Move

hiking

With a few tweaks, hiking can be a great exercise for the glutes, which, in turn, helps promote a healthy spine. The key is good posture and gluteal activation.

Let’s start with stairs. Practicing this on some stairs will help you get the feel for it before you go for a hike. When you walk up the stairs, do you feel the muscles in your butt working? Hopefully so. If not, you aren’t using your body’s biggest asset (no pun intended) for going uphill. Think about pushing yourself up the stair with your glutes rather than pulling yourself up the stair with your quads and calves. Start by standing erect with the shoulders down and back, head centered over the shoulders. As you step up it’s okay to lean forward slightly if you must, but don’t hunch forward. Once your body weight is on the forward leg, propel yourself upward by extending the hip pushing with the glutes, rather than pulling through with your thighs. Hint: if you feel like you need to put your hands on your thigh to push yourself up a big step, you probably aren’t using your glutes and/or don’t have enough strength in those muscles.

Once you feel the glutes working on stairs, then it’s easy to translate that into hiking. Begin with a hike with some degree of uphill. The steeper the uphill, the easier it is to use your glutes. Maintain good posture throughout and be conscious of feeling a light to heavy (depending on degree of uphill or size of step up) contraction in the glutes while hiking uphill. Done properly, you should feel like you are standing tall with your chest slightly out and abs lightly tense. If you are new to this or didn’t feel your glutes at first doing the test on stairs, this will take some effort and thought in the beginning. It gets easier and will become natural in a relatively short amount of time. Coming downhill, you will rely more on your quads, but still try to maintain good posture.

If you are having trouble, read the blog on gluteal amnesia or feel free to email us at backinstitute@aspenclub.com. Happy hiking!

Out of Pain. Into Possibility. Jeremy James.

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plank

As I mentioned before in my blog about sitting, it is very important to break up your day with exercise and movement. The following exercises are the most effective and efficient exercises you can do without equipment for spine and overall health. They target all the important muscle groups. Try doing a few of every hour or so if you are sitting at work all day. Or, get a full circuit done at once.

Squats: In the beginning, use a chair or bench to get the feel of the movement. Place the chair or bench behind you. Stand with legs shoulder width apart and feet forward or slightly outturned. Squat back at a 45-degree angle so that your butt slightly touches the bench. Keep the back still. Then drive upward using the glutes to extend the hip. If you are doing this right, you should feel the muscles in your butt working more than the muscles in your thighs. A trick that can help activate the glutes is to push outward with the heels (“spreading the floor with the feet”) as you rise. This should make you feel the glutes working. Again, if your knees are dropping in, you are probably not using the glutes. Do this for 10-15 reps.

Planks: Lie on your stomach, up on your elbows. Engage your glutes and abs. Depress your shoulders. Lift your butt and knees off the floor. Keep your back and hips level. Gently tug your elbows toward your feet (no movement should take place). Hold for 10 seconds. Repeat three to five times. If this is too hard, leave your knees on the floor.

plank

Side Planks: Lie on your side, up on one elbow. Engage your abs and glutes.  Lift your hips and knees off the floor. Hold for 10 seconds. Repeat three to five times. If it is too hard, leave your knees on the floor.

side plank

Push-Ups: Think of a push up as a “moving plank.” Your body should stay stiff like it does with the plank. The movement comes from the shoulders. Engage your abs and glutes. Press yourself up with your elbows angled down towards the ribcage, not out from the ears. If this is too hard, start by staying on your knees or having your hands on a chair or bench. Do this for 10-15 reps.

push ups

Hip Extension Lift: Lie on your back with your knees at a 90-degree angle and your heels on a chair. Engage your glutes and abs. Drive your heels down on the chair keeping your toes pointed upward and lift your butt off the floor. Hold for three seconds. Return to starting position. If this is too hard, start with feet flat on the floor. Do this for 10-15 reps.

hip extensions

Try getting two to three circuits done in a day if you can.

All the important muscle groups worked with no equipment. Now, you have no excuse not to exercise! As always, if you experience pain with any of these beyond just muscle exertion, stop and contact your healthcare provider (or email me at backinstitute@aspenclub.com). Enjoy!

Out of Pain. Into Possibility. Jeremy James.

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yoga

I commonly see patients who consider themselves to be ultra-fit because they excel at a method of training, sport, or exercise class. This includes people who are masters at CrossFit, Pilates, martial arts, various types of yoga, running, swimming, cycling, skiing, etc. Usually these people are quite shocked to learn that they have significant weaknesses and imbalances, which, over time, have caused serious dysfunction and pain.

Before I go any further, let me first say that being good at any of these activities is usually far better than being sedentary, or even moderately fit. Each of those activities mentioned have substantial benefits to the participant. Troubles can arise when one of these activities is taken to the extreme, without being built on a proper foundation.

I’ll pick on yoga briefly because it has some of the most dedicated adherents, who also turn out to be the most surprised when things go south. Depending on the type (I am generalizing here), yoga can offer a multitude of benefits including increased flexibility, endurance, strength, and mental well-being. With some types of yoga, die-hard enthusiasts tend to become too mobile, or hypermobile, over time. While mobility is important, especially in the hips, people who do some types of yoga exclusively will find themselves too mobile at the expense of stability of the spine and endurance of the supporting musculature. After a few decades, this will land them in my office wondering how this happened to them. They are also usually quite surprised to learn that they must avoid or alter certain poses to stop further injury from occurring.

The same can be said to varying degrees for most other sports, classes, or training styles. Some are better than others but few, if any, are perfect all by themselves. Taking one concept and thinking it should be applied as much as possible all over the body doesn’t work. Flexibility is good to a degree in certain areas. Strength is the same. Stiffness is the same. Balance is key.

Any exercise routine should be built upon a solid foundation of spinal stability, hip mobility, proper movement patterns, and good posture. I have touched upon these concepts in previous blogs. Once these are learned, practiced, and incorporated into your exercise routines and daily life, you can enjoy those other things that you like to do. Just remember, if there is something you absolutely hate doing, you probably need more of it.

As always, feel free to send us a message with all your questions about spine health and fitness at backinstitute@aspenclub.com. Good luck!

Out of Pain. Into Possibility. Jeremy James.

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back pain

One of the most common denominators in my patients with chronic back pain is a lack of gluteal activation and strength. This pattern is sometimes referred to as gluteal amnesia. Usually due to a life of prolonged sitting, people forget how to use their glutes and their back suffers.

There are several different muscles in the buttocks, with the gluteus maximus and gluteus medius being two of the most important ones. The gluteus maximus is the biggest muscle in the human body. It has the job of keeping the trunk straight in a standing posture and for propelling us upward and forward (extending the hip). The gluteus medius functions to abduct the hip (pull away from midline) and stabilize the hip and spine, especially when on one leg. When these muscles are not used properly, the spine can suffer significantly. I am often asked “How could I have been doing these movements all my life without using these huge important muscles? Wouldn’t I know it?” One of my favorite analogies goes as follows, from Bill Fabrocini: If you have a car with one flat tire and you push the gas, the car is still going to go. You can probably drive a long way with that flat tire. Though at some point the axle, or another important part of the car, is going to give out from the stress and you are going to have a much bigger problem than just a flat tire. So, it goes with the human body. You can still move without using your glutes, but at some point, the spine, or another joint is going to break down.

Probably the most common movement pattern where gluteal amnesia is apparent is the squat pattern. When the glutes don’t fire properly during activities like squatting, the lumbar erectors and hamstrings take over and exert enormous forces through the lumbar spine (low back). This one is easy to check. Stand in front of a mirror and squat down. If your knees drop inward towards each other as you squat down, you probably suffer from gluteal amnesia.

Thankfully, gluteal amnesia can be fixed. Once identified by a trained specialist, an exercise protocol can be undertaken to reverse this pattern. The following are some simple exercises to do this. But remember, the goal is to incorporate gluteal activation into your daily activities and sports. A skilled therapist can help you with this.

Bridge: Lie on your back with knees bent. Tighten your abdominals and squeeze your glutes. Lift the hips off the ground without rolling up through the spine. Hold for five seconds. You should feel the muscles in your butt contracting on both sides. The hamstrings should be relaxed. If you feel that the hamstrings are doing most of the work, push your feet away from yourself into the floor. This will activate the quads and relax the hamstrings. After holding for five seconds, repeat 10 or 12 times.

bridge exercise

Clam Shell: This is a very basic exercise to activate gluteus medius (along with some other muscles). Lay on your side with knees and hips bent. Place your thumb on the bone in the front of your hip. This is called your ASIS. Lay the fingers across your hip as shown and they will be on the gluteus medius. Open the knee up like a clam shell. Repeat several times, thinking about the muscle under your fingers.

clam shell exercise

Modified Clam Shell: To start the strengthen the glutes, move to this exercise once you have done clam shell. The key to this exercise is to open the hip up and slightly outward, making sure not to pull the knee towards the chest. You also want the knee slightly above the foot in the opening phase of the exercise. Lay on your side with knees and hips at 90 degrees. Brace your core and start the movement by contracting the gluteus medius (follow directions in clam shell). Open the hip up and out (with foot) to about 45 or 50 degrees. Lower slowly with control.

modified clam shell exercise

Squats: After you have mastered some of the above exercises, you are ready to try squats. In the beginning, use a chair or bench to get the feel of the movement. Place the chair or bench behind you. Stand with legs shoulder width apart and feet forward or slightly out turned. Squat back at a 45-degree angle so that your butt slightly touches the bench. Then drive upward using the glutes to extend the hip. If you are doing this right, you should feel the muscles in your butt working more than the muscles in your thighs. A trick that can help activate the glutes is to push outward with the heels (“spreading the floor with the feet”) as you rise. This should make you feel the glutes working. Again, if your knees are dropping in, you are probably not using the glutes.

Reactivating your glutes after years of inactivity in those muscles can be very challenging. Often, it takes the help of a skilled therapist to accomplish this goal. If you suffer from chronic back pain and have not been evaluated for gluteal amnesia, you need to be.

As always, feel free to send us a message with all your questions about spine health and fitness at backinstitute@aspenclub.com. Good luck!

Out of Pain. Into Possibility. Jeremy James.

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If you’ve been told that you have arthritis or degenerative disc or joint disease, you are far from alone. Around 80% of people over the age of 55 have some sort of x-ray evidence of osteoarthritis. No matter what your age, whether a teenager, a senior, or somewhere in between, there are things you can do to avoid or minimize the effects of degenerative conditions like arthritis.

Although genetics do play a role in developing osteoarthritis and how severe it will be, a lot is in your control. Movement is one of the main contributing factors that cause degeneration of joints including the hip, knee, and spine. Our bodies are designed for constant mobility; however, when our movement patters are poor and repeated daily, it causes excessive wear and tear on your joints. These problems don’t develop overnight and learning to move properly and purposefully will enable you to do your favorite activities without pain well into your senior years.

Below are four great tips to help you move properly:

Hip hinge: Bend from the hips and not the back. Practicing “hip hinging” spares your low back from repetitive stress and strain. Lumbar disc herniation is usually the result of bending from the back repeatedly daily.

hip hinge - proper and improper form

Rotate from the hips and not the waist. Our lumbar spines weren’t designed to rotate very much and repetitive rotation wears down the discs. Imagine squeezing and twisting a sponge over and over and you get the picture. Eventually that sponge will crumble and tear and so will your discs. Combining bending and twisting from the low back is a very bad combo.

Proper form: rotate; Improper form: twist

Squat instead of bending when possible.Use your gluteal muscles and legs to lift objects instead of your low back.

squat proper vs improper form

Use your butt. The gluteus maximus is the biggest muscle in the human body. It has the job of keeping the trunk straight during a standing posture and for propelling us upward and forward. You should feel your butt muscles (gluteal) working when you stand from a squat position, climb stairs, jump, or brace yourself during weight lifting. Using the gluteal muscles spares the spine of unhealthy loads and repetitive stress.

For a more in depth discussion, a great resource is Thinner This Year, the follow-up to the New York Times bestseller, Younger Next Year by Chris Crowley.

Source: http://www.uptodate.com/contents/osteoarthritis-symptoms-and-diagnosis-beyond-the-basics

 

As always, feel free to send us a message with all your questions about spine health and fitness at backinstitute@aspenclub.com. Good luck!

Out of Pain. Into Possibility. Jeremy James.

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back pain

Back pain is very common in the United States. Eight out of 10 people will experience it some time in their lives. Back pain is also one of the most common reasons for missed work, outnumbered only by upper-respiratory infections. The chances are, you or someone you know are going to experience back pain at some point in your life.

For back pain that doesn’t go away in a few days, it is recommended that you see a healthcare provider. There are many different causes of back pain. Most causes of back pain are mechanical. This means that they are not caused by more worrisome conditions such as cancer, fracture, infection, or inflammatory diseases. Mechanical causes of back pain usually respond well to conservative, non-surgical, treatment. This includes treatment offered by physical therapists and chiropractors, as well as over the counter medications and prescription medications.

The difficult questions arise when conservative care has been tried with poor results. How does one know whether to consider surgery? Here are a few points to consider when trying to answer that question:

  • Was the conservative care provider doing a good job? A good therapist should take a detailed history, which includes correctly identifying the cause of pain and any aggravating factors. They should set objective outcome markers so that you and your therapist know if the treatment is working after a predetermined amount of time. Therapy should be specific to you determined by a comprehensive evaluation and your daily activities and/or sports. Any aggravating factors in your life should be identified and removed in the first phase of treatment. They can then be modified and reintroduced later if needed. Therapy should usually combine some sort of manual therapy and exercise prescription, with the goal of self sufficiency over time. Good therapy will not always consist of both at any given time. In the acute phase, manual therapy may be all that is indicated for a time until the patient is ready for exercise. In most cases, exercise should be introduced at some point. If you don’t feel like you had a great therapist, try someone else before considering surgery.
  • What is the cause of the pain and are there any other symptoms? Symptoms can be very important when determining if someone is a candidate for surgery. If pain is determined to be mechanical and is concentrated in the back, conservative care is usually a good option. Pain into the legs or arms can be more complicated. Pain in the leg or arm can be from irritation of a nerve root, called radicular pain, or muscular in nature, called myofascial pain. It is very important to differentiate between these two types when deciding on treatment. A skilled therapist or medical doctor can determine between the two. Myofascial pain into the leg, foot, hand, or arm can be treated with conservative care quite well. Radicular pain can be more challenging. Radicular pain from a disc herniation, for example, can be quite intense. Most discs will heal over time with conservative care, but the pain can be so debilitating in the meantime that surgery might be a better option. Tingling or numbness in the leg, arm, foot, or hand can mean nerve root irritation as well and should be taken seriously. Finally, loss of motor skills such as strength or the ability to move, should be taken very seriously and can be an absolute indication for surgery, as this can be slow to reverse or irreversible. Any symptoms into the leg, foot, arm, or hand require careful evaluation by a skilled practitioner to determine the cause.

 

Once these questions have been answered, a decision should be easier to make. One final factor to consider is the success rate of the procedure that you are considering. Speak to your healthcare provider about all options and what a reasonable expectation for outcome is for each option. For more information feel free to contact us at 970-925-8940or email us at backinstitute@aspenclub.com.

 

Out of Pain. Into Possibility. Jeremy James.

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warm up exercise

As I have written before, it can be very difficult for the average person to know when to consider surgery for chronic back or neck pain. One of the most challenging questions for a patient to answer is whether they have had good conservative care before considering surgery. I hope this blog helps answer that question. This entry will build upon my previous blog entitled “When and when not to consider surgery for back or neck pain.”

I see the same patterns over and over when patients come to our clinic after being treated unsuccessfully elsewhere. Here are a few of the most common mistakes I see:

  • Their previous care was completely (or mostly) passive in nature. Chronic back pain patients go to chiropractors over and over and get adjusted without ever being transitioned to exercise. While manual therapy (including adjustments when indicated) is useful and necessary at times, a transition to exercise should almost always be made at some point.
  • Their exercise protocol did not progress as the patient improved. An exercise protocol is a dynamic thing. It should be constantly monitored and updated as the patient improves and changes. In most cases, you shouldn’t be doing the same exercises, resistance, repetitions, etc. in the second month of treatment that you did in the first week. The caveat here is that there are a few basic exercises which are good to do permanently for many back patients (plank, bridge, side plank, etc.). Generally, those exercises are prescribed as a daily “warmup” with progressions built on top of them.
  • Patients push through pain during their exercises. Proper exercises for spinal rehab should not generally aggravate a patient’s back or neck pain. The adage “no pain, no gain” does not belong in a spinal rehab program. While some exercises might cause some mild discomfort in other areas, they should not cause an increase in the patient’s chief complaint pain. If a person’s prescribed exercises are causing an increase in back or neck pain one of the following is happening: it is the wrong exercise for that person’s condition, it is too much resistance, there are too many repetitions, or the person is doing it wrong.
  • Details matter! It is incredibly easy to do an exercise the wrong way. In fact, it is usually easier to do it the wrong way than to do it the right way. The old movement patterns that contributed to your problem in the first place are going to take over as soon as you let your guard down. Zoning out in front of the TV and going through your routine is not the way to get better. Make sure you understand exactly what muscles you are supposed to be using and the goal of each exercise. Your therapist should pay close attention in the beginning stages of treatment to make sure you understand each exercise and know how to do each of them properly.

 

As always, feel free to send us a message with all your questions about spine health and fitness at backinstitute@aspenclub.com.

Out of Pain. Into Possibility. Jeremy James.

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Having just gotten back from a very long 14-hour flight from Sydney, Australia, I can empathize with my frequent-flying patients who tell me that the worst thing for their back is a plane flight. Back and neck pain are extremely common during and after long flights. This is due to an unpleasantly (but appropriately) named process called creep. Simply, creep causes deformation in the ligaments and other tissues in your back and neck when they are subjected to load. As you sit in that impossibly cramped little airplane seat (who designed these things anyway), creep sets in and causes the various tissues in your back to change, setting you up for painful spasm during the flight and potential injury after the flight, especially when lifting that heavy suitcase. How can you fight creep? Move!

  • Change positions in your seat often. Cross one leg over the other, shift your weight from side to side, put a pillow behind your low back, even slouch from time to time (yes, it’s okay for short bouts).
  • Get up and walk. If you aren’t sleeping, get up and walk to the back of the plane. While there, try a few of these dynamic stretches and movements. Do this for at least five minutes. Try to do this at least every half hour if you can. Don’t worry, you won’t look crazy! I see more and more people doing variations of these when I fly now.
  • After you get off the plane, make sure you give your body as much time as you can to rebound from the creep process before you pick anything up. You won’t have time to fully recover as this takes several hours, but the more time the better. Walk around a bit if you have time. Stand for a while. This will minimize your chances of straining your back when you pick up that heavy suitcase. When you do lift, use your butt, not your back.
  • Remember that prevention and preparation are key. The proper, regular exercises build endurance in the postural muscles that support the spine resulting in a better defense against the negative effects of creep. Building endurance in the core is key. Practice these exercises as mentioned in my previous blogs.

 

Standing Hip Flexor Stretch with Gentle Back Extension: Ease into this position until you feel a slight stretch in the groin and thigh of the rear leg. Open the chest and gently extend the spine. Hold for five to 10 seconds while breathing. Repeat a few times then switch legs.

hip flexor stretch ​​Pec Stretch/Chest Opening: Use a corner or doorframe for this one. Place your hand on the wall and step forward until you feel a gentle stretch in the chest. Turn your head to the opposite side and slightly downward. Hold for five to 10 seconds while breathing. Repeat a few times then switch arms/legs.

pec stretch

Squats: Stand with legs shoulder width apart and feet forward or slightly outturned. Squat back at a 45-degree angle so that your butt drops behind you, not below you. Keep the back still. Then drive upward using the glutes to extend the hip. If you are doing this right, you should feel the muscles in your butt working more than the muscles in your thighs. A trick that can help activate the glutes is to push outward with the heels (“spreading the floor with the feet”) as you rise. This should make you feel the glutes working. Again, if your knees are dropping in you are probably not using the glutes. Do this for 10-15 reps.

squat

Seated Relief Position: Sit with your buttocks at the edge of your seat. Spread your legs apart slightly. Turn your toes out slightly. Rest your weight on your legs and feet. Tilt your pelvis slightly forward and Lift your chest up, gently increasing the curve of your lower back. Turn your palms up. Breathe for 10 seconds. Repeat a few times.

seated relief position

 

As always, feel free to send us a message with all your questions about spine health and fitness at backinstitute@aspenclub.com. Good luck!

Out of Pain. Into Possibility. Jeremy James.

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situp

We hear a lot of talk these days about “the core” being crucial to many aspects of health and fitness, including spine health. But what exactly is “the core?” I like to keep it simple: Think of the core as everything between your shoulders and hips, which includes all the muscles in your abdomen and your back.

There are many ways to target the core muscles during your exercise routine. Some of them can do a lot to strengthen and define the muscles in your abdomen, while adding stress and strain to the spine. The goal should be to build stability, endurance, and strength (in that order) in the core, while sparing the spine of excess wear and tear.

First, STOP DOING SIT-UPS. Sit-ups focus on one group of muscles in the abdomen, which don’t happen to be that important (in isolation) for spine health. In addition, sit-ups create excessive force through the lumbar discs (the discs in your low back), which can produce disc bulges and herniation over time. Sit-ups are a lose/lose exercise. What to do then?

Stability: First, you want to build a fair amount of stability in the core before you start more aggressive exercises. To start, lie on your back with your knees bent. Lightly tense your abdominal muscles as if someone was about tickle you or drop a light object onto your stomach. Now breathe normally and maintain the tense abs. Make sure your abs don’t turn on and off as you inhale and exhale – you want to learn to control your abs independently of your diaphragm. Once you’ve mastered that, start to “march in place.” The trick here is to keep your back still while your legs move: this is what I mean by core stability. If this seems difficult at first, you are not alone, but don’t give up, everyone gets this after a little practice.

Now, you are ready to move on to some endurance and strength-building exercises. Remember that you must practice a stable core/spine throughout. So, remember to keep your abs slightly tensed and move independently through the hips and shoulders while keeping the spine still. Start with these five basics:

Bridge – 10 reps, five-second holds. Lie on your back with both legs bent. Tighten your abs and squeeze your glutes. If you like, you can put a pillow or a ball between your legs and squeeze it. Lift your butt off the floor. Hold for five seconds.

bridge exercise

Bird Dog – 10 reps, five-second holds. On hands and knees with neutral spine, tense your abdominals and keep your low back quiet. Then reach way out with one hand, thumb up, and reach way back with the opposite foot, pushing through the heel, not the toes. Hold for five seconds with each reach. Activate all the muscles of the core, hip, and shoulder girdle.

bird dog

Plank – five reps, 10-second holds. Lie on your stomach, up on your elbows. Engage your glutes and abs. Depress your shoulders. Lift your butt and knees off the floor. Keep your back and hips level. Gently tug your elbows toward your feet (no movement should take place). Hold for 10 seconds. Repeat for three to five reps. If this is too hard, leave your knees on the floor.

plank

Side Plank – five reps, 10 second holds. Lie on your side, up on one elbow. Engage your abs and glutes. Lift your hips and knees off the floor. Hold for 10 seconds. Repeat three to five times. If it is too hard, leave your knees on the floor.

side plank

Crunches – 10 reps, five-second holds. Lie on your back with your knees bent and feet flat on the floor. Raise your shoulder blades off the ground and engage your core. Keep your neck in line with your upper back and shoulders. Hold for five seconds.

crunch

 

As always, feel free to send us a message with all your questions about spine health and fitness at backinstitute@aspenclub.com. Good luck!

Out of Pain. Into Possibility. Jeremy James.

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woman doing pilates at Aspen Club

The Pilates Method was developed by Joseph Pilates during World War I as a form of rehabilitation for ill and injured soldiers. Pilates has become a beneficial mode of exercise, which focuses on whole body control and an integration of strength, stability, flexibility, breathing, and alignment. Based on the principles of breathing, concentration, control, centering, precision, balanced muscle development, rhythm and flow, whole body movement and relaxation, Pilates exercises stress quality of movement.

Using Pilates equipment such as the reformer, or no equipment at all, most Pilates exercises use the individual’s own body weight or resistance in the form of springs to strengthen the entire body. Pilates focuses on the foundation of core and trunk stability without ignoring upper and lower extremity strength, allowing patients to more effectively strengthen their whole muscular system. Exercises vary from small, isolated movement focusing on a couple of muscles to whole body movements integrating multiple muscle groups and joints, while emphasizing the muscle co-contraction, which improves joint stability and dynamic alignment.

When recovering from an injury, Pilates-based exercise optimizes strength and muscle balance, while minimizing load and stress through the joints or other injured tissues. There are hundreds of Pilates exercises that can be tailored to each patient to address their specific impairments, while respecting their healing precautions. Pilates also integrates breathing to maximize core stability and overall muscle function. Pilates-based rehabilitation is designed to efficiently transition each patient back into their functional activities, including daily activities, sports, and recreation. While all programs incorporate breathing instruction, core stabilization, and improvement of overall muscle function, each Pilates-based program is individualized to specifically meet the needs of the patient’s strength and flexibility deficits to match the physical demands of their daily life.

Pilates-based rehab has become more popular in recent years due to its effectiveness and success in safely treating nearly every condition, including post-operative one. Frequently, patients who are introduced to Pilates through rehabilitation end up making Pilates part of their lifestyle in the long-term.