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!