Pilates Equipment Classes Seattle

Upstretch – Much More Than a Stretch

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Planking is all the rage and with good reason! It strengthens arm, shoulder, abdominal, back, and hip muscles. Want the specifics? Or course you do! The following muscles are utilized during your basic plank when practiced in good form:

  • Transversus abdominis (if you remember to contract it)
  • External obliques
  • Rectus abominus
  • Quadratus lumborum
  • Erector spinae
  • Gluteus medius and minimus
  • Anterior deltoids
  • Pectoralis major
  • Infraspinatus
  • Teres major and minor
  • Serratus anterior
  • Rhomboids
  • Lower trapezius
  • Biceps brachii
  • Brachialis
  • Triceps

That’s an awful lot of muscles for just one exercise and this is with just a basic plank. Think of all the additional muscles groups that are added as you modify your plank. In the video above I am demonstrating one of my favorite planking exercises called up stretch. As you can see, it is really much more than a stretch!

Advanced Breast Stroke

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Today’s vlog post is of an advanced breast stroke variation I developed. My motivations for developing this variation were:

  • To provide greater to challenge to my advanced clients
  • To integrate more dynamic shoulder and arm strengthening into this exercise.

More specifically, I wanted to target muscles that abduct the arm, abduct (or protract) the scapulas, and upwardly rotate (or elevate) the scapulas.

Pro Tip: If you attend training session where the trainer in constantly barking at you to press your shoulders down or squeeze your shoulder blades together no matter what your arm position is, think twice about this. Remember that as your arms move, in order to maintain glenohumeral congruency (i.e.- safe and strong shoulders) the position of your scapulas should reflect the position of your arms to a certain extent.

 

Motherhood, Leaky Bladders, and Back Pain – Part 2

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In last week’s blog post, “Motherhood, Leaky Bladders, and Back Pain – Part 1” I introduced the musculoskeletal structures of the pelvic diaphragm and their purpose. This week’s follow-up post will cover:

  • Correlation Between Chronic Back Pain and Stress Urinary Incontinence
  • Pelvic Diaphragm Facilitation and Multifidus Facilitation
  • Exercises to identify the Muscles of the Pelvic Diaphragm!!!
  • Exercises to Strengthen Muscles of the Pelvic Diaphragm

Correlation Between Chronic Back Pain and Stress Urinary Incontinence

Research has established the role that the pelvic diaphragm muscles play in continence.  Given that the pelvic diaphragm muscles facilitate sacroiliac joint stability, which in turn support lumbar vertebral column stability, one could hypothesize that there is a positive correlation between chronic back pain and stress urinary incontinence.  That is, the likelihood of having stress urinary incontinence is increased if one suffers from chronic back pain.

Bush et al., (2013), conducted a survey of 2,341 women who suffered from chronic back pain and found that 44% of these women also suffered from stress urinary incontinence (p.4).  Furthermore, Bush et al., (2013), references multiple studies with similar findings:

Finkelstein et al reported a strong association between “back problems” and UI in both men and women.  A cross-sectional study of women only by Smith et al found a relationship between continence disorders and back pain “in the past 12 months.”  In addition, Kim et al found women with greater UI severity also have a higher perceived severity of LBP and LBP perceived disability.  Lastly, Elliason et al surveyed women who were receiving physical therapy for LBP and reported 78% of these women also reported UI  (Bush, Pagorek, Kuperstein, Guo, Ballert, and Crofford, 2013, p.2).

Multifidus
Multifidus

Pelvic Diaphragm Facilitation and Multifidus Facilitation

Multifidus originates at the sacrum, the posterior superior iliac spine, the mammillary processes of the lumbar vertebrae, the transverse processes of the thoracic vertebrae, and the articular process of C04-C07.  It inserts to the spinous process two to four vertebrae superior from it’s origin.  According to Martini, Nath, Bartholomew (2012), it’s action is to extend the vertebral column and rotate towards the opposite side (p.341).

A study involving thirteen men and women who had chronic low back pain was conducted by Huang et al.  The goal of this study was to investigate the effects of an intervention that involved: 1) proprioceptive neuromuscular facilitation, 2) neuromuscular joint facilitation, and 3) neuromuscular joint facilitation combined with pelvic diaphragm muscle exercises.  According to Huang et al. (2013), neuromuscular joint facilitation combined with pelvic diaphragm exercises produced the greatest multifidus change (p.813).  Huang et al. (2013), speculates that while neuromuscular joint facilitation promoted isometric contractions of the multifidus, the pelvic floor exercises promoted increased intraabdominal pressure, thereby increasing lumbopelvic stability and enhancing the effectiveness of multifidus (p.813).

Case Study

Jellad, Bouzaouache, Salah, Migaou, & Sana (2009), conducted a case study in which they designed a rehabilitation program for a patient suffering from osteoarthritis of the sacroiliac joint.  The rehabilitation program involved strengthening the transversus abdominis, internal obliques, coccygeus, pubococcygeus, and iliococcygeus, as well as stretching psoas (p.511).  The program was found to have a positive effect on reducing the patient’s pain and functional impairments.

Exercises to identify the Muscles of the Pelvic Diaphragm!!!

Calais-Germain (2003) recommends the following two exercises for identifying muscles of the pelvic diaphragm:

  1.  Balloon Exercise
    1. While sitting, pretend you are blowing into a balloon.  Look to identify one of the three possible pelvic region responses:
      1. blowing caused the urge to urinate
      2. blowing caused the pelvic floor to be pushed down
      3. blowing caused the pelvic floor to draw up (p.104)

Calais-Germain (2003), notes that the urge to urinate is symptomatic or weak pelvic diaphragm, while the drawing up sensation is symptomatic of well-toned pelvic diaphragm (p.105).

  1. Face Cloth Exercise
    1. Fold a small face cloth into quarters.  Place the folded cloth between the two ischia, and between the coccyx and the pubis.
    2. Notice  pelvic sensations during normal breathing and while practicing the balloon exercise in this position.

Exercises to Strengthen Muscles of the Pelvic Diaphragm

Calais-Germain (2003) recommends the following exercises for strengthening muscles of the pelvic diaphragm:

  1. In a sitting, or supine-crook position, visualize your two ischia and your pubic symphysis.  From here mentally visualize two inches above the ischias and pubic symphysis.  Now, draw theses two areas of visualization upward and inward.
  2. Contract your anal sphincter.  Notice how it constricts and draws up.  Now, try to contract your anal sphincter without constricting it, but just drawing it up.
  3. After performing the above exercises, relax completely and feel the weight of pelvic organs dilate.

The research suggesting that pelvic diaphragm muscles enhance lumbopelvic stability is convincing.  Pel, Spoor, Pool-Goudzwaard, Hoek Van Duke, and Snijders (2008) showed a decrease in sacroiliac joint shear force by 20% with a 400% increase of transversus abdominis and pelvic diaphragm muscles (p.415).   Additionally, Bush et al. showed that nearly one-half of women who suffer from chronic low-back pain also suffer from urinary incontinence (p.4).  Huang et al (2013), suggests that the compressive forces that the pelvic diaphragm muscles can exert between the coxal bones and the scarum enhance lumbar vertebral and trunk stability (p.813).  Lastly, Jellad, Bouzaouache, Salah, Migaou, & Sana (2009) successfully applied a rehabilitation protocol for a women suffering from sacroiliac joint pain that involved pelvic diaphragm exercises (p.511).

That’s it ladies (and gents) not only will strengthening your pelvic floor muscle recover urinary incontinence it will also enhance lower back strength. Get to it, find those pelvic floor muscles and when you can, incorporate pelvic floor contractions into whatever exercises you are working on, whether that be supine ab exercises, standing arm exercises, leg exercises like squats, or whatever. Now, onward, upward, and inward!

References

Bush, H. M., Pagorek, S., Guo, J., Ballert, K. N., & Crofford, L. J.  (2013).  The Association of Chronic Back Pain and Stress Urinary Incontinence: A Cross-Sectional Study.  Journal of women’s health physical therapy, 37(1), p.11-18.  doi: 10.1097/JWH.0b013e31828c1ab3

Calais-Germain, B.  (2003).  The Female Pelvis: Anatomy & Exercises.  Seattle, Wa.: Eastland Press Inc.

Floyd, R.T.  (2012).   Manual of Structural Kinesiology.  New York, NY: McGraw Hill.

Huang , Q., Li, D., Yokotsuka, N., Zhang, Y., Ubukata, H., Huo, M., & Maruyama, H.  (March 1 2013).  The Intervention Effects of Different Treatment for Chronic Low Back Pain as Assessed by the Cross-sectional Area of the Multifidus Muscle.  Journal of Physical Therapy Science, 25(7), p.811-813.  doi: 10.1589/jpts.25.811

Jellad, A.,  Bouzaouache, H., Ben Salah, Z., & Sana, S. (July 2009).  Osteoarthritis of the sacroiliac joint complicating resection of the pubic symphysis. Interest of a rehabilitation programme.  Annals of Physical and Rehabilitation Medicine, 52(6), p.510-517.  doi: 10.1016/j.rehab.2009.03.002

Martini, F. H., Nath J. L., & Bartholomew, E. F.  (2012).  Introduction to Anatomy and Physiology.  San Francisco, CA: Pearson Education Inc.

Nestor, K.  (n.d.).  Sacroiliac Joint.  Physiopedia.  Retrieved from: http://www.physio-pedia.com/Sacroiliac_joint.

Pel, J. J. M., Spoor, C. W., Pool-Goudzwaard, A. L., Hoek Van Dijike, G. A., & Snijders, C. J.  (18 January 2008).  Biomechanical Analysis of Reducing Sacroiliac Joint Shear Load by Optimization of Pelvic Muscle and Ligament Forces.  Annals of Biomedical Engineering, 36(3), p. 415-424.  doi: 10.1007/s10439-007-9385-8

Visible Body Software.  (2014).  [All images].

First Vlog – The Teaser!

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Over the past year or so I began video documenting myself performing various Pilates exercises. The purpose of this is 3-fold: 1) to document exercise ideas, 2) to serve as a visual tool in finessing these exercise ideas, and 3) to critique my own form during certain exercises. I returned to teaching from maternity leave recently and found myself visiting some of these videos for inspiration. While reviewing these videos I thought why not share these with the world? They offer an interesting peek at the exercise creation process, plus show off some of the fun exercises that Bodytonic Pilates clients perform.

My video debut features advanced Teaser variations. I start with the Teaser simply because it is a classic. I created this particular video more so to critique my own form as the variations seen in this video have long been in my advanced clients repertoire. The video starts out with me performing a few basic teasers, then I gradually move through a few advanced variations. I never intended for anyone to watch these videos aside from myself, so please forgive funny hairdos and faces. 🙂

My main critique to myself:

  1. Slow down. 🙂 (something I frequently ask of my clients)
  2. Be more mindful of harnessing iliopsoas with regards to hip versus lumbar flexion.

Now for a little anatomy geek-out. Iliopsoas is a group of muscles: iliacus, psoas major, and psoas minor. Iliacus flexes the hip, rotates the pelvis anteriorly, rotates the hip externally, and creates transverse pelvic rotation contralaterally when the ipsilateral femur is stabilized. Psoas major and minor does all that iliacus does, plus flexes the lumbar spine, laterally flexes the spine, and rotates the pelvis laterally to the contralateral side. During this teaser I needed to tease out lumbar flexion from hip flexion to create more lumbar stability. Pun intended. Hardy-har-har!

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Back to School Special 3 Privates/$99

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Back to School Special! Back-to-School

3 Privates for $99

To help you settle back into your fall routine we are offering a special package of 3 private lessons for $99. This package serves as great introduction to Pilates or is a great way to dust off your Pilates bones if it’s been awhile since we’ve seen you.

Offer valid for first time clients & for clients returning from a 3+ month hiatus from the studio (AKA summer vacays).

Offer Valid until 10/31/14.

Contact us to Schedule your Appointment Today!

Too little movement or too much food?

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Take a Booster Break!

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booster breakHow do you spend your work breaks?  Do you find yourself munching on M&Ms, smoking a cigarette, or even working more?  A qualitative analysis conducted at the University of Texas investigated the effectiveness of structured work-break activities designed to enhance physical and psychological health.

The study involved 35 subjects across 5 worksites and was conducted over a period of 6 months to one year.   While Booster Breaks may involve physical activity, meditation, and rhythmic breathing, this study focused on using physical activity oriented breaks to reduce sedentary behavior.  Subjects were required to participate in one 15-minute physical activity booster break per work day.  Researchers found three themes among the subjects response:

  • Reduced stress and increased workplace enjoyment.

  • Increased health awareness and facilitate positive behavior changes outside of the workplace.

  • Enhanced interpersonal relationships with coworkers.

Subjects noted two barriers to participation in the interventions:

  • Desire for greater variety in intervention’s activities.

  • Lack of permission, encouragement, and support from managers and supervisors.

To support workplace health promotion, Bodytonic Pilates is now offering 30-minute private sessions!  We hope your bosses support you in creating a healthier, happier, and more efficient workplace.   See our rates page for more pricing details.  For a limited time we will be offering a booster break promotion:

3 30-minute private lessons for $99!

 

References

Taylor W. C., King K. E.,  Shegog R., Paxton R. J., Evans-Hudnall G. L., Rempel D. M., Chen V., Yancey A. K. (2013).  Booster Breaks in the workplace: participants’ perspectives on health-promoting work breaks.  Oxford University Press Health Education Research, 28(3), 414-425.   doi:  10.1093/her/cyt001

 

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PNW Hikes

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summerlandI’ll admit it, when it comes to outdoor exercise I’m a fair-weather friend.  I consider myself, of course with the proper skin protection, much more of a sun bird than a snow bunny.  Yesterday was the most gorgeous spring day I can remember in Seattle with temperatures reaching the mid-80s.  All this sunshine has me really excited for an amazing Pacific Northwest Spring and Summer full of beautiful and temperate, outdoor exercise.  In my enthusiasm, I created a pinterest board of hikes within a 3 hours drive from Seattle and with a minimum roundtrip distance of 5 miles.  All of these hikes feature waterfalls, rivers, lakes, and/or wildflowers.  I guess I’m a sun and water bird!

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The Limitations of “No Pain, No Gain”

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23physed-tmagArticleA New York Times article published on April 23rd, 2014 references a study conducted at the University of Utah in Salt Lake City that investigates the the relationship between neuromuscular activity and perceived as opposed to actual fatigue.  During the study mice were injected with equal amounts of lactate, adenosine triphosphate (ATP), and other chemicals.  The scientist found that the neuromuscular response demonstrated in the mice varied depending on how much lactate, ATP, and other chemicals were injected.  Next, the scientist injected the abductor pollis brevis muscle (thumb) of ten humans.  The scientists produced three different dosages of these chemicals to simulate the amounts that would be found in the muscle during moderate exercise, strenuous exercise, and finally muscular exhaustion.  Following the moderate exercise dosage, subjects reported feelings of fatigue, puffiness, and tiredness in their thumbs.  The strenuous dosage was associated with increased fatigue and the onset of slight pains and aches, and the muscular exhaustion dosage was associated with considerable soreness.  The findings as interpreted by NYT reporter, Gretchen Reynolds (2014), suggests that “Each subsequent increase in the levels of lactate and other substances amplifies the sense of fatigue, Dr. Light said, until the substances become so concentrated that they apparently activate a different set of neurons, related to feelings of pain”.  Furthermore the article suggest that working through some levels of fatigue and achiness is associated with improved physical performance, though working through symptoms of pain can cause muscle damage.  Hence the adage “no pain, no gain” is not the wisest strategy to use in improving athletic performance.

I appreciate and agree with Reynolds conclusion that “no pain, no gain” is an antiquated training approach.  She references the original article (which unfortunately was not available in it’s full version on pubmed) and sought out to personally interview a researcher associated with the study, which lends to the article’s credibility.  Though one issue takes away from her credibly; she states that ATP is released during muscular activity, whereas according to sliding filament theory, it is actually hydrolyzed during muscular activity.  In other words, Reynolds suggestion that ATP is released or produced during muscular activity is incorrect, rather ATP is consumed and broken down during muscular activity.

Aside from the details relating to sliding filament theory, I like and appreciate this article.  I believe the attitude “no pain, no gain” has cummulative negative effects on the physical activity levels of communities.  The belief that exercise should be painful not only discourages people from participating in physical activity, it also creates more injuries and prevents people from exercise.  It’s important for people to have healthy and realistic expectations for themselves with regard to athletic performance and understand that experiencing some fatigue and mild to moderate discomfort can improve athletic performance, but acute pain is more frequently associate with damage and injury and will likely impede, if not recede athletic performance and health.

Reynolds, G.  (2014).  The Limit’s of No Pain, No Gain.  The New York Times.  Retieved from: http://well.blogs.nytimes.com/2014/04/23/with-exercise-the-limits-of-no-pain-no-gain/?partner=rss&emc=rss

 

Exercise and Your Pleasure Center

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09well_physed-tmagArticleYesterday, the New York Times published an article titled “Are you programmed to Enjoy Exercise?”  The article reports on a study conducted by the University of Missouri-Columbia and published by the Journal of Physiology that investigates the genetic and environmental influences that impact the subjects behavior surrounding exercise.  In this study, the subjects were rats who were bred and divided into two subgroups; one group consisted of rats who spent hours on running wheels and the second group consisted of rats that spent zero to little time on running wheels.  The NYT article implies that active rats were hypothesized to produce active offspring and inactive rats were hypothesized to produce inactive offspring.  It was discovered that a portion of the brain called the nucleus accumbens was more developed in the rats who liked to run as opposed to the rats who did not like to run.  The nucleus accumbens is the portion of the brain, sometimes referred to as the “pleasure center” and is associated with motivation, pleasure, and addiction.  Two other noteworthy facts were discovered: 1) regardless of running behavior, the rats who were bred to run had a more developed nucleus accumbens than those rats who were bred for malaise and 2) when the non-running rats were encouraged to exercise on the running wheels, they started to develop more mature neurons in their nucleus accumbens.  In essence, both genetic and environmental factors influenced the rats behavior with regard to physical activity, and specifically the environmental factors may have a long-term influence over genetic factors.

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