Sunday, November 20, 2011

Pilates Consult brought to you by Team Pilates: Commonly Asked Questions: The Mystery Behind Spine...

Pilates Consult brought to you by Team Pilates: Commonly Asked Questions: The Mystery Behind Spine...: Ang, I am reading the Pilates Style Mag nov/dec issue & pg 50 spine stretch forward does not roll back on the pelvis like we did at the work...

Commonly Asked Questions: The Mystery Behind Spine Stretch Forward

Ang, I am reading the Pilates Style Mag nov/dec issue & pg 50 spine stretch forward does not roll back on the pelvis like we did at the workshop. Which way is correct & safe to do in class? I am confused on this exercise again. Debi Frey, PTA Great Falls, MT

Thanks for your question Debi as this is an exercise that is frequently confusing to many Pilates Practioners and students alike.

The key to Spine Stretch Forward is to NOT hinge/tip forward at the waist, but to maintain a rounded back and stable pelvis to ensure a true stretch throughout the spine vs turning it into a hamstring stretch. In Pilatesstyle Magazine (Nov/Dec 2011) on pg 50 you will notice they mention "keep your deep back muscles (which would be Quadratus Lumborum and deep spinal extensors) engaged". The model does not have very much lumbar spine flexibility so that can be confusing if you are trying to assess the movement visually. The purpose is spinal stretch and pelvic girdle stability. In order to achieve this two fold, you must deeply engage the abdominals to keep from "hinging" forward at the waist while reaching forward over the toes (thus the slight posterior pelvic tilt to initiate the movement.)

I would reword the passage in Pilatesstyle as they emphasize engaging the deep back muscles but don't clarify what they mean by "engage". We are trying to stretch the spinal extensors and thus must deeply flex them to achieve this goal vs keeping them extended and in their active state.

On a side note, the Classic Version of "Spine Stretch" in RETURN TO LIFE THROUGH Contrology, by Joe Pilates, he does hinge at the waist and adds a forward stretch with 3 pulses that take you further forward into the stretch. So, we need to be very clear to our clients as to the version we are asking them to perform and what the overall purpose behind the exercise is.

1. Spread legs as wide apart as possible. Draw toes upward and backward.
2. Rest palms flat on mat, with outstretched arms and chin to chest. Begin reaching forward with three (3) successive movements as far forward as possible with the abdomin "drawn" in.

Tuesday, July 26, 2011

NEW! Commonly asked questions! "How to deal with overactive hip flexors"

Hi Christina,

I hope you are enjoying summer!

Yes, it is common that clients will tend towards gripping their hip flexors. Initiating from the deep pelvic floor and transverses abs prior to movement will help. This takes patience and a continual process from you of educating them on how their body needs to engage before they ever move.

Cueing from the posterior side of the body will be key as well. Heels on the bar for footwork and curing to fully stretch the leg in extension so that the insertion points of the hamstrings, all the way up at the sits bones, engage fully. Sometimes we get too caught up with not wanting to "lock" into a client's knee joints and we lose the ability for them to fully straighten their legs.

I hope this helps!

Angelie Melzer, Owner
Team Pilates

On Jul 25, 2011, at 9:39 PM, wrote:

Hi Angelie,
Thanks for the information. I wanted to ask you if you can help me with wrapping my brain around the hip flexors. I have a few clients that tend to be grippy. Does that eventually go away with constant cueing?

Also, I have a client who comes to class. She does 2 reformer classes a week plus a mat/springboard. She has recently gone in to her massage and PT for psoas work. I am modifying and decrease resistance for the hip flexors but is this normal. Could there be excessive wear to certain muscles if always used?
Since we do have a lot of exercises where inevitably those hip flexors kick in, how can I approach this? I'm trying to read anatomy trains and see if I can see how to approach this.
Your expertise is always appreciated.
Thank you
Sent from my Verizon Wireless BlackBerry

Tuesday, May 10, 2011

Irritable Bowel Syndrome-"How Small Variations can Make a Huge Difference"


Dear Angelie,

PILATES JOURNAL is your Personal Pilates Consultant. We have featured articles and corresponding programs, bringing you up to date information and news in the Pilates Industry. We strive to give you the tools you need to offer the highest quality Pilates Education and Services!

In this issue:


Feature Articles


By: Karen Sanzo, MS, PT

Balanced Body Faculty Member

Pilates Unlimited, Dallas, TX

As a physical therapist, I find that Pilates is an essential extension of treatment for most patients. I realized years ago that just alleviating pain was not enough. I had to educate my patients to live and thrive in their bodies with all the challenges their injuries or disorders present.

One client, we'll call her Jill, came to me with chronic upper back and neck pain. Physical therapy helped resolve each acute episode, but it didn't prevent the inevitable onset of another crisis. She seemed like a perfect candidate for follow-up with Pilates exercises. Jill also suffered from Irritable Bowel Syndrome (IBS), a digestive disorder that afflicts an estimated 15 to 20 percent of the population. It has been called "a disturbance in the interaction between the gut, the brain, and autonomic nervous system which regulates involuntary reactions of internal organs." [1] Symptoms include bouts of diarrhea alternating with constipation, painful colon spasms, cramping, gas, and bloating. The pain from the IBS often prevented her from doing exercises that she had been told would strengthen her core, which would give her needed support for her back.

Jill was very enthusiastic about Pilates. The idea of strengthening the core seemed ideal for both her back problems and her digestive issues. Unfortunately, her IBS symptoms worsened after every session. Exercises such as Hundred Beats brought on cramping, and after the session she reported increased gas and bloating, which signaled the beginning of an IBS attack. This made her extremely wary of attempting to do the routine Pilates exercises.

Over the years, working with many different types of body issues, I have learned that just a small variation on a traditional exercise can make a huge difference in how the client feels. There are nuances in the work that have the power to help many people who have come to believe that exercise is not for them. In working with Jill, I made minor alterations, removed certain exercises from the routine, and educated her on breathing and on developing awareness of what she was doing as she exercised.


The mark of success in Pilates is when a client "gets it" and carries the concepts they learn in class over into their daily lives. For this, education is key. Without awareness, people can't change. The first area we worked on was Jill's breathing. She learned that if she stopped breathing, she was clenching, but if she focused on her breathing, she tended not to grip her abdominal muscles. I taught her that rhythmic breathing pushes the diaphragm down to stimulate abdominal organs, which helps you avoid bracing. For Jill, it was her "Aha" moment.

Sometimes it's the cue that throws people off. A common cue for scooping is "knit the ribs." For some people, especially those who experience a lot of stomach pain, that means "clench." They're so used to trying to keep their gut relaxed, that when you tell them to scoop, they think "clench," causing the area to become locked and essentially inhibiting the ability to contract the muscles correctly. To help them avoid this, have them stay focused on the inhalation portion of their breath. The portion where the diaphragm is pushing down on the internal organs as the diaphragm moves out of the way to allow the lunges to fill with air. This will eccentrically contract the abdominal area and then will allow for a more natural concentric contraction during the exhalation phase, rather than a forced contraction.


It is very easy for a Pilates novice to ignore or misunderstand cues for exercises like the Hundred Beats. The instructor is saying Beats and client is thinking Crunches. In their enthusiasm, they grip their abdominals and aggravate their IBS symptoms. The solution is Education, Education, Education!

(1) Demystify the Core. Core work extends beyond trunk flexion. Cut out any abdominal curling exercises from the regimen and explain why the curling compresses the digestive organs, aggravating their symptoms.

(2) For some, even the Scoop (transverse abdominus exercise) is too much. Focus on the Kegel instead. Research has shown that a good Kegel will activate the trA, avoiding the tendency to brace.

Assess if your client is engaging the abdominals by putting your hands on the front and back of the trunk, then cue the client to relax the clench.

Nuance #3 BACK WORK/SPINAL EXTENSION, Swan with Propped Passive Extension

IBS sufferers often present with closed front body. That could be a protective instinct, from bracing, or from any number of other causes. If you just focus on Swan, the client may only extend from the lower back and never open the chest.

Have the client lie supine over a folded blanket or towel (the ½ barrels and foam rollers are too hard). Place it east/west approximately at the shoulder blades (depending on the height of the client). You're looking for a lengthening of the infrasternal angle away from the pubic bone. This passive extension will allow the client to begin experiencing chest opening and abdominal lengthening.

Gradually progress to prone on elbows and Swan, using the arms to press up. The key is to maintain the open chest and lengthened abdominals while teaching the arms and the spinal extensors to lift up.

Don't be afraid to encourage Passive Extension each session. The IBS sufferer needs to feel that sense of space and opening in the front body.


In axial extension, with all the intervertebral spaces maximized, the front and back bodies are lengthened equally. You have to educate your client before they can achieve this. Spinal lengthening is often confused with spinal extension. Telling someone to sit up tall may not be the ideal cue if, when doing so, they increase their lumbar lordosis and roll the pelvis forward. Indirectly, this anterior pelvic tilt often inhibits the action of the Kegel. Instead, educate on sequential use of the spine. Line the client up using a yardstick or a wall, or if they are seated, have them place their feet flat on the floor. When they lengthen up, make sure they are lifting the front and back ribs equally, not changing the position of the pelvis. Traveling up the spine requires that the sternal area be lifted without moving anything below. A useful cue for that is what I call the Necklace: Imagine you are showing off a beautiful necklace as you lift just your chest.

Pilates, so often thought of as synonymous with Core work, is often counterproductive for IBS sufferers. But with some nuances, it can actually be beneficial. Education and clear explanation is more important initially than the exercises themselves. But with that preparation and awareness, the IBS client can gradually ease into a full-blown Pilates program.

*A special thanks to Karen Sanzo for offering her expertise and vast knowledge to the Pilates Journal. We truly appreciate her time and efforts to enlighten our readers on the topic of IBS.

Pilates Unlimited is a Pilates and Physical Therapy clinic located in Dallas, TX. Advanced Pilates devotees will discover exciting new approaches and a deepened understanding of exercise advancement from Karen and her instructors, all of whom have undergone rigorous training programs from various prominent teachers across the country.

Please visit their website at:

[1] Participate,Quarterly Bulletin of the IFFGD, Vol 8, No. 3, Fall 1999, p. 7

Fast Facts on IBS

Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea due to lack of motility in the colon. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.

  • IBS is one of the most commonly diagnosed diseases in America.
  • 1 in 5 Americans, approximately 20%, suffer from IBS.
  • It occurs more in women than men.
  • It is characterized by sudden strong muscle spasms in the colon.
  • IBS causes a great deal of discomfort, but it does not permanently harm the intestines.
  • IBS does not normally lead to serious disease, such as cancer.
  • Symptoms include: Abdominal pain or discomfort for at least 12 weeks out of the previous 12 months.
  • The abdominal pain includes these features: a feeling of uncontrollable urgency to have a bowel movement, relief by having a bowel movement, a change in how often you have a bowel movement, and a change in the form and look of the stool.