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	<title>Centerworks Blog &#187; neck pain</title>
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		<title>Six Easy Ways to Reduce Neck Tension during Pilates Exercise with Better Breathing Habits</title>
		<link>http://www.centerworks.com/blog/2010/08/16/six-ways-to-reduce-neck-tension-during-pilates-exercise-with-better-breathing/</link>
		<comments>http://www.centerworks.com/blog/2010/08/16/six-ways-to-reduce-neck-tension-during-pilates-exercise-with-better-breathing/#comments</comments>
		<pubDate>Mon, 16 Aug 2010 23:14:32 +0000</pubDate>
		<dc:creator>Aliesa George</dc:creator>
				<category><![CDATA[All Posts]]></category>
		<category><![CDATA[Breathing]]></category>
		<category><![CDATA[Pilates-Teaching Tips]]></category>
		<category><![CDATA[Breathing Tips]]></category>
		<category><![CDATA[neck pain]]></category>
		<category><![CDATA[Neck Strain]]></category>
		<category><![CDATA[Pilates Exercise]]></category>
		<category><![CDATA[Pilates Exercise Tips]]></category>
		<category><![CDATA[Reducing Neck Tension]]></category>

		<guid isPermaLink="false">http://www.centerworks.com/blog/?p=1346</guid>
		<description><![CDATA[I’ve seemed to have a flurry of issues with Pilates clients lately who are dealing with neck pain. And with the Optic Neuritis that I’ve been dealing with for the past 6 months, the tension in my neck has been an issue too!  Whether we end up with increased neck pain from an accident, injury, [...]]]></description>
			<content:encoded><![CDATA[<p><strong><img class="size-medium wp-image-1350 alignleft" style="margin: 10px 5px;" title="Reduce Neck Pain" src="http://www.centerworks.com/blog/wp-content/uploads/2010/08/iStock_000001759791Medium1-200x300.jpg" alt="" width="168" height="252" />I’ve seemed to have a flurry of issues with Pilates clients lately who are dealing with neck pain.</strong> And with the Optic Neuritis that I’ve been dealing with for the past 6 months, the tension in my neck has been an issue too!  <strong>Whether we end up with increased neck pain from an accident, injury, or just how we use and move our body for work and daily life, chronic neck pain, is no fun</strong> and literally a pain in the neck!</p>
<p><strong> </strong></p>
<p>Pilates exercises done correctly are excellent for strengthening core muscles for support, which over time helps  to reduce neck tension.  However, sometimes getting started – newer Pilates participants can aggravate a neck problem, by not understanding, or having the strength and flexibility needed to support the body well and keep the stress out of the neck.  <strong>If you’re doing any exercise and you begin to feel stress or strain in your neck –Stop!  Better to take a break, then start to use muscles that shouldn’t be doing the work and continue to aggravate neck issues. </strong> There are hundreds (maybe thousands) of exercises that can be done without neck pain.  The challenge is finding the right exercises for your body to start with, and continue to progress.  <span id="more-1346"></span></p>
<p><strong>Regardless of the exercise, good breathing habits are critical for opening the joint space in the neck and helping to lengthen the neck muscles to reduce neck strain and improve posture and body alignment.</strong> Our head is basically an 8-10 pound bowling ball sitting on a straw.  If the ball is not well-balanced on the straw, the straw will lean or bend and the head will tip to funny angles striving to stay perched at the top of our body.  At this point, some muscles are working too hard, and others are not pulling their weight.  Over time, the body accepts this way of holding the head and neck as correct (whether its good or bad)  and the pattern of muscle use becomes a habit – whether we like it or not!</p>
<p style="text-align: center;"><strong>The good news…It’s never too late to change a habit!</strong></p>
<p>With a little effort, and having some new strategies to play with and practice, you can effectively reduce neck tension and neck strain quickly and easily just by paying attention to where you are holding tension and practicing better breathing habits during  your Pilates exercises.</p>
<h2><strong>Here Are Six Tips To Help Reduce Neck Strain During Pilates Exercise<br />
<em>(AND Daily Life Activities!)</em></strong></h2>
<h4 style="padding-left: 30px;"><strong>1.  Posterio-Lateral Pilates Breathing Technique</strong></h4>
<p style="padding-left: 60px;"><strong>Learning how to utilize the Pilates style of posterior-lateral breathing is KEY to helping lift the head up off the neck and lengthen the spine.</strong> Emphasis is placed on inhaling to fill the back of the ribcage from the bottom to the top.  In effect, what happens is as you fill the lungs with air, you are increasing the natural curves of the spine.  This should happen from the tailbone to the top of the head.  So your inhale helps to float the head up off the neck.</p>
<p style="text-align: left; padding-left: 60px;"><strong><em>For more details on a variety of Breathing Exercises to practice your Posterio-Lateral Pilates technique check out my blog post <a href="http://www.centerworks.com/blog/2005/10/10/breathing-basics/" target="_blank">Breathing Basics</a></em></strong></p>
<h4 style="padding-left: 30px;"><strong>2.  Keep the Front of the Neck and Throat Relaxed on Your Inhale</strong></h4>
<p style="padding-left: 60px;">I notice that a lot of people actually inhale through the torso and tense up so much through the front of their neck that the head actually gets closer to the body on the inhale!  When this happens – the neck muscles are pulling the neck bones closer together (when things should be lengthening apart!)  <strong>Watch yourself breathe in front of a mirror and see if you notice your neck get longer, or shorter as you inhale.</strong> <strong>Do you see the muscles in the front of your neck tense up on your inhale?  Or do they stay loose and relaxed? </strong> Think about your neck and throat being an open tube that air can easily flow in and out of.</p>
<p style="padding-left: 60px;">
<h4 style="padding-left: 30px;"><strong>3. </strong><strong>Tongue Placement</strong></h4>
<p style="padding-left: 60px;">Where your tongue is placed in your mouth can make a difference!  <strong>Lightly touch the tip of the tongue to the roof of your mouth on your inhale, and drop the tongue away from the roof of your mouth on your exhale. </strong> This helps facilitate proper use of the diaphragm, and as the tongue drops on the exhale, you may notice that the muscles in the front of the neck soften and relax a bit.</p>
<h4 style="padding-left: 30px;"><strong>4. </strong><strong>On Every Exhale Use a “HA” Sound To Release and Open the Jaw</strong></h4>
<p style="padding-left: 60px;"><strong>Using “HAaaaaaa”  and opening the jaw to exhale moves the primary support lower in the torso to help activate core muscles.</strong> You might actually make the “HA” sound as you exhale until this becomes a familiar habit to release the neck and open the jaw.</p>
<p style="padding-left: 60px;"><em>The habit I notice if people aren’t doing a “HA” breath, is exhaling like you’re playing a flute, through a slightly pursed lip.  This creates the look of a sour lemon face.  If you make a sour lemon face, you’ll notice that the front of the throat tenses up, scalene muscles grip, and the head and neck get pulled closer to the body.  Plus,  it is more difficult to feel the activation of core support – support almost gets stuck in the throat instead of dropping lower into the center.   Can you see how this can create or aggravate a neck problem?</em> <strong>Strive to make “HA” breathing your new habit!</strong></p>
<p style="padding-left: 30px;">
<h4 style="padding-left: 30px;"><strong>5. </strong><strong>Pelvic Floor</strong></h4>
<p style="padding-left: 60px;">While I’ve got this as #5 on my list….It probably should be #1!  <strong>Effective use of the pelvic floor provides the anchoring at the base of the spine which is necessary for lift and lengthening that occurs during breathing.  Without an active, engaged pelvic floor, it’s impossible to get the ribs to lift away from the pelvis, the neck to lift away from the torso, and the head to lift away from the neck! </strong> How do you effectively find and use the Pelvic Floor?  If you’re not already familiar with using your Pelvic Floor, check back soon, for a blog post on this very important topic!</p>
<p style="padding-left: 60px;">
<p><strong> </strong></p>
<h4 style="padding-left: 30px;"><strong>6. </strong><strong>Shoulder Depression</strong></h4>
<p style="padding-left: 60px;">Our body is a system of levers and pulleys.  Think of a teeter-totter.  Both ends can’t go up!  One goes down and the other goes up.  So <strong>for our body, the shoulder blades doing down provide the leverage for our upper spine, neck, and head to lift up.</strong> If your shoulders are wrapped around your ears, chances are your head and neck are jammed in too close to your torso.  <strong>Pull the shoulders down and you should feel your head shoot up another inch or two closer to the ceiling.</strong></p>
<h2><strong>Which Pilates Exercises Should You Apply These Six Tips to Reduce Neck Strain?</strong></h2>
<p><strong>ALL of Them!!!</strong> Whether it’s a Pilates Matwork Exercise, or Exercises on the Reformer, Cadillac, Chairs, or Barrels.  If you’re walking, running, riding a bike, swimming, lifting weights, dancing, riding a horse, playing golf, tennis or other sports…  You have lots of opportunities to apply these six tips to get your support where you need it and reduce the amount of tension and stress you feel in your neck.</p>
<p>Don’t forget about moments throughout your day too&#8211; at work, driving the car, doing things around the house…<strong>anytime you remember to take a minute or two and practice utilizing these six important neck lengthening tips – you’ll be changing your habits for better health!</strong></p>
<p>Don’t worry if you can’t make them all happen at once!  Pick one and practice for a few days.  When it gets easier, see if you can add another one, then another – until you’re able to incorporate all six into any and every exercise you do!</p>
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		<title>Neck Pain and Pilates Exercise</title>
		<link>http://www.centerworks.com/blog/2009/10/27/neck-pain-and-pilates-exercise/</link>
		<comments>http://www.centerworks.com/blog/2009/10/27/neck-pain-and-pilates-exercise/#comments</comments>
		<pubDate>Tue, 27 Oct 2009 17:13:34 +0000</pubDate>
		<dc:creator>Aliesa George</dc:creator>
				<category><![CDATA[All Posts]]></category>
		<category><![CDATA[Articles]]></category>
		<category><![CDATA[Exercise and Fitness]]></category>
		<category><![CDATA[Health]]></category>
		<category><![CDATA[Pilates]]></category>
		<category><![CDATA[Pilates Exercise]]></category>
		<category><![CDATA[Pilates-Teaching Tips]]></category>
		<category><![CDATA[neck pain]]></category>
		<category><![CDATA[Pilates Teaching]]></category>

		<guid isPermaLink="false">http://www.centerworks.com/blog/?p=600</guid>
		<description><![CDATA[As Pilates teachers, our goal is to help our clients find, feel, and correct bad alignment, and muscle imbalances so that they can improve their whole-body health and enjoy life!  It&#8217;s frustrating for us and them, when problems or pain lingers longer than we think it should.  Chances are if a client walked through your [...]]]></description>
			<content:encoded><![CDATA[<p>As Pilates teachers, our goal is to help our clients find, feel, and correct bad alignment, and muscle imbalances so that they can improve their whole-body health and enjoy life!  It&#8217;s frustrating for us and them, when problems or pain lingers longer than we think it should.  Chances are if a client walked through your door with pain, and it&#8217;s been there awhile &#8211; making changes isn&#8217;t going to happen overnight!  But generally speaking &#8211; Pilates has fantastic things to offer for improving body awareness and developing new posture and movement habits to help pain and problems go away and improve your quality of life!</p>
<h2>Here&#8217;s a Great Question about Neck Pain and Pilates that I received recently:</h2>
<p>Hello:  I receive your newsletter and I have to say thank you for your time and your commitment.<strong> I would really appreciate your point of view about people who practice Pilates for a very long time, but still feel pain in their necks, and this stops their progress in the work.  I have two students with this problem.  They are good physically (don’t have any structural problems in their bodies) which makes me think this is more than a physical problem. </strong>Thanks for your time!<strong> Any insights would be great.</strong> ~ Regards, Barbara</p>
<h2>Thoughts from Aliesa George on Neck Pain and Pilates Exercises for Healthy, Experienced Students:</h2>
<p>Neck pain during Pilates is a common problem for new students who don&#8217;t have great spine flexibility or the strength to get into a good curled up position for exercises like the Hundred, but I think it’s probably a more common issue than one might think for experienced students too!<span id="more-600"></span></p>
<p>Because you’ve indicated that the clients you are working with don’t have any structural or health issues that would be causing neck pain during their Pilates exercises, my guess is that mechanically they do not yet have full articulation through the spine for flexion and extension – especially through the upper back (thoracic region).  And there’s a chance that even though they are strong, they may not be really using their core muscles as well as they could to support them.</p>
<p><strong>When you evaluate standing posture position, is their head placement appropriate – ears over shoulders?  Or are the ears slightly forward which would indicate a shearing of the neck bones, and will create more neck stress even in a vertical position.</strong></p>
<p><strong>If the head is forward at all, the natural curve of the neck is compromised.</strong> For that matter if the curves of the entire spine are not well balanced the ability for free and functional movement of the whole spine in any direction (flexion, extension, side bending, or rotation) will be compromised.  Your clients probably won’t notice these limitations in extension, side bending, and seated rotation as much as they will for forward flexion, and exercises like criss-cross during Matwork – because when they lay on their back and have to hold their head up, or curl up AND twist,  those are the exercises that makes their neck hurt!</p>
<p><strong>If anyone has an issue with their neck – healthy or otherwise, I start making alignment changes from the feet!  You can’t just realign a neck, because everything beneath it is a part of why the neck and head are sitting where they’re at.  Fine-tune foot and leg alignment, then get all the curves of the spine to be functionally correct for both stabilization and movement, and you’ll discover that the head and neck have no choice but to happily follow along and end up well placed on the body!</strong></p>
<p>There are definitely a couple of things that I always do, and look for, when I know that I need to help my Pilates clients get out of their necks.</p>
<h2>Here are some things for you to consider when developing your Pilates exercise programs for your healthy clients that continue to be challenged with neck pain during exercise:</h2>
<p>1.<strong> Go back to basics.</strong> There is some additional detail work that their body needs to continue improving technique.  While the may be able to do wild advanced exercises – in the long run they will get more benefits from everything when they are better and more correctly supporting every exercise.  This is easiest to work on during private sessions.  If your clients are only participating in group classes, that is the first change I’d make.  Encourage them to schedule some one-on-one training so you can help figure out what exercises, cues, and concepts need to be reinforced and corrected.</p>
<p>2.	<strong>Evaluate their movement technique for a Standing Roll Down on the Wall.</strong></p>
<p style="padding-left: 60px;">I would place bets that your two clients drop their heads forward, then begin bending somewhere in the middle of their torso to fold forward, and that there really isn’t any articulation of the spine happening through the upper back.  Since the breastbone is a solid vertical, if it is held rigid and you try to bend forward, the only thing that moves is your head and neck, resulting in neck strain.  Then the articulation needed by every segment from T1 down to flex forward is skipped and the body folds forward somewhere around T12.  This is not an ideal movement pattern; since we have so many Pilates exercise that require full articulation of the spine.</p>
<p style="padding-left: 60px;"><strong>The breastbone should be pliable.  To bend forward it should soften back towards the spine and slide down the front of your shirt.  This allows the upper back bones to lift in opposition creating the space for good movement and that one by one articulation of each segment of the spine.</strong></p>
<p style="padding-left: 60px;">When the breastbone softens and slides back and down as the body bends forward into flexion, the shoulder blades should spread apart and each segment of the spine has the ability to move independently, so you can learn to peel your back away from the wall and roll forward one segment at a time.  In reverse, to roll up – each segment lifts and stacks and is supported from below, the eyes stay looking at the front of the shirt for as long as possible to lift through the spine, through the neck, and then stack the head.  Getting an understanding of this feeling of pliability with the breastbone and flow of movement when you’re not fighting gravity is helpful to keep stress out of the neck and begin changing bad habits.</p>
<p>3.	<strong>Look at their eye placement during every flexed spine exercise.</strong> If their eyes aren’t looking in the right position, their head and neck won’t be in optimal alignment either.</p>
<p style="padding-left: 60px;"><strong>Examples of exercises to pay attention to eye position:</strong></p>
<ul>
<li><strong>Pilates Matwork:</strong> The Hundred, Series of 5, Rolling Like a Ball, Open Leg Rocker, etc…</li>
<li><strong>Pilates Reformer:</strong> Hundred, Short-Spine Massage, Coordination, Back Stroke, Up Stretch, Stomach Massage Round, Short Box Round &amp; Flat, Long Spine Massage, and Kneeling Knees Off are all good ones to spot check.</li>
</ul>
<p style="padding-left: 30px;">Basically you need to pay attention to their neck and whole-body alignment on every exercise they do!</p>
<p style="padding-left: 60px;"><strong>Here are a few examples of what to look for and why it’s important:</strong></p>
<p style="padding-left: 30px;"><strong>Example: The Hundred</strong></p>
<p style="padding-left: 60px;">If the body is lying down and curling into say the 100 position, and the eyes are looking at the ceiling instead of the stomach – the head did not curl around the corner to flex the neck so that the higher abdominal muscles could weight-load the lift.  If the cervical and thoracic spine flexes appropriately – the body should easily curl up to the bottom tips of the shoulder blades which places the head in a vertical position and held here with the abdominals, there is no stress or tension in the neck.</p>
<p style="padding-left: 30px;"><strong>Example: Short Spine Massage / Long Spine Massage</strong></p>
<p style="padding-left: 60px;">These two exercises are very similar from the neck’s perspective.  If the eyes look backwards to follow the line of the legs and feet lifting overhead, the neck is being pulled into extension, while the spine is bending into flexion to roll upside down.  The neck or back will tense up to avoid injury and a strained or pulled muscle will result.  Be sure that throughout the exercise, the eye focus is on the abdominals to allow the neck and upper spine to flex more deeply the higher the body lifts upside down.</p>
<p style="padding-left: 30px;"><strong>Example:  Short Box – Flat</strong></p>
<p style="padding-left: 60px;">If the eyes lead the movement to hinge backwards instead of the hips, the head moves backwards off the spine and the body arches back instead of hinging placing more stress on the neck and shoulders.  Keep the eyes looking down and forward towards the toes, so that the head and neck just go along for the ride on a stabilized spine.  This way the movement is correctly initiated from the hips and pelvis to go backwards and return to vertical.</p>
<p>4.	<strong>Focus on exercises that move into forward flexion with gravity assistance to help find better abdominal support and allow the head and neck to hang forward and relax</strong> to create the space between the bones needed for better movement.</p>
<p style="padding-left: 30px;"><strong>Pilates Exercise Examples:</strong></p>
<p style="padding-left: 60px;"><strong>Wall Exercises</strong> &#8211; Roll down on the wall</p>
<p style="padding-left: 60px;"><strong>Spine Corrector</strong> – breathing over the barrel</p>
<p style="padding-left: 60px;"><strong>Reformer</strong> &#8211; Up Stretch, Elephant Round, Kneeling Knees Round &amp; Knees Off</p>
<p style="padding-left: 60px;"><strong>Chair</strong> – Washer Woman, Pike, Cat</p>
<p style="padding-left: 60px;"><strong>Pilates Cadillac / Trapeze Table </strong>– Kneeling Rolling in and out (the prep part – just rolling down and back up, or rolling down and doing the arm circles then rolling back up), Kneeling Cat with the push through bar, Push Through, Standing Roll Down with the roll down bar (2nd half of the Standing Squat exercise), Spread Eagle</p>
<p>There are lots of choices, and many other exercises I utilize to reinforce these concepts.  Hopefully this short list will get your brain thinking about exercises that you know, or modifications you can do to work on this.</p>
<p>5.	<strong>Change the arm and hand placement for exercises that roll upside down to assist in deepening the upper thoracic spine’s ability to move into flexion and practice softening the breastbone.</strong> If the arms are lying on the mat by your sides and you use them to actively push against the mat to roll the body upside down, you are actually cueing the back muscles to tighten and move into extension.  Ideally with the arms by your sides all you should do is depress the shoulder blades and elongate the arms in opposition to the lift so that the shoulder blades can spread apart as the breastbone softens and the body bends to roll upside down.</p>
<p style="padding-left: 30px;"><strong>Here are three options for arm placement to help articulation of the upper spine:</strong></p>
<p style="padding-left: 60px;">a.	If you are on the Reformer – bend the arms behind the head and hold onto the back of the shoulder pads.  Elbows will be in towards the body and pointing to the ceiling to help spread the shoulder blades wide.</p>
<p style="padding-left: 60px;">b.	If you are on the Reformer –  lift both arms up to the ceiling while executing the exercises like Short Spine, Long Spine, and Pelvic Lift</p>
<p style="padding-left: 60px;">c.	If you are on the Cadillac and holding onto the upright poles, be sure that the arms are high enough on the poles to get the blades to depress and spread so you see the breastbone drop towards the mat into a more functional upper thoracic curve that is supported by the abdominals.</p>
<p>6.<strong> Spine rotation will facilitate improvement for both flexion and extension.</strong> If you’ve identified that the upper spine is not very flexible…you might want to incorporate additional rotation exercises into their program to assist in mobilizing the upper back.</p>
<h2>Final Thoughts on Pilates and Neck Pain</h2>
<p>No client should be in pain during any Pilates exercise.  It&#8217;s our job as a well-trained Pilates teacher to look at every client&#8217;s posture, alignment, and movement habits, as well as ask questions about daily life activities that may be contributing to any issue, so that we can make smart choices in the exercises we teach first, and progress into.</p>
<p>You’ve got lots of information to digest here!  Hope that this helps you continue to develop your critical thinking skills for selecting the best exercises to assist your Pilates clients, and hopefully so new things to look at when you’re watching your clients and cueing corrections.</p>
<p>I’m always available for workshops, and it’s way more fun to actually work with bodies and see them change. <a title="Contact Aliesa George and Centerworks to Host an Awesome Workshop!" href="http://www.centerworks.com/contact-us/" target="_blank">Contact me</a> if you’re ever interested in hosting a workshop!</p>
<p>And for all of my fellow Pilates teachers who are reading this, keep me posted on how it’s going with your clients, and let me know if you’ve found this information useful or helpful to add to your expertise!</p>
<p>Have a Fit and Fabulous Day!</p>
<p>Aliesa George</p>
<p><a title="Centerworks - Pilates and Wellness Resources for Whole-Body Health" href="http://www.centerworks.com/" target="_blank">www.Centerworks.com</a></p>
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		<title>Reduce Back Pain: The Benefits of Breathing as Taught in Pilates</title>
		<link>http://www.centerworks.com/blog/2009/08/19/reduce-back-pain-the-benefits-of-breathing-as-taught-in-pilates/</link>
		<comments>http://www.centerworks.com/blog/2009/08/19/reduce-back-pain-the-benefits-of-breathing-as-taught-in-pilates/#comments</comments>
		<pubDate>Wed, 19 Aug 2009 17:44:11 +0000</pubDate>
		<dc:creator>Aliesa George</dc:creator>
				<category><![CDATA[Articles]]></category>
		<category><![CDATA[Back Pain]]></category>
		<category><![CDATA[Breathing]]></category>
		<category><![CDATA[Exercise and Fitness]]></category>
		<category><![CDATA[Pilates-Teaching Tips]]></category>
		<category><![CDATA[Back Care]]></category>
		<category><![CDATA[Breathing Exercises]]></category>
		<category><![CDATA[Breathing Techniques]]></category>
		<category><![CDATA[neck pain]]></category>
		<category><![CDATA[Pilates]]></category>
		<category><![CDATA[Pilates Exercises]]></category>
		<category><![CDATA[Reduce Back Pain]]></category>

		<guid isPermaLink="false">http://www.centerworks.com/blog/?p=432</guid>
		<description><![CDATA[Back Pain is something that affects way too many people these days!  According to the American Chiropractic Association, back pain is the fifth most  common reason for all physician visits in the US, and the most frequent cause of activity limitation in people younger than 45 years old. In fact according to the AMA, 70 [...]]]></description>
			<content:encoded><![CDATA[<p><a rel="attachment wp-att-391" href="http://www.centerworks.com/blog/2009/08/19/reduce-back-pain-the-benefits-of-breathing-as-taught-in-pilates/back-pain-72/"><img class="alignright size-full wp-image-391" title="Get Relief for Back Pain with Pilates Breathing Exercises from Aliesa George and Centerworks.com" src="http://www.centerworks.com/blog/wp-content/uploads/2009/08/back-pain-72.jpg" alt="Get Relief for Back Pain with Pilates Breathing Exercises from Aliesa George and Centerworks.com" width="135" height="180" /></a>Back Pain is something that affects way too many people these days!  <strong>According to the American Chiropractic Association, back pain is the fifth most  common reason for all physician visits in the US, and the most frequent cause of activity limitation in people younger than 45 years old. </strong></p>
<p><strong><strong>In fact according to the AMA, 70 to 85 percent of all people have back pain at some time in their life. </strong></strong> Yikes, what a staggeringly high number of people, and I suspect that unfortunately, these numbers are probably going up rather than down!</p>
<p>As one of those in this majority, who suffers with congenital back issues, I have spent most of my life actively doing things to help keep my body strong, fit, and flexible.  I have discovered over the years, that there are some things my body loves to do, and other things that are guaranteed to cause me grief.  And what I have learned is that the more I exercise and stay active, generally, the better my back feels, and the happier and healthier my whole-body is.</p>
<p>Let&#8217;s face it, <strong>when your body hurts, it&#8217;s under stress.   While some muscle tension is good and appropriate to maintain posture and help us move around, overly tight muscles create unnecessary stress and too much tension which unfortunately can lead to back pain. </strong> When any of the bones in our body are held too tightly together by muscle contraction, or misalignment, freedom of movement will be restricted and over time, with the inability to enjoy free and easy movement, poor posture and pain can be the result.  It&#8217;s no secret that stress causes tension&#8230;  <strong></strong></p>
<p><strong>Discover how to reduce neck pain, and back pain with Pilates breathing techniques. </strong><span id="more-432"></span></p>
<p><strong>Learning effective breathing techniques can be one of the easiest and most effective ways to begin releasing stress and mobilizing the spine </strong>without big, dramatic movement or specific back-care exercises.  Whether back pain bothers your lower, middle, or upper back and neck &#8211; learning how to lengthen and support the back, AND breathe is a great exercise that can be practiced anytime and anywhere to help release stress and reduce pain.</p>
<p>While it&#8217;s always best to consult your physician if you&#8217;re experiencing any pain or injury, breathing is still required to stay alive!  And <strong>there are lots of different ways to breathe. </strong> When your body is in pain, it will resort to an instinctual pattern that is shallow and will help you turn over just enough oxygen to keep all systems functioning to keep you alive.</p>
<p>While this is practically helpful to be able to get through the day, it may not help solve the bigger issues at hand.</p>
<p><strong>Pilates posterio-lateral breathing is an excellent choice to benefit back care.</strong> This is a big fancy word for breathing into the back (posterio) and sides (lateral) of the ribcage.  Under the ribcage are the lungs which fill with air on every inhale.  Not only does the ribcage help to protect our lungs and other internal organs, but each rib attaches to the spine.  As we inhale, and fill our lungs with air, each rib should lift and separate creating space and length through the back of the body (basically stretching the spine!) As the ribs separate, since they are attached to each segment of the spine(vertebrae) , the segments are pulled apart too.</p>
<p>Because I&#8217;m personally prone to both lower back and neck issues, I like to take the practice of my posterio-lateral breathing and carry it the full length of my spine so I can feel my inhale lengthen down through my tailbone, and up through the top of my head.  It feels slightly different when I&#8217;m seated, standing, or laying down, so I&#8217;ve got lots of different places to practice throughout the day.  I find that lots of times my inhale tends to stop at my shoulders and my head actually jams down on my neck &#8211; No wonder it hurts!  Feeling the head float off the neck on an inhale is very liberating for releasing tension.</p>
<p><strong>Good breathing habits provide compression and decompression for the spine.</strong> Inhale and the vertebrae lift apart &#8211; decompression.  Exhale and the vertebrae come closer together &#8211; compression.  <strong>This rhythmic action should be happening with every breath we take, all day long to provide a pumping action for vital nutrients and fluids to move up and down the spinal column. </strong> When we experience an injury, accident, or back pain for any reason, there may be one, two,  or multiple segments restricted from this natural movement.  This tension of our bones being held too tightly together, and lack of freedom to move for decompression and compression during breathing, and daily life activities, may, over time result in a chronic back pain problem.</p>
<p>Practicing better breathing habits may not solve all your back pain issues, but it&#8217;s certainly a great place to start, and will assist you with good movement and muscle use while you incorporate the most appropriate back-care exercises into your daily routine to keep your body healthy and pain-free.</p>
<p><strong>Discover helpful tips and techniques for Pilates posterior-lateral Breathing Exercises here:</strong></p>
<p><a href="http://www.centerworks.com/blog/2005/10/10/breathing-basics/">http://www.centerworks.com/blog/2005/10/10/breathing-basics/</a></p>
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		<title>Pilates Exercise Programs for Chronic Back and Neck Pain</title>
		<link>http://www.centerworks.com/blog/2009/02/04/pilates-exercise-programs-for-chronic-back-and-neck-pain/</link>
		<comments>http://www.centerworks.com/blog/2009/02/04/pilates-exercise-programs-for-chronic-back-and-neck-pain/#comments</comments>
		<pubDate>Thu, 05 Feb 2009 00:03:05 +0000</pubDate>
		<dc:creator>Aliesa George</dc:creator>
				<category><![CDATA[Health]]></category>
		<category><![CDATA[Back Pain]]></category>
		<category><![CDATA[exercise program]]></category>
		<category><![CDATA[neck pain]]></category>
		<category><![CDATA[Pilates]]></category>
		<category><![CDATA[Pilates Exercise]]></category>

		<guid isPermaLink="false">http://www.centerworkspilates.com/blog/?p=74</guid>
		<description><![CDATA[Considering the large number of clients I&#8217;ve seen with chronic back and neck pain, and the great results they&#8217;ve had from participating in Pilates programs with me, I strongly agree with the findings from this recent research article I read in SOAP notes from PT Products. Exercise Underutilized for Chronic Back and Neck Pain About [...]]]></description>
			<content:encoded><![CDATA[<p>Considering the large number of clients I&#8217;ve seen with chronic back and neck pain, and the great results they&#8217;ve had from participating in Pilates programs with me, I strongly agree with the findings from this recent research article I read in SOAP notes from PT Products.<br />
<span id="more-74"></span></p>
<h1><strong>Exercise Underutilized for Chronic Back and Neck Pain</strong></h1>
<h2>About the Research Study</h2>
<p><img class="alignright" title="Neck &amp; Back Pain" src="http://www.Centerworks.com/blog/wp-content/uploads/2009/02/istock_000001759791medium1.jpg" alt="" width="164" height="247" />A recent study, funded by the <span style="color: #0000ff;"><span style="text-decoration: underline;"><a href="http://www.nih.gov/" target="_blank">National Institutes of Health</a></span></span>, 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.</p>
<p>This study was published in the February 2009 issue of <a title="Arthritis Care and Research Journal" href="http://www3.interscience.wiley.com/journal/77005015/home" target="_blank"><em>Arthritis Care &amp; Research</em></a>. Led by Timothy S. Carey and Janet K. Freburger of the <a title="Cecil G. Sheps Center for Health Services Research" href="http://www.shepscenter.unc.edu/" target="_blank">Cecil G. Sheps Center for Health Services Research</a> at the <a href="http://www.unc.edu/" target="_blank">University of North Carolina</a><a title="University of North Carolina" href="http://http://www.unc.edu/" target="_blank"> </a>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.</p>
<h2>The Benefits of Exercise for Chronic Pain</h2>
<p>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.</p>
<h2>Results of the Study</h2>
<p>&#8220;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,&#8221; 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 &#8220;who you see is what you get.&#8221;</p>
<p>The authors conclude:  &#8220;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.&#8221;</p>
<h2>Pilates Exercise Programs for Chronic Pain Clients</h2>
<p>As Pilates practitioners, it is beyond our scope of practice to &#8220;prescribe&#8221; 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 &#8220;prescription&#8221; recommended by your client&#8217;s health-care providers.</p>
<p>The following things I always request from clients who are starting a Pilates program and have special considerations / health issues:</p>
<p style="padding-left: 30px;">1.    A written release \ authorization to begin an exercise program from their physician.</p>
<p style="padding-left: 30px;">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.</p>
<p style="padding-left: 30px;">3.    Information about any medications they may be taking for pain management.</p>
<p style="padding-left: 30px;">4.    A copy of the exercises they have been &#8220;prescribed&#8221; by their health-care provider (physician, physical therapist, chiropractor)</p>
<p style="padding-left: 30px;">5.    Any other information they think might be beneficial and relevant.</p>
<h2>Physician and Physical Therapy Referrals for Pilates and Exercise</h2>
<p>It&#8217;s actually been my experience, that when a physician says, &#8220;you need to exercise.&#8221;  That&#8217;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&#8217;t need physical therapy and needed to get started with an exercise program right away!</p>
<p>I believe that as Pilates professionals it&#8217;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&#8217;ll be confident that they are in the safest, most appropriate program to start.</p>
<p>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&#8217;s PT can be an excellent networking opportunity to establish a lifetime Pilates wellness program for ongoing post-rehab care.</p>
<p>If a client is currently in therapy and has been given the ok to begin Pilates, it&#8217;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.</p>
<p>If a client has been released from therapy, it&#8217;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.</p>
<h2>The Medication Consideration <em>(and effects on exercise)</em></h2>
<p>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&#8217;t feel the pain that would normally indicate the need to stop or modify an exercise.</p>
<h3><strong>Ask lots of questions before starting an exercise program.</strong></h3>
<p>Here are some I usually start with when interviewing a new client with chronic pain:</p>
<ul class="unIndentedList">
<li> Is your condition related to an injury? What happened and when?</li>
<li> How long has this bothered you?</li>
<li> Do you ever experience numbness or tingling?</li>
<li> What do you do for a living? Sit more, Stand, Active?</li>
<li> What activities, exercises, movements aggravate your condition the most?</li>
<li> What activities, exercises, movements give you the most relief?</li>
<li> Is your pain a dull, ache? Sharp? Stabbing?</li>
<li> Are there times of the day when you feel better or worse?</li>
<li> What things are you doing now to improve your health?</li>
<li> What things have you tried in the past? How long? What were the results?</li>
<li> What has your doctor told you to do and/or avoid?</li>
<li> What exercises have been prescribed by your doctor or physical therapist?</li>
<li> How often are you supposed to do these exercises? How often are you doing these exercises? How do you feel while you&#8217;re doing them? How do you feel after?</li>
<li> How can I help you the most?</li>
<li> What are your goals for participating in Pilates?</li>
<li> Are there any other injuries or accidents that you&#8217;ve had during your lifetime? (Related or unrelated to the current issue?)</li>
<li> Is there anything else you feel it&#8217;s important that I know?</li>
</ul>
<p>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.</p>
<h2>Be Pro-Active and Incorporate a Pilates Exercise Program into your Lifestyle to Manage Chronic Back and Neck Pain</h2>
<p>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!</p>
<p>********</p>
<p>Resources:</p>
<p>Article: &#8220;Exercise Prescription for Chronic Back or Neck Pain: Who Prescribes It? Who Gets It? What Is Prescribed?&#8221; Janet K. Freburger, Timothy S. Carey, George M. Holmes, Andrea S. Wallace, Liana D. Castel, Jane D. Darter, Anne M. Jackman, Arthritis &amp; Rheumatism (Arthritis Care &amp; Research), February 2009.</p>
<p><strong><a href="http://www.ptproductsonline.com/SOAPNotes/2009-02-04_01.asp" target="_blank">http://www.ptproductsonline.com/SOAPNotes/2009-02-04_01.asp</a> </strong></p>
<p><strong> </strong></p>
<p>************************</p>
<p>Aliesa George is a wellness consultant and author with 25+ years of professional experience.  She is founder and president of Centerworks&amp;#174; Pilates Institute.  Certifications include: PMA Pilates Teacher, ACE Personal Trainer &amp; 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 <a title="Pilates and Health Resources from Centerworks and Aliesa George" href="http://www.Centerworks.com" target="_blank">www.Centerworks.com</a>.</p>
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		<title>Improving Posture with Pilates</title>
		<link>http://www.centerworks.com/blog/2008/03/22/improving-posture-with-pilates/</link>
		<comments>http://www.centerworks.com/blog/2008/03/22/improving-posture-with-pilates/#comments</comments>
		<pubDate>Sun, 23 Mar 2008 05:00:38 +0000</pubDate>
		<dc:creator>Aliesa George</dc:creator>
				<category><![CDATA[Health]]></category>
		<category><![CDATA[Pilates]]></category>
		<category><![CDATA[Pilates-Teaching Tips]]></category>
		<category><![CDATA[body alignment]]></category>
		<category><![CDATA[body posture]]></category>
		<category><![CDATA[correct bad posture]]></category>
		<category><![CDATA[correcting bad posture]]></category>
		<category><![CDATA[fitness activities]]></category>
		<category><![CDATA[functional scoliosis]]></category>
		<category><![CDATA[good posture]]></category>
		<category><![CDATA[how to correct posture]]></category>
		<category><![CDATA[improve posture]]></category>
		<category><![CDATA[knee pain]]></category>
		<category><![CDATA[lordosis]]></category>
		<category><![CDATA[neck pain]]></category>
		<category><![CDATA[Pilates and Posture]]></category>
		<category><![CDATA[pilates method]]></category>
		<category><![CDATA[posture assessment]]></category>
		<category><![CDATA[posture improvement]]></category>
		<category><![CDATA[posture yoga]]></category>
		<category><![CDATA[shoulder pain]]></category>
		<category><![CDATA[tense muscles]]></category>

		<guid isPermaLink="false">http://www.centerworkspilates.com/blog/improving-posture-with-pilates</guid>
		<description><![CDATA[Just a quick thought&#8230;  While improving posture may or may not be on the list of goals Pilates participants, it might be because posture improvement isn&#8217;t what they want, but rather the BENEFITS of correcting bad posture, which include:  Reduced back and neck pain, less stress on all the body&#8217;s joints (spine, shoulders, hips, knees, ankles), easier [...]]]></description>
			<content:encoded><![CDATA[<p>Just a quick thought&#8230;  While improving posture may or may not be on the list of goals Pilates participants, it might be because posture improvement isn&#8217;t what they want, but rather the BENEFITS of correcting bad posture, which include:  Reduced back and neck pain, less stress on all the body&#8217;s joints (spine, shoulders, hips, knees, ankles), easier breathing in daily life &amp; sport activities, shoulders that are no longer wrapped around the ears, ease of movement for daily living &#8211; walking, stairs, standing, sitting in front of the computer, driving, enhanced recreational &amp; sports performance, and reduced risk of injury.  </p>
<p><span id="more-24"></span></p>
<p>Improved posture means reduced stress &#8211; physical, emotional, and mental! If the body is in balance, the brain doesn&#8217;t have to work (or overwork) to keep over tense muscles on tension. Balance should be easy and effortless. A body off-balance will require some initial effort to strengthen the muscles that have been on holiday. Over time, as these weaker muscles become stronger - the long term goal is efficient, effortless ease of movement &#8211; Good balance &amp; Great Posture.</p>
<p>How long has your body been off-center? Have noticed your posture gradually shifting? With age are you getting shorter, developing body posture tending to kyphosis/lordosis, or a functional scoliosis? Do you have neck pain, shoulder pain, back, hip, or knee pain?  Current posture habits might be a contributing factor. There are so many things you can do to help make improvements. If you&#8217;re alive and alert &#8211; there&#8217;s lots you can do to stand &amp; sit taller!</p>
<p>Practicing good posture reinforces the principles of better body alignment learned through the Pilates Method.  Also, practicing pilates will strengthen and reinforce your good posture habits. But it doesn&#8217;t just have to be Pilates to help improve posture &#8211; Yoga, and all other fitness activities give you a chance to stretch and strengthen the body to help correct posture issues.</p>
<p>Here are a few helpful hints for Posture Improvement:</p>
<ul>
<li>If you stand with locked knees (you might experience knee pain) - keep the knees slightly soft when standing. The hamstring muscles will work harder to help support the knee joint.</li>
<li>If you sit with crossed legs &#8211; chances are it&#8217;s usually the same leg. Sit with both feet flat on the floor, or if you have to cross, cross at the ankles.</li>
<li>Learn to breath by expanding the ribcage and feeling your spine lengthen. Inhaling should make you taller! When you exhale &#8211; strive to stay tall. You&#8217;ll notice your muscles working to support your improved posture. </li>
<li>Strengthen your Pelvic Floor &amp; Core Muscles (this will help relax the shoulders and provide you with better back and neck support.)</li>
<li>Invision lifting the body tall like you&#8217;re suspended by a string.</li>
<li>Add exercises to your workout program to stretch your chest &amp; shoulders &amp; strengthen your upper &amp; lower back.</li>
</ul>
<p><a title="Posture Principles for Health" href="http://www.centerworkspilates.com/posture-principles-special.html" target="_blank">Click here to get a great posture improvement resource!</a></p>
<p>It doesn&#8217;t take alot to make positive changes for body Posture improvement - You can do it, stay conscious, assess current posture habits and correct bad posture to enjoy better health.</p>
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