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Case studies
While we do provide group classes, it's crucial to recognize that Pilates is ultimately a personal journey. As instructors, it's our responsibility to be well-versed in common client conditions, ensuring we tailor sessions to their specific needs. To assist you in this endeavour, I've gathered the following case studies. I also recommend creating your own library as you come across unique cases.
While we do provide group classes, it's crucial to recognize that Pilates is ultimately a personal journey. As instructors, it's our responsibility to be well-versed in common client conditions, ensuring we tailor sessions to their specific needs. To assist you in this endeavour, I've gathered the following case studies. I also recommend creating your own library as you come across unique cases.
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1. Pregnancy considerations
2. Rheumatoid arthritis
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1. Exercise During Pregnancy and Post-partum: Guidelines for Safe Practice
Exercise is a wonderful way for pregnant women to stay active and healthy, provided they do not have any pre-existing medical conditions. However, safety is paramount, and certain considerations must be taken into account to ensure the well-being of both the mother and the baby. Please adhere to the following guidelines for our pregnant clients:
1. Medical Approval is Essential:
Trimester-Specific Guidelines:
First Trimester:
Transitioning Away from Core-Centric Work:
1. Medical Approval is Essential:
- Before beginning or continuing an exercise routine during pregnancy, clients must obtain prior approval from their physician.
- Why: Every pregnancy is unique, and medical guidance ensures exercises are safe and appropriate for individual circumstances.
- We accept pregnant clients up until the 6-month mark. This does not apply to clients who have been regularly attending classes throughout their pregnancy.
- Why: Ensuring a client has been with us prior to the 6-month point ensures a level of familiarity with our exercises and routines.
- Although it's recommended to maintain an exercise routine during pregnancy, beginning a new regimen midway into pregnancy is not advisable.
- Why: Starting a new exercise routine during pregnancy might introduce unnecessary stress to the body. Maintaining a familiar routine is generally safer.
Trimester-Specific Guidelines:
First Trimester:
- In most cases, exercises can continue without major modifications.
- Stay hydrated and cool during workouts.
- Why: Proper hydration and comfort are essential for both maternal and fetal well-being.
- Modifications start to be introduced, avoiding curl ups and sit ups.
- Shift the focus from direct abdominal stimulation to obliques and back.
- Suggested Alternative: For ab work, consider modified planks on the elbows and knees with the hips slightly elevated.
- Why: Adapting exercises supports changing body dynamics and helps avoid strain on the abdominal area.
- Limit time spent on the back to 5 continuous minutes.
- Certain moves may become difficult due to belly size; provide alternatives.
- Abdominal muscles are weakest; offer supportive modifications.
- Suggested Change: Modify the cat-cow stretch to isolate the pelvic tilts only, avoiding deep spinal flexion and extension.
- Why: Protecting the spine and pelvic region is crucial during the third trimester.
Transitioning Away from Core-Centric Work:
- As the pregnancy progresses, focus on leg and upper body exercises (arms, back, and chest).
- Reduce the proportion of exercises that heavily target the core.
- Why: Adapting the workout to include more leg and upper body exercises minimizes strain on the abdominal area and supports overall body strength.
- Avoid Overexertion: Clients should be able to maintain a conversation while exercising.
- Listen to the Body: Encourage clients to take breaks when needed to catch their breath and cool down.
- After pregnancy, clients can resume exercise with physician's approval after 6 weeks.
- For those who underwent a C-section, recovery may take longer.
- Focus on gradual strengthening of abdominal and pelvic floor muscles.
- Why: Pregnancy and delivery can be challenging for the body. Gradual recovery and strengthening are essential for postnatal well-being.
2. Rheumatoid arthritis(RA)
Rheumatoid arthritis (RA) is a chronic autoimmune condition that primarily affects the joints, causing inflammation, pain, and swelling. Unlike osteoarthritis, which is often the result of wear and tear on joints, RA is an autoimmune disorder where the body's immune system mistakenly attacks its own tissues, particularly the synovial lining of the joints.
How RA manifest itself:
Supporting Individuals with Rheumatoid Arthritis (RA)
Living with Rheumatoid Arthritis (RA) is a journey filled with unique challenges as RA affects not only the body but also the spirit. Through this guide, we aim to provide tailored strategies and a foundation of understanding. Our goal is to empower individuals with RA to thrive, armed with knowledge and support towards enhanced well-being and a higher quality of life.
In the following paragraphs, we'll explore how reformer Pilates can be a powerful tool in managing RA.
How can physical therapy help:
Physical therapy though a reformer Pilates practice can be highly beneficial for individuals with rheumatoid arthritis (RA). Our goal is to design a customized exercise and treatment plan to address their specific needs and improve overall function. Our focus will be on:
It is crucial to make thoughtful exercise modifications that prioritize comfort and safety. Remember to have a measured approach with your exercise selection. Allowing a gradual progression as the client’s strength and confidence flourish, from exercises that are well tolerated to more challenging movements.
With compromised elbow joint we wish to work with the following modalities:
Focus on lower body work
The limitations on the lower body will be minimal but the benefits will remain. So centre the bulk of the workouts on the lower body which is half of the body and provides extra benefits such as improvements in balance, flexibility, core and breath control
Avoid exercises that use the arms to support the body
With the elbows compromised, the elbows will find it hard to support one’s body weight, exercises such as the following should be removed or modified:
Straight arm planks, Superman, Push-ups
instead use variations just as elbow planks
Prefer kneeling and supine arm work with loops
We still wish to strengthen the muscles around the elbows and will thus need to work our upper bodies. Using the loops for resistance means using a much more manageable workload that can be adjusted to the strength of the client.
Exercises such as:
Kneeling arms series, supine arms series, kneeling torso twists
Adjust the springs to make the exercises more accessible
Get some stretches in
The final piece of the puzzle is to work on increasing the range of motion of the joints. This will naturally occur during some of the exercises mentioned above. We can then specifically focus on this goal by using gentle stretches such as:
This concludes the guide. This is meant to be a short but informative introduction to the management of Rheumatoid Arthritis within the confines of a Reformer Pilates class. We all can play a role in our clients recovery by always learning and personalizing our programs to suit each clients individual needs
How RA manifest itself:
- Inflammation and Pain: RA leads to persistent inflammation in the joints, resulting in pain, stiffness, and reduced mobility.
- Joint Swelling and Deformation: Over time, inflammation can lead to swelling and deformities in the affected joints, particularly in the hands, wrists, and feet.
- Fatigue and Weakness: RA can cause general fatigue and muscle weakness, making physical activities more challenging.
- Limited Range of Motion: The inflammation and stiffness associated with RA can significantly limit a person's range of motion, making certain movements uncomfortable or even impossible.
- Variable Symptoms: RA symptoms can vary greatly from person to person and may flare up or subside over time. Flares can be triggered by a number of things such as stress or illness
- Psychological Impact: Chronic pain and physical limitations from RA can also have psychological effects. This may include feelings of frustration, depression, or anxiety, which can be important to acknowledge.
Exercising will not only work as physical therapy in helping to alleviate symptoms, but it will also have the significant psychological impact of reducing anxiety and depression whilst improving mood and mental well-being - Chronic Nature of RA: RA is a lifelong condition and it’s management and coping strategies are essential for long-term well-being.
Supporting Individuals with Rheumatoid Arthritis (RA)
Living with Rheumatoid Arthritis (RA) is a journey filled with unique challenges as RA affects not only the body but also the spirit. Through this guide, we aim to provide tailored strategies and a foundation of understanding. Our goal is to empower individuals with RA to thrive, armed with knowledge and support towards enhanced well-being and a higher quality of life.
In the following paragraphs, we'll explore how reformer Pilates can be a powerful tool in managing RA.
How can physical therapy help:
Physical therapy though a reformer Pilates practice can be highly beneficial for individuals with rheumatoid arthritis (RA). Our goal is to design a customized exercise and treatment plan to address their specific needs and improve overall function. Our focus will be on:
- Range of Motion (ROM) Exercises: These exercises aim to improve the flexibility and movement of affected joints. They include gentle stretching and controlled joint movements.
- Strengthening Exercises: These exercises help build muscle strength, which can provide support to the joints and improve stability. They often focus on the muscles surrounding affected joints.
- Balance and Coordination Training: These exercises help improve balance and coordination, reducing the risk of falls or injuries, which can be particularly important for individuals with RA who may experience joint instability.
- Breathing Techniques: We will highlight the importance of incorporating breath control techniques into exercises to help promote relaxation, reduce muscle tension, and improve overall movement efficiency.
It is crucial to make thoughtful exercise modifications that prioritize comfort and safety. Remember to have a measured approach with your exercise selection. Allowing a gradual progression as the client’s strength and confidence flourish, from exercises that are well tolerated to more challenging movements.
With compromised elbow joint we wish to work with the following modalities:
Focus on lower body work
The limitations on the lower body will be minimal but the benefits will remain. So centre the bulk of the workouts on the lower body which is half of the body and provides extra benefits such as improvements in balance, flexibility, core and breath control
Avoid exercises that use the arms to support the body
With the elbows compromised, the elbows will find it hard to support one’s body weight, exercises such as the following should be removed or modified:
Straight arm planks, Superman, Push-ups
instead use variations just as elbow planks
Prefer kneeling and supine arm work with loops
We still wish to strengthen the muscles around the elbows and will thus need to work our upper bodies. Using the loops for resistance means using a much more manageable workload that can be adjusted to the strength of the client.
Exercises such as:
Kneeling arms series, supine arms series, kneeling torso twists
Adjust the springs to make the exercises more accessible
Get some stretches in
The final piece of the puzzle is to work on increasing the range of motion of the joints. This will naturally occur during some of the exercises mentioned above. We can then specifically focus on this goal by using gentle stretches such as:
- Child’s pose, Puppy stretch, Chest openers
This concludes the guide. This is meant to be a short but informative introduction to the management of Rheumatoid Arthritis within the confines of a Reformer Pilates class. We all can play a role in our clients recovery by always learning and personalizing our programs to suit each clients individual needs