PILATES

AND

OSTEOPOROSIS

NATALIEGILLOT

20thJuly2017

2015

THEPILATESCLINIC

WIMBLEDON

UK

ABSTRACTSUMMARYOsteoporosisisaprevalentcondition,mostcommonlyoccurringinwomen,butalsooccurringinmentoalesserdegree.Asit’saconditionthatcanbothbepreventedandimprovedbyexercise,itseemstomecrucialthatweasteachersofexerciseunderstandtheconditionandmoreimportantlyknowhowwecansafelyandeffectivelycreateprogramsforourclientsinthispopulation.Pilatesstudents,atleastatthemomentarepredominantlyfemale,andweseeperhapsaproportionallyhighernumberintheover50’sagecategorythantraditionalgyms.ItisthereforehighlylikelythatwewillbeteachingpeoplewithanOsteoporosis.IthereforewantedtoresearchtheconditionsothatIcanconfidentlycreateandteachmyclientswhoarepresentingwiththecondition.

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CONTENTS1.TITLEPAGE2.ABSTRACTSUMMARY3.CONTENTSPAGE4.ANATOMICALDIAGRAMS5.WHATISOSTEOPOROSIS6.WHATISOSTEOPOROSISCONT7.WHATISOSTEOPOROSITCONT8.CASESTUDY9.PILATESWORKOUTPLANUTILISINGTHEBASISYTEM10.CONCLUSION11.BIBLIOGRAPHY

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ANATOMICALREFERENCES

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Comparisonofhealthybonetoosteporoticbone

Commonfracturesites

Effectsofosteoporosisonthespine

WHATISOSTEOPOROSIS?DuringmyresearchIwasgenuinelyshockedtolearnthatintheU.K.1in2Womenand1in5menwillsufferafracture,typicallyinthehip(neckoffemur)spine(lumbarorthoracicvertebra)orwrist(distalradius)duetoOsteoporosis.Osteoporosisisdefinedaslossofbonedensity.Theproblemoccurswhenboneresorptionoutpacesbonedeposition.Inlargepartthisisduetodepletionofcalciumfromthebody–morecalciumislostisurine,fecesandsweatthanisabsorbedfromthediet.Thiscanbeduetoanumberoffactors,themainreasonbeingthedeclineinoestrogenafterthemenopauseinwomen.BoththemainhormonesOestrogeninwomenandTestosteroneinmenstimulateosteoblastactivityandsynthesisofbonematrix,soadrophasadirecteffectonbonehealth.TherearemanyotherpossiblereasonswhysomebodymaydeveloposteoporosisincludedlongtermuseofsomemedicationorhavingaspecifichealthconditionsuchasHyperthyroidism.Asedentarylifestyleandapoordietalsoarefactors,aswellasgenetics,smokingandalcoholconsumption.Medicalexpertsadviseadietprovidingadequatecalciumandregularweightbearingexercise.Althoughitisclearthatthiswillbefarmorebeneficialwhenadoptedasyoungwomenthatdrugslateron.Preventionisdefinitelybetterthancure!

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Osteoporosisisasilent,oftenpainlessdisease.Thefirstindicationthatsomebodymayactuallyhavetheconditioniswhenaboneisbrokenafterwhatseemslikeafairlyinnocuousincident.Asubsequentbonedensityscanmayrevealthatbonedensityhasbeenlost.Afterafirstfractureasecondishighlylikely.Afractureofthehipisseriousandalwaysleadstohospitalization,areductioninnormalactivityandcancauseprolongedorpermanentdisabilityorevendeath.Afractureofthespinalvertebrawillresultinlossofheight,nerveentrapment,severebackpainanddeformity–thoracickyphosis.ItisthereforeimportanttofocusonpreventionoffallsinaPilatesprogramforthoseStudentswhohavebeendiagnosedwiththecondition,infactbalanceworkisanimportantpartofanyPilatesprogrambutspecificallyforOsteoporosissufferers,forwhomtheresultsofafallcouldbedevastating.Thepsychologicalimpactofafracturemustn’tbeoverlooked.Anactive60yearoldwhofracturesawristandthendiscoversshehasosteoporosiswillsuddenly

feelveryold.Shewilltemporarilyloseindependence,beunabletodrive,anddoallthethingssheenjoys.Preventionisalwaysthegoalbutwemayalsoseeclientswhoarepostfracturewhowillneedreassurancethattheycantakepartinanexerciseprogrammesafelywithoutfurtherinjuries.Itisalsoquitepossiblethatifweareteachingolderclientsthatosteoporosisisalreadypresent.Theremaybeindicationssuchaspain,lossofheight,or

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kyphosisthatwerecommendthattheseclientstalktotheirdoctoraswecouldbegivingthemunsuitableexercises,puttingthematriskoffracture.ThePilatesmethodisanidealoptionforosteoporosissufferersasitencompassesweightbearingresistancetraining,inaverysafeenvironmentundertheguidanceofateacher.Movementswhichshouldbeavoided,includeflexionandflexionwithextension.Flexioncanincreasepressureontheanteriorportionofthevertebralbodieswheretheyareweakest.Loadedlateralflexionshouldalsobeusedwithcautionandanyabruptorexplosivemovementsavoided.Extensionexerciseswillhelpboneincreasebonedensitywiththeaddedadvantageofimprovingposturebystrengtheningthemusclesoftheposteriorchain.Theposteriorportionofthevertebraisstrongeranddenserthantheanteriorportion,makingextensionasafeoption.Encouragingaxialelongationwillhelptocreatespacebetweenthevertebrae.

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CASESTUDYIhavebeenteachingalovelylady,Kateforabout5years.Sheis57yearsold,veryactiveandfit,infactshewasonceafitnessteacher.Overthelast5yearsshehasbeencomingtomygroupmatclassesregularly.ShehashadseveralregularepisodesoflowbackpainovertheyearssinceIhaveknownher.Therehavebeenafewacuteepisodeswhenshehasbeenunabletoattendclassesduetobackpain.Usuallyavisittoherosteopathhelps.ShehashadM.R.IscansandX-Raysshowingagerelateddegenerationinthelumbarspine.Recentlyshehasalsobeenexperiencinghippain.DuringclasstheonlylimitationKatehasshownisexperiencingdiscomfortduringaspinecurl,soIadvisehertoavoidtherollingupanddownandrathergoingupanddownwithastraightlumbarspine.Sheisaverycapablestudentandhasverygoodbodyawarenessandperformsexerciseswithexcellentform.AboutamonthagoKatehadabonedensityscanduringaroutinemedicalassessmentunderherhealthscheme.Osteoporosiswasdiagnosed,andKateisquiteupsetasshehasalwaysexercisedandeatenagoodhealthydiet.Shefeelsherbodyhasletherdown!Wehaveagreedthatshewillstarttocometoprivatestudioclasses.Icanthenintegratetheuseofthereformer,chairandtowertocreateanappropriateosteoporosissafeplan.Kateisotherwiseingoodhealth,walksherdogsforaboutanhoureverydayandhasnootherhealthissues.

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OSTEOPOROSISSAFEPLANUTILISINGTHEBASIBLOCKSYSTEM

BLOCK EQUIPEMENT

SPRINGS EXERCISE NOTES

Warmup

Cadillacasamat

Pelviccurls OnlymobilizinglumbarspineTeachandremindprinciplesoflateralbreathing,neutralspine,hipdissociation,axialelongationandabdominalmuscleactivationatthewarmuppartofthesession.

LegCircles

Bentkneetomodify

SpineTwistSupine

Feetdowntomodify

SingleLegchanges

Headdown

Footwork Reformer 3Red AllFootworkPositionsDoublelegSingleLeg

Addspringtoincreasechallenge

Abdominals Reformer 1redor1red+1blue

HundredPrep–headdown

Progresstohundredifgoodpelvicstabilization.Headdown

Co-ordination–headdown

Onlyifgoodpelvicstabilization

Hips ReformerorCadillac

1red+1blue2longyellow

SupineLegSeries

Encouragegoodpelvicstabilization

SpinalArticulation

Reformer 2red+1blue

BottomLift Addextensionafteranumberofsessions

Stretches Reformer 1blue StandingLunge Encourageliftedtorso Hamstring

stretchEncourageflatback

FullBodyIntegration

Reformer 1red+1blue

KneeStretchFlatBack

Reformer 2red+1blue

StomachMassageFlatBack

Onlyifaflatbackcanbemaintained

Cadillac RUB2shortyellow

ThighStretch

Arms Cadillac Armsprings2yellow

ArmseriesomittingButterfly

FullBody Reformer 1red Balance *Onlywithaverycapablestudent

IntegrationAdvanced

ControlFront whocanperformafrontsupportwellonthemat.Wristweightbearingveryimportant.

Legs Cadillac Yellowsprings

Squats Encouragingliftedchest

Chair Light/med Legpressstanding

Balanceworkisimportanttoreducefallrisk.

LateralFlexion/Rotation

Chair Lightspring

SideKneelingstretch

Watchforanyforwardflexing

Extension Reformer 1blue Pullingstraps1Pullingstraps2

Foamroller

Spinalextensionoverarollerorrolleduptowel

Ausefulhomeexercisetoteachclients

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CONCLUSIONAsPilatesTeachersweareperfectlyplacedtohelpthemanypeople,menandwomenwhohavehadadiagnoseofOsteoporosisbyprovidingasafe,supportiveenvironmentwheretheycanfeelconfidentthattheyareworkingpositivelytowardsimprovingtheirbonehealth.Theywillalsobegainingmanyotherbenefitsthroughregularpractice,suchasincreasedflexibility,astrongercore,betterfunctionalmovementandimprovedbalance.Wecanalsoteachourclientshowtosafelycarryoutdailyactivities,lifting,bending,evensneezingandcoughing!Teachthemtomovewell,usingtheprinciplesthattheylearninclassduringtheirdailylife!Itisalwaysgoodpracticetobuildanetworkofpractitionersofotherdisciplines.WewillthenbeabletoreferourStudentsontoOsteopaths,Nutritionists,AcupuncturistsandPodiatristsforspecialisttreatmenttosupportourwork.WecanalsoeducateouryoungerstudentsonpreventionofthisdebilitationDisease.

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BIBLIOGRAPHYBooks:IsacowitzRael.Pilatesyourcompleteguidetomatworkandapparatusexercises.HumanKinetics2006

Isacowitz,Rael.StudyGuide:ComprehensiveCourse.CostaMesa,CA:BodyandArtsScienceInternational,2000-2013.

Isacowitz,Rael.MatAnalysisWorkbook.CostaMesa,CA:BodyArtsandSciencesInternational,2000–2012BodyArtsandScienceInternational2000–2012

Isacowitz,Rael.ReformerMovementAnalysisWorkbook.CostaMesa,CA:BodyArtsandSciencesInternational,2000-2012

SherriRBetzOsteoporosisExerciseBook:Buildingbetterbones.OsteoPhysicalTherapy.2008.PrinciplesofAnatomyandPhysiology-TortoraandDerrickson.JohnWileyandSonsInc.2006Websites:/Websearcheshttp://www.therapilates.com/index.htmlhttp://www.ideafit.com/fitness-library/pilates-osteoporosis.SherriBetzApril2005www.nos.org-NationalOsteoporosisSocietywww.pilatesanytime.com

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