When done correctly, Pilates can address an obese body’s structural imbalances and posture; enhance respiration and coordination; and improve how the client views his or her body, which may be the most powerful benefit of all. As with any special population, there needs to be a deep sense of compassion and understanding, great patience and a willingness to shift one’s approach to meet a client’s needs.
The following six principles have been distilled from Joseph Pilates’s work and, while the order and definitions vary among practitioners, the basic concepts are similar in scope and style. For the purposes of this article, the principles are being applied to overweight and obese clients.
Centering. Movements originate from the center of the body, the powerhouse, located between the lower ribs and pubic bone. In an overweight client, there may be mass covering the pubic bone, even in a prone position. Therefore, at first it might be challenging for the client to “find center,” but visualization should help. This can be a good time to introduce the location of internal organs. It is empowering for an overweight person to know intellectually and kinesthetically where the stomach, liver and kidneys are located. (Often, overweight women, when asked, will point to the area of the uterus as the location for the stomach.) Centering paired with visualization may eventually allow for the other five principles to occur.
Concentration. At first, concentration may be very challenging for overweight clients. They are generally not connected to their bodies, so encouraging full-body awareness can be frustrating, overwhelming and overloading to the central nervous system. Begin by asking your client to be aware of the moving body part. If that is too much, ask her to become aware of what is working in her body. In the beginning, it may be nothing, or she may feel nothing. Break this down even more. Try asking, “Is there one molecule engaged/working in this exercise?” Slowly the central nervous system will get on track, as well as the client’s ability to arrive fully in her body, one molecule at a time.
Control. Initially, control may be interesting to monitor. The overweight body is amazing in its ability to adapt. The body compensates by engaging different muscle groups to perform an action instead of using the appropriate biomechanics and firing the accurate muscles. Teach your client awareness so he isn’t “muscling” the movement, but is instead using control and exertion specific to the action.
Precision. While precision is important, it may be more beneficial to focus on what is working for the client instead of what is not working. When you build on the positives, step by step, the body and the mind begin to work in sync. Until your client gains a better grasp of the work, too much detail may flood the client. You must understand how the client learns best—kinesthetically, auditorily or visually. A kinesthetic or visual person may not be able to integrate auditory cues. Use a blend of all of the approaches, notice which ones resonate with the client, focus on what is working and refine precision from there.
Breath. Many Pilates instructors teach very full breathing, using the lungs as “bellows.” Most Pilates moves coordinate with the breath, and it is a key aspect of the practice. You can teach your client how to palpate the collarbone and lower ribs to help her “feel” the breath. Touching the bones, even deep behind the flesh, will let her sense the lungs’ potential to expand. As with internal organs, bringing awareness to the location and capacity of the lungs is empowering. Also, your obese client may have been told to “suck it in” on the inhalation, so natural diaphragmatic breathing may need to be re-established.
Flow. The overweight person tends to hurl his body through space without being aware of the “how” involved in locomotion. Using Pilates equipment can help your client find flow in movement, which may be different from his experience in day-to-day living. Explain that even the space between one movement and another can flow seamlessly. Teaching the concept of flow will add a sense of grace to a body that often feels cumbersome and weighted down. Simple observation by the client can facilitate curiosity and acceptance in a once fearful body and allow for the possibility of safe, flowing, precise movement.
The obese client’s body adapts remarkably well to moving through space; however, anatomically, it is most likely misaligned. Typically, an obese body presents with poor balance, biomechanics and proprioception. Also, keep in mind that the bony landmarks may not be visible in the overweight body. With trust and respect, you can teach your client how to palpate her own body so she gains a deeper awareness that there are bones beneath all the flesh.
The obese client is often forward-shifted in her posture, from the feet to the top of the head. Structurally, this places pressure on the small bones of the feet, knee joints, low back, shoulders and neck. Obese clients tend to be very strong in their legs and sometimes even in their arms, so it is easy to be deceived about the body’s needs.
Another common issue is that plus-size people will “hang out” in their joints, meaning there is a lack of muscular support for the knees, hips and back. The transversus abdominis needs to be “turned on” to provide stability and to support the lumbar pelvic girdle. Joint integrity is weak in the knees, hips, lumbar spine and shoulders. Strength is needed so that the muscles can hold the joints properly. Building strength in the knees, hips and lumbar spine will bolster alignment, allowing the client to move on to other activities. See the complete article for sample exercises and more details.
For additional information, please see “Introducing Pilates to the Overweight Client” in the online IDEA Library or in the November–December 2011 issue of IDEA Pilates Today.