Hare are 11 simple tips to make sure your Pilates studio or Pilates teacher is able to look after low bone density, Osteoporosis or Osteopenia.
Tip number one. Your client information form should have a section on health history which should include questions about bone health. It may even ask if the client has broken any bones, shrunk in height or gone through menopause if female.
Tip number two. Make sure that the Pilates person instructing has seen this form so that they are aware of any bone density loss and can modify a program to suit. There is no point in having a form filled out if it is not seen by the instructor!
Tip number three. Make sure that that Pilates Instructor understands what Osteoporosis means in terms of programming. I have seen a standing roll down taught to an older client who’s posture reflected that of consecutive compression fractures in the thoracic spine, so a very stooped posture. For me I thought it would be obvious that this would be a contraindicated exercise, but perhaps as the instructor was fresh out of school that this was not understood, or perhaps had not seen the client information form.
Years ago a Pilates friend of mine was asking me about the difference between Osteoporosis in the spine and Osteoarthritis in the spine. Both are very different and require different exercises and programs. An Osteoporosis program may be more indicated towards spinal extension, whereas an Arthritic spine may be aggravated by spinal extension.
Studios have a duty of care to keep client forms updated and that instructors have access to these forms and understand any issues listed in terms of programming. Client information forms should also be updated regularly.
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Tip number four. Pilates sessions should include modifications for exercises so that flexion, loaded flexion and flexion and rotation of the spine are not given to someone with Osteoporosis or Osteopenia.
Tip number five. Safe balance challenges should be included in the program such as the many variations of the standing leg press on the Pilates Chair.
Tip number six. Strength training should be included in more upright and functional positions to increase bone density such as Lunges on the Pilates Chair, and Squats with the Cadillac arm springs. These exercises should have additional safety in mind, so using handles on the Pilates Chair and a dining chair behind the client doing squats with the Cadillac arm springs, so that if these is a miss-balance, the chair is there for them.
Tip number seven. Improving posture and opening out rounded shoulders should be included in the program. This should be a balance of stretching out tighter muscles at the front of the body and strengthening the postural muscles through the upper back.
Tip number eight. It is important to have supple and strong feet for good balance, so including exercises that mobilise and strengthen the feet should be included too.
Tip number nine. The program should include exercises that increase proprioception – understanding where the body is in space so that confidence is increased and that there will be less chance of falls going forward into the future.
Tip number ten. The program should be fun and it should be varied so that bones are always challenged with a new exercise!
Tip number 11, tactile cues should be light and informative. I heard of one lady who was injured through a tactile cue that had too much pressure.
If you are interested in increasing your knowledge and repertoire on Osteoporosis and Osteopenia please check out my course here.
This course has been recently updated to include current research on exercise and bone health, as well as three Pilates manuals full of safe exercises that help to build bone, and many programs included.