Knee Pain and Stiffness – How You Can Be Pain Free With a Combination of Pilates & Physical Therapy

Are you using the handrail more and more often when you go down the stairs. Are your knees failing you? Registering for a Pilates instructor course is the best move in starting to change your lifestyle.

More people are now seeing their doctors because of painful joints, muscles and tendons than for the common cold, and the knee joint is responsible for over 20 million doctor visits each year in the US alone. Your knee plays a major role in the chain of weight bearing in the leg. It has to respond to ground forces from below and the load of your body from above. It is a relatively simple joint, but it has to be ready to quickly react to force from the ground while balancing the load of the rest of the body at the same time. Your knee is at the mercy of what’s going on in the joints directly above and below: the hip, pelvis, ankle and foot.

Although there are many reasons for knee pain (arthritis, meniscus and ligament damage for example), long term relief of knee pain has to start with an assessment of your whole structure. This assessment begins with your feet to see how they influence the alignment and forces at the knee. Any joint is only as good as its structure, and poor alignment in the feet and ankles has a negative influence on the knee, creating muscle imbalances and eventually pain and stiffness.

The hip joint also has a similar affect on the knee – poor mechanics and muscle imbalances in the hip creates problems for the knee. And because the socket of the hip joint is formed by the pelvis, it has to be aligned correctly too. In fact, when doing a full assessment of the knee, the whole body must be evaluated, since any structural imbalances in the body can affect the knee’s ability to function.

The good news is that a well balanced Pilates-based Physical Therapy program addresses the whole body. Pilates is a recent addition to many Physical Therapy programs and is rapidly growing in popularity throughout the world. Combining Pilates with Physical Therapy will improve your body awareness, alignment, strength, flexibility and balance. You’ll learn how to move with more efficiency and less pain.

At first, new and balanced movement habits feel weird and unfamiliar because they’re foreign to your nervous system. Working with a skilled Pilates trained Physical Therapist will help you understand your own unique postural and movement habits and help you practice correct patterns effectively.

Here are a couple of things you can do right now to find out how your knees stack up:

1. Stand in shorts, barefoot in front of a full length mirror and look at your leg alignment. What do you see? Are there any funny angles between your hips and your knees? What about your feet? Do you have an arch on the inside of your foot? Can you see that your whole leg influences the alignment of your knee? This includes the alignment of your pelvis, since the pelvis is the top of your hip joint. Be aware that when you do any exercise “for your knees”, you must also consider the rest of your body, especially the foot, ankle and hip.

2. While standing, imagine a line going through the center of your leg from your hip joint, through the center of your thigh, your knee joint, the center of your lower leg, ankle and out the 2nd toe. This is the ideal alignment for your leg. A word about your hip joint: did you know that your “hips” are not the wide bones of your pelvis, but the place where you crease when you bend your knee towards your chest? This is where your heel should line up when your foot hits the ground when walking. The hip joint itself is really quite narrow – about the same distance apart as your sits bones in the back.

3. When you stand, walk and exercise, the alignment of your whole leg affects which muscles you use to move. And the way you use your muscles strongly influences your alignment. Be very aware of keeping correct alignment from your pelvis to your foot – hip to 2nd toe – so that you create good balance around your knees. If you do exercises like squats and leg press, do you pay attention to your leg alignment? Your knee program will be far more effective if you do. Remember that pain is your body’s way of telling you that something’s not right, so if you can’t modify your position to relieve the pain, skip the exercise. Remember also that not every “recommended” knee exercise is right for every knee – you need to find out what’s right for your knees.

The point is that your knee pain is usually just a result of the alignment you set up from the ground (you feet and ankles) and the load you put on them from above (your hips, pelvis and trunk). Figure out how to de-stress your knee joints by changing your whole-body alignment and your knee pain and stiffness will resolve.

If you have knee pain and want to find out how to get relief, see a Pilates trained Physical Therapist who will assess your whole body, rather than looking only at your knees. A Pilates exercise program, with a home routine, is a great way to reduce pain and stiffness in your knees, and a 2nd pair of experienced eyes will help you sort out your unique imbalances. Then you’ll know exactly what to do for YOUR knees.

How do you find a Pilates trained Physical Therapist? Many PT clinics now offer Pilates, and many Pilates centers employee Physical Therapists. Check your local PT clinics and Pilates centers. And make sure that your practitioner has completed a comprehensive Pilates training program.

Copyright © Park Meadows Pilates 2008

Lindy Royer is a licensed Physical Therapist. She was introduced to The Pilates Method in the late 1990s and completed Pilates Certification in 2002. She had added Pilates to her Physical Therapy practice and is a Pilates educator and Master trainer.

In January 2005, Lindy opened Park Meadows Pilates and Physical Therapy in Lone Tree, CO. Park Meadows Pilates and Physical Therapy offers a program that seamlessly transitions patients from rehabilitation to fitness. The combination of research-based Physical Therapy and Pilates in private and group sessions improves outcomes and provides an environment for permanent pain relief.

The integration of Pilates into Lindy’s Physical Therapy practice has had a significant impact on the level of successful recovery she sees in her patients. Because Lindy has had her own health and physical challenges, she approaches her practice from a different perspective and uses her experience as a former patient to help others.

You can find out more about Pilates and Physical Therapy at:

Article Source:

Article Source:

Pilates Breath – The Goal That Keeps on Giving

Pilates is huge. Not in the cultural sense. Pilates was somehow everywhere before most people had even heard of it. Nor do I mean financially, that phase seems to have peaked. No, the hugeness I refer to is that of the system itself. A lot of folks might not realize how big the total body of the work is. Or, that the different routines inter-relate to support each other. Six different machines plus the mat, three to five Levels and Lengths of routine each, the volume of choreography and information is equal to a Black Belt in a respectable Martial Art. Good nutrition is probably the single most important factor in determining health that why we need help with nutritionist Northern Beaches.

Consider also, that the work evolved over decades to support consistent ideals. Meaning to say, if you are struggling with an intermediate or advanced mat exercise, there will very likely be a reformer or Cadillac exercise designed specifically to help you. The system is so wide that there are multiple directions one could take one’s study of Pilates. And, it can be confusing. Navigating the hugeness means having a goal, a relevant goal, maybe a series of relevant goals. Knowing where you want to go is as important as starting at the beginning.

Pilates, like any worthwhile pursuit, has layered goals. What one strives to “master” today may be no more than a prerequisite for next week’s study. Some goals we transition past and never look back. When was the last time you practiced your times tables? Other types of goal are never met, simple at first but progressively more difficult to maintain. “Keep your hands up.” is hardly news in the first seconds of a boxing match, but it turns into Rocket Science as the rounds progress. Without that basic skill firmly in place… other skills will lose their relevance. The Boxer becomes vulnerable.

Pilates has a similar vulnerability. The more advanced moves are as tempting as they are complicated. We tend to want to notch our belts as we did on the earlier moves. But those moves were simpler, and the incorporation of good breath goals are stressed quite clearly. The very structure of many basic Pilates movements helps to show the need for breath as a tool, and not merely a metronome. “Spine Stretch” and “Roll up” are both good examples of this for different reasons.

“Spine stretch” is obscure and a simple “inhale when you do this/exhale when you do that” will not help you find the always subtle, and initially distant, sensation of the Nuchal Ligament. However, if you demand that both inhale and exhale display classical hallmarks of intentional breathing as, or before, the outward movement begins, then you will at least have a direction for your efforts even if they aren’t immediately rewarded with a clear feeling. The exercise itself helps us focus on the mechanics of breath.

Look at “Roll up”. For most of us, this exercise is just hard enough that we can only do it if our breath really helps. Saying your exhale at just the right time, like a line on cue, is not going to get your torso up off the deck. An actual redistribution of body weight is needed for most of us, and until we stop “trying harder” and let the breath lead, we are doomed to flop and arch like a fish (Well I did, and I’m pretty strong.). A Perfect Basic Exercise because success, and ohh, let’s call it “pre-success” are self evident. If the Client/Practitioner is striving or tensing in a possible injurious way, then that will also quickly reveal itself. Again, Seemly the definition of a Basic Exercise.

The Vulnerability I spoke of lies in the more advanced moves. As the complexity and difficulty increase, the self corrective aspects decrease. Its the standard ” ’nuff-rope-to-hang-yourself problem “. Please examine “Arabesques” in the Advanced Reformer. There is potential for repetitive stress damage to the hip, lumbar, and shoulder. These damages could take months to show themselves, and you would have been enjoying your workout the whole time. Problems of this nature ought to be solved by Breath. Using the inhale or exhale to align the skeleton before movement lends protection from as well as sensitivity to distortion. The original sensations of proper skeletal alignment are stored within a focused, almost ritual Breath.

Retaining these sensations is the best way to protect yourself as you progress, and the breath is always there to provide guidance. Without that guidance, you cannot know if you are safe or even correct. It is a layered goal. Don’t leave home without it.

Now, all of this presupposes that somewhere along the line you were taught an ideal breath to create alignment and activate your core. That you practiced enough for it to morph from choreography to sensation. That you own it at a deeper than verbal level. This is super important because your verbal learning parts are always busy at Pilates Class.

The necessary relationship between core and alignment need not be re-proven. It is how these two triangulate with the breath that needs to be more closely observed. The core is forever linked to breath by a simple fact. A person’s “Core” is like Big-foot, it cannot be photographed. It doesn’t exist in stillness, there are no muscles you could lock into place to display it. Your “Core” is more of an event than a collection of anatomy. It only manifests during motion like climbing or running or jumping or, best of all, breathing. The essential support for the essential movement. The “flow” (a Pilates buzz word) or counter-tension in the low frontal torso is a response to breath.

The primary muscle of inspiration is, of course, the diaphragm. Neither the core (a list of muscles and tendons) nor the “Core” (a holistic event) respond to the Diaphragm. The Diaphragm exerts no upward force and does not expand or contract the Ribcage. Those functions are served by the secondary muscles of inspiration and these are the muscles that trigger core response. Furthermore, the greater the total percentage of secondary inspiration muscles activated, the greater the total percentage of core muscles activated.

Whole careers (mine included) are based on describing this phenomenon. My favorite visual metaphor is of a mushroom cloud, an omnidirectional expanding plume driven ever higher by an arcane column of force, oh yeah, that’s the stuff. In reality, its kind of the opposite. Your Ribcage is cleverly anchored to your Spine, Shoulders, and Head and the secondary muscles of inspiration pull it multi-directionally away from the Diaphragm’s tug. This enhances the basic function of the Diaphragm and creates more expansion in the Ribcage. It also serves to counter the downward pull so you don’t slump. Because expansion and contraction of the Ribcage are necessarily linked to the Ribcage traveling up and down the Spine, even a rudimentary study of improving Ribcage volume (not total breath volume) will enhance Spinal alignment. Simply put, you could stifle this monorail-esque traveling up and down the Spine of your Ribcage, but then you could never reach or improve your Ribcage Volume potential. The up/down is structurally built into the expand/contract of the Ribcage. The longer and straighter your Spine, the further up your ribs can go, the further up, the more they can expand. So, it follows that breath and alignment are permanently linked, but it goes deeper than that. A well studied breath can create significant therapeutic effects in and of itself. Consider that the maximally expanded Ribcage shows the least imprint of tension, stress pattern, or injury. An exhale begun from this point has the best chance of ending in an optimal contraction. A well studied exhale can reset the scapula and neck, lessening the unwanted imprint. Even the Diaphragm itself, as it resets during the exhale, gives direction to the Spine if not actual support.

A complete list of the secondary muscles of inspiration would invite tepid debate and violate the spirit I’m trying to create. Namely, that you should/ought/must spend some shirtless time in front of a mirror isolating, recognizing, and recreating the effect until some measure of clarity and confidence develop. Ya’ know, practice.

My description shall be inexact and imperfect, try to have fun with it. Get all skins to the waist in front of a good, well lit mirror. Since we are studying the inhale first, we’ll need to finish a pretty good exhale as a jumping point. For our purposes, a good exhale is one that vents air without losing any height. Not as easy as it sounds. The mirror reveals that our exhale tends to slightly lessen bearing, bust, and stature. Just keeping your full height as the air flows completely out is a good challenge. All tall and empty, your inhales should begin as I describe. If it doesn’t, one possible reason might be that having pursued your exhale into unknown territory, your inhale is coming with awkward suddenness. A bit of practice will help find the difference between a complete exhale and an intense one. At the beginning, your pre-contracted ribs will seek to expand due to stored potential energy. Allowing them to do so helps start the process which we hope to enhance. The low belly will draw inward and upward, keeping pace with the rising Ribcage. This effect will persist for less than half the total inhale, and may be staccato or intermittent. More practice will smooth this out until each studied inhale has a gut-in and a gut-out phase, with the first phase ending as the ribs stop expanding. The directionality of the guts during the gut-in phase is “Core”. Elongating this core active, gut-in phase is the main benefit of Pilates, and also the key to progressing in it as well. It may feel goofy at first but, you can increase your personal quotient of Ribcage expansion.

The mirror is vital at the outset when the sensations of progress are unfamiliar. Seeing breath happen real-time aids in rooting out unnecessary tension patterns (Hulk Smash!) normally present during exertion. Various muscle groups may need to relax against habit so you can see/feel the Ribcage expand or the “Core” manifest. In other words, an extra big Ribcage does not require shoulders like football pads. Use that mirror!

You’ve already absorbed the key aspect of a good exhale, so I’ll just elaborate a bit. The further your exhale progresses without a loss of height, the more correctly you have contracted your Ribcage. Begun well, the pattern is easy to follow. The mirror should report greater release of Trapezius and most other neck area muscles. What the mirror might not reveal is the upward resetting of the Diaphragm, although its productive effects may be visible elsewhere in the Spine.

Good inhales beget good exhales, but it will take focus time to modulate the intensity and chain these events into a series we Scholars call breathing. Until this goal is achieved, its wise to avoid the complicated or dangerous exercises because the whole point of the advanced work is to retain the benefits of proper breathing through the more distracting or difficult challenges.

Breath is the goal that keeps on giving, and the reason why I never accept money from anyone for their first Pilates session. I want to change their view of Life, the Thoracic Universe, and Exercise. I don’t want to talk about skinniness or sturdiness or serenity or even layered goals, I just want to talk about breath.

Eric Schimel, co-author of Pilatez Comix The Basic Mat, is a Kung Fu Black Belt and Pilates Instructor currently based out of Austin Texas. A gifted poet/playwrite, he completed his Pilates Training with Wendy LeBlanc Arbuckle, founder of the Pilates Center of Austin, in 2000 and has since taught both throughout the USA, and internationally at Espace Pilates, a prestigious studio in Boulogne, France as well as in the Philippines. Sought after by both beginners and professional pilates instructors alike for more extensive study, Eric has a unique approach to pilates philosophy he coins Pilatez. Pilatez Comix The Basic Mat is available in both Hard Copy and Digital Download editions. Want to find more articles, blogs, and podcasts please click here. [].

Article Source:

Article Source: