Benefits of Pilates and Fibromyalgia Lesli J. Spaulding January 2017 2016 Costa Mesa, Ca.
Abstract My research paper explores the application of a Pilates training program, and the health benefits that my client experienced who suffers with incapacitating fatigue and muscle pain due to a underlying neurologic condition. My client came to me about nine months ago after being diagnosed with fibromyalgia. She had been suffering for about 3 years with symptom that included headaches, ligament pain, irritable bowel syndrome, and other tormenting symptoms. She was only 32 years old and desperate to fight to get her life back! As a trained BASI pilates apprentice my solution was to develop an exercise conditioning program that would be a complementary approach with low impact to accommodate her painful symptoms and physical limitations. Over our nine month journey together her emotional and physical well-being has demonstrated an incredible improvement with a decrease in symptoms. She understates it is a slow process but she is getting stronger and feels back in control. She has an incredible appreciation of how Pilates has begun to change her life. 1
Table of Contents Abstract. 1 Table of Contents 2 Anatomical Description. 3 Case Study. 6 Conditioning Program 7 Conclusion. 11 Bibliography.. 12 Anatomical Description 2
Description/Symptoms/Treatments The term fibromyalgia is from New Latin, fibro-, meaning fibrous tissue, myo - Greek muscle, and Greek altos- pain, thus the term literally means muscle and fibrous connective tissue pain. Fibromyalgia (FM) is a medical condition characterized by widespread pain and a heightened pain response to pressure. It is thought to be a neurologic condition that causes generalized disorder with tender spots in the body effecting the muscle, tendons and ligaments. People suffering with FM typically have tormenting fatigue and exhaustion, sleep disorders, IBS and headaches just to name a few. These symptoms tend to lead to anxiety, depression, and difficulty concentrating. There is no definitive test for FM and the cause is unknown, but it effects 6-12 million people in the US; mostly women 25-50 years old. Doctors use what is called a diagnosis of exclusion meaning that when similar conditions are eliminated as possibilities (such as osteoarthritis, bursitis, tendinitis), fibromyalgia may be diagnosed. While FM can last a long time and be devastating, it does not result in death or tissue damage. As with many other medically syndromes, there is no universal accepted treatment or cure for fibromyalgia, and treatment typically consists of symptoms management. Development in the understanding of the pathophysiology of the disorder have led to improvement in treatments, which include prescription medication, behavioral intervention, and especially exercise. 3
Fibromyalgia Syndrome (FMS) The location of the nine paired tender points that constitutes the 1990 American Coulee of Rheumatology criteria for Fibromyalgia (FM). 4
Treatment of FM Pain Relief through Pilate Exercises Daily life for people affected by FM is a routine consisting of chronic pain, sleep problems and debilitating fatigue, as well as, many other conditions like stiffness, soft tissue and musculoskeletal pain. Due to their situation FM patients are resistant to exercising because they are afraid that it s going to cause their pain to worsen. However low-impact exercising is the key to reduce pain and to improve stamina. Pilates is a low-impact program that emphasis mind and body discipline that teaches body awareness. This is of great importance since FM suffers tend to disconnect from their body. Pilates is a wonderful and fun way to experience well-being while getting healthy and moving the stiff joints and muscles. It is a program based on gentle strengthening which helps to relieve muscle tension, reduce fatigue and anxiety, and increase energy. BASI pilates focuses on core strength, flexibility, range of motion and balance while reducing stress; all of the areas needed for FM suffers. Pilates is based on the individual and this philosophy method is so appropriate for the FM population. The center is a personalized program focusing on gentle stretching exercises, and on a deep core stabilization work for both the pelvic and scapula stabilization. FM clients should optimize early hour sessions so that they start their day oxygenating their bodies with a breathing-focused routine, and the onset of fatigue can be pushed back in many case. 5
Case Study My client was only 29 years old when she first began experiencing symptoms of pain throughout her body. Many days she had a horrible feeling of being exhausted, and in need of a nap halfway through her day. Her joints felt stiff and this kept her from enjoying her day which resulted in depression. When she began missing work, and missing out on activities with her children she consulted her doctor. She ended having to go through several diagnostic tests. There is no definitive test for fibromyalgia. Doctors used what is called diagnosis of exclusion (ruling out other potential causes and verifying that a set number of symptoms are present). The cause of FM is unknown and believed to involve a condition of genetic and environmental factors with half the risk attributed to each. Her doctors recommendations included getting enough sleep, exercise regularly and a healthy diet. My goal for my client was to begin a slow and low-impact program including gentle stretching of the musculature with gentle contraction of the muscles. Using the BASI block system my focus is quality of movement as opposed to quantity. The BASI system uses controlled exercises that promote balance, strength, flexibility and muscle development, while also helping to relieve muscle tension. Pilates promotes both physical and mental health. Conditioning Program 6
When developing a conditioning program for my client I took into considerations the following concerns: medications that she was taking and any other psychological components that may exist, poor posture and a sedentary lifestyle due to her pain and tender points. I also notice a presence of fibro fog memory problems, and a disconnection tendency to her body due to pain. Pilates while safe for almost anyone at nearly any age and level of fitness, there are certain conditions and symptoms that must be accommodated or might be a contraindication. It is important to conduct a fitness assessment that includes measuring the client s flexibility and strength, as well as, assessing balance, joint range of motion, posture and gait. Communicating goals and expectations is great way to design a safe, fun, and challenging individual program that can help overcome symptoms of fibromyalgia. Note that when you first begin working with your FM client s conditioning program, they may have to work through some additional discomfort at first as their body becomes used to no movement, but within weeks pilates will start to alleviate their symptoms. And without exercise, fibromyalgia can become a progressive disorder, as unused muscles stiffen and atrophy, causing more pain and muscle damage. Pilates also improves their mental state, helping to reduce anxiety, sadness and stress that can be experienced coping with fibromyalgia. BASIC PROGRAM SESSION 7
WARM UP (MAT) Sometimes mat work maybe challenging as a starting point for client s with fibromyalgia because it lacks the support and proprioceptive associated with the Reformer and Cadillac. But the Foundation Warm up exercises are excellent for stretching and pelvic stabilization. I also incorporate Theraband stretching and chest opening. Roll Down - Access posture and alignment Pelvic Curl - Neutral spine, deep pelvic floor and focus on abdominals and hamstrings. Spine Twist Supine - Spinal rotation while maintaining alignment of the core. Chest Lift - Abdominal strength and pelvic stability. Chest Lift with Rotation - Abdominals with obliques and pelvic stability. Rest Position - Relaxation of lower back and lumbar stretch. FOOT WORK (REFORMER) Foot work is a great secondary warm up because of the focus on the hamstrings and quadriceps. Great for strengthening hip extensors, knees and ankles. Parallel Heels Parallel Toes V Position Toes Open V Heels Open V Toes Calf Raise Prances 8
ABDOMINAL WORK (REFORMER) Hundred Prep - core stability and shoulder extensor control. Hundred - Abdominal with Oblique emphasis and Hip flexor strength. Coordination - Abdominal strength and stabilization. HIP WORK (REFORMER) Frog - Hip adductor strength and knee extensor control. Circle (Down, Up) - Hip adductor strength and knee extensor control. Opening - Hip adductor stretch and strength. Extended Frog - Hip adductor stretch and strength. Extended Frog Reverse - Hip adductor stretch and strength. SPINAL ARTICULATION (REFORMER) Bottom Lift - Spinal Articulation. STRETCHES (REFORMER) Standing Lunge - Hip flexor and Hamstring stretch FULL BODY INTEGRATION (REFORMER) Scooter - Knee stretch ARM WORK (REFORMER) ARMS SUPINE SERIES Extension - Shoulder Extensor strength Adduction - Shoulder Adductor, Extensor and Mobility. 9
Up Circles - Shoulder Adductor, Extensor and Mobility. Down Circles - Shoulder Adductor, Extensor and Mobility. Triceps - ElbowExtensor strength LEG WORK (WUNDA CHAIR) Leg Press Standing - Balance focusing on hamstring. LATERAL FLEXION/ROTATION (REFORMER) Mermaid - Spinal mobility and Scapular stabilization. BACK EXTENSION (REFORMER) Breaststroke Prep - Back Extensor I continued sessions on the Reformer with the adjustment of incorporating intermediate exercises. I also added work on the Cadillac and stretches on the Ladder Barrel. Conclusion By incorporating a BASI pilates program using the Block System, my client experienced amazing health benefits. Her pain and fatigue improved, and she noticed a reduction in muscle tension. She noticed improved posture and coordination, and an overall feeling of being back in control of her life. As her flexibility, strength and functional improvements were made in her joints she was also able to begin other forms of fitness such as cardiovascular exercises. 10
The pilates conditioning program focused on core strength, flexibility and balance which decreased her stress level. This therapeutic form of exercising uses a low- impact routine; it was slow and controlled with little or no impact on her joints which gave her confidence. This is so importance due to her tender spots of pain, and her fear of making it worst by exercising. She is now back to being able to partake in her family activities, and she is no longer having to miss work due to pain and stiffness. She has fewer headaches and her IBS is improving. She is committed to her weekly pilates sessions because she has experienced such a vast improvement in the quality of her life and is having fun too. She is grateful! Bibliography Books Isacowitz, Rael- MA Founder and Director. Body Art and Science International Study Guide Comprehensive Course 2000-2014. Costa Mesa, California: 2014. Clippinger, Karen and Isacowitz. Pilates Anatomy. Human Kinetics Champaign, IL USA 2011 11
Websites Shirer, Gabrielle. Benefits of Pilates. Pilates Coreterly. Sacramento, California Fall 2006 Fibromyalgia -Symptoms.org / Fibromyalgia and Pilates. 2016 ATMD, LLC. Pilates for Fibromyalgia Mayo Clinic and National FM Assoc. C. 2017 12
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