Pilates for Parkinson's

It's crucial for individuals with Parkinson's to be diligent about maintaining healthy muscle length. Unfortunately when muscles are tight and shortened, it can be very challenging to access traditional exercises and releases due to immobility.  Because of this, those who need the exercises the most are discouraged, and steer clear of exercise all together.

Over the last fifteen years of assisting such clients, I have learned to break out of the box, get creative, and find ways to make the exercises work for the individual, not the other way around!

Here are a few modifications to traditional Pilates exercises that are easy to get into and perform, while putting very little stress on the body. These exercises are geared towards those with Parkinson's, but will also work great for those with Rheumatoid Arthritis, Arthrits, and other motion restricting conditions. 

Upper Arm Release: 

Kneel down and place a foam roller under the ankles to support tight ankles and prevent cramping. Place another foam roller on the Wunda Chair, and roll out the upper arms with the palms facing up, down and towards one another. Perform 10 reps of each.

Lower Arm Release: 

Kneel down and place a foam roller under the ankles to support tight ankles and prevent cramping. Place another foam roller on the Wunda Chair, and roll out the lower arms with the palms facing up, down and towards one another. Perform 10 reps of each.

Lower Leg Release (shins):

On all fours, weight bearing on closed fists (see below for modification if hands are an issue) roll from below knee to just above the ankle with the toes pointing down, out, and in. Keep core tight and spine neutral. Try to keep the head from dipping toward the floor. Perform 10 reps of each.

If weight bearing on hands is an issue, try  modifying further by weight bearing on Forearms placed on the Wunda Chair.

Lower Leg Release (Calves):

Lie on your back with your head supported to protect tight neck, shoulders an upper spine. Place a foam roller on the Pilates box, cross one leg over the other, add pressure to the bottom leg, with the top one while rolling from just below the knee to just above the heel. Perform with the bottom toes pointing up, out, and in, 10 reps of each.

Lower Arm/Hand Release:

Kneel down and place a foam roller under the ankles to support tight ankles and prevent cramping. Place the lower arm into the Pilates handle with the ring up, and the foam roll under the arm. Roll out the upper arms with the palms facing up, down, and in. Perform 10 reps of each, then slide the palm onto the foam roll and release the hand.

Pilates Geek Independent Study

Consistency is very important when it comes to Pilates, after all consistency yields results. I've decided to make a short routine that will keep you on track while I'm away, while you're away, or in the event that something comes up and you miss class. This full body routine is just enough to keep you on track, but not enough to put a big dent in your day.

The exercises are broken into segments to allow you to complete the desired repetitions before moving on. Ten to fifteen reps are a good rule of thumb for each exercise. My wonderful sister, Heidi will demonstrate a few reps of each exercise, and only to one side. Since she's only doing a few, don't think it's ok to stop when she stops, and also remember to do both sides when applicable.

The props you will need are: Foam Roller, Mat, Thera-Band (light to medium resistance). If you do not have these props at home you can improvise and perform the exercises with out props, or skip that exercise. I recommend that everyone have these three props in their Pilates toy box at home.

*Toe Taps can be preformed on the floor without a roller

*Mermaid can be done without a roller

*if you don't have a roller, lie face down, stack hands under forehead like a pillow, extend the spine/arms/head off of the mat by engaging glutes, abs and back muscles

*you can substitute with light hand weights, although band is preferred

                       And that's a wrap, keep up the good work, and I'll see you in class soon!

Neck, Shoulder and Arm Pain Part 2: Strengthen Long Muscles

This is the second part of the tutorial on how to keep the shoulder girdle balanced to prevent pain in the arms, back and neck. In this segment we will focus on strengthening. We will begin with a tutorial on what it means to stabilize a winged Scapula, this is what will help us understand if we are in good form (or bad) Winged=BAD. 

How to Identify and Correct a Winged Scapula

Now we will cover three versions of Scapular Push-ups (to strengthen the shoulder girdle). You should perform 2 sets of 10 reps each per exercise, only doing the version your body is ready for. If you find it difficult to hold good form in a version of the Scapular Push-up (if your scapula are winging or poking out), stick with the previous version until you are strong enough to perform the next version of exercise with good form. However, you should continue to perform all versions, even when you are strong enough to successfully complete the most challenging version. Remember, the emphasis here is on proper form and muscular balance- so if you push ahead before your body is ready, you are setting yourself up for imbalance. 

Basic Scapular Push-up

Moderate Scapular Push-up

Intermediate Scapular Push-up

*to advance you may come up off of the knees into full push- up position when you are ready.

Now for our final exercise in the series: Breast Stroke, which will strengthen the back extensors and challenge the shoulder girdle to move properly. This exercise must be performed with the head neutral (ears should not drop below the level of the shoulders- imagine you are swimming and your head and shoulders are both above water, do NOT look out at the horizon, DO look down at the water below you. Start out with 3 sets of 5 reps, move up to two sets of 10, and then 3 sets of 10.

Breast Stroke

Finally- What is that Occipital Ridge I keep mentioning, and why is it so important? Well, for starters, it is a bony landmark on the back of the scull, that indicates the very top of the spine (where the spine and the head meet). This junction is crucial for shoulder health. Our heads are very large and very heavy, and they are held up by a very long and thin neck. Ideally the head stays positioned over the shoulder girdle, where it can balance with very little help from the neck. This allows the muscles of the neck to do their REAL job, which is to move the head around. Unfortunately, we often let our head drift out in front of us, which makes our neck muscles have to carry the load of the head constantly (and the head weighs more the further forward it is). This prevents the neck from doing its REAL job effectively, and soon turns into neck pain, imbalanced neck muscles, shoulder pain, and then finally arm, elbow, wrist pain. It trickles down, just like that. So, that is why I'm always talking  about that Occipital Ridge. I like to use it to check in, making sure our head is balanced with our shoulders properly, whether sitting, standing, lying on our back or tummy- we always need to check in on this balance.

Occipital Ridge

 

Neck, Shoulder and Arm Pain Part 1: Lengthen Short Muscles

Low Back Pain Relief Part 1: Sitting

One of the most common complaints I hear from new clients is "I have pain in my lower back". This isn't surprising to me when I observe how they sit with their tails sheepishly tucked under, perched right on top of their butt cheeks. I mean it makes sense, those butt cheeks do make for a nice little cushion. Unfortunately this is disastrous for your back because it puts pressure on the discs, causing pain and discomfort. It also disrupts proper breathing, creates dysfunction in the shoulders and promotes laxity and weakness in the abs.

Since our bodies don't come with an owners manual, we tend to defer to it's agenda, which is to exert the least amount of effort as possible. This is actually pretty efficient in the short term, as it conserves energy, however, it is often deleterious in the long term. Hence back pain.

So here we go- learning how to sit. It may seem silly, but most of us have never actually learned how to do this properly. As usual, I am going to try and break this down into as few steps as possible. The sixth step is is for extra credit, and focuses on breathing.

1. Find your SIT Bones and create a Triangular Base

• Stand up
• Lift your arms up over head
• Arch your back
• Stick your butt out
• Keeping your butt sticking out, sit back down

You should feel two prominent bones underneath of you (meet your SIT bones- you are supposed to sit on them), your butt cheeks should be behind you (after all, that is why it is called your "behind"). Your SIT bones and your perineum should make a triangle, with even pressure on all three points. OK, so this is a good start. we have a wide, stable base to perch on.

2. Find your Pelvic Bowl and keep it from spilling

• Place your hands on your hips
• Notice that your pelvis makes a cylindrical shape (meet your Pelvic Bowl)
• Notice that when you sit on your SIT Bones, your Pelvic Bowl is upright, and if it were full to the brim with water, no water would leak out from the front or back of the bowl (because you aren't tipping the bowl)

 3. Find your spine

• Your spine should have the feeling that is extending up out of the center of your pelvic bowl
• Your low back should be gently (not forcefully) arcing forward (picture the front of a bow and arrow) 

 4. Balance the Pelvic Bowl and the Bowl of the Ribcage

• The ribcage is also a cylindrical shape and can be thought of as the ribcage bowl. In this case, the bowl of the ribcage should be stacked over the bowl of the pelvis. It's a balancing act, similar to building blocks or stacking rocks. 

 5. Create an HOURGLASS!

• WITHOUT changing the shape of the spine
• Pull the front of the belly in and up (you can actually lift your belly button up)
• Pull the sides of the waist in toward the spine (think- away from the shirt)
• Gently hug the back muscles in and up toward the spine
• At this point you should feel like an HOURGLASS- wide base, wide top, narrow middle that hugs in on all sides

6. You get Brownie Points for BREATHING

• Imagine that you can put a stopper in the middle of the hour glass
• Now pull the breath into the top of the hourglass only
• Feel the bowl of the ribcage fill out on all sides- front to back and side to side
• Feel the belly being strong and supportive, don't lose the stopper, we don't want to fill the belly- only the ribcage.
• This strengthens the ABS and the back, relieving tension in the shoulders, neck and ribs.

Bonus tools:

• Take some colored tape and use it to place three small X's on the base of your chair that form a triangle, this is where your sits bones and perineum should be. This will remind you to sit on your triangular base every time you sit down.
• Print out an image of an hourglass and keep it taped to your monitor, reminding you to sit up properly.

Your body may be working overtime (even if you aren't)

Fridays are my work from home day, the day I take to do admin duties; write checks, review my Pilates schedule, pay bills, and when I find time- my day to post to Pilates Geek. On the days that I work from home I sit more than usual. I notice that for a couple of days following my WFH days I get a bit sore in my right shoulder and feel the need to adjust my neck regularly. Sometimes I even notice soreness in my jaw. On days like these I find myself wondering- how does the average person do this on a regular basis?

I understand that tech geeks and desk jockeys love their jobs, just as much as this Pilates Geek loves hers, but I cannot imagine what it would be like to work like this day in and day out without a good understanding of how to better adapt to the physical demands of sitting, typing, mousing, repeat...

So today's post is dedicated to the die-hard geeks (of any trade) who are held hostage to a desk all day (and, who most likely, love every minute of it).

In my last several posts we have discussed how to sit in good posture while working and how to breathe properly in order to relieve tension. We went over techniques to release and strengthen tight shoulders, and learned some simple exercises to do from just about anywhere. Today we are going to tackle a more subtle problem that can undermine the best of our efforts when it comes to posture and endurance at the desk- CLENCHING!

That's right, clenching. That nail biting, gum chewing, white knuckled, teeth grinding arm crossing aggressive habit that goes hand in hand with hard work and extreme focus. In fact, if you look around your office right now, you may be able to observe some of these behaviors first hand. See that guy over there with the little muscle above his jaw bouncing around like a little rabbit, or how about your boss over there snacking on his finger nails, ooh, or maybe him, that guy next to you on the phone without a headset squeezing his phone between his ear and his shoulder while he hammers away at his keyboard. It may be surprising how many examples you can pick out in just one sweep of the office. The simple fact is, these behaviors are so common we hardly notice them anymore, in others or in ourselves.

Unfortunately these unconscious and unnoticed habits create long term tension in the muscles, tendons and ligaments of the jaw, neck and shoulders. Over time the accumulation of tension causes muscles to spasm and inflammation to occur. When this happens regularly nerves become compressed, leading to pain, tingling and numbness in the arms, hands and fingers.

The first obstacle in correcting these habits is that they are usually unconscious. So you are going to have to use your habit radar and start seeking out some indicators that these things are happening in the first place. Once you pinpoint one or two of them, well, then the real work begins...

Here are a few things to be on the lookout for, and what to do to correct them once recognized:

Phone cradling- this one is pretty simple, make an effort to use your headset and avoid holding the phone to your ear. Even holding the phone with your hand for more than several minutes causes poor elbow mechanics and clenching. If you know you are going to be on longer than a minute or two, use your headset!

Gum chewing- skip it, or do it very minimally, for a very short amount of time. Repetitive chewing mimics jaw clenching and teeth grinding which produces major tension in the jaw, neck and shoulders.

Jaw clenching- this is a bit trickier because it is less noticeable. For starters it is helpful to realize that unless you are chewing up your food, you should always have space between your teeth (all of them). The lips can be closed, but the top and bottom teeth should have space between them at all times. It may help to use a rest break software that can help to remind you to relax and release your jaw.

Nail biting- this could, by far be the most difficult to tackle. I'd recommend designating two 5 min nail biting times during the day- say 11 am and 3pm. Outside of those times do not bite- and when you catch yourself biting stop and remind yourself of your biting time. Set an alert to notify you it's time and bite away. Over time you may find that you no longer have the desire to bite.
If this doesn't work I would recommend doing some research, and possibly looking into some cognitive behavioral therapies for suggestions on how to break this habit. Nail biting also has a negative impact on jaw, neck and shoulder tension, because, like gum chewing and jaw clenching you repetitively engage and stress these muscles.

Shallow breathing- this clenches the muscles between your ribs and compresses all of the soft tissues of the torso. Learn to take full deep breaths (see previous post on breathing techniques).

Aside from these detailed tips, here are some general recommendations to keep your body happier:

• Seek out stress reducing activities that you enjoy like Pilates, Yoga, Meditation, or maybe running.
• Take breaks regularly. I've mentioned there are software options that will remind you when a break is needed http://www.workrave.org/
• Make time for physical activity, don't "try and find it", because it will not magically appear, you have to make it happen
• Take a walk around the block, or try taking the stairs
• If you have difficulty staying motivated, schedule regular workouts with a trainer. If you have it on the books and are accountable to someone else, you are more likely to actually follow through.

You can take it with you- Pilates Anywhere in 10 Min

Summer is upon us, and for many of us that means vacations and long weekends away, relaxing, soaking up the sun, eating exotic foods... what's not to enjoy? That's why I'm often surprised, pleasantly so, that many of you express concern about going without Pilates while you're away. I thought I was the only Pilates Geek who felt this way, I now stand corrected. So here I am, the geek of all Pilates Geeks offering you a simple solution- take it with you!

5 simple Pilates Mat exercises, in just 10 minutes, anywhere!

Bridge targets: core, hamstrings, glutes and spine
Set up: Lie on your back, knees bent, feet hip-distance apart, arms by your sides, palms down
Movement: Lift butt and spine off the floor maintaining a neutral spine position, coming all the way up onto your shoulder-blades, then lower down maintaining a neutral spine and neck throughout the movement.
Reps: 5

Chest Lift targets: core
Set up: Same as above, with palms interlaced behind your head
Movement: Slowly peel your spine off of the floor one vertebrae at a time, until you reach the bottom tip of your shoulder-blade, slowly roll down, keep some space between the chin and the chest and keep elbows very still, refraining from pulling with the arms
Reps: 10

Criss Cross targets: core
Set up: same as above, with legs in table top
Movement: Roll up slowly and cross your right shoulder towards your left knee, lower and repeat on other side, keep elbows still, do not pull with the arms
Reps: 10

Plank targets: whole body, a slim core and Pilates arms await you
Set up: Kneel on all fours, 90 degree angle in hips and shoulders, hands shoulder distance apart, fingers wide apart, middle finger forward
Movement: step one foot back and then the other, until you are in "push up" position, draw heels back and spread wide across your upper back, keep head in line w/ shoulders (not above, not below), hold pose.
Reps: 10 breaths
Variation: Add leg lifts, lifting from gluteal fold only, 5/leg
* to master your plank, see my blog post on the Perfect Plank in 10 Simple Steps

Reverse Plank targets: whole body, great for correcting computer posture
Set up: sit down with bent knees, feet on floor, hands behind you, fingers face forward
Movement: Push yourself up until you resemble a table (90 degree in knee and shoulder joints), stretch the chest open and extend legs out until they are straight, hold pose.
Reps: 10 breaths
Variation (+ challenge): Leg lifts 5/leg, keep spine stable
Modification (-challenge): Keep legs bent

And that's a wrap! Hope you enjoy your guilt free, strong, sexy, geeky vacation, and rest assured, knowing that your body has been worked from tip to toe.