Basic Pilates Training for Sports and Massage Therapists

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Basic Pilates Training

For sports and massage therapists

WelcomeBasic Pilates Training: 26th November

With Louise Rigby and Alicia Jamous


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Itinerary


9-9:45- Welcome and Pilates Taster class9:45-10:30-History and Theory of Pilates10:30-10:45-Break10:45-11:05- 5 key elements11:05-11:25-Visual Imagery Workshop11:25-11:55-Key Pilates exercises11:55-12:15-Case Studies12:15-12:45-Equipment Workshop12:45-1:00- Research and Questions

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Introduction


What is Pilates?● Exercise concept that focuses attention on the balance of

deeper core muscles Vs larger superficial muscles.● Pilates can be adapted to any level and pathology, so it is very

useful for therapists to use as part of a rehabilitation programme.

● Aspects of pilates includes improving balance, coordination, mobility and muscular strength and endurance.

● Evidence ? Same as many rehabilitation techniques- little to support Pilates but some good work around stability from authors such as Panjabi, Hodges, Richardson.


Pilates Taster

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History of Pilates


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History of Pilates• Joseph Pilates• Born in Germany in 1880• Suffered with many childhood

illnesses• He studied zen, yoga and exercise

regimes of the ancient Greeks to increase his immunity

• During WW1 he worked as an orderly in hospital and introduced exercise…


History of Pilates


History of Pilates• In 1926 Pilates and his wife Clara developed

and taught the method in their “body conditioning gym” in New York.

• The “contrology” exercises soon became popular especially amongst the dance community.

• As Pilates and his wife did not speak much english, most of the teaching relied heavily on hands-on corrections, a teaching method still used today.


History of Pilates• Pilates published two books “your

health” in 1932 and “return to life through contrology” in 1945.

• Through these writings his exercises were developed by his students following his death in 1967 age 83. The contrology exercises were then remained to Pilates.

• Through the years pilates has evolved to include modern pieces of equipment, however the roots and key techniques have remained the same.

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Theory of Pilates



Mobilisers Vs stabilisers Mobilising muscles

○ Found close to the body’s surface

○ Typically made up of fast twitch muscle fibres so can produce great power but lack endurance e.g. Rectus femoris/ Psoas

○ Cross two joints

Stabilisers○ Found deep in the body○ Made up of slow twitch

muscle fibres so have great endurance which is used to assist postural control e.g. Transabdominals

○ Only crosses one joint


ImbalanceTo avoid dysfunction, both muscle groups should work together.

During times of injury or dysfunction, mobilising muscles can take over stabilisers and try to stabilise on their own..


Muscular Slings● The Myofascial Slings provide force

closure of the Sacroilliac joint to help stabilise the pelvis and spine

● Failure of any sling to provide stability leads to lumbo-pelvic pain and dysfunction.


Muscular Slings

There are 5 key muscular slings:○ The primary slings○ The longitudinal sling○ The posterior oblique sling○ The anterior oblique sling○ The lateral sling


The Primary Slings ● ‘The Centre’● Provides segmental stabilisation

to the spine● Comprised of the transverse

abdominus, multifidus, pelvic floor and the diaphragm.

● Dysfunction: delayed Transverse abdominus activation.

● Assess dysfunction usingscissors and Hundreds.


Deep Longitudinal Sling

● Provides gluteal and hamstring balance● Comprised of the erector Spinae muscle

group, thoracolumbar fascia, sacrotuberous ligament, long dorsal ligament and the biceps femoris.

● Dysfunction: overactive hamstrings.● Assess dysfunction using shoulder bridge

and one leg stretch.


Posterior Oblique Sling● Provides force closure SIJ.● Comprised of the latissimus Dorsi, the

contra-lateral gluteus maximus muscles and the posterior layer of the thoracolumbarfascia.

● Dysfunction: Delay in gluteal activation which may cause SIJ laxity.

● Assess dysfunction using swimming.


Anterior Oblique Sling ● Comprised of the external oblique and

contra-lateral adductors● Compresses pelvic girdle, securing the

Symphysis Pubis● Dysfunction: delay in abductor and

adductor strength● Hip twist, Adductor Lift


Lateral Sling● Glutes and adductors● Provides pelvic stability in the frontal plane● Dysfunction: Trendelenburg● Clam, Side kick, Hip twist


Pilates for rehab Pain/injury:

● Alters normal movement patterns as inhibits muscles stabilisers

● This can cause initial global muscle spasm● Reduces proprioception = reduced local joint protection● Disuse muscle atrophy (multifidus) ● Recovery is not automatic ● Pilates aims to retrain local and global muscle systems

and incorporate synergy into function● Principles work for all joints- neck, shoulder, hip etc.


Other benefits ● Injury prevention● Chronic pain/fatigue management● Improved posture● Increased flexibility● Improved balance/co-ordination● Enhanced sporting performance● Relaxation/reduced stress● Improved mood● Better daily function● Social aspect


Tea/Coffee Break

Please follow:@LouPhysiocouk@Aliciajamous1


Five key elements of Pilates

1. Head and neck position2. Shoulder position3. Ribcage placement4. Neutral spine/ pelvis position5. Breathing


In groups come up with sentences which can be used to describe how to:

1) Activate transAb/pelvic floor.

2) Assume a neutral spine position/pelvis

3) Scapula position 4) Head and neck

Imagine you are describing it to an alien who has never even heard of pilates before.

Visual Imagery Workshop


● Shoulder Bridge

● Hip Twist

● Scissors

● Side Bend

● Breaststroke

● Swimming

● Sidekick

● Clam

Key Exercises


Case studies


● Lower back pain can be the result of a variety of problems within the spinal muscles, ligaments, nerves, bones, discs or tendons in the lumbar spine.

● Pilates exercises can strengthen the muscles in your primary sling which can support and improve the posture and function of the lower back.

Exercises to help reduce lower back pain include:

1. Scissors L1 and L22. Shoulder bridge L1 and L2

In pairs, practice teaching and performing these exercises. REMEMBER: Apply the 5 key elements to all exercises.

Lower back pain


● Poor posture is a result of of weakness and lengthening in the posterior shoulder muscles and shortening of the anterior shoulder muscles.

● Also referred to as Upper crossed syndrome.

Exercises to improve posture include:

1. Breast strokes L1 and L22. Swimming L4


Poor Posture/Mechanical Neck Pain


Knee Pain● Knee pain can be a result of many lower limb dysfunctions such as

muscular imbalance, repetitive straining or poor foot/knee posture.● Weakness within the glute muscles can cause the “trendelenburg

effect” with every step.● Knee pathologies that could benefit from pilates include

patellofemoral pain syndrome, valgus deformity, patella tendinopathy, knee osteoarthritis.

Exercises that can help reduce knee pain:1. Clams L1 and L22. Sidekick L1 and L2



Shoulder Pain● Shoulder pain can be the result of postural or muscular imbalances in

addition to traumatic or repetitive injuries.● Common shoulder pathologies that could benefit from pilates

include: previous shoulder dislocation, hypermobility and impingement.

Exercises that can help to reduce shoulder pain by improving proprioception:

● Side bend L1 and L2● Swimming L4



Equipment Time

magic circlesoft ball

theraband weight

foam roller


Precautions/ Contraindications

● Acute/ Severe pain ● Unstable/ Acute disc pathology● Overactive piriformis (glute work only)● Spondylolisthetis (avoid Lx extension)● Avoid supine positions if 12 weeks + pregnant● <6 weeks post natural birth and <8 weeks post C-section● Diastasis (no rectus abdominus activation)


Research


Influence of pilates mat and apparatus exercises on pain and balance of buisnesswomen with chronic low back pain. (Chae-Woo Lee, 2014).

● Participants: 40 buisnesswomen with chronic non-specific low back pain● Methods: participants randomly allocated to pilates mat exercises or pilates apparatus

exercises. Both groups performed pilates exercises 3 days a week for 8 weeks. Exercise programme were 50 minutes long- 10 minutes of warm up/30 mins of main exercises and 10 minutes of cool down.

● Outcome measures: static balance ability (sway length and velocity) were measured when stood on a balance performance monitor. Pain measured via VAS.

● Results: both groups resulted in significant decreases in pain level the improvements in PME was greater. Both groups showed decreased sway length and velocity but again PME was greater decreases.

● Conclusion: Pilates exercises are successful in improving balance and reducing pain in patients with non-specific LBP.PME is more suitable for LBP patients as it uses body weight to strengthen core muscles rather than heavier apparatuses as in PAE.


The effects of pilates-based exercise on dynamic balance in healthy adults (Johnson, 2007).

● Participants: 40 subjects were randomised to a control or experimental group.● Methods: Experimental group completed 10 pilates sessions within 5 weeks. All

exercises were performed on a reformer. The control group received no pilates training and were instructed to retain current exercise levels.

● Outcome measures: Functional reach test- patient stands with arm flexed 90 degrees in front of them. Baseline measurement taken from toes to 3rd metacarpal. Patient then asked to lean as far forward as possible without moving feet. New measurement taken and amount of excursion recorded.

● Results: Those in the experimental group experienced significant increases in balance. The control group demonstrated no significant changes from pre- and post- intervention time.

● Conclusion: 10 sessions of pilates was helpful at improving balance in healthy subjects and therefore athletic performance. Subjects were able to improve core stability and become more kinesthetically aware of how to reduce faulty movement patterns, resulting in improved motor control.


The effects of pilates training in people with anklylosing spondylitis (Altan et al, 2012).

● Participants: 55 participants with anklylosing spindylitis (duration of disease 2-22 yrs)● Methods: Patients randomly assigned to one of two groups, group 1=pilates exercise 1

hr 3x a week for 12 weeks. Group 2=patients continues previous standard RX programme.

● Outcome measure: Primary outcome measure- functional capacity Bath ankylosing spondylitis functional index (BASFI). Exploratory outcome measures: disease activity (Bath ankylosing spondylitis disease activity index (BASDAI), Spinal mobility (Bath ankylosing spondylitis metrology index (BASMI), chest expansion (measuring increase in chest circumference), Health quality (anklylosing spondylitis quality of life).

● Results: group 1 showed significant improvements at week 12 and 24 in primary outcome measures and chest expansion.

● Conclusion:pilates exercise programme can promote improvements in functional capacity in patients with AS for up to 6 months

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Basic Pilates Training for Sports and Massage Therapists

Healthcare

Transcript of Basic Pilates Training for Sports and Massage Therapists