Hi my name is Stephen Dunn, I am a Physical Therapist at CORE Therapy and Pilates in Austin, Texas. I want to go through a reformer video today on how to work with a scoliosis patient. We’re going to do this video in supine and go over neutral spine, extension, side bending and rotation. We’re going to avoid flexion which would make this appropriate forvsomeone with osteoporosis as well.
So first thing we do is go through some basic breathing and as we inhale to push gently into my hand and as you exhale pull gently away from my hand. Inhale push up into my hand, exhale pull up on the pelvic floor and draw the ribs down. Inhale, exhale pelvic floor, deep abdominals. Inhale, exhale… ribs… good and as you, on the next exhale start sliding your shoulders down into what we’re going to call scapula setting. Reach it back and down from the lats and the lower traps. Inhale shrug up just gently into the pads, exhale shrug down… reaching away.
Now we’re going to add a little resistance with a basic thera-band, actually a thera-tube with a piece of pool noodle that’s been cut and tied on to it. I’m going to put this under your head… now the pool noodle create some ergonomics, better ergonomics for the hand. Now this gives a little bit of resistance and a little bit of assistance to press into to the hand.
So we’re going to tie in the lumbar stabilization with the scapula stabilization at the same time. So inhale and now exhale, push into the hands and stabilize and now we’re going to add moving the foot with the foot work at the same time. Inhale shrug gently and as you exhale, co-contract… long through the neck and out through the feet. Inhale and exhale, stabilize push out through the hands, so we have some opposition of the hands going this way as the heads going this way. Inhale and exhale… good we’re going to keep going about three more of those.
According to the National scoliosis foundation:
- About two to three percent of the population that have scoliosis.
- That includes about 6 million people here in the United States.
- On a yearly basis we see 30 thousand children get braced with the cast brace
- We see 38,000 people receive spinal fusion surgeries…
All right now we’re going to go
into the next round and add some side bending and some rotation. As we do this we’re going to actually remove the headrest… I’m sorry we’re going to remove the shoulder rest not the headrest. We’re also going to use one sticky mat right down in the middle of the spine but more towards the lower mid spine… and we’re in the second gear on the Revo footbar.
Now we’re going to add some side bending in so I want you to bring your hands behind your head. Actually before we go into side bending and we’re going to do a little bit of footwork just setting the scapula but just in this position. So on the inhale, you relax and as you exhale you’re going to go
into some footwork and setting the shoulders back and down. So now it’s a little different angle here versus when we’re just using the resistance band to go here. So we’re exhaling, stabilizing and pushing gently into the back of the head to create the chin tuck effect. Inhale and exhale… set the shoulder blades, flatten the back… good. So that gets us into the good neutral spine idea.
Now we’re going to go into some side bending. So as we go into some side bending, don’t worry about moving the legs quite yet… as you exhale we’re going to think of side bending to one side. As you side bend, think of really pushing and reaching towards the mirror and keeping this open, but keeping this flat and engaged. Inhale you are going to come out of that and exhale go into the other side. Push it into my hand, stability through there… good. Inhale, back to the center and exhale reaching long. Pushing down… there you go. Inhale and push me towards the ceiling, towards window. I’m sorry and coming back.
Now we’re going to add a little movement with the feet in here. So we’re going to go in one leg into tabletop, either leg. So as you push into this leg you’re going to side bend away. So we’re creating this lift through the whole chain here. Inhale come back. Switch the feet and tabletop here, exhale reach out of that elbow… good. Inhale come back to the center and switch. Good. Good. And with scoliosis you’re going to really see a difference in these side-to-side motions. The difference will be strength as well as flexibility. This will start teaching you some things on how to handle yourself in day to day activities as you get a better awareness in these positions… good. One more. To the opposite side… good. So we’re scapula setting, trunk is side bending and take a break.
All right, now we’re going to bring your hands down. One up and over to the side of the bar and then that one here. Now without moving the legs at all as you inhale you prepare. As you exhale you are going to reach that hand up and over to that hand tracing it with your eyes. Keeping this connection right here. Inhale come back and switch and then we are… that’s it… good. Inhale come out of that and undo and exhale connect as you come across. That’s it. So this is our rotation component and again in a supine position staying very safe. Flattening of my hand… good. And we’re going to do one more of those in each position and then start adding a little bit of leg movement. Last one, connecting… good. All right now switch the hands again. Now we’re going to go into tabletop here and you’re going to push through this leg as you rotate away. Keep this good stability here… yes. Come out of that on the inhale, switch the hands and switch the legs. Exhale. If it’s too much to switch the legs and the hands, you can do it one side about three or four times and then switch and do it the other way. Pushing through the heel, opposition here. Length… good. Coming out of that and switching sides. Through the right foot… that’s it. and we’ll do one more on each direction here. That’s it, shoulders stay down, eyes gaze with the hand coming from the bottom. Last one here and good. Okay come back in.
Now we’re going to have her roll over to your stomach and we’re going to do a little bit of spinal extension. And with spinal extension, we are going to stay fairly small in the range, we are not going to get real big with it. She is going to have her toes at the edge of the wooden deck there. Her elbows are going to stay wide on the carriage. All I want her doing is keeping that contact with the elbows into the carriage as she sets the shoulder blades back and down on the exhale. Lifting the sternum but keeping the rib connection so it’s a very small amount of extension. Inhale out of that and again the feet are working slightly with this as well. Shoulders down, head is long… good. Inhale out of this exhale, co-contract. Shoulders down… yes. The shoulders down and the rib connection will keep you from over arching or going into a lordosis or a sway back. Two more of these… good. Inhale out of this and exhale and release… good. And come on up to sitting.
That concludes our video for the day. Hope you enjoyed it… Thanks a lot.
Would you like to learn more about our studio and if we are the right fit to help you reach your goals. Those goals may be sitting in the bleachers to watch your kids perform. Maybe it is to sleep through the night or avoid dangerous surgery or addictive pain pills…
Call 512-215-4227 to tell us your story with scoliosis. We have 2 great starting points for our potential clients to enter our studio. Both are free and consist of a in depth Q and A about your history and goals.
One is called a Pilates Taster Session with one of our Trainers. This is ideal for those who are not suffering from pain, but want to improve their breathing capacity, improve strength, flexibility and posture. You know you have been thinking about giving Pilates a go!
The second is a Discovery Session with a Physical Therapist. This is perfect for the person suffering from pain, limited mobility and a fear of things heading in the wrong direction. Learn how our hands on and Pilates approach tp Physical Therapy can help you reach your goals.