Movement with Meaning

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July 2003

By Lori Coleman-Brown, PT, and Virginia Haley-Kanigel, PT

The Roll Back: 1) In a fully equipped studio, a Roll Back Bar may be used for assistance in this exercise

The Pilates Method is a time-tested system of exercise developed by Joseph Pilates at the turn of the 20th century. It is a philosophy of training the body and mind to create uniform development of all muscles. Integrating the mind, body, and spirit, it combines eastern and western exercise traditions—the eastern being calm, whole, and flexible, and the western path being energetic and strong.

In the Pilates system, the “powerhouse” is the basis for all movements. The powerhouse consists of the trunk muscles that extend from the lower ribcage to the upper pelvis, anterior, lateral, and posterior to the spine (transverse abdominus, obliques, rectus abdominus, quadratus lumborum, deep postural muscles, back extensors, iliopsoas, and the hip musculature). The pelvic floor muscles are included in a general way. These muscles are included via a cue of “pull your internal organs in and up.”

2) a client sits in the proper position to begin the Roll Back;

Pilates is an excellent form of dynamic spinal stabilization exercise. It teaches full body, multi-plane control that transfers to real life activities. It is a disciplined system of exercises, each one valuable in and of itself. Together they are more than the sum of their parts.

PILATES 101

The six key principles of Pilates are control, concentration, centering, flow, precision, and breath. The Pilates program is ultimately a string of movements that flow with a minimum of motion in between. Each movement has strength and flexibility components and is always performed with control. Full body posture is attended to at all times. Romana Kryzanowska, protégé of Joseph Pilates, says, “Correct posture is corrective exercise.”

3) the client rolls back one vertebra at a time, starting from the base of the spine, and then will reverse the move.

These principles applied to any movement can improve the quality of exercise taught by a professional. Pilates is best taught one-on-one so the instructor can address individual needs. A good instructor has been educated to use detailed verbal, tactile, and imagery cues along with utilizing quality of voice for rhythm and direction. This enables the client to focus their attention on working deeply and efficiently. The instructor chooses specific exercises to create a system for each individual.

The Pilates system includes mat exercises, as well as exercises on several unique pieces of apparatus. Much of the apparatus is spring-based with the springs either resisting or assisting movement. Joseph Pilates created many types of apparatus. Those most frequently used today are the Universal Reformer, the Cadillac, Wunda Chair, High Chair, Ped-a-pull, Barrels, and Spine Corrector.

There are more than 500 Pilates exercises. The following is an overview of three specific progressive basic movements that we chose because they can be integrated into most abdominal strengthening programs. These exercises demonstrate key concepts for developing dynamic spinal stabilization programs.

THE ROLL BACK

The Roll Back is an exercise for articulation of the spine and training of the deep abdominal muscles. It facilitates segmental spinal motor control and is a preparatory exercise for the Roll Up. The Roll Back brings attention to your ability or difficulty in controlling your spinal movement. It is a key movement in the Pilates system because it addresses the core musculature of the powerhouse in detail. This exercise gives an opportunity for an instructor to observe the body’s symmetry. It allows them to cue a client to move straight through the spine, correcting the body’s inefficient patterns (ie, scoliosis). In a fully equipped studio, one could get assistance for this movement from the Roll Back Bar, (bar attached by springs to two upright poles)(see photo 1).

How to do the Roll Back:

1. Sit on a mat with knees bent, heels together, and knees in line with the shoulders. Place hands behind thighs and make sure shoulders are over hips. Pull the powerhouse in and up, hollowing out the abdomen. Eyes gaze toward navel (photo 2, page 28).

2. Roll back one vertebra at a time, starting from the base of the spine, until the elbows are straight or only as far back as you can control segmentally. The arms act to assist the abdominals as necessary. Then reverse the move (photo 3, page 28).

3. Repeat five times, or as many as can be performed precisely.

Once you can control this range, progress by allowing your hands to slide down your thighs (and then slide up your thighs to return). The key to safety in this movement is to be aware that you are contracting your deep abdominals. In the event that a client has a ligamentously lax body type, or a hypermobile lumbar segment, the cued controlled lifting and lengthening component during the segmental rolling will help maintain a safe spinal alignment. It is also training for normal lumbo-pelvic rhythm, which is required for a safe Roll Up, the next stage of this movement.

4) lying on a Universal Reformer, the client places her toes wide apart on the bar, relaxes her spine, and lengthens and bends her legs with control;

The Roll Up

Here are the steps for the Roll Up:

1. Lie supine. Stretch the body out long. Arms are extended overhead, just in front of the ears. Make sure that the lower ribs are in contact with the mat. Legs are pressing together.

2. Inhale and lift the arms toward the ceiling. Begin exhaling and roll up the spine by initiating with craniocervical flexion, taking care that the superficial cervical flexors (sternocleidomastoid and scalenes) do not override the deep cervical flexors (longus colli) that offer stability to the cervical segments. Continue to roll segmentally up the spine, until the arms reach over the toes. Continually pull in the deep abdominals exhaling all of the air by the time you reach your maximum stretch.

3. Inhale and roll back down lengthening the spine vertebra by vertebra. When your head returns to the mat, exhale and again reach the arms back up toward the ears, keeping the lower ribs in contact with the mat. 4. Repeat five times, or as many as can be performed precisely.

5) move is repeated with the arches of the feet on the bar and toes curled;

Modifications: If you are unable to deeply articulate, due to weakness or shortening of soft tissues, there are several modifications. One is to slightly bend your knees at the point just before you lose segmental control, and then lengthen them out again as you are able. You can also at this point use your hands behind your thighs to assist your movement, as in the Roll Back; or a therapist could hold the legs down lightly.

It is very important to understand that the greatest injury risk during the Roll Up arises if hip flexion occurs without the truck curl. This may happen because of lack of abdominal strength, inability to flex the lumbar spine (stiff spine), or hip flexor dominance.

THE FOOTWORK SERIES

The Footwork Series on the Universal Reformer is an effective full-body exercise concentrating on the lower extremities and engaging the core muscles while pushing against spring resistance in a variety of foot positions. For example, it allows a patient with a low back pathology to work their legs, and begin to engage their powerhouse muscles in an unloaded spinal position. The support of this dynamic apparatus can assist in regaining body awareness and in restoring appropriate synergistic movement patterns. The Footwork Series facilitates coordinated, controlled multi-joint (ankle, knee, hip) movements, while also integrating pelvic and torso stability and stressing alignment.

6) move is repeated with the heels on the bar and the feet dorsiflexed.

How to do the Footwork Series:

1. Lie on the Universal Reformer with the toes placed wide apart on the bar, the heels together and knees in line with the shoulders. Relax and allow the entire spine to be supported by the carriage. Engaging the powerhouse, lengthen and bend the legs with control. Be careful not to lock the knees or tilt the pelvis. Repeat 10 times (see photo 4, page 30).

2. Repeat as above with the arches of the feet on the bar, curling the toes over the bar and the heels under the bar like a bird on a perch. The legs and feet press gently together in parallel (photo 5, page 30).

3. Repeat as above with the heels on the bar and the feet dorsiflexed. Again limbs are in parallel/together (photo 6, page 30).

4. Place the toes slightly apart on the bar, heels together and knees slightly apart. Press out until the legs are long. Keeping the legs long, lower and lift the heels 10 times. Control the alignment of the legs, with a close watch to prevent hip internal rotation, knee hyperextension, and/or ankle pronation or supination.

Modifications are made for the various anatomical differences such as genu varus or valgus, body weight, height, and injuries. The apparatus allows the professional to adjust for range of motion and intensity of resistance.

CONCLUSION

The Pilates philosophy regarding working with injured people is that injuries are “worked around.” The rest of the healthy body is strengthened and stretched, allowing the injured part to begin healing via increased circulation. Joseph Pilates called this increased blood circulation an “internal shower.”1 Many of our clients receive traditional physical therapy in addition to their Pilates workouts to address a specific injury. Conversely, our physical therapists utilize their Pilates skills in their treatment programs. Learning the Pilates system appropriate for your own body can facilitate understanding the total impact of this method. We recommend that you check the credentials of your local Pilates instructors, as there is no copyright on the name Pilates. The education ranges from a weekend course to certification programs that require more than 700 hours of study, with rigorous written and practical testing.

With over 500 exercises to choose from and many modifications, it is possible to create a safe and effective Pilates System for any individual. A client can progress from a basic level through very advanced acrobatic-like movements. Pilates, similar to the study of a martial art, can be a lifelong pursuit.

Lori Coleman-Brown, PT, is co-owner and co-director of The Pilates and Physical Therapy Center of Seattle. She is a Certified Pilates Instructor and Pilates Teacher Trainer. Virginia Haley-Kanigel, PT, is a staff physical therapist and Certified Pilates Instructor at the center.

Reference

1. Pilates JH, Miller WJ, Gallagher SP, Kryzanowska R, eds. The Complete Writings of Joseph H. Pilates: Your Health and Return to Life Through Contrology. Philadelphia: Bainbridge Books; 2500:55.

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July 2003