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 6. Conclusion 7. Bibliography and references 1
Abstract People are living longer and what may have been considered elderly a two decades ago is no longer seen in the same way. Today the mature population are healthier through lifestyle choices, modern medicine and exercise. In my opinion a mature client is someone who has experienced physical and psychological changes which has in turn forced them to change the way they live. Pilates is a wonderful exercise option for the mature client if they have never tried it before. It provides a low impact exercise program which is gentle on joints, as well as engaging the mind through the use of the breathing techniques it requires. Pilates training builds a strong core whilst increasing flexibility. It is beneficial to the mature population who might be struggling with balance and muscle and joint stiffness. Pilates is a full body functional movement workout and it s extensive repertoire of exercises can be modified to suit the clients individual needs and sessions can be designed with that need in mind. 2
Anatomical Description Kyphosis is the term used to describe excessive curvature of the spine and can contribute to a hunchback appearance. There are several types of kyphosis and the condition can affect children, adolescents and adults alike. The most common form of Kyphosis is postural kyphosis and is often attributed to poor posture. Postural kyphosis is marked by a smooth flexible curve that is not typically associated with pain. 3
Kyphosis affects 20-40% of the aging population and may include a jutting chin, tight chest muscles, weak spinal extensors causing strain on the neck and a tucked pelvis when standing. A person with postural kyphosis looks like they are slouching as the excessive curve of the upper back forms a hump which is accompanied by the rounding of shoulders forwards. 4
Introduction to case study When planning a Pilates training program for a person with Kyphosis excessive flexion of the spine should be avoided as it will only further promote the posture habits. The focus should be on the stretching the pectoral muscles and strengthening spinal extensors, the rhomboids, deltoids and the core muscles to create more stability and therefore better posture. Case study My client s name is Barbara. She is 73 years old and until a year ago has been physically active playing golf. She had always had slight kyphosis because she is large chested but recently had a reduction surgery to reduce the stress on her body. As a golfer she was in flexion whenever she was swinging the club and combined with a large chest it has put a strain on her back and exacerbated the kyphosis. She also suffers from neck pain and shoulder pain which she often treats through physical therapy. Barbara came to me for training after her reduction surgery to increase her core strength and work on her posture to stop the kyphosis from becoming more exaggerated. At the time she was not following any fitness routine or program and had given up golf as her back was beginning to hurt as well as her shoulders. The only exercise she was doing was walking 30 minutes a day. 5
As Barbara s goal was to increase her core strength and stability, to improve her posture and to halt the onset of further kyphosis. We agreed that she should have Pilates training twice a week for the first 12 sessions. 6
Session plan BLOCK EXERCISE MUSCLE FOCUS GOAL Warm Up Roll Down Fundamental Mat Pelvic Curl Spine Twist Supine Chest Lift Chest Lift with Rotation Abdominals Spinal Extensors Warm up the body, the roll down to assess Barbara s flexibility and tightness and the Mat Warm Up to warm up the body Footwork Reformer Parallel Heels/Toes V-Position Toes Open V Heels/Toes Calf Raises Prances Prehensile Single Leg Heel/Toes Hamstrings Quadriceps Ankle Plantar Flexors Carry on with the warm up especially in the hamstrings and quadriceps. At the same time promoting hip and knee extensor strength, ankle plantar flexor strength. Abdominals Spine Corrector Chest Lift Abdominals The Spine Corrector supports the spine as well as promoting abdominal work. It also gives a good thoracic stretch which is great for Barbara as it will open up the chest. Reformer Hundred Prep Abdominals This is slightly more challenging for Barbara as she was having neck pain. We practiced the exercise with her head down and focused on engaging the abdominals and maintaining a 7
BLOCK EXERCISE MUSCLE FOCUS GOAL Abdominals (Cont) neutral spine throughout as well as keeping her arms straight aligned with her shoulders Hip Work Reformer Frog Circles Down/Up Openings Hip adductors Hamstrings The goal of hip work was to increase hip adductor strength and reinforce pelvic lumbar stabilization whilst maintaining a neutral spine position..great for balance and posture Spinal Articulation (Sessions 10-12) Wunda Chair Pelvic Curl Abdominals Hamstrings Will improve hip extensor control as well as abdominal control and spinal articulation with very light springs. If Barbara felt she didn t want to lie on the floor we performed the pelvic curl on the reformer. 8
BLOCK EXERCISE MUSCLE FOCUS GOAL Full Body Integration (Sessions 10-12) Cadillac Kneeling Cat Stretch Abdominals Back Extensors Core strength and trunk stabilization. Also wonderful shoulder stretch and works on spinal articulation. Arm Work Reformer Arm Supine Series Latisssimus Dorsi Lying down will keep Barbara in a neutral spine position and will allow her to focus on her arm work whilst keeping her chest open and maintaining scapular stabilization. Full Body Integration (Not to be included at this point until session 21) Leg Work Wunda Chair Leg Press Standing Hamstrings A good posture exercise as it challenges balance. It also promotes hip and knee extensor control whilst strengthening the core. Lateral Flexion/ Rotation Ladder Barrel Side Over Prep Abdominals with oblique emphasis Barbara is completely supported by the ladder barrel and can concentrate on maintaining correct alignment and achieving the trunk lateral flexor stretch and strength. Back Extension Reformer Breastroke Prep Back Extensors Barbara is supported by the box and the arm movement is very controlled. The 9
feedback from the box helps to maintain abdominal engagement as well as back extensor engagement. Final Roll Down 10
Conclusion Barbara began the Pilates program with an open mind and was very excited to see the results after 12 sessions. She learnt a great deal about her body throughout the training, learning to stand tall, how to engage her abdominals correctly whilst maintaining a neutral spine and how to get up and down from the equipment correctly. I encouraged the warm up and laterly the spinal articulation block to be on the floor so that she remained fully mobile and maintained confidence in herself and her own mobility. Barbara began to feel more flexible and less tight within the first few sessions and really embraced the learning of the Pilates breathing and the cueing I was giving her. The flexibility of the equipment through the use of springs allowed me to adjust the exercise to make sure it was correctly executed and Barbara felt the most benefit from it. After the initial 6 week training program Barbara has decided to carry on with her Pilates training and has felt a significant decrease in shoulder and neck pain she had been experiencing. She also feels that although Pilates might not reverse the kyphosis she already has, a regular Pilates program will definitely slow its progression. 11
Bibliography and References Books Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts and Science International, 2013 Isacowitz, Rael. and Clippinger Karen. Pilates Anatomy. Your illustrated guide to mat work for core stability and balance, Human Kinetics, 2011 Website Kyphosis, West Ave Neuro and Spine, 2017 by Amir S. Malik. Pilates and Older Adults: A safer, gentler, effective way to stay fit, Balanced Body by Ken Endleman Power of Pilates for older body, myageingparent.com, August 25th 2017 What is Kyphosis?, Healthline Media, 2018 Top 5 Benefits of Pilates for Seniors, sportsconditioningandrehab.com, Scar Fitness Website, 2018 Posture 201: Kyphosis, thepilateshundred.blogspot.com, April 2 2011 Other Research Material Pilates for the Mature Client, Developed and Presented by Sheri Long, BASI Senior Faculty, 2012 12