Excellent question! The quick answer is spinal flexion exercises are a risk to seniors or those with osteopenia.
Check out these statistics:
One in every 2 women and 1 in every 4 men aged 50 or older will suffer an osteoporosis-related hip, spine or wrist fracture during their lives. (National Osteoporosis Foundation 2005).
Among women over 50, 1 in every 2 who walk into your exercise classes has low bone density and is at risk for fracture. (NOF 2005).
WOW! With stats like these there is plenty to learn in order to design a safe mat class with appropriate exercises for these populations.
Although Pilates is great for improving core strength and postural alignment, many Pilates mat exercises focus on spinal flexion (100’s, roll ups, rollovers, rolling like a ball, bicycles, jackknife, to name just a few). Spinal flexion is problematic because the area at greatest risk of fracture is between the scapulae at T6, T7 and T8, the location affected when performing many of the popular abdominal forward flexion exercises! However, spinal extension is safe. FYI, other sites having greater potential for fracture are the hips and wrists.
To read much more on this topic and for further education, I’d like to share the following excellent resources:
Sherri Betz, PT, http://www.therapilates.com/index.html
Article: “Modifying Pilates for Clients with Osteoporosis”,
April 2005 IDEA Fitness Journal
Rebekah Rotstein, http://incorporatingmovement.com/
Article: “Osteoporosis and the Abs”
Sara M. Meeks, PT, http://www.sarameekspt.com/
Book: Walk Tall! 2nd edition
Susan E. Brown, PhD, http://www.betterbones.com/
Hope this is helpful. Good luck!
I third Peggy. Because of decompression to the spine, and often poor postural habits/weak muscles, working in neutral spine (spine twist, half rollback, toe taps, bridge, single leg stretch & others without curling up, quadruped and side lying positions) and in extension will be the safest and most rewarding. If you are worried about wrists (in quadruped) you can modify the exercises by having them on their forearms (and triple the mat to protect the knees).
You have many suggestions to help you.
I believe that the exercises will help slow the progression of bone loss; just, start out slow and easy in the beginner format with less ROM. Keep a close eye on the clients and make sure to keep open communication with them for any signs of difficulty and poor form. Do not let them lift both arms or both legs simultaneously, either. Have you tried using thick, soft or multiple mats on the floor?
Not to mention, how many of us have disorders that we are not aware of?
Good luck and enjoy keeping the seniors healthy.