The Dirty Secret

April 4, 2015 — 10 Comments

Or, ‘Clinicians, what have you done to Pilates?’100910doctor

“We only hire experienced Physiotherapists trained in Pilates to teach in our Pilates studios: we dig the bloke that started it, but can’t understand how you’d let anyone who can’t relate your pain and pathology to your problem come anywhere near you!” 

(‘Clinical Pilates’, http://www.sixphysio.com)

There seem to be frequent scuffles in the Pilates teaching world (at least in the forums that I see) between ‘classical’ and ‘contemporary’ Pilates teachers. I’ve no interest in pursuing that particular debate here, not least because I think it may not be the right on to be having. Rather, I’m interested in the influence of physiotherapy and ‘clinicians’ on Pilates, and the profession of teaching Pilates.

It seems appropriate that, over the years, different teachers developed what may be termed ‘pre-Pilates’ exercises, to provide a kind of ‘on-ramp’ to the original work for those who may need it, for whatever reason. I guess that this is how some ‘contemporary’ Pilates developed. However, I suspect that ‘contemporary’ Pilates is routinely intermingled with ‘clinical’ Pilates, and the ideas that underpin the various ‘clinical’ Pilates brands (yes, there are lots of them) are increasingly exerting a pernicious influence on much of Pilates teaching.

Why the ‘Dirty Secret’ title? I was recently listening to an interview with Kelly Starrett, a physiotherapist particularly well know in the CrossFit community. In the interview he refers to what he calls the “dirty secret” of physiotherapy – the phrase “within normal limits”. He describes the tenets of physiotherapy training as getting the patient functional -‘can you do your daily activities’, and resolving pain. Clearly these aren’t bad things but, as Kelly says, “within normal limits” does not mean “full function”. So, allowing for the fact that this is a generalisation, and that there are many excellent physios in the world who are committed to their clients high achievement, the fundamental measure of a successful outcome for a physiotherapist might well be ‘can you walk to the shops without pain?’

Joseph Pilates wrote of his method: “You will develop muscular power with corresponding endurance, ability to perform arduous duties, to play strenuous games, to walk, to run or travel long distances without undue body fatigue or mental strain. And this is by no means the end.” His ambitions were a little higher than ‘can you walk to the shops without pain?’

The term ‘evidence based exercise’ seems to be increasingly popular, and probably underpins a lot of the colonisation of Pilates by clinicians. Clinical Pilates™ have a video on YouTube called “What is Clinical Pilates™” which makes reference to “recent research into spinal stability“. The APPI (The Australian Physiotherapy and Pilates Institute) website tells us that “Pilates focuses on building an efficient ‘central core’. In Pilates, ‘central core’ refers to the TrA, multifidus, pelvic floor and diaphragm. In Pilates, abdominal hollowing techniques are utilized to activate this central core.” (About Pilates, http://www.ausphysio.com) The Clinical Pilates™ video goes on to explain that “Some of the original exercises have been cut from the regime, as research cannot support their efficacy. What’s left over is a set of proven, effective exercises, now known as ‘Clinical Pilates’“. (What is Clinical Pilates™, dmaclinical pilates, YouTube). So, research tells us that we can prove the efficacy of certain exercises, but not others. Best practice is therefore to exclude anything that we cannot prove is efficacious. This may be a line of reasoning that appeals, but does it have anything to do with Pilates, or real life, for that matter? I’m in no position to question the merits of research, like Hodges’ & Richardson’s ‘A motor control evaluation of transverses abdominis’ (published in 1996), that concluded “The delayed onset of contraction of transversus abdominis indicates a deficit of motor control and is hypothesized to result in inefficient muscular stabilization of the spine.” In case you are unfamiliar with this, their research found that in healthy subjects – those without back pain – EMG readings showed that their TVA fired in anticipation of movement, whereas the back pain suffering subjects showed delayed TVA firing. I do wonder, though, about it’s application to Pilates.

This happened before my introduction to Pilates, but I imagine that, because Pilates was recognised to help people with back pain, it was then deemed necessary (by whom – who knows?) to incorporate conscious, isolated TVA contraction into Pilates. As APPI told us above, Pilates uses ‘abdominal hollowing techniques’, though I can’t find any reference to it in Pilates’ own writing. I recently had an online conversation of sorts with a former Pilates teacher and studio owner who described herself as a ‘master trainer’. The conversation started because she had blamed Pilates for her ‘weak’ rectus abdominis, and she explained to me that: “The pilates priciple of navel to the spine creates an imbalance in the abdominal muscles.” I have no wish to impugn the integrity or sincerity of this lady, presumably her view is a reflection of what she was taught herself. But where did it come from? I’d be very interested to hear if anyone who was trained by Romana, Kathy, Eve, Ron, Carola or any of the other first generation teachers ever heard a ‘navel to spine’ or abdominal hollowing cue. Again, Pilates himself never mentioned any such thing in ‘Return to Life’. I know from other exchanges that I’ve had on Facebook forums that, amongst plenty of teachers, the importance of cueing transversus, and the correct usage of transversus are, beyond question, fundamental to Pilates.

So, research appearing to indicate that transverses contraction is normally reflexive, we find that it is being cued nearly constantly in Pilates. The truth is that, having had a lumbar disc injury, I probably benefited greatly from some simple spinal stabilisation/hip dissociation exercises when I first started Pilates, but these were in preparation for doing Pilates, not central to it. In other words, these were pre-Pilates exercises that seem to have somehow morphed into what Pilates is perceived to be. Indeed, organisations like APPI and Clinical Pilates™ will teach their students that this is how Pilates should be – “The APPI Pilates Method provides Physiotherapists and equivalent degree therapists with a clinical and user friendly tool for retraining correct activation of the Multifidus, TrA muscles and pelvic floor muscles.“(The APPI Pilates Method, http://www.ausphysio.com) I should say here that, of course, physiotherapists do a very important job of helping people to be pain-free, and I am sure too that there are many great and dedicated teachers trained under these and similar methods. My concern is, to revert to the analogy above, that the on-ramp becomes the freeway, first in the perception of teachers trained in this thinking, and then in the public perception.

I’ve written recently about our willingness to believe that we understand bodies and movement better than Pilates did, and I assume this is the reason that Pilates teachers were apparently so willing to adopt clinical concepts in their teaching. The slightly bizarre thing to me is that at the same time some of those clinicians were busy declaring that physiotherapists are the natural bearers of the Pilates flame – that they are the people best qualified to teach Pilates. It’s an idea that is routinely promoted now -“Pilates instructors may be able to teach Pilates but are they qualified to give rehabilitation to someone who has an injury or medical diagnosis? We would suggest not. Physiotherapists can give full rehabilitation and can be taught to teach Pilates.” (The Benefits of Physiotherapist Led Pilates, http://www.pilatesandtherapy.co.uk) and, of course, in the quote at the top of the page.

Intertwined in this is the notion that actually Pilates is for people who are injured, or in pain. This brings us back to the ‘within normal limits’ outcome, and the idea that repertoire that hasn’t been validated by research should be discarded – “We don’t know for sure that this will help to resolve your pain, or increase the efficacy of your spinal stabilisation strategies, so you shouldn’t do it.” What was devised as a system is reworked (unsystematised, perhaps) and then, weirdly, appears often not to work. I have a strong suspicion that there are plenty of teachers who have arrived at Pilates after pain or injury, followed the unsystem approach and failed to enjoy the outcomes that Pilates intended. They’ve trusted the clinicians instead of the system, and thus find themselves ‘within normal limits’, when Joseph was trying to offer “godlike attributes” – what a compromise!

 

41HJGOjnmrL._SY344_BO1,204,203,200_Firstly, thank you to everyone who read Part 1 – something about this topic clearly resonated because more people have viewed that post than any other that I’ve written (no, it’s not saying much, but ‘from little acorns’ etc…)

Some of the comments that were made in response to Part 1 indicate that I didn’t do a very good job of arguing that there isn’t too much flexion, AND indicate to me that there are plenty of teachers who will happily declare that ‘there is too much flexion’, or ‘classical Pilates is mostly flexion’ as a gospel truth – as one of those things that’s so manifestly true that it needs no qualifying. When I asked for an example of a particular exercise that symbolised ‘too much flexion’ there were no examples forthcoming. The argument seems to go: “Just look at ‘Return to Life'”, and that’s exactly what I plan to do.

Before that I would like to quote Jean-Claude, from Bluebird Pilates in Munich, whose comment on the Facebook pilates-contrology-forum very neatly sums up what I believe:

“If you ask the question, if there is too much flexion in the Pilates Method and you generalise like followed: Roll Up = Flexion , Swan = Extension , I believe it is a black and white approach. 

Looking closely at the Roll Up for example, I can see an important part of extension, lying flat reaching you arms up and over you head without lifting your middle back, reaching into the two way stretch through your feet and finger tips. For me that is clearly an extension that most clients have to work on pretty hard.”

So, trying to see the original mat exercises in glorious technicolour, here we go. In case it’s not obvious, I’m assuming that the ‘too much flexion’ accusation refers to the spine, and not to other joints.

The Hundred

My understanding is that The Hundred is about breathing, and that it is about chest expansion (thank you Kathryn Ross-Nash, this was so helpful to me). I’ve argued elsewhere that the position of this exercise is essentially the gymnastic ‘hollow body’ or ‘dish’ position. A big part of which is hip extension – JP is pointing his toes in the pictures in RtL, which is (as Carl Paoli says) an expression of pushing. I would suggest that, if you are thinking of holding your legs up in The Hundred, then you are mistaken – you need to be pushing your legs down. The action of hip extension will help to centre your femurs well in your hip sockets, and assist a posterior pelvic tilt (which is different from tucking, of course) that will lengthen your lumbar and flatten it into the floor. Yes, there’s some lumbar flexion, but as always in Pilates, it’s coupled with elongation. For me, the component of hip extension is far more significant than lumbar flexion. It is my upper thoracic that really has to flex, meaning that I have to find some extension from my lower thoracic, which is where the chest expansion challenge comes in – can I flex my upper thoracic without closing the front of my shoulders? (Yes, if I really concentrate).

In short, not a flexion dominant exercise.

The Roll Up

The instructions begin “Lie flat with entire body resting on mat…” Yes there’s lumbar flexion to achieve that, but it’s about flexing to lengthen rather than flexing to curve, and the pelvis/leg relationship is the key, so the facility for hip extension is central again. I bet too that the thoracic extension challenge is significant for many to achieve the desired start position. I won’t pretend that the movement itself doesn’t in involve flexion, but the ability to move efficiently at your hip joints is the key. I saw it asserted on Facebook this morning that the 3 challenges to doing The Roll Up are: “the proportion of the body; the mobility of the spine; the strength of the abdominal muscles” No! If you can’t assume the start position – lumbar lengthened and hips extended (that slight posterior tilt will require you to be in hip extension). If you can’t dissociate at your hip joint your spine will have little chance of moving appropriately and this, I believe, is the usual reason for people to struggle with The Roll Up.

As I mentioned in Part 1, my understanding is that the eccentric (resisting force) phase of any exercise is at least as important as the concentric (applying force) phase. So you are always resisting gravity or, in the studio, the springs. Therefore rolling up from the floor is not the big challenge, rolling back to the floor is where the control really occurs, and this is when you have to be able to extend your hips, and your thoracic (see Jean-Claude’s observation above). The alignment of your spine is (pathology aside) a product of the orientation of your pelvis on the top of your legs. If we disagree on this we will probably disagree on most things movement related.

So The Roll Up is an exercise of hip dissociation, spinal flexion and extension.

The Roll-Over

This exercise is almost a reverse Roll Up, so many of the same ideas apply. Spinal control becomes more significant than hip control, because part of your spine remains the anchor to the floor, whereas in the Roll Up your pelvis and legs are the anchor. The eccentric phase is, as far as I’ve seen, always harder than the concentric phase (again, it’s Pilates – that’s how it’s supposed to be).

Of course there’s flexion, with elongation, and it’s working your hip extensors that will help to maintain that length (ie. Resist gravity) but the hard work comes in maintaining shoulder placement (there’s that chest expansion idea from The Hundred) and extending your upper thoracic, so that you’re not over extending your neck, on the way down – and then maintaining that while you extend your lower thoracic too.

So the shape looks like flexion but The Roll-Over is an exercise in controlling spinal extension.

The One Leg Circle

It’s the Roll Up start position again – there’s as much thoracic extension as there is lumbar flexion..

Rolling Back (Rolling Like a Ball)

Yes, it’s in flexion – I would say a (-curve, not a c-curve. As with earlier examples, it is hip extension that will help to maintain lengthened lumbar flexion – you push out against you own pulling in – that’s the opposition that creates length in the shape and gives you dynamic control. If you’re rolling and only pulling in then balance is going to be more a matter of luck than control.

So it is flexion but you’d better not be just thinking about flexing.

The Leg Stretches

Just like The Hundred, the lumbar flexion is really about elongation, and once again hip extension, and the capacity for deep flexion at your hip joint. And there’s the chest expansion element again – can you keep that as your draw your knee(s) in?

They looks like flexion exercises, but maybe that shouldn’t be the focus if you’re doing them well.

The Spine Stretch

In truth, I’m not thrilled with JP’s start position in RtL – it looks like there’s a bit too much posterior tilt to be able to really maintain length while going into lumbar flexion….

Here the flexion happens on the eccentric phase, so you work hard to lift into flexion against gravity wanting you to collapse. The concentric phase is all extension and, for me at least, this is one accession when it’s just as demanding as the eccentric part – to really sit up without hinging at my lumbar-thoracic junction, to really extend my thoracic, takes a lot of concentration and control.

It’s another exercise in both flexion and extension – the middle position of any Pilates exercise rarely tells you what the exercise is all about.

With just a few exceptions, I’ve already written about the exercises that follow, or (hopefully) they obviously don’t involve spinal flexion to any significant degree.

Rocker with Open LegsThe Seal, The Crab = Rolling Back (and The Crab gives me the most fantastic upper thoracic stretch, in the area that so few exercises reach).

The Corkscrew, The Jack-Knife, The Control Balance = The Roll-Over, and you’d better be using your hip extensors to organise and lengthen your spine.

The Saw, and the spinal articulation component of The Push Up = The Spine Stretch.

The Teaser is The Roll Up but with less feedback, and a harder involvement of your hip extensors (yes, they have to work to help organise your spine and maintain the length in your lumbar).

It’s tempting to say that, if anything, there’s too much hip extension in Pilates, because your hip extensors need to be working in (borrowing a generalisation) ‘pretty much everything’. This is where the idea that when Joseph Pilates devised the system people had different lifestyles and needed different things (which is often the underpinning of the ‘too much flexion’ argument) seems to fall down. In my experience everyone could have more efficient hip extensors, and I guess that JP had this worked out.

To try to summarise, many exercises, seen in a snapshot, appear to be flexion biased but we do the whole exercise, not a snapshot. Inevitably, how we think of an exercise, our perception as we approach the movement, influences what we do and feel. If you believe that Pilates is flexion biased then that will probably be your experience. What happens if you allow your perception to change?

ef968f90d366b4532cfa664a2f58a743Related to, and along with “we now know more than Pilates did“, ‘too much flexion’ seems to be another observation/statement about the original Pilates repertoire that frequently goes unchallenged. To be clear, this seems to invariably mean ‘too much spinal flexion’. This may well be coupled with a faith in the research of Stuart McGill (yes, this is a favourite topic of mine), which may be taken to mean “never flex your lumbar spine under load of any kind”, or worse, “never flex your lumbar spine, ever”.

Brief digression – if you apply load (compression, for instance) to a cell, it will react, perhaps by adapting to that load. The cell is alive, it breathes, it responds to stimulus. If you kill a pig, remove its spine, put that spine in a vice and repeatedly apply load to it in one direction it will only reliably teach you about what happens when you do EXACTLY that. It will not tell you much at all about what happens to a living spine, made of living, breathing, adaptive cells, human or porcine. So we do know one thing about ‘Safe spines’ for sure: don’t allow anyone to remove your spine from your body, put it in a vice and apply repeated uni-directional load to it. Excellent.

So, there’s lots of flexion in Pilates, right? Everyone says so, not least The Pilates Nun: “It’s true that in the repertoire there are way more spinal and hip flexion exercises than extension, side bending or rotation, inward or outward rotation. By “way more,” I mean a ton more, tens of percentage points more, or, put another way (and to properly use a double negative) almost none are not flexion based.” I have only singled out The Pilates Nun because her website was one of the first hits in my Google search and because she states it so vehemently. She’s by no means alone in making this assertion, as you can see here, and (oh dear) here.

(Disconcertingly, The Pilates Nun explains this flexion dominance by stating that we are ‘flexion biased’ creatures, and goes on to claim that: “humans move forward through hip flexion and our bones are set up to facilitate that. If our legs moved as easily backward or to the side as they do forward, we’d be far less stable, less powerful and nowhere near as fast.” Is it wrong to be profoundly alarmed that someone who may be regarded as an expert in our field believes that it is flexion that propels us forward? Pilates teachers often seem to regard themselves as having greater understanding of movement than other fitness professionals but I imagine that the most novice strength and conditioning coach will tell you that hip EXTENSION propels us forward, and more powerful hip extension makes you faster).

My purpose here is not to write about how safe it can be to do lots of flexion, when done properly – you can read about that on The Vertical Workshop blog (though I still take issue with the writer’s willingness to go along with the ‘Pilates is lots of flexion’ dogma). Instead my intention is to suggest that when we look at exercises and classify them as ‘flexion’ we are only seeing half the story, and sometimes even less.

Do we see the shape at the mid-point in the exercise, and then categorise it based on that shape? If so, we forget about the process of arriving in that shape, and then returning to the start position. There are only a few isometric holds in Pilates. I habitually tell clients who are new to Pilates (in slightly different language) that we are as, if not more, interested in the eccentric movement of an exercise than we are in the concentric movement. Are we seeing concentric flexion and forgetting about eccentric extension? Or just as likely, seeing eccentric flexion and forgetting about the concentric flexion? The whole movement counts, and the exercise isn’t finished until you’ve returned to your start position.

In the simplest instance, if you do The Spine Stretch you return to upright to finish the movement (ideally a little longer than when you started, of course), so is it really an exercise of flexion?

Could it be that a position that appears to be one thing is actually about another? How often is a position that looks like flexed spine and flexed hips actually about an action of hip extension to maintain a robust connection of the legs to the spine, and at the same time organisation of the spine itself?

To avoid writing an epic, I plan to write Part 2 of this by looking at each of the classical mat exercises in terms of their movement patterns and objectives, to try to reinforce this point. In the meantime, I’ll be glad to hear what you think. If you usually think of an exercise as ‘flexion’, try thinking of it differently when you next do it, and see what happens.

Thanks for reading.

 

Part 2 is now available here.

 

Occasionally, when something causes me to reflect on how little I’ve achieved over the course of my life, I console myself with the thought that Joseph Pilates was 50 years old when he published his first book (1934), and arguably did his best work between then and his death in 1967. It’s not that I imagine I will ever achieve as much as he did, rather that I still have plenty of time to learn and develop, physically and mentally (yes, emotionally too, but that’s a whole other can of worms).

It seems that it is broadly accepted doctrine within the Pilates teaching world that science has significantly advanced our understanding of human movement, beyond that of Joseph Pilates. Therefore (the doctrine would seem to go), it is safe to assume that we know more about movement than Pilates did, we understand muscles, mechanics and stabilisation better than he did. In some cases it leads to the notion that many of his exercises, perhaps many of the ‘Return to Life’ repertoire, are unsuitable for normal people. Therefore, we are able to adapt Pilates exercises to be safer and better. Here are a few samples of this manifestation to be easily discovered on the web:

“Unfortunately we only have material from his later days of practice and many of those exercises are very unsuitable for the general public!!! Modern Pilates combines the best principles of Pilates with sports science and research from the 21st Century. Simply that! Modern Pilates is a modern contemporary approach to an old exercise discipline.” (http://www.thepilatesstudioglossop.co.uk/introduction-to-modern-pilates/)

“Having been taken from the dance community by medical professionals it has emerged within physiotherapy, sports training facilities and in more recent history in general fitness circles. With influence from physiotherapists, dancers, doctors, movement therapists and scientists Pilates continues to change and advance.”(http://www.marylebonephysio.com/pilates.htm)

“But the advances of exercise science have enabled teachers to adapt the technique into a safe effective form of exercise, that can be practiced by almost everyone.” (http://www.reigatepilates.com/joseph-pilates/)

“You will also learn variations and modifications that were developed in response to scientific advances and the needs of todays student for work that is safe, effective and fun.” (http://www.purely-pilates.co.uk/instructor.html)

“STOTT PILATES® is a contemporary approach to the original exercise method pioneered by the late Joseph Pilates. Co-founders Moira and Lindsay G. Merrithew, along with a team of physical therapists, sports medicine and fitness professionals, have spent over two decades refining the STOTT PILATES method of exercise and equipment. This resulted in the inclusion of modern principles of exercise science and spinal rehabilitation, making it one of the safest and effective methods available.” (http://www.ymcafit.org.uk/courses/stott-pilates-mat-plus)

I was about to write “at the other extreme”, but since the above ideas seem to be distinctly mainstream then ‘extreme’ is inaccurate – instead, let’s say that the opposite view of this might be considered the school of ‘everything about Pilates is perfect and nothing should be changed in any way’. Or perhaps – Don’t ask questions, just trust the method.

I would have to agree that we cannot practice or teach Pilates with total disregard for the world outside – as a species we are more captive (see Katy Bowman), more ‘zoo-human’ (see Erwan LeCorre) than we were in the 40s, 50s and 60s, so we have changed ourselves, and probably not for the better. (This is quite different from ‘very unsuitable for the general public!’ – if anything, the general public have become unsuitable, not the exercises.) It is also true that some of Pilates assertions are problematic: “In a newly-born infant the back is flat because the spine is straight. Of course, we all know that this is exactly as intended by nature, not only at birth but also throughout life.” I’m inclined to see this as excessive zeal in an argument for maintaining spinal elongation. Perhaps he did get it wrong – I certainly always thought so until, after years of lying on a Stott reformer, lay on a Gratz reformer with distinctly more cushioning and had a different sense of what he may have meant by ‘flat’. Again, maybe he was wrong about this, but should this be cause for us to think that he didn’t understand human bodies and movement well.

To return to my self-consoling thoughts, even if we only start counting from the publishing of ‘Your Health’, Joseph Pilates had 33 years of watching people move, designing, experimenting and refining. As Andrea Maida puts it:

“Joe Pilates toiled his entire lifetime of 80+ years indefatigably tinkering with and perfecting his method. Jay Grimes insists no detail was left to chance or done by accident in the entire body of Pilates’ work.” (http://www.pilatesandrea.com/on-the-order-of-the-pilates-mat-exercises/)

I’ll be the first to agree that understanding how our bodies work in greater detail is wonderful, and that there are all sorts of technologies that allow us to ‘see’ how our bodies behave that weren’t available to Pilates. It’s also easy to believe, perhaps fuelled by the wonder of our advancing technology, that we know more than we do. Do EMGs, for example, tell us exactly which muscles work during a specific movement, and in what sequence etc? Perhaps they do, but EMGs have also recorded muscular activity in cadavers….

Perhaps as an extension of the belief that we know better, it seems to be another common view that an adherence to a set sequence of exercises is short-sighted, perhaps like literally interpreting the Bible (the ‘Don’t ask questions, just trust the Method’ view). I can’t pretend to teach according to a specific sequence on the Reformer, for example, but I do  follow one when I am working out myself, and it definitely asks more questions of me then not following the sequence does. To paraphrase Andrea Maida again, I tend to shy away from the exercises that I don’t like and, surprise surprise, those are the ones that I know I really need. Following an order makes me do the things I need, and makes me think too “perhaps JP was really on to something here”. Why not? He spent a lot of time working on this. Here’s a suggestion – follow the original order (if you don’t already) 2/3/4 times per week, for a month or two, and then see if you think it doesn’t have validity. I love learning about biomechanics, about movement, about anatomy, and very often the things that I learn I then find are already there within the Pilates system – I just didn’t know to look for them.

In short, if I’ve heard about some studies on TVA activation during lumbar perturbation, or about the effects of repeated lumbar flexion on pig spines (yes, dead pig spines…), or I’ve simply been told that we know more than they did back then, does that really make me smarter about human movement than Joseph Pilates was?

 

 

The Pilates System (?)

February 11, 2015 — 3 Comments

imagesAs seems so often to be the case, the convergence of two sources at a similar time has got me writing. Soon after I saw this from Andrea Maida’s blog, I also saw this piece, written by Joanne Elphiston. Wildly different, you might say – one is an attempt to define the original order of Reformer exercises, as determined by Pilates himself (no doubt a demanding piece of research in itself), and the other is a critique of (what may be) the prevailing thinking around stability training and injury management.

To stray from these for a moment, after spending 4 days last year learning from Ido Portal, I felt that my concept of movement, and teaching movement had been blown apart. For the first few hours it was mildly traumatic as I wondered how on earth I could go back to teaching what I then recognised, as a result of what I’d just seen, heard, tried etc.,  as the relatively narrow approach of Pilates. What saved me was recognising that, like most if not all movement disciplines, Pilates only makes sense as a system, and what I needed to do was to keep exploring the new material and ideas, integrate them into my teaching as appropriate, and teach in a systematic way. I hope that prior to this my teaching hadn’t been haphazard, but there was definitely room for more of a systematic approach. (It may be worth mentioning that I have become much better at the kind of record keeping that insurance companies recommend as a consequence).

Naturally then I’m drawn toward articles like Andrea’s, because it helps to reinforce a system. Not to mention that, as well as laying out a sequence, she does a great job of rationalising the order that she offers (and with humour – so much nicer than dogma…). There are other orders laid down for the Reformer – Whereas in Andrea’s list the Long Stretch Series comes after the Long Box, in the Romana Legacy Series DVDs the Short Box appears immediately after the Long Box – I don’t think these distinctions are important because there is an underlying system to both.

What of Ms Elphinston’s thoughts? In case you haven’t read it yet, she begins: “We see a lot of injured physiotherapists and Pilates teachers in our clinic. Many of them have turned to Pilates in order to address their own back pain, and it initially gave them a sense of control over their situation. However, they nevertheless still have back pain.” And she goes on to ask why this should be. Partly because I have seen this scenario many times (or at least it feels that way), I am willing to bet that the Pilates teachers whom she refers to have not pursued the system – have not treated it as something that you keep working to progress within. My guess is that they discovered, through Pilates, the exercises that they feel help them (which can feel like a miracle), and they get repeated over and over (“I know what I need.”), but the idea of Pilates as a system to progress in gets lost. Or maybe it was never there in the first place. I began Pilates at a studio where there was a clearly defined warm-up sequence that most clients learned sooner or later. There were ways to modify or layer things but the basic movement patterns were the same. Over the years things changed – my guess is that teachers got drawn into playing therapist, or got bored and added their own ‘creativity’, or simply lost faith/interest in the system. If you go there now you may be hard pressed to find a teacher who expects that the clients will adhere to a system.

There may always be debates around whether or not you can teach exercises that you cannot do yourself. Leaving that aside, I suspect that we tend not to teach the exercises that we don’t do ourselves. Or that we don’t effectively teach the exercises that we don’t do. I’ve been here before – if we entertain the idea that there’s Pilates repertoire that we needn’t aspire to, then why bother with any of it?

It seems that a lot of continuing education in the UK Pilates world relates to other disciplines, or to approaches to specific pathologies and, therefore, modifications. (Why should, for example, Pilates for Golfers, be substantially different from Pilates for non-golfers? Is there repertoire that’s contra-indicated for golfers, and other repertoire only suitable for golfers?) This, coupled with an absence of goal-setting and diminishing expectations, means that it’s easy to ‘do Pilates’ and actually only scratch the surface. The system itself can act as goal-setter, and inspiration (me, I’m working on nailing Balance Control/Step Off this year), and means that you don’t avoid the things that you don’t like. It’s now a running joke/accepted law in our studio that everyone hates the things that they need the most (and I do NOT love Breaststroke…)

Ms Elphinston’s writes “we remember that stability arises from systems, not muscles. This requires variety and variation in our programmes, working our way up to variability in order to foster robustness and a range of solutions to meet the challenges in our work, play and general environment.” Hah, Systems! I know that she is not referring to systems in the same way that I was above, yet it seems that these ideas dovetail nicely. The Pilates system is about developing stability not by focusing on muscle recruitment but by developing a range of movement patterns with ‘variety, variation and variability’. The mixture of midline stabilisation and hip/shoulder dissociation with spinal articulation fosters robustness – not, God help us, ‘Safe Spine Pilates’.

If you’ve spent any time in a health club then I’m sure you will have seen those people who dip in and out of things – a bit of treadmill, some shoulder presses, a bit of a stretch, the cross-trainer, maybe the leg press etc. Perhaps you’ve felt sorry for them and their lack of structure in their workout, and maybe thought that if only they had some more method to their session that they may see more progress. The Pilates studio (or mat class) is just the same – the magic’s in the system.

 

 

Who Is Your Teacher?

November 2, 2014 — 4 Comments

or The Trouble With Virtual,
or even I’m So Lucky

I really enjoy the opportunity to have dialogue with people that I have never met (and may never meet) that Facebook affords. The streamed classes that services like Pilates on Demand, Pilates Anytime and Pilatesology are a fantastic resource for students and teachers alike, too.

I’ve also read what both Frank Forencich and Mark Sisson have to say about the kind of social groupings that we have evolved to flourish within. I’m sure they are just two of many people commenting on the very novel (and who knows how ‘harmful’) phenomenon of superficial connection with hundreds, even thousands of people, rather than a ‘tribe’ of maybe 20-30 with whom we have a face to face and more intimate connection. Still, if you are able to have both then there are many potential advantages to a broad scope of opinion and experience that something like a Facebook group can offer.

The reason that I consider myself to be very lucky is that I live with one of the best teachers that I’ve ever encountered, with both a broader movement background, and many more years of practice than me. In other words, I always have a teacher on hand – someone who will give me feedback about both my own practice and my teaching, and whom I can go to for advice.

One of the drawbacks of the kind of qualification (in the UK) that will sanction someone to teach Pilates in health clubs and local authority facilities is that it can be gained without having a teacher yourself. I have met a teacher with this qualification who had never been to a Pilates class – all her own practice had been done following a DVD or online class. I imagine this will seem utterly bizarre to the majority of teachers reading this, and yet I suspect that, once qualified, it’s not so hard to get into a similar situation. Classes cost money, and take up time that you could be using to earn money – it’s an easy trap to fall into. Would anyone disagree that we all need a teacher (or teachers)? That there is any substitute for having someone in the room with you, watching you move, using the x-Ray vision that Pilates teachers (perhaps all teachers of movement) seem to develop? In fact, isn’t it essential to have a ‘live’, present teacher in order to develop those kind of skills?

Again, it’s an amazing resource, to be able to post a question in an international forum on Facebook, and to get feedback from teachers around the world with hundreds of years of experience between them. Truly this is one of the great benefits of the Internet. Then, sometimes, a question appears that makes me think ‘this is a question for your teacher’, hinting at the possibility that this person doesn’t have a teacher. If I wasn’t married to a teacher this might be me, and in writing this I’m reminded that I could be spreading my own net wider. Will I be more successful as a teacher if I don’t develop? Will I really develop as a teacher, if I don’t have one myself? So having a teacher isn’t expensive, it’s an essential investment.

Image from Disney's "Wall-E"

Image from Disney’s “Wall-E”

I’ll be the first to acknowledge, if I haven’t on this platform already, that I tend to like research that reinforces my beliefs, and to dismiss that which does not. I know that correlation does not equal causation, yet correlation can still be attractive if it seems to hint that a belief may really be the truth.

It’s always been easy to dismiss studies (I’m referring to studies on humans) whose results I might find inconvenient, because it’s so difficult to account for every variable in any human study, be it lifestyle, gender, size, weight, ethnicity etc. Then we have to consider the possible bias of the researchers, and possible massaging of the results to fit the desired outcome. So, ‘The China Study‘ may appear to show a correlation between plant based diets and reduced mortality rates, but it certainly does not provide proof of any such thing. It seems that, in general, interesting correlations are the best information that we can hope for from human studies.

I’ve recently had a debate, of sorts, via the comments section of a previous post, on ‘neutral spine’ in Pilates exercises, and the relevance, or not, of Stuart McGill’s research into low back disorders. Earlier this year I heard Ido Portal being summarily dismissive of this and other research, into diet for example, as having been conducted on ‘Homer Simpsons’. In other words, if the research subjects do not have a similar lifestyle or diet to his (and have not had for years), then what relevance would it have to him? Subsequently, I heard the excellent Katy Bowman articulating a similar position, in a little more detail.

Just as Erwan LeCorre refers to “zoo humans”, Katy describes us as humans “in captivity”. In effect, post-industrial lifestyles have made us captives of our own inventions. The comforts that have become so normal as to be invisible have robbed our bodies of the inputs that many thousands of years of evolution led them to expect. Many of us have feet that have not touched real ground in years, except through the (desensitising) cushioning of shoes. Frank Forencich wrote an essay that I particularly like, called “Sculpted by cats”. He writes of a time when big cats were far more widespread than they are now, and preying on our ancestors. Thus, those ancestors’ behaviour was in part dictated by sharing the land with their predators, and evolving particular traits or skills as a consequence. As Katy explains, we are now “sculpted by chairs” instead.

Nutrition inputs for most of us have changed almost beyond recognition from those that evolution led our bodies to expect. Simply, we don’t live, or eat in the way that humans have for millennia – we are almost a new species – homo sedentarien? Homo diseasus?. If you have seen ‘Wall-E’ you’ve seen this species depicted.
If you’re interested in being a Homo sapiens, and not being some sort of post-industrial, corrupted-by-comfort variant, then does research conducted on subjects that aren’t like you have much relevance to you? If you move and eat in a way that nourishes your whole body, if you avoid ‘foods’ that promote inflammation, will it fall apart on you? Do you need to be concerned that, like an IKEA kitchen drawer, your joints have a finite number of movements in them (dictated by your genetics, perhaps) before degeneration? Can science tell you much about how to live, eat, play or work if it’s looking in the wrong direction?

 

Epilogue

This post is really an acknowledgement of some of the ‘giants’ upon whose shoulders I endeavour to stand, to optimise my current world view:

Frank Forencich

Ido Portal

Katy Bowman

Neutral?

October 18, 2014 — 13 Comments

This subject may have been done to death, but the last post that I wrote garnered reaction from a number of people, specifically in relation to my writing that “I may have uttered the phrase ‘neutral spine’ at some point in my life” (as if that were a bad thing). So, it seems like something worth addressing, and having done some hunting in books and via the internet, there is plenty of (at least) potentially conflicting information available.

Neutral posture is defined as one “where the joints and surrounding soft tissues are in elastic equilibrium and thus at an angle of minimal joint load”.

(sorry, I’ve seen this quoted repeatedly but cannot find the original source).

If you’re going to be lifting weights, whether a barbell or bags loaded with a weekly shop, neutral is a fantastic place for your spine to be. There will be load on your spine, because it is the transmission from your arms (carrying the weight) to your hip joints, which should be moving the weight, but the load will be distributed evenly through the joints. If you are a Pilates teacher, or enthusiast, you probably know what Joseph Pilates believed about spinal flexibility – he wrote, in ‘Return to Life’ “If your spine is inflexibly stiff at 30, you are old. If it is completely flexible at 60, you are young.” In the lifting example though, the facility to maintain stiffness in your spine is very valuable.

One of the foremost proponents of spine stiffness is Prof. Stuart McGill (the link is to an article that he wrote) who has spent years researching spines, and apparently gathered lots of evidence that supports his theories.

I can’t disagree with a lot of what Prof. Mc Gill says in the video (and what right, as a layperson, would I have anyway?), especially in relation to the importance of lifting with the hips and not simply bending your knees. I heard recently of research on dancers showing a strong correlation between poor hip hinging (the ability to hinge the trunk around the hip joints without spinal articulation) and both back and knee pain – back pain especially. There would seem to be a strong case for making sure that the people we teach understand how to hip hinge (to powerfully extend their hips, you might say.)

Are there exercises in Pilates that involve the spine acting as a static transmission of load from one extremity to another? Absolutely. And there are also, of course, plenty that require us to sequentially articulate our spines, or to maintain spinal flexion. I suspect that the work of Prof. McGill has caused some teachers to believe that we should be avoiding lumbar flexion (it seems to be regarded as more sinister than thoracic or cervical flexion, presumably because the majority of disc injuries occur there). If you look you can find video online (try “the Pilates Nun”) of the Rollup being taught with a neutral lumbar spine, so as to keep it safe. If you peruse Professor McGill’s ‘Ultimate Back Fitness and Performance’ book you will see that he particularly advocates exercising with lumbar in neutral for people who have had back injuries or back pain: “Generally, for the injured back, spine flexibility should not be emphasised until the spine has stabilised and has undergone strength and endurance conditioning – and some may never reach this stage!” (page 47). This is not at all the same as never, ever flex your lumbar spine, yet this is what some people have taken from his work.

As a concept, neutral spine seems to be predominantly taught lying supine, which is curious to me because it seems to be the one position where neutral has least value or application. Under what circumstances, when lying down, do you need to maintain a neutral spine? If the only answer is ‘during exercise’, then we have to wonder what the purpose of the exercise is. I’m referring to mat based exercise, Footwork on the Reformer, and similar exercises with straps/springs being an exception, because you are applying force from your hip joint against mechanical resistance – they are mimicking deadlifting and squatting while supine. There is not a single exercise in ‘Return to Life’, beginning from a supine position, that calls for neutral spine, so it would seem reasonable to say that any pre-Pilates exercise (that is truly progressing toward an actual Pilates exercise) would not call for it either.

You might want to encourage a neutral spine in standing, in which case this is entirely dependent on the leg/pelvis relationship. If that is well organised – pelvis neutral – then cues related to axial elongation will surely help to achieve an appropriate spine position. After all, as Shari Berkowitz writes in her blog post ‘Neutral Pelvis and Neutral Spine: What are they and why do we care?‘, neutral spine is not a specific shape but unique to each individual. And, with that reference, ‘neutral pelvis’ rears its head.

Neutral pelvis, defined by Ms Berkowitz in her article as: “ASIS and pubic bone in line with each other in the Coronal Plane”, seems to me a more appropriate thing to be talking about than neutral spine, but do we really need to talk about it at all? Yes, it may well be a helpful cue to some, and my discomfort with the term may be a little irrational. (I’m much happier talking/thinking about organising one’s pelvis on the top/end of one’s legs..) Once again, I have to wonder if the term have a place in Pilates – particularly the matwork?

maxresdefaultMany gymnastic exercises involve the hollow body, or ‘dish’ position, and it seems to be central to gymnastics foundational strength programs (Gymnastic Bodies, for example). Having been introduced to the hollow body position it became apparent to me that this was the basis for a number of Pilates exercises – The Hundred; Single & Double Leg Stretches; and even The Push Up (ask any gymnast – push ups aren’t done in ‘neutral’). In fact, the second picture accompanying The Double Leg Stretch in ‘Return to Life’ is identical to the picture above. According to gymnastics coach, and author Carl Paoli, the hollow body is fundamental to learning to control your lumbar spine against the natural tendency to excessive flexion. It seems entirely natural to me that Joseph Pilates would have adopted this idea from gymnastics, which was particular popular in Germany.

One of the most valuable elements of the hollow body position for me was the understanding that my spine is organised by my glutes. My abdominals can then go to work to help to sustain that organised position but, under load, my glutes (the auto spell check is determined that I use my flutes to organise my spine…) are paramount. In a supine position this has the effect of lengthening my lower back into the ground, rather than jamming it down, and it becomes a much more sustainable position than it used to be for me. I would go as far as to say that my abdominals depend on the efficient functioning of my flutes (see?) to be able to function efficiently themselves. This does not equate to neutral pelvis.

Aside from it not seeming to be what Pilates himself was teaching, the problem with ‘neutral pelvis’ is that, once you take yourself away from either vertical or horizontal, the term has no meaning, except in relation to your spine. So, when a teacher calls for a variety of exercises from the original repertoire to be performed in ‘neutral pelvis’, I suspect that what they are really saying is ‘lumbar neutral’. If that is what’s intended, why stop there? If you flex your thoracic but not your lumbar then one would think that there would necessarily be significant intervertebral compression in the lower thoracic. If it is truly important to keep the lumbar in neutral, then why not the thoracic and the cervical? Where does that take us? Everything neutral in the sagittal plane only allows us to include The Twist, Side Kick Lying and Kneeling, and The Leg Pull (if you’re careful).

Under those circumstances, Pilates, as an exercise method, is dead – killed by the creeping influence of physiotherapy and disc injury and rehabilitation research. If you think that gymnastics may not hold all the answers to sound movement then I’d agree – practiced at an elite level it’s probably not fantastic for your health. That doesn’t mean that the basics haven’t been worked out over a long period of time – at least a century more than Pilates has been around. Gymnastics, like Pilates (I hope) is also very much concerned with having control over one’s body in movement. Can the same thing be said for the advocates of ‘neutral’?

 

 

 

 

 

 

IMG_2043Spoiler alert! What follows necessarily involves generalisations, and is in no way intended to disparage any individual(s).

I’m a little surprised to find myself writing this, and perhaps it’s in part a reflection of conservatism increasing along with age. Within the Pilates world it seems that the arguments over the merits, and legitimacy of “classical” and “contemporary” Pilates go on and on. Not long ago I may have found the dogma of the classical followers a bit hard to take. I may even have referred to some of the die-hard adherents to the classical form as ‘fundamentalists’, which I admit has some unpleasant connotations these days.

More recently, and as a result of various experiences, I’m starting to think that teachers (here’s generalisation No.1) in the UK have done Pilates a terrible disservice. Actually, not just the UK (a video from a well-known Australian teacher contributing to my dismay) but this is the region that I’m best placed to observe. One of the mantras that gets repeated in the argument in favour of a more contemporary approach to Pilates is that, because of advances in science, biomechanics, kinesiology etc, we understand movement better than Joseph Pilates did. If we believe that then it’s logical to apply the fruits of this deeper understanding to Pilates’ system.

Inevitably, as my understanding has shifted (up, down, sideways – who’s to say?) my teaching has changed. I’ve been seduced in the past by ideas and information that have complicated my thinking when teaching, and encouraged me to try to teach something in a more complicated way. I hope I can truthfully say that it’s been a long time, but I suspect that I’ve uttered the words “neutral spine” in the past. I’ve come to realise, too, that in trying to be inclusive of everyone in the class, I’d habitually compromised a movement to the point that I’d forgotten what the movement was supposed to be in the first place. I’ve worked to try to make people comfortable in an exercise at the expense of actually doing the exercise. I believe that we have done this sort of thing over and over, until the intention of the original exercise has been lost completely. There are apparently many people in the UK that believe Pilates is boring, and I’m inclined to believe that it’s because many of them have been taught some pale (wan, iron-deficient, malnourished) imitation of the real thing.

Part of the responsibility for this may be the prevalence of Pilates mat classes taught in health clubs, where the teacher has very little control over who attends the class. The lowest common denominator will often set the tone. Interestingly, the government approved qualification for Pilates teachers, that many health clubs require, is more geared toward the teachers ability to include everyone than in the teachers understanding of Pilates’ system. This is a relatively recent phenomenon, but the ‘dumbing down’ of Pilates has been going on for a lot longer.

It’s still shocking to meet teachers, who have been plying their trade for perhaps 10 years, that were not taught the original mat exercises during their training. It’s almost laughable. Imagine: “I’m a maths teacher, but I don’t teach multiplication or division because my trainer didn’t believe that it was suitable for the general public.” There’s a whole strain of ‘creativity’ – teachers finding new things to do with or without equipment, that may have roots in another discipline, or not (“Can I do that exercise with the foam roller and the rotating disc when you’r holding the push-through bar?”) that may deserve a separate post. More disconcerting is the idea, it appears many teachers have, that Pilates is full of relaxation. I think this comes in part from the world of somatics, and disciplines like Feldenkrais, which are great in themselves but maybe not applicable to the practice of Pilates (unless perhaps none has a particularly vivid understanding of how to move well). The other part of the relaxation dogma, I suspect, comes from trying to help people who are challenged in some of the original work by, for example, poor hip dissociation (see, I can’t stop the modern science creeping in). This seems to me to be one of the fundamental skills of good movement, and therefore Pilates too. Here’s an example: someone can’t Roll Up, or back again, without their legs leaving the floor. Could it be that we have encouraged the notion of relaxing the inhibited muscles, instead of actually teaching those people where to work from so as to overcome the inhibition – working toward correcting a faulty pattern? (Work the right muscles, so that the ‘wrong’ muscles get the chance to return to natural function).

In similar territory, have we pursued that things that feel ‘nice’ in our own practice, and for our clients? The practice of starting a class with side-flexion seems strangely prevalent, and mostly because it “feels nice” – or stretches muscles that the teacher perceives to be tight. The logic of working on central support to give some relief to overworked superficial muscles, instead of just trying to stretch those muscles, seems to have escaped us. Pilates didn’t need to spell this out, he just put centring exercises at the beginning of the sequence (and now modern science has taught us better, perhaps?) How have we got to a situation where what feels nice is the key determinant for exercise choice? It’s true that Pilates often makes me feel good, but that’s typically a response to my body working hard, rather than doing things that feel relaxing, or nice. The lasting benefits always seem to come from working hard, and it still amazes me when clients have that ‘Oh, this is hard!’ reaction to Pilates. Was it ever intended to be anything else? The idea of working just as hard as you need to is very appealing, and one of the seductive things about Pilates is that it probably takes decades of practice to reach the point at which the really difficult things begin to feel like they don’t require maximum effort.

I am not advocating a ‘one size fits all’ approach, as seems to be the view of some teachers – that if you want to hold true to the intent of the original exercise you are trying to force square pegs into round holes. My wife attended a workshop with Kathryn Ross-Nash a while back, and one of the nuggets that she passed on to me was the idea that every Pilates exercise has a single purpose. Several objectives, perhaps, but a single purpose. Adding to that the idea that exercises should not be adapted or modified, but rather broken down into their constituent parts, in order to work towards the whole. I suspect that I will do Ms Ross-Nash a disservice if I try to paraphrase any further, and the best advice may be to seek her out in person, or here, for example. To me, her thoughts seem to tie into what I wrote earlier, about adapting an exercise to accommodate everyone, to the point that the original exercise, along with its purpose, is a distant memory. Teach people what they need to know/do, in order to do the exercise, instead of reinventing it.

I know that there are many teachers in the UK to whom what I have written does not apply and, as I tip my hat to all of them, I’m trying hard to be one. I’m not sure that the system that Joseph Pilates devised is perfect, but I think it’s almost certainly a good deal better than has often been allowed for by teachers (and teacher trainers) in the UK.

If it’s not too late, what is to be done about this sorry state of affairs? Here are a few ideas:

Sweat more (and don’t tell others that Pilates doesn’t make you sweat). There’s a reason that Pilates believed it wasn’t necessary to do a lot of repetitions, and quite often that’s because, if you’ve put your whole body and mind into the exercise, 5 or 6 is all that you can manage.

Relax less – that’s what sofas and television were invented for, not Pilates. (Oh, and don’t get too comfortable either – very few useful adaptations are derived from comfort).

If you’re a teacher – take more classes. Unless you think that you’ve learned everything by the end of your teacher training.

And please accept my apologies if the tone of this is especially hectoring. Conversations, social media postings and the stars have aligned in such a way that writing this felt imperative.

 

 

 

I’m always fascinated by what Pilates teachers, individually and collectively (if that’s possible) believe that Pilates is for. One idea that I always like is that Pilates can be a significant help toward achieving one’s full potential – optimal expression of our genetics, if you will.
Consequently it’s been interesting to see some recent forum threads touching upon exercises that one might not attempt, or teach. Questions arise about, for example, whether or not one needs to do advanced or super-advanced reformer exercises. This strikes me as a rather rocky path: does anyone need to do Pilates in any form? (Of course I know it’s fantastically helpful to many people, and loved by many more, but is that the same as needing it?)
A few years ago I was tasked with teaching the Return to Life exercises to a group of teachers in training, and was horrified when one of them asked why she needed to know them, since she “would never teach them”! So where does one draw the line?
I would agree that some of the advanced repertoire on both Reformer and Cadillac require great strength, mobility and control. Working toward those qualities is an excellent reason to be practicing Pilates, so why not aspire to the zenith of the work (and work towards it)?
Another thread around a discussion on what is the ideal size for a reformer (it feels ridiculous to even type this) included a reference to splits only being necessary for dancers. This would suggest that our joints have unnecessary capacity – that there is no need to be strong throughout our available range of movement. Never mind recovering lost range. To me this is a bizarre attitude for a Pilates teacher to have, and it seems to relate to the discussion about advanced repertoire, and giving people ‘what they need’, as if we can predict that an office worker will never slip and be forced into a split position in which they have neither strength nor control. What?!
Again, I wonder what we think Pilates is for. How about if we said Pilates is for being more awesome, and not installing any glass ceilings?