Case Study: Working with a Vietnam Veteran
A Pilates instructor shares her approach to training a client with special needs.
Holly Geringer, owner of AnyBody Pilates in Portland, Oregon, teaches a broad spectrum of people. Her clients include Olympic and elite athletes, people new to exercise and clients with injuries, illnesses or disabilities.
Greg arrived at my studio in pain and in a wheelchair. Thirty years ago he broke his back during a “night jump” in Vietnam. A night jump is when a soldier jumps from a helicopter under cover of night, opens his or her parachute and lands blindly. Unable to see in the darkness, Greg hit the ground with his legs completely straight, sending a shock wave through his body, which resulted in a debilitating spinal injury.
Amazingly, after several surgeries, Greg was able to function quite well. He cycled, walked and gardened. But as the years went by, his spine began to shift, becoming so off-center it threw his entire body out of balance. This eventually caused unbelievable shooting pain, paralysis in one leg and numbness in the other. At this point he became bedridden.
Three years passed. During those years Greg underwent countless tests and surgeries. He saw dozens of doctors and specialists. Finally, he found an excellent physical therapist who helped him get to the point where he could sit with minimal pain for 1 or 2 hours a day. This may sound like small potatoes. But imagine how freeing it would be to spend 2 hours a day sitting upright after spending more than 3 years lying in bed!
Intake and Goal Setting
This is when I met Greg. Referred by his physical therapist, he came to me with the goal of living a more independent (and less painful) life. It was a slow and arduous process. When we started working together, Greg needed his wheelchair to move from one piece of equipment to the next. He was neither stable nor strong enough to walk even a few feet without being overwhelmed by pain and having his legs give out. Initially, Greg’s weekly lesson was only 20 minutes long. I taught him “Pre-Pilates”–gentle strengthening and stabilizing exercises that Joseph Pilates created for people who were not physically ready to perform regular Pilates exercises. My main focus was to create more symmetry in Greg’s body, thus reducing his pain and increasing his stability and balance.
As Greg grew stronger, we increased his lessons from 20 minutes once a week to 30 minutes twice a week. He began performing regular Pilates exercises and became strong enough to use some of the equipment. The reformer was key during his workouts. Greg was able to lie down, which prevented him from becoming too fatigued. The shoulder blocks, headrest, foot bar and some of my cues held his body in a more symmetrical position. He began in third gear (preventing too much flexion in the knees) with one spring, sometimes two.
All of the exercises I taught Greg required him to use both sides of his body evenly. On the cadillac, he used the roll-back bar with his feet placed evenly apart. Although he still arrived and left my studio using his wheelchair, at this point he was able to walk with a cane from one piece of equipment to another. He noticed that his pain, although still present, had diminished in intensity. He also found himself able to sit in an upright position for longer periods.
As the difficulty and complexity of the moves increased, I began teaching Greg stretches that lengthened his tighter side and exercises that strengthened his weaker side. We finally got to the point where he was able to perform a full basic reformer workout with a few intermediate exercises to add some spice. His reformer workouts were in first gear (just like any other client’s) and used all four springs. By then, he was coming in three times a week for 30–45 minutes each time. In addition to using the reformer and cadillac, he learned balance exercises on the electric chair (up front, up side, press down, etc.) and focused strengthening moves on the wunda chair (mermaid, pumping, pull the pedal up, etc).
Joy in Strength and Balance
I will never forget the first time I saw Greg walk from his car to the studio. I felt so proud, and deeply moved. Although he was still using his wheelchair for most activities, he was strong enough to go grocery shopping, run errands and go out to lunch with friends. Over the months, his stability and balance continued to improve, and his pain lessened.
When Greg and I first met, he couldn’t even walk around the block. Now, he walks 2+ miles a day, 3 or 4 days a week. He can take his dog for walks, and he’s gardening again. I am proud and happy to have played a part in Greg’s story. He is truly an incredible human being with endless determination, focus and drive. He could have given up long ago and resigned himself to a life of solitude and pain. Instead, he continues to rise above his injury and to work toward living a happy and independent life!
Brent Anderson PhD, president and CEO Polestar Pilates Education, is a physical therapist and orthopedic certified specialist. He specializes in performing arts medicine and Pilates-evolved...