Having its roots in the science of physical rehabilitation, Pilates can help people counteract the passing of time-by using the body's own resistance to improve strength and flexibility. By recommending these exercises, you can help patients prevent and treat several conditions associated with aging, including low back pain, thoracic kyphosis and osteoporosis.
 To read more about the history of pilates, its benefits and modifications, read our story from print here.
Click the image to the left to view a slideshow of Pilates exercises*.
Moves to Correct Posture
A modified full swan exercise can decrease thoracic kyphosis and help correct posture. This exercise strengthens the erector spinae, the posterior shoulder, the scapular stabilizers and the deep cervical extensors.
For a modified full swan, the patient should begin lying on his stomach. He should press his hands into the floor and lift his chest off the floor as he presses up through his arms, extending his back only to his comfort level. Keeping the neck long and squeezing the gluts, he slowly lowers himself to floor. The second part of this exercise is to lower down, lift the legs, then gently lower the legs back to the mat.
Baby boomers should take caution if they have osteoarthritis or spinal stenosis in the low back because this exercise has extension throughout the spine into a position of increased lumbar lordosis. In this case, the patient can try simpler modifications, centering on the scapular cervical extensors without excessive extension of the lumbar spine.
For example, the patient can be cued to lie on his stomach with his hands next to his chest. Next, the instructor tells him to pull his navel to his spine, and lift his chest and his hands off the floor. The patient then squeezes his shoulder blades together and holds for 10 seconds. The patient is cued to lower his body to the floor with control. Patient should keep looking at the floor so that the neck stays in alignment with the rest of his spine. This improves scapulothoracic strength and provides a gentler way to improve posture and upper back strength without aggravating any arthritis that might be present in the low back.
Exercises for Low Back Pain
If you have a patient that has low back pain involvement or any issues that prevent them from lying prone on the floor, the patient can still use Pilates with some help from a therapy band.
One exercise from Ellie Herman's Pilates Props Workbook, called the three way pectoralis stretch, can help the more involved patient because it does not stress the low back.
It stretches the tight pectoral muscles realigning forward shoulders, yet it activates the upper back muscles. As the person lengthens the therapy band, he is engaging the intrascapular muscle that often become weak when he stands with the forward shoulders and protracted scapulae.
The patient stands with his abdominals pulled in tight. Remind him to prevent his low back from arching as he lifts his arms up and overhead. The patient should hold one end of the exercise band in each hand with his elbows facing towards each other and his palms facing away from each other. Patient inhales and then exhales as he stretches the band apart squeezing his shoulder blades together against the resistance. Patient should concentrate on pulling his navel to his spine and keeping his back tall without an arch in the lower portion of his back.
Next, the patient should inhale as he lowers the band so that is right behind his back and just above his shoulder blades. Patients should exhale as he lengthens the band squeezing his shoulder blades together. Patient should again concentrate on the navel.
Patient should inhale as he internally rotates his arms letting his palms face each other as he brings the band down to the level of his lower back. Patient exhales as he pulls the band apart squeezing his shoulder blades together. The patient should perform his final postural check making sure that he still has his abdominals pulled in tight and that he is not demonstrating an excessive arch in his low back.
Christy Hiltz, PT, MPT, is the owner of Christy Hiltz Pilates and Wellness LLC in Cincinnati, Ohio. She is a licensed physical therapist and certified Pilates instructor. Christy provides physical therapy services to the geriatric and pediatric populations and teaches Pilates classes throughout the greater Cincinnati area.
*ADVANCE thanks Carol Beringer, certified Pilates instructor and owner of Pilates and More, A Carol Beringer Studio, Wayne, PA, for demonstrating Pilates exercises in the slideshow.
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