Modifications to BASI Repertoire for the Scoliotic Client

Transcription

1 Modifications to BASI Repertoire for the Scoliotic Client Nicole Mohovich November 7, CCTT Flow, Chicago, IL

2 Abstract Pilates can be a beneficial form of exercise and treatment for clients with scoliosis. It encourages correct muscle recruitment, efficient posture, ideal alignment and re-enforces functional and positive movement patterns. The awareness and muscle control that are essential to Pilates make it a useful tool for achieving relief from some of the complications of scoliosis. Improved strengthening of the pelvic flower and lower abdominals help to increase stability of the spine and assist in de-rotation of the spine. 2

3 Table of Contents Cover Page Page 1 Abstract Page 2 Table of Contents Page 3 Anatomical Description & Diagram Page 4 Introduction Page 5 Case Study Page 5-6 Repertoire Program Page 7 Conclusion Page 8 Bibliography Page 9 3

4 Anatomical Description & Diagram Figure 2 Figure 1 Figure 1. An alignment and posture evaluation of myself reveals an imbalance in the shoulders with the left higher than the right, resulting in the right arm being longer than the left; left pelvis hiked higher than the right, resulting in trunk shortening on the right. Figure 2. A visual representation of a normal spine compared to a spine with scoliosis. 4

5 Introduction Scoliosis affects 2-3% of the populations, or an estimated 6 million people in the United States. The condition impacts the curvature of the spine, causing it to rotate and twist to one side. Although most cases are mild, severe scoliosis may include an uneven pelvis and shoulders as seen in figure 1, one hip being higher than the other, difficulty breathing and back pain. It s unknown why some people develop this condition and is most commonly seen in adolescents ages 10 and older, many times running in families. Exercise or physical therapy cannot straighten your spine or stop scoliosis, however exercise can improve overall health and well-being. As stated on livestrong.com, Reports in the medical literature on individual patients with scoliosis show that Pilates, alone or in combination with other exercise, helps flexibility and mobility, strengthens and stabilizes muscles around joints, decreases back pain and allows posture adjustments to improve spinal alignment and symmetry. One of the greatest benefits Pilates can offer is giving some control back to students by teaching them internal control. Being able to hold your spine from inside is one huge relief to those of us with soft spines, says Suzanne Martin, PT, DPT. Case Study As a scoliotic student, I have used myself as a case study for the purpose of this assignment. I am a female, 36 years old, with a slight thoracic curve to the left. When I was 10 years old, my dance teacher noticed my right should was resting 5

6 considerable lower than the left. Upon having my doctor perform a visual spine check with a roll down it was determined the degree of curvature was not severe enough to warrant a treatment program. Throughout my years of dance and the last few years of Pilates practice, it has presented itself as a challenge and occasionally lower back pain. My full-time career as an event planner has me spending most days sitting at a desk and when on-site executing events a significant amount of time on my feet. I have weak lower abdominals, tight low back extensor muscles, and a high tendency for the quadratus lumborum to fire over the multifidus. During my advanced Pilates repertoire in the last year I began to experience pain and tightness in my lumbar spine. I first worked with my Pilates instructor with emphasis on strengthening my lower abdominals as a way to provide more support to my lower back. With the recent addition of manual physical therapy to my program I have experienced improved pelvic alignment, firing of the lower abdominal and Kegel muscles and reduced tendency to grip in the quadratus lumborum. 6

7 Repertoire Program Block Exercise Desired Result Reason Warm Up -Pelvic curl -Spine Twist Supine -Chest lift -Chest lift w/rotation Bring awareness to the body and warm up muscles to be used during session Warm up the body, engage muscles that will be initiating throughout the session Footwork on Reformer Abdominal Work on Cadillac Hip Work (Strap Work) Spinal Articulation on Reformer Stretches Lateral Flexion/Rotation Full Body Integration F/I Arm Work Full Body Integration A/M Leg Work (strap work) -Parallel heels -Parallel toes -Open V heels -Open V toes -Prances -Mini roll-ups -Mini roll-ups oblique -Roll-up top loaded -Frog -Circles -Hip extension -Bicycle -Bottom lift -Short spine -Standing lunge -Side split -Scooter -Mermaid -Elephant -Up stretch 1 -Down stretch -Chest expansion -Biceps -Hug-a-tree -Balance control front -Changes -Scissors -Circles Pelvic stability Initiate with pelvic floor Maintain neutral spine; when lying on left side relax ribs into mat Spinal articulation; adductor control Psoas engaged, maintain c-curve De-rotation and rib shift left Stabilization of trunk, shoulder, hamstring Focus on shoulder extensor strength, trunk stabilization, de-rotation & rib shift to left Trunk stabilization Pelvic control; allow ribs to relax into mat on left side Strengthen lower abdominals and pelvic floor Adductor strength; initiating from pelvic floor Adductor engagement Rib shift and derotate to the left side Maintain derotation Strengthen back extensors Relax quadratus lumborum, engage pelvic floor Scapular and abdominal strengthening Feedback from springs will allow me to recognize when hip is hiked Lateral -Side stretch Abdominal oblique De-rotation with 7

8 Flexion/Rotation Back Extension (Avalon) -Side kneeling stretch -Side Over with extended arms -Swan Prep (over ball) -High Swan strength and stretch Back extensor strength rib shift left Reduce stress on lower lumbar Conclusion Scoliosis is a prevalent issue among people of all ages, and unfortunately, it can lead to body imbalances, which that lead to functional adaptations. Different muscle groups begin to respond and often over compensate causing the initiators to weaken and become lazy. Pilates can be a great tool to bring awareness to the body, and any compensations or imbalances that may be present. With modifications, Pilates can be used to give clients with scoliosis the ability to control and stabilize their imbalances. 8

9 Bibliography Carlon, Brianne, Scoping Out Scoliosis. 17 December Dance Teacher Magazine Martin, Suzanne. Pilates for Scoliosis. Articles. 3 April Pilates Pro. 1 December National Scoliosis Foundation, Singleton, Bonnie, Scoliosis and Pilates. 5 March