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. A hairdresser must stand for many hours at a time in a hunched over or forward leaning position whilst also rotating and twisting the body in many different positions during the course of a day. It is no surprise then that hairdressers can suffer from a range of occupation-related conditions of the musculoskeletal system over the course of their careers. These complaints can range from head and neck pain, shoulder impingement, lower and upper back pain and lack of mobility and movement in the spine and body. The European Agency for Safety and Health at work found that the number of hairdressers reporting with serious or regular musculoskeletal complaints is estimated to be almost 40% for work-related arm, neck and shoulder complaints. It also states that complaints of the forearm and wrists such as Carpal Tunnel Syndrome and Tennis Elbow are common amongst hairdressers due to repetitive movements and badly designed workspaces and equipment. 2
Table of Contents Content Page Abstract 2 Anatomical Description 4 Case Study 6 Pilates Conditioning Programme 8 Conclusion 11 Bibliography 12 3
Anatomical Description The spine is designed to move in many directions, including flexion, extension, lateral flexion and rotation. Good movement patterns in all directions are recommended to avoid imbalances in the body. The diagram below illustrates the main muscle groups involved with movement of the spine. 4
When the thoracic spine is stiff and immobile due to repetitive use in one position or poor mechanics, the upper trapezius and levator scapulae tend to get overworked and become tight. The serratus anterior and lower trapezius then become weak and the pectoral muscles become tight. As a result they pull the shoulders forward into a rounded position. This can cause a kyphotic posture and lead to instability and pain around the shoulders and upper back area. This is a common complaint amongst people whose jobs involve leaning forward i.e. desk workers, hairdressers, drivers etc. Diagram shows the main muscles of the upper back and shoulder. 5
Case Study Name: Louise Age: 51 Limitations: Stiffness and pain in upper and lower back, general lack of mobility for her age Louise is a 51 year old who has worked as a hairdresser for 35 years. She works five days a week and runs her own small salon. Being selfemployed Louise holds full responsibility for all the running of the salon and only has assistance at extremely busy times like Christmas or major calendar events. She is therefore stressed most of the time. She has had lower back issues for many years but recently has begun suffering with severe pain across her upper back, shoulders and neck. She also complains about foot pain and swollen ankles and a general lack of mobility in her body. Although she is on her feet all day working she does very little physical activity outside of work. She had been attending weekly Pilates mat classes for about a year and found they helped but her attendance was erratic due to work commitments. She decided to commit to one-to-one Pilates sessions and agreed to come twice a week. 6
Although Louise s main problem area was her upper back, it was clear that she needed a fully body conditioning programme that addressed not only the upper back but dealt with her long-standing lower back issues as well as the lack of mobility in her hips, knees, ankles, feet and hands/arms as well. She also needed help managing stress as her sleep patterns had deteriorated and she was unable to switch off from work. She was also at the early stages of menopause and had been gaining weight, particularly around her stomach area. I designed a programme for Louise following the BASI Block system, which encompasses the body, mind and spirit. I explained to her that Pilates is not just a system of exercises for one part of the body, it is a full-body holistic discipline which involves movement as well as body awareness and mindfulness. Regular practice would help her to deal with her stressful life and bring that body awareness to her work to help improve her posture and movement patterns. It would also serve to strengthen her body in order to avoid future injuries and teach her how to stand and move so that she could continue working in the profession she loves for many more years. 7
Pilates Conditioning Programme Block Sessions 1-10 Sessions 11-20 Observations Warm Up Footwork Abdominals Hip Work Roll Down Pelvic Curls Spine Twist Supine Chest Lift Chest Lift with Rotation Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raises Prances Prehensile Single Leg Heels Single Leg Toes Hundred Prep Hundred Supine Leg Series: Frog Circles Down/Up Openings Roll Down Pelvic Curls Spine Twist Supine Chest Lift Chest Lift with Rotation Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raises Prances Single Leg Heels Single Leg Toes Roll Up with RU Bar Mini Roll-Ups Mini Roll-Ups Oblique Basic Leg Springs Series: Frog Circles Down/Up Walking Bicycles Warm up helped to get the client into a relaxed state, leaving the outside world behind and engaging fully in the practice with deep breathing. Starting to gently move the body. Good for assessing mobility, flexibility and strength. Client found footwork challenging, particularly calf raises and prances due to tightness and stiffness in ankles. However she felt the benefit immediately. Worked on proper engagement of abdominals in neutral pelvic position without neck tension. Adductors and hamstrings tight and right-side dominant. Focused on balancing effort on both legs and pelvic stability. 8
Block Sessions 1-10 Sessions 11-20 Observations Spinal Articulation Stretches Full Body Integration Arm Work Bottom Lift Step Barrel Shoulder Stretch Lying Side Standing Lunge Knee Stretch Series: Scooter Round Back Flat Back Reverse Knee Stretch Arms Supine: Extension Adduction Circles Up/Down Triceps Wunda Chair Pelvic Curl Step Barrel Shoulder Stretch Lying Side Standing Lunge or Kneeling Lunge Push Through Series: Sitting Forward Side Reach Kneeling Cat Stretch Arms standing: Chest Expansion Hug A Tree Circles Up/Down Punches Biceps Focused on controlled, accurate articulation, particularly upper back and stabilising ribcage. Hamstring flexibility and glute strengthening. Gradual progression to full ROM in shoulder, chest opening/holding pectoral stretch. Standing/kneeling lunge helped to lengthen shortened hip flexors and hamstrings. Focused on teaching abdominal engagement in full body movement also spinal articulation with thoracic spine opening in side reach and shoulder stretches. Worked on precision of arm movements, building shoulder mobility, scapula stabilisation, engagement of serratus anterior, work on rhomboids and lower trapezius. Building functional strength and training good postural movement. 9
Block Sessions 1-10 Sessions 11-20 Observations Leg Work Lateral Flexion/Rotation Single Leg Skating Mermaid Squats Butterfly Leg strengthening work and functional movement. Thoracic spine and obliques focus. Bilateral functional movement. Back Extension Step Barrel Swan Prep Wunda Chair Swan Basic Gradual progression of upper back extension to encourage more articulation and movement, also stabilisation and awareness of scapula placement. 10
Conclusion Before Louise started her Pilates programme she was generally quite unhappy with her state of health. She had chronic pain in her back and was barely able to bend down to put on her shoes. She saw her pain and discomfort as a natural consequence of her job. However once she made the decision to commit to coming to Pilates twice a week she saw an almost immediate improvement. There have been times when she is too stiff and sore to do some exercises but we modify the movement to suit. The beauty of Pilates is that ability to work to the needs of client on the day. Louise has achieved considerable relief from the back pain, has gained more mobility in her spine and is moving much more freely. Pilates has taught her how to hold herself when working and she is more aware of her posture. After a busy day in the salon Louise now does some home stretching and Pilates breathing and finds this helps her to wind down, so she is managing her stress much better. She continues to come twice a week and has said that Pilates saved her career. Louise has proven that the art of good movement is key to a happy and healthy lifestyle. 11
Bibliography Books 1. Isacowitz, Rael. Study Guide: Comprehensive Course. Body Arts and Science International, Costa Mesa, California 2000-2014. Websites 1. European Agency for Safety & Health at Work: Risk Assessment for Hairdressers http://osha.europe.eu 2. Diagram of Upper Back Muscles: http://acefitness.org/acebonesdiagram 3. Diagram of Movements of the Spine: http://cemmaresme.com/ 12