Conquering Curves Pilates for Scoliosis

Transcription

1 Conquering Curves Pilates for Scoliosis Keli R. Jager BASI Comprehensive Teacher Training Course Fort Worth, TX June 26,

2 Abstract One shoulder is higher than the other. One hip is hiked up and one lays lower. There is a large hump in your back that twists all your shirts, and your pants never hang properly. Welcome to the day-to-day of someone with severe scoliosis. Though most people with this condition may only have a slight curve in their back that seems to not affect them noticeably, there are others who suffer greatly due to this imbalance. However, even the first will eventually see the long-term effects of his/her lack of symmetry. As bodies adapt to this condition it is inevitable that other imbalances with follow which can result in pain, limited mobility, and dysfunction in some aggressive cases. Scoliosis is a complex condition that needs medical attention, however, Pilates offers a way to manage this abnormality by allowing those suffering to develop corestrength to help alleviate the pressures from the spine and achieve better alignment and balance through balanced, unilateral movements. 2

3 Table of Contents Title Page...1 Abstract...2 Table of Contents...3 Anatomical Description...4 Introduction...5 Case Study...6 Conditioning Program...7 Conclusion...9 Bibliography

4 Anatomical Description Scoliosis can be described as lateral curvature of the spine usually forming a C or an S shape. There are many types of scoliosis titled by cause, placement along the spine, number of curves and how and when it developed. Each case is unique in its shape, severity and direction, meaning each case should be analyzed individually. For those who have a severe scoliosis, the likelihood of the condition worsening over time increases. In critical conditions scoliosis can have grave effects including: intense pain, restricted lung space, and deformity. 4

5 Introduction To provide my client with the best session to achieve optimal goals, I must look at their specific structure. With the curves of scoliosis these things are important to take into consideration: where the concave is (the side that needs elongation) and where the convex is (the side that needs to be strengthened and shortened ). Through unilateral movements, I am able to specifically address the individual s needs directly. Also, I must take into consideration the immense amount of pressure that is placed into the spine, and keep a constant focus on developing the client s core strength which can relieve them of their back pain as they learn to lift and hold their posture through the abdominal region as well as in their back extensors. The client who suffers from severe scoliosis will have an elevated shoulder, and it is my job to work on working the latissimus dorsi to help pull down the elevated shoulder as well as elongate the opposite side s obliques. 5

6 Case Study My client s name is Shelley. She has suffered with scoliosis for as long as she can remember and never received the much needed assistance of a brace during childhood. Now 47 years old, she is in constant pain due to the worsening of her condition and the lack of physical therapy or intentional exercise these last years. From the posterior view, Shelley s thoracic spine curves to the right, causing her right shoulder to be elevated, and a slight smaller curve at the lumbar spine to the left. One of the most critical pieces of information I receive is that she has had 4 abdominal surgeries over the past 12 years and has very little abdominal strength. So, I know that the pressure and tension she holds in her back is only worsening her condition and adding additional pain. Her back is very tight, but not necessarily strong, and her anterior side is weak and stretched. So, I must work with her to stretch out her back muscles and build proper back extensor strength while always working toward core (particularly abdominal) development. 6

7 Conditioning Program: Roll Downs: Focusing on keeping towards midline and avoiding favoring/leaning to one side. Fundamental Warm Up: Pelvic Curls (Focusing again on symmetry and using both sides equally and abdominal engagement) Spine Twist Supine (Keeping in range from pain, focusing on rotating without hiking up one side or the other as well as using abs instead of her lower back). Chest Lift Chest lift with rotation Foot Work on Reformer: (Focus on Pelvic stability and using both legs equally.) Parallel Heels, Parallel Toes, V Position Toes, Open V Heels, Open V Toes, Calf Raises, Prances, *Single Leg Heel, *Single Leg Toes (*Great for Scoliosis b/c of the lack of balance and symmetry). Abdominals- Hundred Prep on Reformer: (Focusing again on pelvic stability to strengthen core and relieve back-pressure). Spinal Articulation- Bottom Lift on Reformer (Block moved for flow reasons only): (again focusing on abdominal strength as well as hamstrings) Stretches- Standing Lunge on Reformer (Block moved for flow reasons only): (Focusing on hip placement and alignment) Hip Work- Single Leg Supine Series on Cadillac: (focusing on Pelvic stability, and working towards symmetrical movement and placement). 7

8 Frog (Parallel Foot), Circles (Down and Up), Hip Extension, Bicycle, and Reverse Bicycle FBI- Push Through Series on Cadillac: (Helps Client focus on keeping feet pressed against poles to gain a sense of balance and symmetry and awareness of hip-hiking tendencies.) Sitting Forward (Great for gaining much needed abdominal strength as well as stretching the tightened back), Side Reach (great unilateral work and important stretch for tightened sides associated with scoliosis.) Arms- Push Through Group: Shoulder adduction Single Arm: (Encouraging using the core to lift up and develop ideal posture, working towards shoulder balance and alignment-great for releasing the hiked up shoulder) Shoulder Adduction Double Arm: (Focus on using both sides equally) Legs- Single Leg Skating on Reformer: (Encouraging Pelvic stability) Lateral Flexion/Rotation- Side Lifts on Step Barrel: (Barrel provides extra support for underside while developing strength in the obliques, this is great for getting both needs in since clients with scoliosis have one side needing extra elongation and another needed more strength, works towards a balanced alignment.) Back Extension- Swan Prep on Step Barrel (allows for a slight stretch while laying over the barrel, as well as additional support while strengthening her back extensors) End With another set of roll-downs. *FBI 2 left out because client is not at an advanced level. 8

9 Conclusion: As I continue to work with Shelley, she will continue to gain strength in her core muscles, lifting her torso with healthier balance which will take away unnecessary pressure on her spine. The development in her abdominals, especially the lower pelvic floor and obliques, will be one of the best gifts Pilates gives her as she learns to hold herself through them instead of in her back. Overtime, her right elevated shoulder will learn to drop away from her ear as she releases tension in her upper traps. The elongation of her left side (posterior view) will also help relieve discomfort. The pelvic stability added through unilateral hip exercises will help her notice the hip she hikes up and give her cognizance to work on pulling it down into symmetry with the other. All of this is in the goal of simply relieving Shelley of pain and giving her a sense of body awareness so that she can take these principles of alignment and balance and work towards them in her day to day life style. Shelley s body awareness has increased immensely, and she is seeing the benefits of abdominal control. We are both enthusiastic and optimistic of the continued success she will find along her journey to pain reduction. 9

10 Bibliography: Ullrich Jr., MD, Peter. "Scoliosis: What You Need To Know". Spine-Health Trusted Information for Back Pain Relief. Spine-Health.com. 30 March Web. 22 June < Diaz, Brett. "Scoliosis Exercises Avoid Those That Can Worsen Your Scoliosis Curves." Scoliosis Treatment Alternatives. 2 Mar Web. 15 Oct < Isacowitz, Rael. Study Guide Comprehensive Training Course. Body Arts and Science International, Print. Moulton, Andrew. "Adolescent Idiopathic Scoliosis." Dr. Andrew Moulton. 1 Jan Web. 15 Oct < Images:

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