**********

Great question!  Personally, I haven’t worked with a client who’s told me she’s ADD and on meds, but I’ve had numerous clients with distraction issues - whether it’s from chronic pain, emotional, work-related, or they just have that personality of wanting to be doing anything but exercise!

In my experience, doing a consistent Pilates program should help improve her focus over time, but there are definitely some things you can do to assist.

Get a routine established for her, and then throughout her workout “quiz” her on the following:

• What is the next exercise?
• How many repetitions should you do for this exercise?
• What is the correct equipment is set up - headpiece, foot bar, springs, pads, ect…
• What is your breathing pattern for this exercise? When do you inhale, when do you exhale?
• Why is this exercise important for your health & fitness?
• What’s the most important thing to focus on and pay attention to during this exercise?

Asking these questions during her workout - should help to keep her engaged with what she’s doing, and will continue to draw her back to her body when she get’s distracted.

Find good visual images that she can associate with for the movements and exercises, or relate one exercise to another.

Examples of Visual Images:

• For Stomach Massage Round you are in the same basic body position as Rolling Like a Ball in Matwork.
• The Stomach Massage Series, and the Short Box Series both start with the body in a round, C-curve position, then move to a tall, good posture position.
• Pretend like you are Queen for a Day - your crown is suspended from the ceiling - sit up tall and reach the top of your head to your beautiful, jeweled crown.

Once you’ve planted the image - you can refresh it quickly - and say, “remember…Queen for a Day!”  Or, “What does the first exercise in the Stomach Massage Series, and Rolling Like a Ball have in common?”

Cross-patterning exercises are also helpful to assist the brain with sequencing, and focus.

You might consider incorporating more of these types of exercises throughout her program from beginning to end.

Examples of cross-patterning exercises would be:

• Pilates Matwork: Single Bent Leg Stretch, Swimming, Criss-Cross.
• Play “Patty-Cake” - Right, Left, Both - Left, Right Both,
• Marching & tapping the opposite knee with the hand,
• Standing - alternate Hamstring curls and touching the opposite foot with the hand
• Other:  Take the “Patty-Cake” pattern and incorporate it into her workout with any arm &/or leg exercises.

Be prepared to have more exercises in her program than you might for someone who can really focus!

It’s better to only do 3-4 good well-focused repetitions of an exercises with the proper form and feeling, and then moving quickly to something else.  Over time - you’ll find that you’ll be able to increase repetitions and keep her engaged with what she’s doing.

This Foot Care Question was just submitted to my inbox by Nicole, thought perhaps there are others out there searching for answers on how to alleviate foot problems and curious to know if exercise might help.

“I have some problems with my feet.  Hyper mobile forefoot and hypo mobile mid-foot with some posterior tibular tendonitis.”

“I was wondering if there are foot care exercises I could do to help?”

Thanks for your question about exercises for your feet.  It is impossible for me to give you specific exercises that I think would be beneficial without actually having a chance to see you, work with you, and evaluate your feet.

Based on your comments about the problem, I do have some thoughts about what I would look for, and I am confident that yes, there probably are some specific foot fitness exercises that you could do to help improve your feet.

I suspect that something in the hind-foot, or ankle might be locked up.  (This potentially could be related to an issue at the knee, hip, or pelvis, or could just be a stuck ankle.)  From a Pilates perspective, we’re always looking at the whole body and how things inter-relate.  Sometimes this can be corrected with the right exercises, other times a manipulation by a kinesiologist, chiropractor, or osteopathic physician can get things moving again quickly, and then the right exercises can help reinforce new muscle habits to keep things working properly.

If any joints are hyper mobile, the muscles that move them, may not be strong enough, or understand how to work correctly to move the bones. Somewhere farther up the chain, the body gets a message to “hold on tighter for support.”  The problem is that over time, this message never shuts off and the body accepts how it’s moving as the correct pattern.  Opening all the joints of the foot and ankle, and improving the strength of your fore foot, arches, and toes, might just provide the support needed to help facilitate more correct movement through the entire foot.

Your alignment for walking and running, and how the body and legs move from the hips are also a factor in how the muscles of the feet fire to propel you through space. Incorrect firing patterns through the whole leg with every step you take, only continue to reinforce problems and may be a reason for the aggravation of posterior tibular tendonitis, as well as the hyper/hypo foot issues.

The exercises in my book Fantastic Feet! I have taught to LOTS of people with a variety of foot issues with great success!  The Yamuna Foot Savers, and Circulator Foot Reflexology Mat are also great tools for improving alignment and muscle use.

Since you know you have diagnosed problems, I would recommend showing the exercises in the book Fantastic Feet! to your foot doctor, physical therapist, chiropractor, or kinesiologist, and have them assist you with selecting the most appropriate exercises for you to start with. Always best to refer to an expert!  If there are any Pilates Studios near you, I’d also recommend checking into a few lessons to have your posture and movement habits evaluated from a whole-body perspective.

It’s great to learn what’s helped other people fix their foot problems -  and this provides possible solutions for folks still looking for their best answer to enjoy happy pain-free feet!  Please feel free to comment below and share what’s worked for you to help fix your foot problems!

So there aren’t too many things that hit my inbox that send instant chills down my spine, and tears streaming down my face… But this did it!

Whatever your hopes and dreams, or goals and visions be it personal, professional, health, family, or life…

May you experience a shift in perspective today to strengthen your belief in yourself and your ability to achieve your potential!

Please close your eyes and attempt to clear your mind for 30 seconds.

Then, read the questions below and enjoy this video clip:

1. What is the “right” age for accomplishing my greatest dream?
2. Do I hear the laughter and believe the doubters when I am mocked for expecting life’s very best?
3. What great possibility have I forced myself to stop considering?
4. Who will be inspired or benefit directly when I succeed?
5. When will right now become the best time to begin?

(forwarded message & questions from — Your friend, Andy Andrews)

Click here to view the embedded video.

The Pilates program outlined here was designed by an Apprentice Teacher and is being used as an example for a critique on designing effective Pilates programs.

This blog posting is meant to assist Pilates teachers, and especially new Pilates trainers with assistance in thoughtful and safe exercise selection to design safe and effective workout programs. I do not recommend that you precisely follow this program, but analyze the program and my comments and suggestions - then use this information to help develop your critical thinking skills, make good exercise choices, and design great Pilates programs for your clients.

As a more-experienced teacher, I enjoy helping the students in my teacher-training program develop their critical thinking skills. It thought there may be other new teachers out there who would find this information useful.

Below is an example of a beginner’s Pilates Workout Program with the consideration of no neck flexion that I recently reviewed for an apprentice teacher. The exercises that were chosen for this program are not right or wrong… Any exercise can be a good choice if done correctly.

Apprentice Program Design: Beginner Student - No Neck Flexion

***Please consult with a Pilates professional, and your Health Care Provider, before following this, or any other fitness program.

Comments and Suggestions for Tweaking and Improving this Pilates Workout Program:

Since I don’t know the reason for this individuals need to avoid neck flexion, I have to ask if it’s because of an injury, Doctor’s request, or just because it’s uncomfortable and creates pain to curl up into exercises like the 100 (due to weakness, muscle imbalance, or lack of body awareness to be mechanically efficient with the movement.)

In my experience – while we play it safe and typically choose exercises that keep the neck in a more neutral position, it’s important to watch closely to see if client’s are “gripping” with their neck and upper traps to hold the head steady. Too many exercises laying on their back, or side lying and you can exacerbate their problems….even when you’re choosing to stay flat!

With neck issues, I tend to do 2-3 exercises laying down (see if they are more or less comfortable with a pillow), and then change to doing 2-3 exercises seated or standing. This will help reduce strain as the head and neck can sit in its normal balanced position on the torso, plus you won’t have clients snoozing after a whole hour in a reclining position!

In The Pilates Program Example above - Here Are the Things I Might Do Differently:

• I would choose to NOT do #3 Shoulder Elevation and Depression. But start from a resting position and cue “diamond down”, then arms hang down lower. The elevation of the shoulders will create more neck tension, but they need to learn how to better utilize lower traps to release shoulder tension. By doing this seated or standing, gravity is assisting the release of neck and shoulder tension.
• 100: I might choose to start with the legs in the straps, and no resistance (straps) in the arms. Or feet on the bar, No Straps. Head down – legs up, and straps could aggravate the neck, especially if the legs are lower.

Here’s where knowing WHY you’re avoiding neck flexion is important…

If a client just has a tense personality and needs to understand how to relax their neck and shoulders…doing Flexion exercises INTO gravity will help you over time progress into safe, strong, well-supported flexion working against gravity. If the head is going along with the rest of the spine in a relaxed state – this might be beneficial.

If a client has experienced an injury, accident, surgery…or other issue that has a medical limitation to avoid neck flexion - the exercise choices may be altogether different! (This limitation may be prescribed by a doctor forever, or for a limited period of time suitable for recovery. This information is vital to a Pilates professional making appropriate exercise choices.

Continuing on with things I would consider changing for this program…

• Ex: Stomach Massage Round – The head should be in a good posture position over the shoulders. The primary flexion is through the pelvis and low ab scoop, with a focus change down and forward, but not the head sheered forward off the neck. There’s a chance this might be safe and appropriate – but if in doubt, better to start with the 2^nd exercise (hands back)
• Ex: Elephant – Round. If the spine is in a properly flexed position, the head and neck are relaxed and handing forward. Gravity is assisting in stretching the neck for someday being able to do flexion and lift the head off the floor. (Same concept for Kneeling Knees Round)
• Arm Springs lying down on the Cadillac may have a tendency to create more neck tension, so watch for this and be prepared to find alternate exercises. Leg Springs – (when you brace the arms on the poles) are strengthening your lower traps if you cue “diamond down” and remind them to keep the shoulders & neck relaxed. Or – you can do with arms by the sides. But long-term you want to work to that overhead arm position, and understanding how to use the arms and shoulders without creating any problems for the head and neck.
• I might choose to do the Standing Cadillac Arm exercises right after the Reformer for a moment of standing, and reinforcement of “Diamond Down,” good posture, and a lengthened, relaxed neck and shoulders. Then would do Parakeet, some of the Matwork, then consider the Arm Springs lying down.
• I would NEVER choose to do Double Straight Leg in Matwork with the head down. Esp. for a beginner with neck problems. The modified one leg at a time version will be safer for their whole body! Until someone can curl up safely – I would personally opt for this one-leg modification.
• I would probably add Alternate 1 Arm Reach (Climb a Rope) as a modified Criss-Cross to cue the Oblique Abdominals, and work on coming from under the shoulder, around the ribcage to a diagonal scoop of the torso.

The STRONGER a client’s core muscles are, the less they will use their upper traps and shoulders for body support. When the core is working, the neck and shoulders will begin to relax – you then focus on transfering this feeling to every exercise, daily life activity, and movement.

• Corkscrew will be a challenge to keep no tension in the neck and a good position. I might consider doing Knee Drops or Can-Can. (This is the 8^th exercise in a row that they’ve done lying down, perhaps a seated exercise would be a nice choice – even though this is not a classical order.)
• If you’re doing a hinging Saw it means that spine rotation is not contra-indicated. I might suggest that you add a Seated Twist to your reformer. This will warm up rotation in a vertical position (if it’s appropriate for them to twist) Rotation improves muscle length for flexion and extension. Seated Twist will help your Swan, and as appropriate progression into gravity assisted flexion, and finally working against gravity.
• There is a chance you’ll need to alternate sides for EACH exercise in the Side Leg Series. Look at neck placement and tension and switch sides before they feel anything in their neck. Ask how they feel while working - and change sides as often as needed - or do the series in a standing position.
• Because you’ve chosen the SEAL, I’m assuming that spine flexion is OK, but neck flexion against gravity is not. If you needed to avoid spine flexion altogether – I would do Dead Bug here instead.
• Because you’ve chosen the SEAL – I would definitely have done Stomach Massage Round, and probably Elephant and Kneeling Knees Round. Stomach Massage round will be warming up the correct body placement and support. It might also indicate that over time – the Roll Down on the Wall and 100 on the Wall would be good progressions.
• It also make more sense to finish your Matwork with the Seal or Dead Bug (a centering exercise,) and then move on to something else. By my re-arrangement of the Arm exercises, this happens automatically, and you finish mat and proceed to your ending stretches.

Other GREAT Exercises to consider for this program:

Chair – Footwork, Going Up Front, Spine Stretch forward, Swan on top, Pump 1-leg Demi-pointe

If gravity assisted flexion is OK – add “Washer Woman” to your safe list.

Spine Corrector – Breathing Over the Barrel, Swan, Hamstring Curl, Leg Extension

If there are NO medical limitations for the neck, and flexion into gravity is OK… I would also incorporate some gentle neck and chest stretching.

Wall – Clock Stretches, Standing W

Gentle Neck Stretch: Ear-to-Shoulder, Nose-to –Shoulder, Forehead-to-Shoulder, Chin- to-Chest, Center head.

• Ballet Stretches on the Ladder Barrel involve Forward Flexion and articulation of the spine & neck through flexion to recover to center. AGAIN – this may be OK, useful, and beneficial for your client. IF I had to play it safe – I would either stretch with the Magic Circle lying down, OR do the Split portion of the Ballet Stretches on the Cadillac with the Trapeze.

Now that you’ve had time to read and review this beginner Pilates Program… What choices would YOU make, and how would you progress your client if avoiding Neck Flexion was something you had to take into consideration when choosing exercises to develop a safe and effective Pilates workout program?

I’d love to hear comments on this! Is this example useful to your thought process for Pilates program design?

The old saying, “You can’t fix it if it ain’t broke…”  Well if you’re not aware of what you’ve been doing to “break” it - how could “fixing” it even begin to solve the problem.  The first “fix” has got to be with the mind-body connection and improved body awareness, or old bad habits will be impossible to break.

Regardless of your athletic  or dance background, or how old you were when you started your first exercise program, or what physical shape your body is in - it’s never too late to improve your health AND strengthen your mind-body connection!  It just takes the desire to work on it - and a good coach to guide you along the way!

It’s been interesting hanging out in the local health clubs recently….I know that there are lots of GREAT personal trainers and Pilates teachers out there...but there seems to be such a difference between the typical weight-room training sessions  that I’ve observed lately, and a one-on-one Pilates training session.  I suppose unless you’ve experienced both - you don’t know the difference.  But they seem to be light years apart in the amount of fine-tuning and corrections a client actually receives to be in the right alignment and improve technique.  I’m sure these comments will stir up some controversy!

I find it difficult to keep my mouth shut at the gym watching these poor people do exercises in absolutely horrible alignment with zero support in the right places, or being asked to do an exercise that is way to advanced when there might be something much more appropriate to start with.  At the moment… this is probably the best venue for me to express myself!

** (For the purposes of the rest of this article - when I say “Trainer” I’m referring to anyone you hire to assist you with your wellness program (personal trainer, Pilates Instructor, Yoga teacher, coach, or other health professional.)

For the less experienced clients out there who are wondering how to get the most from your workouts and hire the right Pilates teacher, Personal Trainer, or Coach.  Here are my tips suggestions:

• If you are not asked to complete a fairly comprehensive personal assessment, medical history, and goal setting evaluation before you begin - proceed with caution… I know that it seems like a hassle to fill out all these forms, but this personal information and/or fitness evaluation gives a trainer the information they need to help design a personalized program that’s appropriate for you.

• If you complete assessment forms and you have had a recent injury, surgery, or medical issues - don’t keep these details a secret! You might even be pro-active and schedule a consult with your doctor or physical therapist to get written pre-approval to start your new fitness or Pilates program.  All this will only help your trainer do a better job for you!  Bring any guidelines, therapy exercises, or information with you that might be useful for your new wellness coach.

• If you’ve notified your trainer that you have a medical issue, back problem, or injury and they don’t seem to be taking that fact into consideration as they are putting you through your paces…Remind them of the problem.  If they ignore the issue - STOP Immediately, Do NOT finish the session, ask for a refund and find a new trainer.

• If any trainer works with you and says, “do 8 more reps.”  And then proceeds to tell you about their weekend, or asks you questions about the weather - or any other conversation unrelated to how your body feels while executing the exercise - they are distracting your focus , shutting the door on improving body awareness , and minimizing the concentration you might need for your effort.  (I need to point out that watching TV, and possibly the music on your IPod may be doing the same thing!)

• If any trainer explains  how to do an exercise, demonstrates it for you, but then never actually looks at your body to make corrections for your breathing, form,  or technique….in my opinion - you’re not really getting your money’s worth. Either they don’t really care about you, or they don’t know enough to critically look at your body and make corrections.  Either way your potential risk for injury just got higher, and they aren’t doing everything they could to help improve your body awareness and health.

• If you are doing an exercise and it hurts–anywhere - Notify your trainer immediately.  If they are NOT able to modify, adapt, or change the exercise to make it safer and more appropriate - find a new trainer! There is a difference between muscle fatigue and pain!  A well-qualified trainer will work with you to be sure that everything you do is beneficial AND safe.   The better your body awareness is - the easier you’ll be able to distinguish between the two.  When in doubt…Leave it out!  Or take a break.  Or go on to a different exercise.  If you’re not used to paying attention to how your body feels during exercise, there may be a learning curve for both you and your trainer to find the right exercises for your program.

• If you are at risk for Osteoporosis, or have Osteopenia (the beginning stages of bone loss)  your doctor probably wants you doing weight-bearing exercise.  However - guidelines in the U.S.A.  for exercise safety are no forward bending, side bending or twisting!  Is your trainer selecting appropriate exercises for you to help build bone density and avoid fractures? If you’re not sure - Find a new trainer.  If you inquire about these guidelines and they can’t tell you why they are important…..Or they’ve never heard of them (and then they ask you to do another ab crunch…)  The potential for you to get injured just went way up!  Please be safe.

• It’s important for every exercise to have a purpose.  Can your trainer tell you why you’re doing everything in your workout program? Knowing the benefits will help make everything you do more valuable to your health and well-being.  (And you may be less likely to skip the exercises you hate - because you know that they are in fact the very best ones for you to do!)

• Ask questions about the qualifications, training, experience, education, certification, and areas of expertise for the trainers you are considering.  There is no hard and fast right or wrong rule here.  Just realize that you will probably get what you pay for.  Sometimes hiring a new or less-experienced trainer because they are “cheaper” may not be in your best interest.  But a few sessions with a seasoned veteran - and they might be able to oversee a continuation of your program with a newer instructor (especially  if you are starting a program and have medical concerns.).

• Your goals and priorities will change - is your workout program changing to help meet your objectives?

• Never hesitate to ask to work with a different trainer. It’s always appropriate to make a change, and can be good to get opinions and insight from a fresh perspective –  It’s YOUR body!

Discover and develop your own sense of body awareness so that you can make corrections in your form, and pace yourself to get the most of your workouts.  Always listen to your body and make safe exercise choices.  Know that workouts with a well-qualified trainer will always be money well spent.  Use your trainer to help guide and motivate you to stay active and healthy and let them assist you with a safe and appropriate workout program.  If you ever have any concerns - express them, and know that there are lots of great fitness and Pilates professionals out there…Keep looking until you find the one with the experience, expertise and personality to meet your needs.

Yesterday I switched things up for my regular aerobic workout and did my cardio on the rowing machine. Whew…I forgot what a great whole-body workout you can get on a rowing machine.

If you’re one to always head to the treadmill, bike, or elliptical machine - I’d encourage you to check out the benefits of adding even a few minutes of rowing to your aerobic workout program and here’s why:

1. Rowing is definitely a whole-body exercise - your upper body, core and back strength is a huge part of the workout.
2. Rowing can help improve your coordination, sense of rhythm/pacing, and body awareness.
3. You can easily vary the intensity of your workouts
   Work harder by:
   • Increasing your speed & rowing faster.
   • Pushing with your legs and pulling with your arms with more power and intensity.
4. Rowing can help balance the strength of the front and back of the thighs to keep your knees safe and injury free. The glutes and quadriceps muscles assist in straightening the legs, the hamstrings work to bend the knees and return to your start position.
5. In a less-than full weight-bearing position, rowing works the leg and hip joints in a full range of motion - which is beneficial for increasing joint range of motion and assisting with building bone density.
6. If you don’t like doing sit-ups, or a lot of weight training…. Rowing effectively targets strengthening your abdominals and back muscles. If you do enjoy ab work and weights - you can put your strong muscles to good use and use rowing as a cross-training fitness activity.
7. Rowing is fantastic for developing strong core muscles. If you do Pilates training, or other targeted core activities - rowing is a great additional workout activity to apply what you’ve been discovering about your body.
8. If you don’t want to do a full 20-60 minutes of cardio on the rower… Row for 5 minutes as an excellent warm-up for your workout.

If you’re not used to rowing - start with 5-10 minutes and progress to a full-length cardio workout. I like a good 25-40 minutes of moderate paced rowing for a training session, or sometimes will alternate 5-10 minutes of rowing with other cardio or strength training activities for a great interval workout.

There are usually at least one or two rowing machines at every health club. (And chances are you won’t be waiting in line to get on one and start your workout!) Incorporate rowing into your weekly, or monthly workout plan, and enjoy the great benefits this fitness activity has to offer.

I would love to hear about your rowing experience! Drop me a comment and tell me what you’ve discovered about your body, you’re health, and rowing as a new cross-training activity in your weekly workout program. Find fun activities you love to do and get out and play to improve your whole-body health and fitness!

Here’s my revelation for the week!  (or perhaps it’s just today’s revelation - and something else will pop up eager for me to share tomorrow.)

I’ve always cued my clients to begin learning their exercises with the awareness of working within the framework of the Pilates “Box.” Think about the torso from shoulder to shoulder, and hip to hip.  Every exercise starts from the center of the box, moves away from, and back to center.  The farther away from center you move, the stronger you have to be to maintain balance, control, and core support for your exercise or movement.  Feeling where the corners of the “box” are help create an awareness of being evenly  distributing your weight and staying centered.  Great concept!

So when the knees bend in towards the chest on any exercise where should they go? 

I encourage clients to stay within the framework of their “Box” and here’s why:

When the knees don’t open wider than the body there are multiple benefits for strength, flexibility, joint range of motion, core stability and control.

Here are 5 Great Benefits for “Knees Over Chest is Best - For Pilates Training”:

1. Better abdominal support for a safe and healthy back. The abdominal muscles have to pull in - out of the way when the thighs/knees pull in towards the chest.  This cues the core muscles to work and get stronger while the legs are moving.
2. This improved abdominal support, and the relationship with the thighs to the chest, provide a massaging action on the internal organs to assist the digestive system and elimination processes. If the knees open wide and the abdominals “pop” out to the front - support for the spine is lost, as well as the strength to hold the organs in a natural resting position in the torso.
3. Strengthen the Adductor Muscles. The inner thigh muscles work more effectively to stabilize leg control, and guide the legs in a precise plane moving away from and back to center.
4. Improve Knee Flexion. The medial hamstrings will do more work and get stronger as the legs bend in towards the body. This will help strengthen the knees and assist with smooth, controlled movement.  (With the legs opening wider than the body the inner thighs and medial hamstrings might not be working much at all!
5. Moving the legs while tracking within the Pilates Box, strengthens efficient alignment and allows the ball to drop in the hip socket to a good posterior-inferior position.  This helps to develop a free full range of motion for the hip joint (which is necessary to maintain and improve bone density),  trains the legs to move independently of the pelvis, and effectively stretches the glutes, and lower back.  AND while all this is happening, you are maintaining support with the back and core muscles.

I encourage you to play with this concept and see how it feels.

With which Pilates exercises can you see value in thinking about the “Box” and Knees Over the Chest position?

Has this post changed your perspective on wide knees vs. knees over the chest?

I’d love to know what you think!  Comments please….

We are bombarded with millions of bits of information every second of the day.  Our brain has to sort, dump, and store based on relevance and importance for our survival and to insure that we enjoy pleasure and avoid pain.  In today’s society - television programs, commercials, and even YouTube have us eager to input micro-blasts of information and entertainment - rapid fire commando style.  We look for instant gratification, expect to point-click, and get what we want.  The faster you can get results -the better, and if it takes more than a few minutes you don’t feel like you have time to wait.

Does this lifestyle make sense to you?  Are you happy having to check your cell phone and text messages every couple of minutes?  Do you ever reach a feeling of overwhelm?  Wonder why you can’t get it all done?  Have you ever gotten completely frustrated with your progress?  Or just wish you could have a moment to think! 

I love the benefits of technology…but wonder where all the humans went?  We used to leave for work and had a peaceful drive with no distractions so we could pay attention to the road.  If someone needed to call us it was at work or home…If you weren’t in one of these two places your time was your own AND your mind was your own!  Now we’re running to check email, voicemail, the in-box, out-box, text messages, snail mail, facebook, twitter, blogs…and the list goes on!  Used to be if you planned a workout, you’d commune with nature on a bike or run.  Stay inside for a workout and there wasn’t a TV in front of every treadmill to distract you from paying attention to what your body was doing and how it’s feeling.  And now we’re a society that’s getting bigger & bigger because it’s “faster” and more convenient (or so we think..) to eat out than to shop, chop, and cook a healthy meal at home.  It seems like everything we’re doing is to try and juggle the frantic flurry of information.  There are so many things we have to do right now!  We are constantly being bombarded with so many things that rarely do we take a moment to “stop and smell the roses,” or tune in and quiet the pace.

I know that one of my least favorite and most beneficial activities is no activity at all!

When was the last time you did absolutely nothing?  AND all the little monkeys in your mind were Quiet!

What do you imagine when you think of a “Peaceful Mind?”  Calm waters, a clear blue sky, the gentle ebb and flow of the ocean, laughing children at play, or perhaps gazing at the stars and realizing the vastness of the universe?

A peaceful mind is an empty mind - clear of thoughts, present in the now, and enjoying what it’s like to just BE.

There are disciplines and exercises that can help you develop the skills to achieve a Peaceful Mind. And in society today these are definitely skills that need to be developed!   Breathing techniques, Yoga, Tai Chi, Meditation, and even Pilates can help to improve focus and attention.  Our ability to pay attention to the body, mind, spirit, or the nothingness and oneness that we all are to just be a part of, and apart of life on planet Earth will go a long way towards sending those monkeys to a quiet place for awhile.  Being able to take a break from the frantic pace that we’ve chosen to live with can help shine light on new perspectives and allow the opportunity to make new choices for a healthier mindset and lifestyle!

Designate a distraction-free time of day to turn on the phone, computer, and TV.  Put the pets out, turn the radio off, ask your kids and spouse to give you an UN-interrupted 5-15 minutes or longer to enjoy your favorite Peaceful mind activity (or indulge in the activity of doing absolutely nothing!)

Enjoy even a few minutes of a peaceful state of mind to rejuvenate, and re-energize yourself.  In no time at all, you’ll start to notice the shift in your consciousness as your worries decrease, your laughter increases, and you will gain the ability to clear your mind.  Gaining control of your thoughts and actions through the state of a Peaceful Mind is a powerful place to create a healthier lifestyle, and can help you manage and enjoy both the peace and pace of your life.

I find that nothing helps adjust my mental attitude like time spent outside in Nature paired with some vigorous physical activity.

It might be a walk, skate around the park, jog, bike ride, or self-taught “circuit boot camp” (stopping at every park bench, bridge, and piece of playground equipment to do an exercise or stretch.)

Just getting started and knowing that I’m doing something good for my health begins to lighten my mood.

By the time I’ve finished a quick 30 minutes or an hour… between the fresh air, exercise, and chance to enjoy the great outdoors; I am always stress-free, invigorated, and happy!

What are YOUR top three favorite Stress-Reduction strategies?

1.

2.

3.

Please share tips on the things you do to help lower stress in your life???

Inquiring minds want to know…  And you just might inspire some one else to use your helpful hints!  So post a reply now!

Exercise Underutilized for Chronic Back and Neck Pain

About the Research Study

A recent study, funded by the National Institutes of Health, looked at exercise prescription-who is prescribing it, who is getting it, and what type of exercise is being prescribed-and found that exercise may be underutilized for chronic back and neck pain.

This study was published in the February 2009 issue of Arthritis Care & Research. Led by Timothy S. Carey and Janet K. Freburger of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, researchers conducted a phone survey of almost 700 individuals who saw a physician, chiropractor and/or physical therapist (PT) and were treated for chronic back or neck pain during the previous 12 months. They asked participants the following questions:  if they were prescribed exercise, the amount of supervision they received, and the type, duration and frequency of the prescribed exercise.

The Benefits of Exercise for Chronic Pain

Exercise can commonly be used to improve physical function, decrease symptoms and minimize disability that can be caused by chronic low back or neck pain. Numerous randomized trials and clinical practice guidelines support exercise as a beneficial modality, and studies suggest that personally designed, supervised exercise programs are associated with the best results.

Results of the Study

“Less than 50 percent of the subjects in our research study were prescribed exercise, one of the few moderately effective therapies for the highly disabling illness of chronic back and neck pain,” the authors state. Also, health-care provider seen played a major role in whether participants received a prescription for exercise. Of those who received exercise prescription, 46% received the prescription from a PT, 27% from a physician, and 21% from a chiropractor. The authors note that these findings correlate with previous studies that have shown that “who you see is what you get.”

The authors conclude:  “Considering current evidence on the efficacy of exercise, these findings demonstrate that exercise is being underutilized as a treatment for chronic back and neck pain.”

Pilates Exercise Programs for Chronic Pain Clients

As Pilates practitioners, it is beyond our scope of practice to “prescribe” anything.  (Exercises included!)  However, you can grow your business with an excellent source of client referrals if you work closely with the doctors, physical therapists, and chiropractors who have prescribed exercise and work to develop personalized Pilates training programs that meet the guidelines and “prescription” recommended by your client’s health-care providers.

The following things I always request from clients who are starting a Pilates program and have special considerations / health issues:

1.    A written release \ authorization to begin an exercise program from their physician.

2.    Contact details for both the doctor and physical therapist, and permission from the client to    contact these professionals and discuss how we can work together to solve the problems, alleviate symptoms and pain and restore a healthy, active quality of life.

3.    Information about any medications they may be taking for pain management.

4.    A copy of the exercises they have been “prescribed” by their health-care provider (physician, physical therapist, chiropractor)

5.    Any other information they think might be beneficial and relevant.

Physician and Physical Therapy Referrals for Pilates and Exercise

It’s actually been my experience, that when a physician says, “you need to exercise.”  That’s as specific as it gets.  They rely on my expertise to develop a safe and effective Pilates exercise program.  I actually had one new Mat class participant show up with stitches from recent back surgery because her doctor told her she was ready to go, didn’t need physical therapy and needed to get started with an exercise program right away!

I believe that as Pilates professionals it’s our job to help educate the medical community as to the benefits of Pilates, and appropriate place to start for their post-rehab patients.  Doctors who have never done Pilates themselves need to be educated about the differences between a personalized Pilates equipment program and group Matwork class so when they refer their patients, they’ll be confident that they are in the safest, most appropriate program to start.

While some physical therapists are in a situation to provide supervised care, unfortunately, our health-care and insurance system is not set up for them to provide patients with the length of care they might require for a full recovery.  This is where communicating with a client’s PT can be an excellent networking opportunity to establish a lifetime Pilates wellness program for ongoing post-rehab care.

If a client is currently in therapy and has been given the ok to begin Pilates, it’s important to know what the safe movement guidelines are for them at this point in their recovery.  As they progress, it is only with physician or P.T. approval that increased resistance, and additional ranges of movement should be incorporated into their program.  Always defer to the recommendations of their medical health-care providers.

If a client has been released from therapy, it’s still important to check before beginning a program or adding anything new-until their physician, and physical therapist are confident that they can do whatever they want with no restrictions.

The Medication Consideration (and effects on exercise)

Many people with chronic pain may be managing it with medication.  This is an important piece of information, as their medications may mask their ability to assess how their body feels before, during, and after exercise.  Encourage clients to work closely with their physician to monitor how much medication they may actually need, as this may change as they get stronger and more flexible with their exercise program.  And be aware that you might easily push too, far too fast, because with their medication they can’t feel the pain that would normally indicate the need to stop or modify an exercise.

Ask lots of questions before starting an exercise program.

Here are some I usually start with when interviewing a new client with chronic pain:

• Is your condition related to an injury? What happened and when?
• How long has this bothered you?
• Do you ever experience numbness or tingling?
• What do you do for a living? Sit more, Stand, Active?
• What activities, exercises, movements aggravate your condition the most?
• What activities, exercises, movements give you the most relief?
• Is your pain a dull, ache? Sharp? Stabbing?
• Are there times of the day when you feel better or worse?
• What things are you doing now to improve your health?
• What things have you tried in the past? How long? What were the results?
• What has your doctor told you to do and/or avoid?
• What exercises have been prescribed by your doctor or physical therapist?
• How often are you supposed to do these exercises? How often are you doing these exercises? How do you feel while you’re doing them? How do you feel after?
• How can I help you the most?
• What are your goals for participating in Pilates?
• Are there any other injuries or accidents that you’ve had during your lifetime? (Related or unrelated to the current issue?)
• Is there anything else you feel it’s important that I know?

The answers to these questions, the information provided by their health-care providers, and an initial assessment of standing and walking posture provides the starting point for developing a safe and effective Pilates exercise program to assist in the care and management of chronic back and neck pain with the goal of using exercise to improve function, decrease symptoms, and minimize disability for an improved quality of life.

Be Pro-Active and Incorporate a Pilates Exercise Program into your Lifestyle to Manage Chronic Back and Neck Pain

As a Pilates practitioner, take the time to network with the health-care providers in your community to build a referral source for quality care.  As a client searching for ways to improve your health, be pro-active!  There are many traditional and non-traditional methods for reducing pain and improving your quality of life-Pilates and exercise can be a great choice!  Consult with your doctor, P.T., and chiropractor to determine the options available in your community.  It is never too late to improve your health!

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Resources:

Article: “Exercise Prescription for Chronic Back or Neck Pain: Who Prescribes It? Who Gets It? What Is Prescribed?” Janet K. Freburger, Timothy S. Carey, George M. Holmes, Andrea S. Wallace, Liana D. Castel, Jane D. Darter, Anne M. Jackman, Arthritis & Rheumatism (Arthritis Care & Research), February 2009.

http://www.ptproductsonline.com/SOAPNotes/2009-02-04_01.asp

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Aliesa George is a wellness consultant and author with 25+ years of professional experience.  She is founder and president of Centerworks® Pilates Institute.  Certifications include: PMA Pilates Teacher, ACE Personal Trainer & Group Exercise Instructor, and Bigu Qigong Weight-Loss/Weight Management Instructor.  Ms. George is available for private/group training and offers workshops in Pilates, movement re-education, and mind-body health enhancement.  For additional resources and to contact Aliesa, please visit www.CenterworksPilates.com.