Pilates continues to be a hot specialty in fitness today. How do you assess function levels and develop safe yet challenging programs? We asked Pilates instructors to tell us about their assessment and injury prevention strategies, especially with senior clients.
Creating “A-Ha” Moments
“I do a complete postural assessment that includes balance and movement patterns. I focus on functional fitness with inactive older adults, incorporating low-load exercises for joint stabilization. It’s important to work from the inside out, since most inactive adults have lost a lot of their ability to properly stabilize [their bodies].
“We watch to see if clients can stabilize their pelvis. Can they maintain proper alignment when adding dynamic movements? Assessing how a participant feels is a great way to assess the program, too. We find out if clients are feeling less pain and have more energy after sessions. I frequently ask, ‘Where are you feeling the exercises?’ during the workout, and I watch for proper body alignment. The more clients understand their bodies and movements, the more they ‘feel’ the exercises.
“Age isn’t really the issue—most of my clients have some of the same challenges. I have clients in their 20s who have pelvic-stabilization issues. Everyone has some kind of postural imbalance they can work on. Even if you are working with a highly functional client, going back to the basics is never a bad idea.
“If clients are very active and have no injuries, I add in more dynamic movements and coordination, but only after they have the basics down. It’s important to assess their internal strength and whether their muscles are firing properly. For example, your low back might be strong enough to let you do a teaser, but that doesn’t mean you’re doing it correctly. I find clients have an ‘a-ha’ moment when you break down the exercises and explain how they should feel when they’re doing them. Watch to make sure they’re taking their time during the parts of the exercise that count. For example, when doing a roll-over, it’s possible to swing your legs over and not even feel your abs working. If you slow clients down so they can feel when their abs need to fire to lift their hips, it’s an a-ha moment.”
—Shari Isaak, owner, Isaak Studios, Fargo, North Dakota
Using Props for Challenge and Assistance
“My top three goals for seniors are improving balance and posture, and increasing joint stability. Most of our senior programs keep clients in neutral position (supine, side-lying or standing). The best way to increase or decrease the intensity of a neutral-spine exercise is with small props. Small therapy balls, foam wedges and arcs add that extra challenge to a basic exercise, whether you’re on the reformer or on the mat. [With props,] you make the exercise new and different each time. I also use small props to offer assistance or guidance to make an exercise successful for a client who has injuries or restrictions. When working on balance, I often have clients hold onto a wooden dowel or a foam roller.
“Many of my older adults have a great fear of falling or have actually fallen and injured themselves. This fear can be extremely disabling, so a sense of security is important. It’s crucial to offer positive reinforcement and slow progressions to a balance challenge. Rushing clients and pushing them out of their comfort zones too soon can result in a huge setback.”
—Rachel Algra, owner, Firehaus Pilates, Denver
For more suggestions, please see “Functional Strategies for Older Adults” in the online IDEA Library or in the June 2013 issue of IDEA Pilates Today