Fatigue posture, also known as "sway back" or "slouch posture", is relatively common in certain groups such as models and dancers. Over time, this posture creates a kyphotic curve in the tho-racic spine, a lordotic curve in the cervical spine, and varying degrees of flatness in the lumbar spine. A posterior tilted pelvis and hyperextended hips are key components, allowing the person with this posture to "hang" in their ligaments. In this way the skeleton self-corrects against grav-ity without needing to recruit the musculature to remain upright, therefore using very little en-ergy and earning the name “fatigue”. Pilates plays a key role in bringing the body back into ideal alignment, which in turn al-lows the spine to once again act as the natural shock absorber that it is meant to be when the natural curves of the spine are present/normalized. Strength is returned to lengthened and/or un-used muscle groups, while allowing shortened, overworked muscles to relax and lengthen. Mus-cles once again take over their natural roles and no longer need to compensate for weakness in other areas of the body.

I was given the opportunity to teach Pilates to young dancers at the Gustafson School of Dance shortly after this training course began. The timing was ideal as it gave me the opportunity to practice what I was learning on two small groups of dancers ages nine to thirteen. Although I went into teaching the class with confidence I quickly realized I had my work cut out for me. Not only did I have to keep the students attention and monitor their form, I had to find ways to make the class fun. My research began immediately, and I was able to find helpful information on techniques for teaching young dancers the benefits of Pilates.

Controlology was the term Joseph Pilates used to describe his body of work. One of the tenets of Pilates is ‘control.’ We all like to control our environment and our bodies. There is one thing, however, that no person can control: time. Time passes, and we age. As we age, our bodies naturally go through many physiological changes. Pilates can help to mitigate or delay many of these changes by increasing our strength, flexibility, mobility and balance. As an instructor of Pilates, however, we need to be aware of the common limitations encountered with seniors so as best to help them maintain their health and not cause injuries. This paper will describe the benefits of Pilates for seniors as well as the precautions and considerations that should be observed when working with this segment of our population.

The human hip, which is a very stable joint, is a complex and intricate series of muscles, tendons and ligaments. It is comprised of a ball and socket mechanism, where the head of the hip bone connects with the cup shaped acetabulum on the pelvis. For a professional dancer, the hip must maintain extreme flexibility and requires excellent balance, strength and coordination. Hip pain is a common problem in dancers, a hyper mobile joint that is used repetitively with extreme range of motion will wear out more quickly because the cartilage under goes unusual amounts and types of friction. This case study of a retired injured female dancer shows by going back to basics with Pilates you can retrain your mind and body that "a no pain no gain" mentality isn't necessarliy the best for pain-free positive results.

"Flat feet" is a medical condition in which arch of the foot is not present and the sole is completely in touch with the floor. "Flexible flat feet" is similar to flat feet except arch of the foot is present when the foot does not bear a weight. When sitting and the foot is not touching the floor, natural curve of the foot is visible on a person with flat feet medical condition. Flexible flat feet is common in early childhood as well as in elders. Flexible flat feet condition disappears as the muscles on the foot and lower leg develops in childhood until the age of 5-6. In the elder population, flexible flat feet occur if muscle strength and flexiblity degraded. Sole of the foot is in touch with the floor and this may accompanied by knees coming together. Sometimes with the femur medial rotation postual imbalances get worse. Center of gravity moves towards the forward of the body, pelvis tilts anteriorly, upper body extends back to compensate and lordosis condition can be seen in the posture. Postural deviations as well as absence of the arch of the foot cause chronic lower leg and foot pain. Walking with flat feet puts pressure on posterior lower leg muscles and tendons, which create pain due to overuse and decreased flexiblitly. Flexible flat feet in mature population is not a condition that can be fixed however, symptoms can be eased by working on muscles on and around the foot. This research focuses on the muscles and muscle groups that are effective in flexible flat feet medical condition and a Pilates program to ease symptoms caused by flexible flat feet.

In reviewing the medical records and obstacles that my client has been presented with, both trochanteric bursitis and supination of the foot are difficult to deal with and even more so to treat. During my observations, I saw many improvements. We saw major improvement in the movement of her toes, abililty to keep her ankle straight and even more blood flow to her foot. I think that Pilates will be great success for her in the challenges she currently has. As far as the trochanteric bursitis, that might take a little longer based on her pain management.

Research has demonstrated that non-surgical methods for treating lumbar disc herniation are just as effective as surgical methods over the long term. Common ailments and symptoms of a patient with a lumbar disc herniation are low back pain, radiating pain down the legs, and a worsening posture including a reduction in the natural lumbar spine curvature, scoliosis, and unilateral slightly flexed and externally rotated hip and knee joints. Although physical therapy is effective, a method that focuses on correcting alignment, posture, and improving the strength and endurance of synergistic muscles is preferred for successful treatment of a herniation. Because Pilates addresses these specifically, it is the most appropriate method to treat my client who has a lumbar spine herniation. A timeframe of 10 weeks will be used for this program which will mainly target the Transverse Abdominals and Multifidus muscles while avoiding contraindicated movements.

The TRAM flap procedure is often considered the gold standard in breast reconstruction following mastectomy. Its benefits include more natural appearance and feel and greater safety than implants. During the TRAM flap procedure the surgeon detaches all, or a portion of, the rectus abdominus, along with abdominal fatty tissues, and transplants these tissues to the mastectomy site where they are used to form a new breast mound. Research shows that the TRAM procedure may result in reduced abdominal strength and function for the patient, including reductions in trunk flexion strength and rotation. Scarring crosses the lower abdomen from ASIS to ASIS. Due to the insertions of the obliques and transversus along the linea alba where the rectus abdominus has been cut, weakness in these muscles may also be seen. In this case study, I worked with a breast cancer survivor who underwent the TRAM procedure 7 years ago and who had not undertaken any core strengthening exercises since the surgery. In order to build core strength, I used various fundamental Pilates exercises on the mat and apparatus. I noted that overall core strength was similar to other previously inactive beginner clients and that focused work developing a baseline of strength was needed before deficits related to her surgery would be apparent.

Objective: The study assessed the benefits of Pilates training to alleviate pain caused by the compression of the sciatic nerve by the piriformis muscle. Methods: A protocol of seven weekly one hour Pilates exercises utilizing the Reformer, Cadillac, and Mat. Focus of the work centered on the muscles and bones of the lower back, posterior and anterior legs. Results: After the first two weeks, subject was free of any sciatic pain for five days. When pain returned, client was able to recognize what triggered the flare-up and shifted her patterns of movement to abate the discomfort. There was a reoccurrence of chronic pain in the fifth week due to habitual patterns and work-related stress that required massage to remedy. From the seventh week on piriformis syndrome discomfort was rarely experienced.

The Northwest is a piece of heaven for those who enjoy outdoor activities. In just a short time, one can drive to oceans and to mountains. The weather in this area is mild all year round so that mountain climbing and hiking can be enjoyed during the heat of summer as well as the middle of winter. Hiking is common in this region, from experienced mountain climbers to inexperienced hikers that simply want to enjoy nature. However, this seemingly leisurely activity can cause wear and tear to the back, hips, knees, and ankle joints, similarly to any other aggressive sport. Therefore, it is critical for hikers to condition their body in preparation of different levels of hiking. The majority of wild terrain is not paved, straight, or flat ground. Rather, wild terrain is typically covered in mud, tree roots, and rocks, and requires a hiker to carefully maneuver through slippery roots and rocks to avoid a dangerous fall. Hikers often experience pain in their lower legs and knees, caused by overuse of their knees in such conditions. Continuing to hike in such conditions can cause greater damage to joints and ligaments. Pain and damage to joints and ligaments may be avoided through regular conditioning of the entire body by practicing Pilates using weight resistance in order to strengthen and stretch proper muscles and to protect joints. Core muscles are the stabilizers for any movement, and by increasing the strength of these muscles, hikers can increase their balance and avoid high impact on a particular joint group, which is often the cause of injury. In addition, Pilates can assist in developing better posture and muscular balance for the body to function efficiently.

Genu recurvatum means (L.genu, knee + re-curvous, bent back) "back-knee" as the knees curve backward in the sagittal plane. The knees extend "beyond straight", creating a convexity of the legs posteriorly. It is more common in females than males. This hyperextension of the knees is thought by some to complement the aesthetic of the legs with pointed (plantar flexed) feet. In dancers, this often indictates a general predisposition towards ligamentous laxity. Trouble arises when the dancer "locks" back in to his or her knees, or has an extreme amount of flexibility in the knee joint (looser ligaments equals a significant amount of hyperextension) and therefore places undue stress on the knee joints and lower legs rather than employing muscule strength for correct postural stance. Hyperextension of the knee can put excessive stress onto other strucutres in and around the knees, which can become painful, and/ or create further injuries. The principals and repertoire of the BASI Pilates method can be used to create more stability and control of the muscles and ligaments surrounding the knees.

The research conducted in this study for this particular client involved finding a pilates program that he can utilize to regain his golfing ability following a shoulder injury and surgery and to improve his overall golf game. The first meeting with this client involved learning what his initial injury was, the surgery that was done to repair it and what his specific goals were. Speaking with his doctor and physical therapist was the next step I took in order to better understand the extent of the injury and the client's exact limitations. After learning that my client had undergone a Bankart repair for chronic shoulder dislocation, it allowed me to begin research on his specific condition. I began reading about the causes of shoulder dislocation which helped me in deciding which specific exercises would be most beneficial in helping my client to regain stability and strength in his shoulder as well as improve his golf game. We began the 3 times per week program with doing exercises that would strenghten and stretch his shoulder region without moving the joint. As my client became stronger, we added resistant and more exercises that would strengthen his internal and external rotators as well as rotation exercises so that he would gain more mobility in his shoulders. Focusing on the mind-body connection and the importance of core strength was important for this client to improve his golf game so we added many exercises that would allow him to improve his overall golf game.

In this study, I addressed the issues of one person who is a marial artist and some general approches to working with martial artists. The included case study is of a martial artist who has "military" posture with an anterior curve in his lower and middle thoracic spine. After addressing his postural issues, I discuss the following areas which are important in using Pilates for cross-training martial artists: lateral flexion and rotation, open and closed chain work with core stability and motion, unilateral work, speed and breathing.

This project offers information on the structure and movement of the shoulder and using the BASI Pilates Block to strengthen and stabilize the upper body, improving the ability to regain range of motion and perform exercises in good alignment to prevent injury in the shoulder. Proper alignment of the scapula flat on the thoracic spine and holding the humerus in the glenoid cavity is essential to scapula stability for proper activiation of the rotator cuff. Scapula thoracic instability is the cause of most shoulder injuries, as many exercises are done without correct position of the scapula while moving. It's important to improve activation of the upper and lower traps and the serratus anterior to prevent stressing the rotator cuff and upper thoracic spine. It is important not to depress or abduct the scapula; and keep ribs connected and the serratus activated, wrapping around the front of the body. Using these cues while performing Pilates exercises for the arm, shoulder and upper back and body help to insure good body mechanics and prevents of injury while building strength and stability in the shoulder.

This paper considers the common knee problem of patellofemoral pain syndrome. It begins with a generalized discussion of the anatomy of the knee joint followed by an overview of patellofemoral pain syndrome, including its symptoms, causes and medical treatment. Patellofemoral pain is further addressed in the context of a Pilates exercise program. A case study of a client suffering from knee pain medically diagnosed as patellofemoral pain syndrome is used to develop an appropriate rehabiliation and conditioning program selected from the Pilates repertoire. It is concluded that Pilates, as one component of a complete program of care, can be an effective and valuable aid in the treatment of patellofemoral pain.

Lumbar hyperlordosis is a faulty posture in which the curve of the lumbar spine is increased. This can be caused by a variety of behavioral or congenital movement patterns or predisposed anatomical structure; but in all cases of lordosis, the pelvis is always in an anterior tilt. The anterior tilt of the pelvis resonates to the muscles surrounding the pelvic complex, resulting in tight hip flexors and back extensors, and weak abdominals and hamstrings. Tariq has an average case of lumbar hyperlordosis, and exhibits all of its characteristics. The goal of his conditioning program is to reduce and possibly correct his lordosis of the lumbar spine. By targeting certain muscle groups, and varying the emphasis from strengthening to stretching, the propsed conditioning program will be of great assistance in finding better alignment and harmony throughout the body. The Pilates program is designed to help Tariq reach his fitness goals, while keeping his lumbar hyperlordosis the priority in the selection of exercises.

In this paper, we will explore the benefits of Pilates during pregnancy. Pilates in great for strengthening the pelvic floor which helps with childbirth and bladder control. The deep abdominal conditioning of the transverse abdominal muscles helps with pushing during labor and regaining abdominal strength post natal. Learning the breathing and relaxation techniques of Pilates teaches the pregnant woman to feel centered throughout pregnancy and in the delivery room. Posture assessment and strengthening keeps pregnant women stronger and taller as their belly grows and their center of gravity changes. The over all body conditioning and toning of Pilates keeps pregnant women stronger during labor, it helps them maintain a positive body-image before and after birth and it aids in a speedier recovery.

Osteonecrosis (ON) is the destruction (necrosis) of bone tissue (literally dead bone). It is a not uncommon, often progessive disease, caused by a decrease in the blood flow to a bone as a result of which the bone is unable to replace the cells that are dying off in the usual course of events. Because the bone cells cannnot be replaced (at leaset at a fast enough rate), the bone weakens, degenerates and may crack or collapse. Joint pain is the primary symptom. It is a chronic pain, usually occurring when standing, walking or litfing. The pain becomes worse as weight is put on the bones or joints. Other symptoms include joint stiffness and limitation of motion. ON affects approximately 20,000 new patients per year in the United States. Typically the patients are between 20 to 50 years old with the average age in the 30's.

This paper examines the spinal condition, scoliosis, and specifically how Pilates can be used to manage the condition and the steps needed to create a proper conditioning program for someone with scoliosis. Scoliosis is a condition where there is a lateral curvature in spine and tightness and weakness are developed on each side of the spine. Muscles imbalances are developed and Pilates is very valuable for this because it works througth the imbalances in the spine and body. Lynda Chalmers is a client that suffers from scoliosis and she is observed and put through a program to show what type of exerciese to do and the reasons for the exercises to create more balance in her spine and manage the condition. Pilates is a very beneficial program that benefits a number of conditions, works the body as a whole, and creates an unbelievable awareness and understanding in the body. 

When one is trying to apply the mechanics of the ankle and foot to dance, there are several technique areas that deserve more discussion. One of these is the issue of achieving the desired aesthetics and placement in demi-point or pointe positions. Another issue is achieving desired foot placement when the knees bends, such as in plies. In ballet, still another important concern is the introduction of point work. The peroneus brevis shares a similar proximal line of pull to the peroneus longus, and so it also assists with ankle-foot plantar flexion and is a prime mover for foot eversion. The peroneals' line of pull also enables them to produce abduction of the forefoot, a motion used by dancers to create a beveled foot, a commonly used position in many ballet and some modern schools of dance. The use of the stirrup muscles for a proper function for inversion and eversion is crucial for ankle-foot action in dancing. This case study presents a corrective approach to strenght of the stirrup muscle to aid the many actions of the feet in a balanced manner. The surgical procedure was the right foot osteotomy 1st metatarsal, arthodesis 2nd digit right foot, arthosplasty right 3rd and 4th digits, tenotomy and capulatomy right 2nd, 3rd and 4th metatarsals phalengeal joints.

This paper has been prepared to assess whether or not the Body Arts and Science International (BASI) method of Pilates and specifically the block system thereof, is helpful in managing the pain associated with Endometriosis. I have chosen to work with Lee Selma, a 35 year old professional woman who was diagnosed with endometriosis at the age of 26. Desperately wanting to manager her pain without the use of harsh medications or surgery, she agreed to begin an extensive practice of the Body Arts and Science International method of Pilates in September 2009. Although balance of the entire body was paramount, attention was directed to specific exercises from the abdominal block, full body integration (1) block, the back extension block and the stretches block. As a result, Lee has seen a reduction in pain, and she's also become stronger, and more cognizant of her entire body as a whole.

The purpose of this paper was to validate the effectiveness of Pilates as the rehabilitation method for lessening recurrent pain associated with low back problems (LBP). An individual that suffered from low back pain (L4-S1 level) was submitted to an eight week Pilates program that consisted of two hourly sessions per week. A comprehensive measure analysis was carried out prior and after the program to identify and compare changes in the level of pain, activity limitation, both physical and psychological factors. According to the results, Pilates program proved to be effective in strenghtening back extensors, developing better core control and education the activation of Transverses Abdomenus (TA), which ultimately lead to decrease in daily activity limitations and, consequently, improved the overall psychological state. Additionally, a postitive change in energy level (vitality and vigor) has been recognized. Pilates training program appears to be a viable method of exercise in improving the management of LBP. Further research with larger sample is encouraged to further examine the effectiveness of Pilates for solving lower back problems and reducing associated pain.

Many people think that Joseph Pilates created Pilates for dancers or that he was a dancer himself, but this is not true. Pilates was first used to help the disabled and sick during WWI. Even though Pilates is for everyone, it can be especially useful to individuals who use their bodies as part of their daily lives or professions. Therefore, Pilates can play a key role in dance teachers cross training. Dance teachers have a difficult time maintaining their body’s health so that they can remain fit for the entirety of their career. One would think that since dance teachers have to be on their feet and moving throughout their workday that they should be in excellent health, but this is far from the truth. Dance teachers just like others have postural problems, misalignments, and neuromuscular patterning and need to train their bodies to correct these issues. Pilates is the training solution for dance teachers.

Hyperlordosis is an exaggerated curve in the lumbar spine in which the lower back curves inwards more than it would naturally do. The spine needs a natural curve to function correctly due to the shape of its individual bones (vertebrae), but too pronounced a curve places stress on other parts of the spine and can cause pain. By strengthening the spine and abdominals and stretching the spine and hamstrings, the spinal curvature can be normalized or reduced. Consistent, weekly Pilates programs have proven to be effective, as explained in this case study.   

This paper deals with the creation of a Pilates rehabilitation program for a male footballer who had anterior cruciate ligament reconstruction surgery. It begins with an anatomical study of the knee, including its biomechanical movements, and a study of the ligaments and their function. That is followed by a description of the surgical procedure and the treatment that preceded and followed the surgery. A post-surgery posture assessment aided in the setting of short- and mid-term goals and, once those were set, the program was constructed.  The decisions for the progression of the work were based on observation and communication with the client.    

This paper illustrates how sound therapy, begun in a timely manner, can benefit both the outcome of surgery and post-surgery recovery. The user case discussed in this paper is that of Maria, a very dedicated teacher and an athletic person, who was confronted by the rupture of her Anterior Cruciate Ligament in her left knee. Maria was able to progress from simple floor exercises to more advanced and difficult repertoire on the Pilates apparatus. Eventually, she regained full use of her leg and returned to her regular activities.

Surfing is a dynamic sport which places many demands on the body. Muscle and joint injuries can be linked to carrying bulky surfboards, prone and knee paddling, and the postures related to actual wave riding. This research focuses specifically on prone paddling and the stress it puts on the shoulders. Most traditional strength exercises pay little attention to the intrinsic musculature that stabilize the shoulder and scapula and externally rotate the arm - which is exactly what surfers need most for their shoulders. 

The contribution of the Transverse Abdominus (TA), Internal Obliques (IO), External Obliques (EO), Pelvic Floor (PF), and Multifidus muscles to spinal stability (particularly lumbopelvic stability) has been well established.  This paper discusses the TA, IO, EO, PF, and DM muscles, with particular focus on the DM muscles, and how Pilates can specifically address weakness, improve strength, and improve function. 

Many people experience foot pain, whether from shoes that are too small or incorrect biomechanics of the feet or any of the myriad other causes. Plantar Fasciitis, the most common cause of pain on the bottom of the heel, according to the American Academy of Orthopedic Surgeons, occurs when the strong band of tissue that supports the arch of the foot becomes irritated and inflamed. Whole-body Pilates for correct alignment and improved balance and focussed foot exercises could go a long way towards alleviating the pain of plantar fasciitis and possibly avoiding surgery.

While working at the  Weill Cornell Medical School’s Iris Cantor Women’s Health Center , I met many post-mastectomy patients suffering from shoulder strains and other symptoms, including extreme tightness, pain, and very little range of motion in the shoulder girdle. Virtually all speak of decreased pain, increased range of motion, increased strength and a better quality of life after physical therapy. But without a continued program of mobilizing and strengthening the effected tissues, the symptoms are liable to return. Pilates is an excellent way for post-mastectomy patients to maintain a healthy and balanced body.

Pilates can greatly enhance the quality of life of the elderly segment of our population. Through Pilates, with its focus on balance and strengthening of ligaments, tendons and joints, older adults have the opportunity to increase their level of functional strength and improve the efficiency of daily life. An individualized program that concentrates on proprioceptive biomechanical awareness, balance, proper gait pattern, and postural positioning and addresses faulty motor strategies (compensations) which have developed over a lifetime can improve confidence and provide better balance, strength and flexibility when performing everyday tasks.

Rheumatoid Arthritis is an autoimmune disease that causes inflammation in the lining of the joints and/or other internal organs.  While the disease has a negative influence on fitness, sufferers from the condition can benefit from managed exercise. This paper discusses exercise recommendation for people with Rheumatoid Arthritis.