be contracted and shortened, and those on the convex side to be stretched and lacking tone. The shoulders can be at different heights with one shoulder blade more prominent than the other, and one hip may be higher than the other, resulting in an uneven waist. The head is sometimes not centered directly above the pelvis and if the curvature is extreme the entire body can be leaning to one side. (Paterson, J Teaching Pilates for Postural Faults, Illness & Injury. Oxford: Elsevier. Pgs 22) The diagram of the child on the right illustrates a severe case and the accompanying effects that scoliosis can have on the body, with the uneven rib cage, and asymmetrical scapulae and pelvis. The diagram on the right shows a healthy spine from the anterior, lateral, and posterior views, with the different sections of the vertebrae labeled.

6 Introduction to Adolescent Idiopathic Scoliosis (AIS) Although there are actually four different kinds of Scoliosis, this paper will focus on the symptoms and problems associated with Adolescent Idiopathic Scoliosis (AIS). AIS affects healthy children between the ages of 10 and 18, affects girls more than boys (they are 10 times more likely to require treatment), and is the most common form of spinal deformity, affecting 3% of the population. It tends to be genetic, appearing in certain families indicating that it may be hereditary. Curves have been determined to progress more rapidly during growth spurts, indicating a relation between AIS and hormones. Case Study: Hayley was born in August of 2000, her scoliosis was diagnosed in spring of 2013, just after the onset of her menses; she started her period while she was twelve and a half years old. Her initial diagnosis was by her pediatrician. As is commonly the practice, Hayley was given the Adams forward bend test, where the adolescent takes a praying position with their hands, extends their arms, and slowly bends forward as if to touch their toes, until the torso is roughly parallel to the floor. The doctor then looked for abnormal elevation of back muscles, rotation of the rib cage, and/or visible lateral curvature of the spine. Hayley s pediatrician used a Bunnell scoliometer, a plastic apparatus that is placed at various points of the back to detect discrepancies between elevations. As there were significant findings an x- ray was performed, a front- back and a side view, as is most common, and then a Cobb measurement ensued. The doctor will have used a protractor to determine the degree of the angle of curvature. The side view will show how much the spine is rotated. Her lateral curve is considered to be 14. The

7 difference in hip height seen on the x- ray suggests that one leg is longer than the other, although this has yet to be determined by a bone measurement. It is independent of, and not related to her scoliosis. Hayley recently saw a chiropractor who, when studying the x- ray of her lumbar vertebrae, was more inclined to see the tilted pelvis as a result of asymmetrical discs between the lower lumbar vertebrae; the left side of the bodies being tilted towards each other, with less space between them. At this time the reason for her hip tilt is not known List of visible asymmetrical symptoms of AIS, which can be observed by a Pilates teacher to assess an individual: One shoulder or hip may be higher than the other One shoulder blade may be higher and stick out farther than the other These deformities are more noticeable when bending over A "rib hump" may occur, which is a hump on your back that sticks up when you bend forward. This occurs because the ribs on one side angle more than on the other side One arm hangs longer than the other because of a tilt in the upper body The waist may appear asymmetrical (

8 Frontal x- ray of Hayley s right- thoracic 14 C- curve, and concurrent but unrelated right- upwardly tilted pelvis.

9 Assessment While assessing Hayley from the posterior view, one can see that her right knee crease is slightly higher than the left and tilts slightly upward laterally. Her right hip appears higher than the left, and her right buttock crease is slightly higher than the left. Her right shoulder blade is slightly more prominent than the left. When she bends forward into the Adams bend test position her slight right rib hump is apparent. She has attended Classical Ballet Russe classes for 5 years, going 2x per week in the first years and 4x per week this past year. Thus, she is used to moving her back into spine extension, maintaining her arms in a lifted position while depressing her scapulae, stretching her trunk laterally, stretching her hamstrings and quadriceps, externally rotating her hips and using her hip adductors. Nonetheless, she is not a naturally flexible person, especially in her hamstrings and quads, and has to work hard to achieve the positions and movements performed in ballet. She sometimes complains of lower back pain when standing for long periods of time or walking slowly, as during shopping, and needs to sit down and stretch her lower back. Because I could view the x- ray taken in February of this year, 2013 (see page 8), I could clearly see the lateral thoracic curve, with convexity to the right, as is most typical of a simple C- curve. The upward right lateral tilt of her pelvis is also very pronounced, but is atypical in that the left hip is usually the lifted one when there is a right convex thoracic curve; her hip tilt is not considered to be related to the scoliosis.

10 Considerations when planning a program for Hayley: In planning her conditioning program I took into account the muscle imbalances probably existing due to her C curve, plus her own desire to improve the flexibility in her hamstrings and quadriceps, and to improve the strength of her ankles and plantar flexors and the flexibility of her feet for ballet. In some schools of thought it is contra- indicated during lateral flexor training to perform concentric training on the concave side, as it is thought that the muscles are already shortened. However, the fact that they are short and tight doesn t have to mean that they are strong. Therefore I included some lateral flexor training. Most challenging however, was her uneven hip alignment due to her tilted pelvis and the imbalances it creates; the abductors can be long and weak on the side that is hiked up, and the adductors can be tight and/or overactive, since the upward tilted side is to some extent perpetually adducted. Conversely, the lower side will have tighter, more used abductors, and weaker adductors. She also had discomfort in certain positions; she had too much pain in her hip to perform any side- lying lateral work. I looked for exercises that would address her issues without adding to the imbalances, as her issues are different and opposing on the two sides of her body. I searched for exercises that would provide elongation of the trunk. I considered scoliotic wedging under her convex side, but I don t think her degree of scoliosis warrants it. There is not a significant difference in her back rib contact with the floor on either side while in the supine position, although her right shoulder is elevated in comparison to her left while supine, and her head is not truly centered in this position. Realistically, I also had to take into account her age, which was still twelve when we started, and how that would play a role in her overall concentration and to some extent cooperation. Thus she does not perform the entire work- out at every session, but we try to at least cover the blocks.

11 Program: Pelvic Curl, + Pelvic Curl with roll- up bar (adding arms overhead for elongation of the spine) Supine Twist Chest lift (sometimes with Magic Circle) Chest lift w/rotation Leg Changes (sometimes supine on the foam roller, arms at sides) Footwork on the Cadillac Parallel Heels, Parallel Toes, V- Shape Toes, The footwork was chosen on the Cadillac because of the hamstring stretch it provides, and because it availed the most comfortable position for her tilted pelvis; the Reformer and Wunda being more difficult to work in a balanced way due to the orientation of the pelvis. In the future we may practice footwork on the Wunda, as she enjoys the challenge the Wunda presents to her trunk stability, and because it resembles the positions in ballet. Abs on the Cadillac- - Mini Roll- Up, Mini Roll- Up with Rotation, Roll- Up Top- Loaded: These were chosen because of the beautiful stretch they provide while working the abs, again since working in elongation is especially important for a scoliotic back. Abs on Spine Corrector- - - Chest Lift, The Reach, Overhead Stretch: these were also chosen due to the back stretch element they all provide. They allow her to decompress her back but also to open up the ribs to some extent on the concave side. Hipwork on the Cadillac- - - Single Leg: Frog, Hip Extension, Circles Down, Up, Bicycle + Reverse chosen to work the hips/legs independently because of the uneven pelvis. Spinal Articulation on the Spine Corrector- - - Rollover Bottom Lift on the Reformer, with the goal of progressing to the Short Spine. Kneeling Lunge (with a view to progressing to the Full Lunge): To stretch her hamstrings we included Kneeling Lunge, in spite of the more difficult position it was more comfortable than the Standing for her hips. Up Stretch One chosen because it allows for thoracic, shoulder and hamstring stretch, with added shoulder stabilization and pelvic disassociation.

12 Shoulder Push + Shoulder Push Single Arm- - - chosen mainly for the scapula stabilization, and with single arm to promote the awareness of working through the scapular imbalances. Arms Supine- - - Extension, Adduction, Circles Down, Up, Triceps. We continued to the Supine Arm set on the Reformer, to maintain scapular stabilization whilst working on shoulder and lat strength. (The Arms Sitting Series provides key exercises for her issues, notably Rhomboids and Hug- A- Tree which we will progress to.) (Sitting Side Prep)- - - Although it was very challenging, I sometimes included Sitting Side Prep, with manual assistance, trying to education movement in the scapula without lateral movement in the trunk When time allowed we added Side Split and Legwork on the spine Corrector (Side Split)- - - added mostly because of the stretch for ballet, and adductor strength. (Legwork on the Spine Corrector)- - - Scissors, Openings, Helicopter, Bicycle, Reverse Bicycle: these were also chosen because of the pelvic stability work and leg stretch and because her uneven hips posed less of a problem in this position. We also experimented with adding ankle weights. Side Kneeling Stretch- - - This proved to be the most comfortable way to work the lateral flexors as she did not have to rest on her hip. Swan Basic + Back Extension Single Arm, although in single arm we modified by just lifting one arm while the other arm held the pedal down, without lifting the torso at first. This was already difficult for her. Swimming- - - Chosen for the trunk rotational stability called upon with the asymmetrical movement, also for use of shoulder extensors and scapular depressors assistors. Rest Position Shoulder Stretch Lying Side: The Shoulder Stretch Lying Side provides both shoulder stretch, and thoracic stretch; both especially important on her left side. She enjoyed adding this stretch at the end.

13 Conclusion: There are differing opinions as to the relative benefits of exercise for AIS, but one has to take into account that not all authors are really familiar with Pilates exercise. Thus when determining the relative benefits of exercise one should consider the type of exercise, and the intensity, prescription and frequency of that exercise, as well as the degree of the scoliotic curves, and to what extent the adolescent is still growing. The goals of the exercise program need also to be addressed. A cure for AIS cannot be expected, but important improvements in muscle balance can certainly be hoped for, and possibly relief of pain where pain is present, which it is not the case in all scoliotic persons. New and not so new research indicates that corrective exercise can have an effect both on the reduction of curve progression and the correction and re- alignment of curves. We now know that there is asymmetry in muscle function for everyone with scoliosis. More specifically, there is an uneven strength in trunk rotation. The former exercise programs of stretching and general strengthening may have been the wrong approach. Studies using exercise equipment that can measure muscle function show that progressive resistive exercises (PREs) are effective for curves. ( A holistic approach is important as was the case with Hayley; it was not only her scoliosis but her upward- tilted pelvis, in her case unrelated to the scoliosis that had to be considered. Pilates offers an excellent mode of exercise to address the complex imbalances and asymmetries inherent in her scoliotic condition.

14 Bibliography: Isacowitz, R., Clippinger, K Pilates Anatomy. Champaign, IL: Human Kinetics Johnson, J Postural Assessment, An Illustrated Guide of 79 Steps. Champaign, IL: Human Kinetics Lyons, B Scoliosis, Ascending the Curve. New York: M. Evans and Company, Inc. Paterson, J Teaching Pilates for Postural Faults, Illness & Injury. Oxford: Elsevier. Pgs All about back and neck pain- - DePuy Synthes Spine, Inc A Patient s Guide to Scoliosis- - OrthoPediatrics Corp. Warsaw, Indiana, USA Role of the Family Doctor in the Management of Scoliosis- - australia.org/scoliosis/doctor_role.html The Major Scoliotic Curves: Pilates COREterly, spring 2011,Rehab Corner, Scolio- Pilates: Working in Multiple Dimensions by Karena Thek Lineback- - spring/rehab- corner.html Scoliosis Exercise; with Scolio- Pilates author Karena Thek Lineback

Pilates for Scoliosis

Pilates for Scoliosis Pilates for Scoliosis Agie Skele July 29, 2017 Pacific Palisades Abstract What is scoliosis and how can clients manage chronic back pain and improve their posture? Scoliosis is a curve in the spine. There

More information

Modifications to BASI Repertoire for the Scoliotic Client

Modifications to BASI Repertoire for the Scoliotic Client Modifications to BASI Repertoire for the Scoliotic Client Nicole Mohovich November 7, 2014 2014 CCTT Flow, Chicago, IL Abstract Pilates can be a beneficial form of exercise and treatment for clients with

More information

PILATES AS A TOOL TO AID IN THE TREATMENT OF MILD TO

PILATES AS A TOOL TO AID IN THE TREATMENT OF MILD TO PILATES AS A TOOL TO AID IN THE TREATMENT OF MILD TO MODERATE SCOLIOSIS BETH NICKS FEBRUARY 16, 2014 SANTA BARBARA 2013-2014 ABSTRACT: Scoliosis is a spinal condition characterized by the appearance of

More information

Pilates for the Fatigued Dancer

Pilates for the Fatigued Dancer Pilates for the Fatigued Dancer Kathryn Duran June 22, 2014 Course Year: 2014 Costa Mesa, Ca 1 Abstract The average person works behind a desk about forty hours a week. Now imagine working those forty

More information

Improving Daily Life for Scoliosis With Pilates

Improving Daily Life for Scoliosis With Pilates Improving Daily Life for Scoliosis With Pilates Maranda Zimmerman 3/3/2018 2015 Chicago, IL Abstact Scoliosis is the abnormal curvature of the spine. The severity of this can vary from person to person,

More information

Pilates for Scoliosis

Pilates for Scoliosis Pilates for Scoliosis Sri Suratmi (Chichi) December 27, 2017 BASI PILATES INDONESIA Abstract What is scoliosis and how can clients manage chronic back pain and improve their posture? Scoliosis is a curve

More information

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

Pilates For the 9-5iver with Neck & Shoulder Issues Pilates For the 9-5iver with Neck & Shoulder Issues Maeve McKnight August 2017 The Pilates Clinic Wimbledon, UK 1 ABSTRACT In today s society, it is evident that we are entering a new phase of body issues

More information

Conquering Curves Pilates for Scoliosis

Conquering Curves Pilates for Scoliosis Conquering Curves Pilates for Scoliosis Keli R. Jager BASI Comprehensive Teacher Training Course Fort Worth, TX June 26, 2014 1 Abstract One shoulder is higher than the other. One hip is hiked up and one

More information

Using pilates to strengthen and stabilise a winging scapula

Using pilates to strengthen and stabilise a winging scapula Using pilates to strengthen and stabilise a winging scapula Lauren Brayshaw January 2018 2017/2018 Pilates Clinic UK Abstract Throughout my journey of practicing and teaching pilates, I have developed

More information

Pilates for mature client with osteoporosis

Pilates for mature client with osteoporosis Pilates for mature client with osteoporosis Ligia Ji Ae Lee 29 December 2018 2017 Comprehensive Apparatus Program Costa Mesa, California 1 Abstract Osteoporosis is a bone disease that occurs when the body

More information

How Pilates Benefits Individuals with Scoliosis

How Pilates Benefits Individuals with Scoliosis How Pilates Benefits Individuals with Scoliosis Mastering Control of the Curves, Twists and Bends Elizabeth Ottenwalder, Comprehensive Teacher Training Course, BASI Pilates Academy, Costa Mesa 2013 September,

More information

The impact of office working on the body: alleviating upper crossed syndrome. through Pilates

The impact of office working on the body: alleviating upper crossed syndrome. through Pilates The impact of office working on the body: alleviating upper crossed syndrome through Pilates Ali MacLennan 4 April 2017 CTTC Guildford 2016 Abstract It is a well-documented fact that, more often than not,

More information

Low Back Floposis. Hannah Hartman (Garroutte) July 2018 BASI Foundation and Graduate 2017 Santa Barbara, CA

Low Back Floposis. Hannah Hartman (Garroutte) July 2018 BASI Foundation and Graduate 2017 Santa Barbara, CA Low Back Floposis Hannah Hartman (Garroutte) July 2018 BASI Foundation and Graduate 2017 Santa Barbara, CA 1 Abstract: Low Back Floposis is a condition often first recognized from the Flop sound when performing

More information

Pilates For The Mother Runner

Pilates For The Mother Runner Pilates For The Mother Runner Emma Wagenvelt July 2018 Comprehensive Teacher Training Certification The Woodlands, TX. 1 Abstract Running as a form of exercise has numerous health benefits, including cardiovascular

More information

PILATES FOR POSTURAL KYPHOSIS AND LOW BACK PAIN

PILATES FOR POSTURAL KYPHOSIS AND LOW BACK PAIN PILATES FOR POSTURAL KYPHOSIS AND LOW BACK PAIN ANA HUBNER JANUARY 15, 2018 COMPREHENSIVE APPARATUS PROGRAM SOUTH PASADENA, CA 2015 Abstract Kyphosis is a spinal disorder in which an excessive outward

More information

Pilates Benefiting Scoliosis

Pilates Benefiting Scoliosis Pilates Benefiting Scoliosis Erin Sossamon January 2017 Basi Pilates Academy, Costa Mesa Abstract This paper will explain what Scoliosis is and how it affects an individual s body. Practicing Pilates can

More information

PILATES THE MATURE POPULATION

PILATES THE MATURE POPULATION PILATES THE MATURE POPULATION AMANDA CURTIS 30th March 2018 Aptos, CA. 2016 Costa Mesa, CA. 2017 CONTENTS 1. Abstract 2. Anatomical description 3. Introduction to case study 4. Case study 5. Session plan

More information

Pilates for the Seated Musician: Muscular Imbalances and Injury Prevention

Pilates for the Seated Musician: Muscular Imbalances and Injury Prevention Pilates for the Seated Musician: Muscular Imbalances and Injury Prevention The Pilates Clinic, Wimbledon 2015-16 Veronica Fulton 10/09/2016 Joseph Pilates method has appealed to physical performers from

More information

Forward Head Posture. Laura Hegle. August 13, Mt Shasta, Ca. Davis, Ca

Forward Head Posture. Laura Hegle. August 13, Mt Shasta, Ca. Davis, Ca Forward Head Posture Laura Hegle August 13, 2017 2016-2017 Mt Shasta, Ca Davis, Ca Abstract For every inch that your head protrudes forward from its proper alignment, it increases the weight of the head

More information

Pilates for Low Back Pain Relief

Pilates for Low Back Pain Relief Pilates for Low Back Pain Relief Tia Stanley May 14, 2017 Course Year: 2015 One Physical Therapy and Wellness, Bryn Mawr, PA Abstract This paper outlines the research and looks at Pilates as a form of

More information

HOW PILATES HELPED A HAIRDRESSER WITH BACK PAIN

HOW PILATES HELPED A HAIRDRESSER WITH BACK PAIN HOW PILATES HELPED A HAIRDRESSER WITH BACK PAIN Valerie Lawrence October 2018 CTTC Dublin 2018 Abstract Hairdressing as a profession puts enormous strain on the body in terms of posture and alignment.

More information

Pilates for Scoliosis

Pilates for Scoliosis Pilates for Scoliosis Carrie Campbell June 10, 2007 Costa Mesa, CA Abstract I did my case study on myself. I am a 30-year-old female with a 51-degree left lumbar scoliosis. I experienced back pain on a

More information

Improving Posture in a Client with Kyphosis

Improving Posture in a Client with Kyphosis Improving Posture in a Client with Kyphosis Name: Nicollette Van den Bergh Date: 5 November 2018 Course date: 10 Aug-25 Nov 2018 Course Location: Physio Pilates, Khyber Pass, Auckland, NZ Faculty Member:

More information

Pilates for Strengthening and Mobilizing the Thoracic Spine

Pilates for Strengthening and Mobilizing the Thoracic Spine Pilates for Strengthening and Mobilizing the Thoracic Spine R. Meson 11 March 2017 2016 Course Balanced Bodies, Herndon, VA. Abstract The spine provides the primary movements of the axial skeleton. And

More information

Pilates for golfers. SoonHong Min CTTC Seoul, Korea

Pilates for golfers. SoonHong Min CTTC Seoul, Korea Pilates for golfers SoonHong Min CTTC 2015.6 Seoul, Korea Abstract Whether twisting the body on a drive or leaning over to pick up a ball, golfers constantly torqueing their bodies. Golf also requires

More information

Pilates & Synchronized Swimming-a conditioning routine program

Pilates & Synchronized Swimming-a conditioning routine program Pilates & Synchronized Swimming-a conditioning routine program Deborah Lo Scalzo 27 April 2018 BASI training program 2016- University place- Gig Harbor - WA 1 Abstract As a mother of a Synchronized swimmer,

More information

Pilates for Runners: Core Strength and Flexibility for Increased Efficiency and Injury Prevention

Pilates for Runners: Core Strength and Flexibility for Increased Efficiency and Injury Prevention Pilates for Runners: Core Strength and Flexibility for Increased Efficiency and Injury Prevention Helen Buehler 9/20/15 Flow Studio // Chicago // 2015 Running is the most natural and accessible form of

More information

EFFECTIVITY OF BASI PILATES BLOCK SYSTEM ON INDIVIDUAL WITH KYPHOSIS

EFFECTIVITY OF BASI PILATES BLOCK SYSTEM ON INDIVIDUAL WITH KYPHOSIS EFFECTIVITY OF BASI PILATES BLOCK SYSTEM ON INDIVIDUAL WITH KYPHOSIS NENENG KASWATI SEPTEMBER 2014 SVARGA HOLISTIC HEALTH CENTRE JL. KARANGSARI 12BANDUNG ABSTRACT The purpose of doing this thesis is to

More information

Benefits of Pilates for Lower Back and Disc Injuries

Benefits of Pilates for Lower Back and Disc Injuries Benefits of Pilates for Lower Back and Disc Injuries Alexandra Gitlitz June 2017 Course Year 2017 Sydney, Australia 2 Abstract Chronic low back pain can be defined as having pain in the posterior lumbar

More information

Cross Training with Athletes

Cross Training with Athletes Cross Training with Athletes Rebekah Budnikas June 5, 2014 2011 2012 Herndon, Virginia & Chicago, IL 1 Abstract Athletes are often lacking balance due to the highly repetitious nature of their particular

More information

L5-S1 Intervertebral Disc Herniation

L5-S1 Intervertebral Disc Herniation L5-S1 Intervertebral Disc Herniation Hayley Kuehn November 2016 Studio 64 Albany Creek Brisbane, Australia 1 Abstract Page This paper discusses the benefits of using the Basi Block System and how it has

More information

Rehabilitation 2. The Exercises

Rehabilitation 2. The Exercises Rehabilitation 2 This is the next level from rehabilitation 1. You should have spent time mastering the previous exercises and be ready to move on. If you are unsure about any of the previous exercises

More information

The Benefit of Pilates for Scoliosis

The Benefit of Pilates for Scoliosis The Benefit of Pilates for Scoliosis Jessica Surya January 2018 BASI PILATES INDONESIA Abstract Scoliosis defined as an abnormal lateral curvature of the spine. While most mild cases of scoliosis do not

More information

Pilates for Rounded Shoulders and Kyphosis. Sylvia Nho 11/26/18 Los Angeles, CA

Pilates for Rounded Shoulders and Kyphosis. Sylvia Nho 11/26/18 Los Angeles, CA Pilates for Rounded Shoulders and Kyphosis Sylvia Nho 11/26/18 Los Angeles, CA Abstract Rounded shoulders are an unnatural posture characterized by an exaggerated curvature of the upper back, often a forward

More information

Lower Crossed Syndrome

Lower Crossed Syndrome Lower Crossed Syndrome Sang mi Yun October 23 rd 2017 Costa Mesa 2016 Abstract Lower-Crossed Syndrome (LCS) is also referred to as distal or pelvic crossed syndrome. In LCS, tightness of the thoracolumbar

More information

Pilates for the Endurance Runner With Special Focus on the Hip Joint

Pilates for the Endurance Runner With Special Focus on the Hip Joint Pilates for the Endurance Runner With Special Focus on the Hip Joint Kellie McGeoy April 11 th, 2014 Aptos, CA 2013 1 Abstract: Endurance running is defined as any distance over 5 kilometers (3.1 miles)

More information

Jesse Alfonso Comprehensive Training in Costa Mesa, CA 10/11/2017

Jesse Alfonso Comprehensive Training in Costa Mesa, CA 10/11/2017 Hamstring Flexibility: Using the BASI PIlates Block System Jesse Alfonso 2016-2017 Comprehensive Training in Costa Mesa, CA 10/11/2017 Abstract A study was conducted to target hamstring flexibility and

More information

Stand Tall with Osteoporosis thru Pilates

Stand Tall with Osteoporosis thru Pilates Stand Tall with Osteoporosis thru Pilates C A S S I T E R P E N I N G P T, D P T, C S C S, C P I C H R I S R I E G E R P T U P S T A T E U N I V E R S I T Y H O S P I T A L J U N E 1 9, 2 0 1 7 Content

More information

Improving a Rhythmic Gymnasts Performance with Pilates

Improving a Rhythmic Gymnasts Performance with Pilates Improving a Rhythmic Gymnasts Performance with Pilates Yvonne Garland 28 July 2018 CTTC, 2017 KZN, RSA Abstract Rhythmic gymnastics is a woman only Olympic sport. It combines dance, ballet, gymnastics

More information

REPETITIVE STRESS SYNDROME AND ITS EFFECTS ON THE LOWER PELVIS

REPETITIVE STRESS SYNDROME AND ITS EFFECTS ON THE LOWER PELVIS REPETITIVE STRESS SYNDROME AND ITS EFFECTS ON THE LOWER PELVIS Kim Turney Body Arts and Science International Comprehensive Global Feb 2018 London, UK ABSTRACT In many lines of work people are subjected

More information

34 Pictures That Show You Exactly What Muscles You re Stretching

34 Pictures That Show You Exactly What Muscles You re Stretching By DailyHealthPostJanuary 27, 2016 34 Pictures That Show You Exactly What Muscles You re Stretching Stretching before and after a workout is a great way to promote blood flow to the muscles and increase

More information

PILATES CONDITIONING FOR SURFERS

PILATES CONDITIONING FOR SURFERS PILATES CONDITIONING FOR SURFERS Michelle Hopper January 11, 2018 Body Arts and Science International Comprehensive Teacher Training Program 2013 Jen Pearlstein Oceanside CA ABSTRACT Modern surfing is

More information

Utilizing Pilates to help with Hyperlordosis

Utilizing Pilates to help with Hyperlordosis Utilizing Pilates to help with Hyperlordosis Julie K. Ruxton November 30, 2017 2017 Cincinnati, OH 1 Abstract! Each year as many as 25 million Americans seek a doctor s care for backache. According to

More information

Pilates for Chronic Low Back Pain

Pilates for Chronic Low Back Pain Pilates for Chronic Low Back Pain Julianne Bettencourt March 23, 2015 Course Year: 2014 Integrated Fitness, Visalia, CA Abstract Low back pain is an injury that affects thousands of people every day and

More information

MODULE 10: Breaking down the Exercises - Stability Exercises

MODULE 10: Breaking down the Exercises - Stability Exercises MODULE 10: Breaking down the Exercises - Stability Exercises Stability is a core component of the Ridefit program, because so much of riding is dependent on the stability of the rider s body in the saddle.

More information

Lower Your Handicap Pilates for Golfers

Lower Your Handicap Pilates for Golfers Lower Your Handicap Pilates for Golfers Cindy Sankhagowit July 20, 2014 CTTC 2014 Portland, OR Abstract To improve one s golf game means shooting a lower score, thereby lowering your handicap. A golf swing

More information

Pilates for Pelvic Lumbar Instability in CrossFit Athletes

Pilates for Pelvic Lumbar Instability in CrossFit Athletes Pilates for Pelvic Lumbar Instability in CrossFit Athletes Emily Von Fange 11/28/2018 Comprehensive Program 2018 Herndon, VA Abstract! Lauren is a CrossFit athlete and coach who injured her lower back

More information

KYPHOSIS/ DOWAGER S HUMP: A CASE STUDY IN SPONTANEOUS SPINAL CURVATURE

KYPHOSIS/ DOWAGER S HUMP: A CASE STUDY IN SPONTANEOUS SPINAL CURVATURE KYPHOSIS/ DOWAGER S HUMP: A CASE STUDY IN SPONTANEOUS SPINAL CURVATURE Debra Rapoport June 4, 2014 Basi Teacher Training Brooklyn, NY TABLE OF CONTENTS Abstract...1 Kyphotic Postural Analysis...2 A Case

More information

Postnatal Pilates. Roni Albrecht June 1, Gig Harbor, WA

Postnatal Pilates. Roni Albrecht June 1, Gig Harbor, WA Postnatal Pilates Roni Albrecht June 1, 2017 2016 Gig Harbor, WA ABSTRACT During pregnancy the female body goes through many physiological and anatomical changes in order to adapt to the growing fetus.

More information

Golf Conditioning and Pilates The Integration of Pilates as Part of a Golf Conditioning Program

Golf Conditioning and Pilates The Integration of Pilates as Part of a Golf Conditioning Program Golf Conditioning and Pilates The Integration of Pilates as Part of a Golf Conditioning Program Margaret Batal November 28, 2013 March- September 2011 Herndon, Virginia Abstract Golf is not a game of power

More information

POSTURAL ANALYSIS & PROGRAMME FOR FEMALE WHO PRESENTS WITH SCAPULA DYSRHYTHMIA

POSTURAL ANALYSIS & PROGRAMME FOR FEMALE WHO PRESENTS WITH SCAPULA DYSRHYTHMIA POSTURAL ANALYSIS & PROGRAMME FOR FEMALE WHO PRESENTS WITH SCAPULA DYSRHYTHMIA BY JENNIFER RUTHERFORD NOVEMBER 2018 THE PHYSIO PILATES STUDIO, AUCKLAND, NZ ABSTRACT As a fairly new comer (3yrs) to pilates,

More information

Running into extra-time. (Pilates for an active ex-footballer) Name: Carmen Suarez. Date: July 2018

Running into extra-time. (Pilates for an active ex-footballer) Name: Carmen Suarez. Date: July 2018 Running into extra-time (Pilates for an active ex-footballer) Name: Carmen Suarez Date: July 2018 Course: London, 2018 Abstract This paper discusses a Pilates programme designed for the specific needs

More information

Pilates for Cauda Equina Syndrome Rehabilitation

Pilates for Cauda Equina Syndrome Rehabilitation Pilates for Cauda Equina Syndrome Rehabilitation Mindy L Mason December 2017 2017 Cosa Mesa, CA 1 Abstract Cauda Equina Syndrome (CES) is a severe condition which is commonly misdiagnosed and even when

More information

Exercises to Strengthen Your Back

Exercises to Strengthen Your Back Exercises to Strengthen Your Back Your 15 Minute Workout By doing your 15 minute workout 3-5 times per week, you can condition the muscles and joints that support your back and keep it in healthy balance

More information

Lumbar Stenosis Rehabilitation Using the Resistance Chair

Lumbar Stenosis Rehabilitation Using the Resistance Chair PRODUCTS HELPING PEOPLE HELP THEMSELVES! Lumbar Stenosis Rehabilitation Using the Resistance Chair a. Description Lumbar spinal stenosis is a term used to describe a narrowing of the spinal canal. The

More information

Snow Angels on Foam Roll

Snow Angels on Foam Roll Thoracic Mobilization on Foam Roll Lie on your back with a foam roller positioned horizontally across your mid back, and arms crossed in front of your body. Bend your knees so your feet are resting flat

More information

Pilates for Pole Athletes

Pilates for Pole Athletes Pilates for Pole Athletes Maria E. Moore July 2, 2018 Body Arts and Science International Comprehensive Teacher Training Program, 2017 Breathe Pilates & Fitness Harrisonburg, VA Abstract Pole dancing has

More information

Pilates and Long Distance Running: An Examination of the correlation of weak. hamstrings and core to injury. By Jacquelyn Reiff.

Pilates and Long Distance Running: An Examination of the correlation of weak. hamstrings and core to injury. By Jacquelyn Reiff. Pilates and Long Distance Running: An Examination of the correlation of weak hamstrings and core to injury. By Jacquelyn Reiff September 2014 BASI Pilates 2014 Comprehensive Teacher Training Course Location:

More information

Fitball and Pilates Unite Filex 2017

Fitball and Pilates Unite Filex 2017 Fitball and Pilates Unite Filex 2017 Lisa Westlake www.physicalbest.com Pilates, fitball and physiotherapy blend perfectly to fine tune movement and postural awareness and provide a focus on technique,

More information

THE SHOULDER COMPLEX: REHABILITATION AND STRENGTHENING THE ROTATOR CUFF THROUGH

THE SHOULDER COMPLEX: REHABILITATION AND STRENGTHENING THE ROTATOR CUFF THROUGH 1 THE SHOULDER COMPLEX: REHABILITATION AND STRENGTHENING THE ROTATOR CUFF THROUGH PILATES BY ALISON NELLA COMPREHENSIVE PROGRAM TORONTO, ONTARIO 2017 2 ABSTRACT Pilates is a form of exercise that was founded

More information

TIGHT HAMSTRINGS. Can you be born with it? Nicole Feder-Perone. 31 January Course Year 2016/2017. Bahrain

TIGHT HAMSTRINGS. Can you be born with it? Nicole Feder-Perone. 31 January Course Year 2016/2017. Bahrain TIGHT HAMSTRINGS Can you be born with it? Nicole Feder-Perone 31 January 2018 Course Year 2016/2017 Bahrain SUMMARY The hamstring muscles attach to the pelvis, thigh, and lower leg. We usually think of

More information

General Principles of Stretching. To be effective, stretching must be done slowly, gently and frequently.

General Principles of Stretching. To be effective, stretching must be done slowly, gently and frequently. General Principles of Stretching To be effective, stretching must be done slowly, gently and frequently. Slowly means that while the exercise is being done the muscle being stretched must be moved slowly

More information

Standing Tall with Pilates

Standing Tall with Pilates Standing Tall with Pilates Alaina Mallory June 1, 2014 Comprehensive Course- 2014 Physiologic Movement and Pilates-Brooklyn, NY ABSTRACT Posture plays an important role in our well being and overall health.

More information

Pilates for Common Alignments in Strength Training Individuals

Pilates for Common Alignments in Strength Training Individuals Pilates for Common Alignments in Strength Training Individuals Connie Youn Comprehensive Program- South Pasadena, CA December 1, 2018 ABSTRACT We see a wide array of athletes these days, from those that

More information

Pilates for Soccer Players. Treatment of Common Injuries and Muscle Weakness

Pilates for Soccer Players. Treatment of Common Injuries and Muscle Weakness Pilates for Soccer Players Treatment of Common Injuries and Muscle Weakness Kimberly Waithe October 21, 2012 Course Year 2012 Ocotillo Pilates, Chandler Arizona 1 Abstract This is an exploration of the

More information

Pilates for rehabilitating groin strain

Pilates for rehabilitating groin strain Pilates for rehabilitating groin strain Helen Turner 14 th June 2017 Guildford, Surrey & Wimbledon, London, UK Comprehensive Training Program 2016 Abstract This paper is about the use of Pilates to assist

More information

Pilates for runners with Achilles. tendonitis

Pilates for runners with Achilles. tendonitis Pilates for runners with Achilles tendonitis Melinda van Tonder September 2018, Basi CTTC Pretoria Abstract Running is a great form of exercise with many health benefits. Some of its benefits include improving

More information

Strengthening and Stretching the. Hamstrings through BASI Pilates

Strengthening and Stretching the. Hamstrings through BASI Pilates Strengthening and Stretching the Hamstrings through BASI Pilates Robyn Boardman June 2017 Ballito, South Africa 1 A B S T R A C T This paper is aimed at researching means of improving of hamstring flexibility

More information

Pilates for an Unstable/Hypermobile Spine

Pilates for an Unstable/Hypermobile Spine Pilates for an Unstable/Hypermobile Spine Aryanna Aronson June 14, 2018 Summer/Fall 2017 Santa Barbara, CA & Brooklyn, NY USA 1 Table of Contents: Title Page.1 Table of Contents...2 Abstract...3 Anatomical

More information

Pilates for Low Back Pain

Pilates for Low Back Pain Pilates for Low Back Pain Sarah Hoffman October 19, 2017 Pilates Body LLC University Place, Washington 1 Abstract Most people will experience Low Back Pain at some point in their life. The most common

More information

Running head: PILATES FOR RUNNERS 1. Pilates for Runners

Running head: PILATES FOR RUNNERS 1. Pilates for Runners Running head: PILATES FOR RUNNERS 1 Pilates for Runners Elizabeth Rao September 6 th, 2014 CTTC Santa Barbara, California La Playa Pilates PILATES FOR RUNNERS 2 Abstract Running is an extremely popular

More information

Correcting Lumbar Hyperlordosis through Pilates

Correcting Lumbar Hyperlordosis through Pilates Correcting Lumbar Hyperlordosis through Pilates Shalyn Lettieri July 11, 2016 BASI CAP 2015 Herndon, VA Abstract Joseph Pilates believed that the Pilates method Is designed to give you suppleness, natural

More information

ETS EXERCISE SHEETS EXPLAINED

ETS EXERCISE SHEETS EXPLAINED ETS EXERCISE SHEETS EXPLAINED Exercises 4pt kneeling Supermans Extend opposite arm/leg whilst maintaining neutral spine. Hips are to remain parallel to the floor during movement. Core. Also assists in

More information

Combating the Ramifications of Extended Sitting

Combating the Ramifications of Extended Sitting Combating the Ramifications of Extended Sitting Theresa Cork July, 2018 Chicago - 2015 Abstract Creator and visionary of Contrology, Joseph H. Pilates believed physical fitness was the first requisite

More information

Stretching Exercises for the Lower Body

Stretching Exercises for the Lower Body Stretching Exercises for the Lower Body Leg Muscles The leg has many muscles that allow us to walk, jump, run, and move. The main muscle groups are: Remember to: Warm-up your muscles first before stretching

More information

Refining Stroke Technique for the Competitive Swimmer with Pilates

Refining Stroke Technique for the Competitive Swimmer with Pilates Refining Stroke Technique for the Competitive Swimmer with Pilates Giovanna Grinarml Healthy Changes Pilates Reading, MA Sondra Karman April 26, 2018 Summary 1 As a competitive swimmer for 12 years and

More information

Improving swimming through Pilates

Improving swimming through Pilates Improving swimming through Pilates Cleia Ramsey 10 Mar 2017 2016 BASI Training Class Herndon, VA Introduction As a mother of two swimmers, I spend many hours at the pool deck and have learned a lot about

More information

A Journey through Pregnancy. Practicing Pilates

A Journey through Pregnancy. Practicing Pilates A Journey through Pregnancy Practicing Pilates Jen Clement September 13, 2017 October 2015 Pacific Palisades 1 Abstract From the very start of pregnancy the body starts to change pretty significantly,

More information

ATHLETIC CONDITIONING ON THE ARC BARREL

ATHLETIC CONDITIONING ON THE ARC BARREL ATHLETIC CONDITIONING ON THE ARC BARREL page 1 INTRODUCTION The STOTT PILATES Athletic Conditioning stream serves as a bridge between STOTT PILATES standard repertoire and the CORE Athletic Conditioning

More information

Marathon Runners and the Benefits of Pilates

Marathon Runners and the Benefits of Pilates Marathon Runners and the Benefits of Pilates Katie Burroughs CTTC January May 2014 South Pasadena, CA 1 ABSTRACT First-time marathon runners spend a few years preparing for a marathon. Conditioning and

More information

Pilates for Running. An Examination of Cross-Training & Core Strengthening

Pilates for Running. An Examination of Cross-Training & Core Strengthening Pilates for Running An Examination of Cross-Training & Core Strengthening Karissa Berg November 11 th 2013 CTTC University Place 2013 Abstract Running is undeniably one of the best forms of cardiovascular

More information

Pilates for Alpine Skiing

Pilates for Alpine Skiing Pilates for Alpine Skiing Jennifer Carr CTTC March- June 2014 Mt. Shasta, CA 1 Abstract Skiing is a sport that demands muscular strength and stability in three planes of movement. Due to the large amount

More information

Balanced Body Pilates Instructor Training

Balanced Body Pilates Instructor Training Balanced Body Pilates Instructor Training Reformer 2: Reformer Progressions Balanced Body Reformer 2 Instructor Training Welcome! The Universal Reformer is the heart of equipment based Pilates and a wonderful

More information

BENEFIT PILATES FOR CHEELEADER WITH HIP IMBALANCE

BENEFIT PILATES FOR CHEELEADER WITH HIP IMBALANCE BENEFIT PILATES FOR CHEELEADER WITH HIP IMBALANCE ANISA FAUZIA WAHYU NOVEMBER 2014 BASI CTTC in SVARGA INDONESIA 1 P age ABSTRACT Several Pilates movements help in chronic back pain, knee and ankle injuries

More information

Case Study: Pilates and the Pelvic Instability of. the Hypermobile Dancer

Case Study: Pilates and the Pelvic Instability of. the Hypermobile Dancer Case Study: Pilates and the Pelvic Instability of the Hypermobile Dancer Markella Kefallonitou 31/08/2015 Comprehensive Training Program 2015 London Abstract Dancers are well known for their extreme physical

More information

Improving the Game of Golf with Pilates

Improving the Game of Golf with Pilates Improving the Game of Golf with Pilates Kristine Miller Basi Headquarters, Costa Mesa Jan 2018!1 Abstract As a personal trainer at a Country Club, I often encounter members wanting to start training with

More information

Trapeze Table A DETAILED GUIDE FOR PRACTICING PILATES

Trapeze Table A DETAILED GUIDE FOR PRACTICING PILATES Trapeze Table A DETAILED GUIDE FOR PRACTICING PILATES TABLE OF CONTENTS 1 Balanced Body Education 2 What is Pilates? 4 Pilates Principles 5 Introduction to the Trapeze Table 10 Upper Arms 12 Roll Down

More information

Masters Swimming Dryland Training Program. November-December

Masters Swimming Dryland Training Program. November-December Masters Swimming Dryland Training Program November-December Staggered Stance High Kneeling Chop with Theraband (1 minute each side) Engage core. Pull Theraband down toward knee that is on the ground keeping

More information

YOUR FREE COMPREHENSIVE GUIDE TO HELP RELIEVE LOWER BACK PAIN NATURALLY

YOUR FREE COMPREHENSIVE GUIDE TO HELP RELIEVE LOWER BACK PAIN NATURALLY YOUR FREE COMPREHENSIVE GUIDE TO HELP RELIEVE LOWER BACK PAIN NATURALLY By: helpwithsciatica HTTPS://HELPWITHSCIATICA.COM Table of contents 1 Introduction 2 Exercise: Extensions 3 Exercise: Curl-Ups 4

More information

Rheumatoid Arthritis and a Pilates Conditioning Program

Rheumatoid Arthritis and a Pilates Conditioning Program Rheumatoid Arthritis and a Pilates Conditioning Program 1 Nicola Ferguson May 29, 2018 Course Year 2016-2017 Bahrain Table of Contents Abstract Page 3 Anatomical Description Page 4 Case Study Page 6 Pilates

More information

Pilates to improve cycling comfort and strength for an ironman lady

Pilates to improve cycling comfort and strength for an ironman lady Pilates to improve cycling comfort and strength for an ironman lady Kathrin Wildeshaus May 2017 Body Arts and Science International Comprehensive Teacher Program 2017 Pilates Clinic Wimbledon, London UK

More information

Lesson Sixteen Flexibility and Muscular Strength

Lesson Sixteen Flexibility and Muscular Strength Lesson Sixteen Flexibility and Muscular Strength Objectives After participating in this lesson students will: Be familiar with why we stretch. Develop a stretching routine to do as a pre-activity before

More information

Osteoporosis Exercise: Weight-Bearing and Muscle Strengthening Exercises. Osteoporosis Exercise: Weight-Bearing and Muscle Strengthening Exercises

Osteoporosis Exercise: Weight-Bearing and Muscle Strengthening Exercises. Osteoporosis Exercise: Weight-Bearing and Muscle Strengthening Exercises Osteoporosis Exercise: Weight-Bearing and Muscle Strengthening Exercises Osteoporosis Exercise: Weight-Bearing and Muscle Strengthening Exercises Introduction Weight-bearing and resistance exercises have

More information

STRETCHING Stretch Express)

STRETCHING Stretch Express) STRETCHING Stretching is a highly important part of all exercise programs, yet much neglected by most people. Why? Because we all want to be leaner, fitter and stronger and by the time we have done the

More information

IMPROVING FLEXIBILITY FOR THE AGING ATHLETE. Britta Nelson- Maki April 27, 2014 Course Year 2014 Gig Harbor, Washington

IMPROVING FLEXIBILITY FOR THE AGING ATHLETE. Britta Nelson- Maki April 27, 2014 Course Year 2014 Gig Harbor, Washington IMPROVING FLEXIBILITY FOR THE AGING ATHLETE Britta Nelson- Maki April 27, 2014 Course Year 2014 Gig Harbor, Washington ABSTRACT Flexibility decreases with age and physical inactivity, and this can cause

More information

Musculoskeletal Age Related Changes That Lead to Movement Loss

Musculoskeletal Age Related Changes That Lead to Movement Loss Objectives Review the factors that can lead to movement loss (age related changes and previous injuries) Discuss the role that posture plays affecting movement loss Discuss exercises to prevent movement

More information

Dynamic Flexibility All exercises should be done smoothly while taking care to maintain good posture and good technique.

Dynamic Flexibility All exercises should be done smoothly while taking care to maintain good posture and good technique. Dynamic Flexibility All exercises should be done smoothly while taking care to maintain good posture and good technique. Lying on back: Hip Crossover: Arms out in T position, feet flat on the floor, knees

More information

The Police Treatment Centres

The Police Treatment Centres Ball Class Exercises The exercises provided here are for general information only and should not be treated as a substitute for professional supervision or advice. By following these exercises you agree

More information

Stretching. Back (Latissimus dorsi) "Chicken Wings" Chest (Pec. major + Ant. deltoid) "Superman" Method: Method: 1) Stand tall and maintain proper

Stretching. Back (Latissimus dorsi) Chicken Wings Chest (Pec. major + Ant. deltoid) Superman Method: Method: 1) Stand tall and maintain proper Chest (Pec. major + Ant. deltoid) "Chicken Wings" Back (Latissimus dorsi) "Superman" 1) Stand tall and maintain proper 1) Reach hands overhead and lumbar curve. grasp one wrist. 2) Place palms on lower

More information

Standing Shoulder Internal Rotation with Anchored Resistance. Shoulder External Rotation Reactive Isometrics

Standing Shoulder Internal Rotation with Anchored Resistance. Shoulder External Rotation Reactive Isometrics Standing Shoulder Row with Anchored Resistance Begin standing upright, holding both ends of a resistance band that is anchored in front of you at chest height, with your palms facing inward. Pull your

More information