Using Pilates to Improve Performance in Yoga

Transcription

1 Using Pilates to Improve Performance in Yoga Karina van de Ven Ampuero 30 December Comprehensive Apparatus Program ATP Specific Training, Pasadena, California 1

2 Abstract Here I have studied the case of a practicing Pilates professional who has asked me to help her improve her upper body strength using the Pilates method. Her goal was to better her performance in handstand and 'chaturanga' in Yoga. I created a program for her that was designed to reinforce her upper body strength but also give her more balance by working on the stabilization of her shoulder region. At the start of the program she was suffering from moderate pain in the right anterior deltoid likely caused from the strain of the repetitive chaturanga movement in Vinyasa Yoga. Over a period of 12 weeks in parallel to the goal to strengthen the upper body we tried to establish any shortcomings in form and 'bad habits'. The pain in the right deltoid remained but we were able to improve her strength and also shoulder flexibility. 2

3 Table of Contents Abstract... 2 Table of Contents... 3 Anatomical Description... 4 Case Study... 6 Conditioning Program...7. Conclusion...10 Bibliography

4 Anatomical description The shoulder joint is one of the most complex joints in the human body and it is also the most mobile joint. This provides a wide range of motion for the arm and it provides a fixed point so we can lift object and push against resistance. Interesting to note is that the scapulae are attached to the axial skeleton only by the clavicle at the sternoclavicular joint. The shoulder is actually comprised of four separate joints: The glenohumeral joint: where the head of the humerus meets the scapula in the glenoid cavity. The glenohumeral joint is the primary shoulder joint. It is a muscle dependent joint. It is a ball in socket joint. The head of the humerus is two or three times larger than the shallow glenoid cavity, hence the instability. The acromioclavicular joint: where the clavicle meets the acromion process. The sternoclavicular joint: where the medial clavicle meets the sternum. The scapulothoracic joint: where the scapula glides against the thoracic rib. Image from arthritis-health.com 4

5 Many muscles act upon the shoulder, and we can divide them into three groups: Muscles of scapular stabilization. This groups connects the scapulae to the surrounding bones and stabilizes and move the scapulae not the arm bone. It is comprised of trapezius, thomboids, levator scapulae, pectoralis minor and serratus anterior. The rotator cuff connects the scapulae to the proximal humerus. This group of small muscles also stabilizes the shoulder joint. It includes supraspinatus, infraspinatus, teres minor and subscapularis. The large shoulder muscles include pectoralis major, deltoids, teres major and latissimus dorsi. These muscles move your humerus bone and are most often addressed in Pilates and other forms of exercise. Image from Ekhartyoga.com 5

6 Case Study Carine is a certified Pilates teacher who is trained through Balanced Body Pilates and is unfamiliar with the Basi Pilates system. She is 45 years old, she used to be a dancer and is in overall good health. To keep fit she practices Pilates through self practice and since 4 years also Vinyasa yoga twice a week. Her objective is to improve her handstand and chaturanga in her yoga practice. To achieve this goal she has asked me to help her strengthen her upper body in general through a Pilates program that will take place over a period of 3 months, meeting twice a week. Carine was experiencing moderate pain on her right anterior deltoid for which she had not consulted a medical professional. In some ways similar to Pilates, Vinyasa yoga is a dynamic form of yoga that connects different postures through a recurring sequence of movements that is linked to breath. Included in this sequence is 'chaturanga'. Carine suspects the pain in the anterior deltoid could be from repeated stress to the shoulders from performing the multiple vinyasas with less than perfect mechanics. Chaturanga is similar to a push up in Pilates except for when you have bent your elbows to lower your chest towards the mat, you don't come back up, instead you straighten your elbows and go into extension with your back ( upward dog). It produces a tremendous amount of pressure on the shoulders and in the yoga world this is a common injury. Just like the push up in the Basi repertoire, chaturanga is a very difficult posture and requires lots of practice. The handstand is a posture that requires even more shoulder flexion and strength as one has to balance all the body weight on just the hands. One advantage to working with Carine was that she has an excellent knowledge of 6

7 anatomy and advanced level in Pilates. This allowed me the luxury to use almost all the Basi repertoire from the beginning. The first session I had with her I used as an assessment to see how comfortable she was with the Basi method, and to assess her overall strength and flexibility. I observed that in her front support position she had slightly winged scapulae a sign of a lack of stability in the shoulders. I also noticed her shoulder heads drooped slightly forward. This could point to tight pectorals and long trapezoids. I decided we needed to give special attention to the stabilizing muscles and the rotator cuff. I had to be careful not to create more stress on the muscle and delay her recovery. I decided to make a well rounded program for her to get a balanced work out each time as part of the Basi method. As per the principles of Rehabilitation Protocols it needed to consider the following: Range of Motion, muscle recruitment patterns, strength, closed kinetic chain exercises, stabilization, eccentric and concentric contractions and movement. Conditioning Program BLOCK EXERCISE SESSION # NOTES Warm up Foot Work (Intermediate Basi Warm up) Roll up Spine twist supine Double leg stretch Single leg stretch Criss cross 1 series on varying equipment 0-24 Given Carine's advanced level I was able to start her off with the intermediate warm up right away 0-24 The focus was not on lower body but we always included a foot 7

8 work series in our sessions. Abdominal Work Pike sitting Full Pike The pikes were great for here engage and strengthen serratus anterior Hip Work 1 series on varying equipment Spinal Articulation Stretches Full Body Integration F/I Arm Work Pelvic curl on reformer Monkey original Shoulder stretch Pole series Scooter Round back Side reach Rowing series Shrugs Triceps prone This was a great way to focus on lateral rotation of the arms Used to teach keeping scapulae on the back We worked this in the last session when the deltoid felt a better Used to look closer at proper shoulder mechanics I avoided the side arm kneeling series as to spare stress on the deltoids Full Body Integration A/M Leg Work Lateral Flexion/Rotation Back Extension Tendon stretch (reformer and chair) Balance control front Long back stretch Balance control back prep 1 exercise varying Mermaid Butterfly arms Side Pike Swan on floor Prone Used when possible if no pain was experienced Play with resistance to work on shoulder stability 8

9 Discussion In the warm up I payed close attention to her keeping her scapulae stable in the roll up and also when hands were behind the head I made sure the shoulder blades were gliding down the rib cage. On the foot work was no particular focus and so it was mostly used as a warm up. In the abdominal work there were more opportunities for us to work on the upper girdle. The pikes on the Wunda chair were perfect for us to work in the stability of the shoulders while getting ab work in. In particular full pike which we used in the last month. The serratus anterior being one the main players in stabilization of the shoudlers this exercise was key in meeting our goal. For the hip work I liked to uses the side leg series on the cadillac for increasing awareness of the shoulders. In the spinal articulation block monkey original worked well to keep the shoulder blades hugging to the ribcage. In the stretches we would cautiously work on her rotator cuff muscles in the shoulder stretch on the cadillac. The Pole series ( we used a theraband) was key in increasing range of motion, we used in every session. In the full body intgration f/i the knee stretch series was ideal for our focus and we noticed a lot of gain in strength in these exercises. The in the arm work block we like the shrugs to work on the trapezius another stabilizing muscle we were seeking to strengthen. The rowing series were very integrative of all the different muscles working together to perform the complex movement. Sometimes we would work with medecine balls as to integrate open kinetic chain exercises. The hug a tree was helpul in developing strength in the pectorals and scapula glide helped mobilize and identify the scapular abductors and adductors. In the full body integration a/m we worked our way up from back support where she would need to use her lower trapezius and serratus anterior to depress the scapulae. We then moved towards balance control back prep and finally balance control. Long back stretch and the tendon 9

10 stretches were our peak poses that integrated the whole shoulder girdle. The lateral flexion was another key block for Carine to put into practice shoulder stabilization. We used the complex movements of standing butterfly arms and side pike to challenge her. The back extensions were sometime painful and we played around with swan on floor to develop trapezius and also prone 1, leaving prone 2 for when she was pain free on the deltoid. Conclusion Carine thoroughly enjoyed being a student again and having bi- weekly private sessions. In spite of her injury to the anterior deltoid we were able to improve her shoulder stability and increase awareness of the shoulder region in the front support position. We worked on reinforcing her upper body strength and range of motion of the arms. Specifically we achieved stability in her scapulae in the chaturanga posture and she noticed more ease in the handstand in the last weeks of the program. We did this by emphasizing the work on the stabilizing muscles and rotator cuff. Pilates was a very nice complement for her Yoga classes where very little time is spent on instructing proper alignment and mechanics of the shoulder. Carine was able to apply her increased awareness of the position of the shoulder blades in her Yoga classes and was able to move with more ease and less pressure on the shoulder joints decreasing the likelihood of more future injuries. 10

11 Bibliography Isacowitz, Rael and Clippinger, Karen. Pilates Anatomy. Human Kinetics. Champaign, IL, 2011 Calais- Germain, Blandine. Anatomy of Movement. Seattle, WA : Eastland Press, Inc, 2014 Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts and Science International, Hately Aldous, Susi. Anatomy and Asana: Preventing Yoga Injuries. Seattle, WA: Eastland Press, 2006 Keil, David. Just blame Chaturanga Yoganatomy Oct. 20, Feldmann, Tim. Where should my shoulders be in chaturanga Loveyogaanatomy April 15, Sugerman, Leah. Rethink your chaturanga alignment: 6 practice tips Toner, Jennilee. Our Complicated Shoulders and chaturanga dandasana Bracilovic, Ana. Shoulder Joint Structure January, 12,