Pilates Chair Program for Osteoporosis Clients

 

Below is an appropriate Pilates Chair exercise program for a client with Osteoporosis or Osteopaenia

Seated Footwork

Reverse Swan on the Chair

Side Bend (without rotation)

Plies

Side Lying leg work

Triceps Press-Seated on the floor

Swan on the floor

Lunges

Mountain Climber

Hamstring Stretch 2-Modified with extension during roll down and a slight knee bend

Note: These are recommended exercises only, and each individual client's needs should be considered prior to starting any exercise program.

Pilates Exercises to avoid or modify with Osteoporotic clients

General: Extreme flexion and rotation of the Lumbar Spine.

Mat Exercises:

Roll over

Rolling Ball

Rocker with Open Legs

Saw

Swan Dive

Neck Pull

Shoulder Bridge

Spine Twist

Jack-Knife

Teaser

Hip Twist with Stretched Arms

Boomerang

Seal

Crab

Control Balance

Reformer Exercises:

Teaser

Down Stretch

Arabesque (Long stretch series)

Stomach Massage (Round back and Twist)

Short and Long Spine (Reformer/Trapeze)

Semi-circle

Thigh Stretch-Advanced

Kneeling Arms (Drawing Sword with rotation and Side bend overhead pull)

Snake/Twist

Corkscrew

Short box (Round back, Rotation, Spear a Fish

Knee Stretch (Round back)

Balance Control

Mermaid

Grasshopper

Bridge with Arm Pulls

Star

High Bridge

Trapeze Exercises:

Roll back

Magician

Ferris Wheel

Thigh Stretch

Kneeling Roll Down

Breathing

Push Through

Saw/Circular Saw

Teaser

Mermaid

Reverse Tower

Tower/Monkey

Short Spine

Semi-circle

All Hanging exercises

Pilates Chair Exercises:

Bridge with Pumps

Hamstring 1/Washer Woman

Hamstring 2

Hamstring 3

Seated Spine Stretch

Jackknife

Pike/Teaser

Handstand

Push-ups

Side Body Twist/Mermaid

Spear a Fish

Osteoporosis: Flexion vs. Extension

Written by: Angelie Melzer, BS, CPT

Exercise and an active lifestyle are essential factors in bone health.  By age 18, skeletal growth is nearly complete and 97% of bone mass has probably been achieved.  By age 20 bone mass has reached it's peak.  The amount of peak bone mass achieved and the subsequent rate of bone loss are key determinants of bone density later in life.

In some cases, increases in bone density has been achieved through the third decade of life with moderate increases in physical activity.  The ideal exercise is weight bearing, as it places necessary stresses on the bones.  Skeletal and muscle mass decrease with age, but preventative measures can be taken with moderate weight bearing exercise and higher impact activities.

Pilates includes a range of exercises that are appropriate in maintaining bone health.  Flexion vs. extention exercises have been the focus of numerous studies in post-menopausal and osteoporotic women.  One such study was conducted by Sinaki M. Mikkelsen BA in her study: "Postmenopausal spinal osteoporosis: flexion versus extension exercises."

This study was conducted over six years with a control group of 59 women with postmenopausal osteoporosis, ages 49-60.  The women were placed into three exercise treatment groups.  (E) 25 patients were placed in an all extension exercise treatment program, (F) 9 were placed in an all flexion exercise treatment program, (E+F) 19 were placed in a combined program and (N) 6 were given no therapeutic exercise.

The study revealed that pre and post spinal x-rays showed group (E) at 16% additional fracture rate, group (F) at 89% additional fracture rate, (E+F) at 53% additional fracture rate and (N) at 67% additional fracture rate.  Thus, the fracture rate was significantly less in the all Extension exercise group.  Those who followed all Flexion exercises had a large increase in fracture rates. 

Pilates practioners need to keep in mind that each individual they work with over age 50 should be considered for a DEXA scan or other bone density testing prior to starting a Pilates exercise program.  It is the responsibility of the Pilates practioner and profession as a whole to be considerate of the safety of these individuals when designing an appropriate Pilates program for them.  Extension versus flexion exercises and recognizing the specific needs of these individuals is of the utmost importance.  This becomes especially important in group mat and exercise programming.  Not all bodies are the same and thus individual needs should be addressed, especially in a group setting.

Please Note: It is recommended that prior to working with women over 50 and men over 60 years of age, you request their results of a BMD test.  If their results or T-score deviates from the norm by -1 to -2.5 this indicates Osteopenia.  A T-score deviation of -2.5 or higher indicates Osteoporosis.

(References: National Institute of Health Osteoporosis and Related Bone Diseases-National Resourse Center.  Pub Med: Arch Phys Med Rehabil. 1984 Oct; 65(10):593-6.)

Fast Facts on Osteoporosis

    * Out of 34 Million Americans, 55% over 50 years of age have low bone mass

    * Of the 10 Million Americans estimated to have Osteoporsis, 8 Million, or 80% are women

    * Osteoporosis can strike at ANY age

    * Direct National expenditures on the treatment of Osteoporosis in the US Healthcare system is estimated at $47 Million per day and rising

    * % of Osteoporotic women who have acquired fractures at the following ages and areas of the body: 

            Age             50              60             70

            Wrist           10%           30%         60%

            Spine          5%             10%         70%

            Hip              10%           50%         90%

(Reference: National Institute of Health Osteoporosis and Related Bone Diseases-National Resourse Center.  Email: orbdnrc@nof.org)

 Reference Links for more information on Osteoporosis

www.nof.org (National Osteoporosis Foundation)

www.ManageOsteoporosis.com

www.fight-fractures.com

www.RA.com

www.SpinalFracture.com

Www.Saveourbones.com/Osteoporosis

 

Pilates Mat Program for Osteoporosis Clients

 

Below is an appropriate Pilates Mat exercise program for a client with Osteoporosis or Osteopaenia.

Hundred

Modified Roll Over with pelvic support from hands

One Leg Circle

One Leg Stretch

Double Leg Stretch

Modified Swan

One Leg Kick

Double Leg Kick

Scissors with modified range of motion

Bicycle with modified range of motion

Side Kick Kneeling

Swimming

Leg Pull Front Support

Leg Pull Back Support

Side Bend with modified range of motion

Push up

Pilates and Osteoporosis

Osteoporosis is the gradual and silent loss of bone and not a normal aging process. It is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture (NOF 2005). Osteopenia is a mildly reduced bone mass--a loss of approximately 10%-20%--indicating the onset of osteoporosis.  It is recommended that prior to working with women over 50 and men over 60 years of age, you request their results of a BMD test.  If their results or T-score deviates from the norm by -1 to -2.5 this indicates Osteopenia.  A T-score deviation of -2.5 or higher indicates Osteoporosis. 

Risk Factors for the development of Osteoporosis are:

Personal history of fracture after age 50

Current low bone mass

History of fracture in a 1st degree relative

Being Female

Being thin and/or having a small frame

Advanced age

A female history of Osteoporosis

Estrogen deficiency

Low testosterone levels in men

Abnormal absence of menstrual cycle (amenorrhea)

Anorexia Nervosa

Low lifetime calcium intake (our total bone mass is set by the age of 30)

Use of certain medications

An inactive lifestyle

Osteoporosis can affect the overall strength of the bones, and is especially problematic in the spinal column and hips.  Weight bearing exercise is key in slowing the process of bone loss due to Osteoporosis.  Pilates is a wonderful exercise regime for clientele with Osteoporosis because of the controlled mindful nature.  However, it is important to remember that their are limitations and precautions that must be addressed with clients who have both Osteoporosis and Osteopenia.

Pilates Exercises to avoid or modify with Osteoporotic clients:

General: Extreme flexion and rotation of the Lumbar Spine.

Mat Exercises:

Roll over

Rolling Ball

Rocker with Open Legs

Saw

Swan Dive

Neck Pull

Shoulder Bridge

Spine Twist

Jack-Knife

Teaser

Hip Twist with Stretched Arms

Boomerang

Seal

Crab

Control Balance

Reformer Exercises:

Teaser

Down Stretch

Arabesque (Long stretch series)

Stomach Massage (Round back and Twist)

Short and Long Spine (Reformer/Trapeze)

Semi-circle

Thigh Stretch-Advanced

Kneeling Arms (Drawing Sword with rotation and Side bend overhead pull)

Snake/Twist

Corkscrew

Short box (Round back, Rotation, Spear a Fish

Knee Stretch (Round back)

Balance Control

Mermaid

Grasshopper

Bridge with Arm Pulls

Star

High Bridge

Trapeze Exercises:

Roll back

Magician

Ferris Wheel

Thigh Stretch

Kneeling Roll Down

Breathing

Push Through

Saw/Circular Saw

Teaser

Mermaid

Reverse Tower

Tower/Monkey

Short Spine

Semi-circle

All Hanging exercises

Pilates Chair Exercises:

Bridge with Pumps

Hamstring 1/Washer Woman

Hamstring 2

Hamstring 3

Seated Spine Stretch

Jackknife

Pike/Teaser

Handstand

Push-ups

Side Body Twist/Mermaid

Spear a Fish