Before starting Pilates make sure your physio has clear you for red flags. Once these have been clear you need to scertain how well your core stability muscles are working. Your physio will assess your lower abdominal strength and co-ordination and strength. The will assess your upper abdominal strength and your oblique muscle balance.
Once all this information is gathered you will be first introduced to phase 1 exercises.
Phase 1
Phase 1 exercises are less than 70% intensity and slow tempo. It’s important to strengthen your core in all planes of motion, and to begin with in the position of least gravitational load. Thus there is no axial loading. You will only be progressed to phase 2 exercises when proficient in phase 1. The aim of phase 1 is to build engine of muscle around symptomatic segments: such as strengthening your core, lats and glutes.
Phase 2
This phase typically lasts 12 weeks. Axial loading is only done with bodyweight, non-compressive loads. The aim is to increase strength.
Phase 3
This means axial loading beyond bodyweight. Work or sports specific conditioning and power phases (70 – 90% 1RM).
Low back pathology that responds to Pilates.
Disc bulges. With disc bulges there is generally pain with sustained flexion and first thin a.m. The most common age for a disc bulge is 30 – 40 years. Discs take 500 days to heal fully. There is progressive loss of disc height with each herniations (protrusion, prolapse, extrusion, sequestration), which causes loss of 10% of ligamentous pretension, subluxation and instability.
Correct the shift (side glides or traction), centralise the disc (? extensions) and build engine of muscle around the segment. Be aware of movements that centralise and peripheralise and coupled motion in the spine. Tape lumbar spine T12 – S1 for Phase 1 exercise. Hydration and anti-inflammatory nutrition is important here as well. After 7 consecutive days with no pain or neuro symptoms = introduce flexion to stretch scar tissue [chin tucks, posterior tilts, SKTC, side lying flexion] No flexion in first few hours of the days.
Spinal stenosis This occurs predominantly in the elderly, therefore your Pilates programme will not be complex. High volume of low number of exercises. Must lose weight is visceroptotic. Avoid extension. Phase 1 in sagittal plane and neutral to stabilise and build engine of muscle around segments involved - tva, MF, Hana’s, lats, glutes, KBE. Careful with rotation. Aggressively progress to flat back posture with La #. Traction. Corrective exercise for posture, ergonomics, education, graded exposure to functional lifts and primal patterns. Management strategies. Have to do anti-inflammatory nutrition.
Spondylolisthesis Phase 1 in neutral to stabilise and build engine of muscle around segments involved, tva, MF, Hana’s, lats, glutes, KBE. Care with HS h ex above gd 1, make HS v more challenging. Avoid EOR flexion, extension and rotation. Progress to flat back posture with La #. Care with stretching and soft tissue work initially. Corrective exercise for posture, ergonomics, education, graded exposure to functional lifts and primal patterns.
Facet joints Associated DDD and loss of ligament pretension levels. Phase 1 exercise, to build engine of muscle around segments involved. Inner unit strengthening, gentle mobilisation of hypomobile segments adjacent + PIVMs. Lx AROM exercises, stretching and corrective exercise for posture, ergonomics, education, sort tissue work and graded exposure to functional lifts and primal patterns.
For more information contact Steve at Wandsworth Pilates in London.
Once all this information is gathered you will be first introduced to phase 1 exercises.
Phase 1
Phase 1 exercises are less than 70% intensity and slow tempo. It’s important to strengthen your core in all planes of motion, and to begin with in the position of least gravitational load. Thus there is no axial loading. You will only be progressed to phase 2 exercises when proficient in phase 1. The aim of phase 1 is to build engine of muscle around symptomatic segments: such as strengthening your core, lats and glutes.
Phase 2
This phase typically lasts 12 weeks. Axial loading is only done with bodyweight, non-compressive loads. The aim is to increase strength.
Phase 3
This means axial loading beyond bodyweight. Work or sports specific conditioning and power phases (70 – 90% 1RM).
Low back pathology that responds to Pilates.
Disc bulges. With disc bulges there is generally pain with sustained flexion and first thin a.m. The most common age for a disc bulge is 30 – 40 years. Discs take 500 days to heal fully. There is progressive loss of disc height with each herniations (protrusion, prolapse, extrusion, sequestration), which causes loss of 10% of ligamentous pretension, subluxation and instability.
Correct the shift (side glides or traction), centralise the disc (? extensions) and build engine of muscle around the segment. Be aware of movements that centralise and peripheralise and coupled motion in the spine. Tape lumbar spine T12 – S1 for Phase 1 exercise. Hydration and anti-inflammatory nutrition is important here as well. After 7 consecutive days with no pain or neuro symptoms = introduce flexion to stretch scar tissue [chin tucks, posterior tilts, SKTC, side lying flexion] No flexion in first few hours of the days.
Spinal stenosis This occurs predominantly in the elderly, therefore your Pilates programme will not be complex. High volume of low number of exercises. Must lose weight is visceroptotic. Avoid extension. Phase 1 in sagittal plane and neutral to stabilise and build engine of muscle around segments involved - tva, MF, Hana’s, lats, glutes, KBE. Careful with rotation. Aggressively progress to flat back posture with La #. Traction. Corrective exercise for posture, ergonomics, education, graded exposure to functional lifts and primal patterns. Management strategies. Have to do anti-inflammatory nutrition.
Spondylolisthesis Phase 1 in neutral to stabilise and build engine of muscle around segments involved, tva, MF, Hana’s, lats, glutes, KBE. Care with HS h ex above gd 1, make HS v more challenging. Avoid EOR flexion, extension and rotation. Progress to flat back posture with La #. Care with stretching and soft tissue work initially. Corrective exercise for posture, ergonomics, education, graded exposure to functional lifts and primal patterns.
Facet joints Associated DDD and loss of ligament pretension levels. Phase 1 exercise, to build engine of muscle around segments involved. Inner unit strengthening, gentle mobilisation of hypomobile segments adjacent + PIVMs. Lx AROM exercises, stretching and corrective exercise for posture, ergonomics, education, sort tissue work and graded exposure to functional lifts and primal patterns.
For more information contact Steve at Wandsworth Pilates in London.