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Posted by on May 20, 2013 in Becoming a Teacher, Madeleine Backlund, Pilates, Q & A | 0 comments

Questions for Madeleine 2

Questions for Madeleine 2

Question:

Dear Madeleine

I teach a young, male 27 years old client, with a severe shortness of hamstrings, back and hips.  We have done already lots of great work that significantly increased his mobility through the spine, hips and shoulders.  However the tightness is not letting go regardless of foam rolling, ball (small tennis ball under hamstrings) rolling, working the muscles at full range with leg springs (supine series on cadillac as recommended by physiotherapist – spinal flossing), etc He said his dad was this same but his physiotherapist and doctor didn’t confirm any inherited condition.

Where can you see it most:

  • roll down still only half way down with knees bend, flat lower back  (which articulates happily in abprep)
  • supine table top legs – very difficult to maintain and bring knees over hips is almost impossible (the spine stays supported though)
  • legs in springs on reformer, still have to use support under pelvis to keep the legs up

He’s got good abdominal strength on both levels, is it really possible that someone could be inherently so tight in the muscles (also add his lats to tight bits) that regular exercises would not give release (he also swims once a week x 50 laps).  This is no doubt a complicated case and I have tried a few different approaches but perhaps looking from outside would give an opportunity to see something I haven’t considered.   Please let me know what you think.

Answer:

I see numerous imbalances when it comes to the human body. Don’t we all?

Yes, some people have very tight muscles…and men seem to have tighter hamstrings then women. There’s tight and there’s short. There’s a DIFFERENCE.

Generally if one muscle is tight on the outside of the leg, others are as well.

If TFL and ITB are tight, then Biceps Femoris (outside hamstring ) usually is as well.

If he has tight hamstrings, it’s probably because he is working with a muscle imbalance between:

  • the quadriceps
  • the glut muscles
  • the hamstrings

Is he shortening in the lumbar?

Clients with this pelvic placement usually have over active or shortened hip flexors.  When these muscles are shortened or over active they actually pull the hips forward causing an anteriorly rotated hip. In this scenario, the hamstrings are now overstretched. And here they feel REALLY tight. Think tight—NOT SHORT!

Is your client suffering from hamstrings that are overstretched tight from the pelvis dropping fwd?

Tight hamstrings are weak hamstrings!

Weak, tight hamstrings will develop a compensation pattern that overwork and strengthen the quads, in the end creating a muscular imbalance in the legs.

What job does he do? Does he sit all day long? Do you think he sits and allows the pelvis to drop fwd. hours on end?

Take a look at his gluteus? Are they under-active?  Most probably.

Strengthen gluteus. Make his gluteus the dominant hip extensors

GREAT TIP:

Single leg-squats….. (Stand on one leg and then try to touch something which is lying on the floor diagonally just in front of you)… Assist him – hands on a bit, so he doesn’t fall over!

Work on getting the gluteus really much stronger than the hamstrings.

You really don’t want the hamstrings to do the work that the gluteus should do. Like running, jumping, squatting because with the hamstrings in an already over stretched state, they have to work so hard because they gluteus are inhibited by short hip flexors…and this will leave his hamstrings so tight and he will always complain of TIGHT hamstrings.

Like very tight strings on a guitar.

In this scenario you need to strengthen his hamstrings and then stretch them.

Strengthening has to come first—-So instead of more pull on the hamstrings, we want a “Reflex Release” of the hamstrings by:

  •     Activating the quadriceps
  •     Activating the gluteus
  •     While keeping the spine long

You mention he swims, a lot, so this will explain that he has very strong latts.

Is he a runner? A runner will often have strong quads and tight long hamstrings and run with a pelvis that is tucked under, because he is ‘pulling’ from the front and not rolling and pushing through his feet as he takes his strides.( Using the front part of his feet). That’s another scenario.

NOW, if you have established that his hamstrings are actually SHORT, there can be a numerous reasons for this:

  • Long hours sitting / driving. (Then lots of walking and then stretching is good)
  • Tension.
  • Back problems. Sometimes they become shorter due to a back problem. This is because the hamstrings are trying to stabilize the back. But Hamstrings can also be a contributing factor in back pain. There can be a vicious circle.
  • Lack of core strength. Here the Hamstrings take on the role of attempting to stabilize the trunk.
  • Poor coordination. The hamstrings do the work the Gluteus should be doing.

Here, stretching in itself is rarely that effective unless the other underlying factors are address as well.

But best of all, after having addressed all of the above; Single leg hamstring stretch (leg up on a chair flex and then lean slightly fwd. with a neutral back. You need to build here. We want STRONG and flexible hamstrings which takes dedication and lots of commitment.

If you’d like to ask Madeleine a question please email it to office@pilatestreemagazine.com

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Posted by on May 17, 2013 in Becoming a Teacher, Madeleine Backlund, Q & A | 0 comments

Questions for Madeleine

Questions for Madeleine

Question:

I began working with my client in December 2012, she is athletic and very slim other than her tummy that was saggy and hanging down, anterior pelvis with a rotation as right ASIS was anterior to left. She had tried exercise to tone her tummy but everything affected her lower back/sacrocilliac areas. Three C sections, children are 6, 5 & 1 the youngest is a very big boy that she carries around too much! lower back problems began after first child and had treatment from physio and osteopath. She has been attending weekly group Pilates and private sessions 2/3 per month. Pelvic stability is much better and she is feeling much stronger, abs are also looking more toned. All good other than the pelvic instability issue is still a puzzle, she quite clearly has unstable SIJ still as some side lying exercises cause a shooting sensation down the back of the leg, apparently not nerve muscular, the exercise was doing side lying on reformer in turn out with heel on foot bar, right was good activated gluts nicely, could not do on left. Although pelvic stability is loads better she still struggles to engage lower abs, I sometimes work with a cushion under tailbone. She also finds it really difficult to stand on right leg in a balance, this I found confusing as the right is the stronger, however she was leaning into the right leg which made it impossible to sustain, I did identify this but she was not able to overcome.

I hope this is enough information, i can’t seem to work out what is going on in the pelvic area, how do I properly identify where the weaknesses are and where the instability is. How would you work with this lady?

Thank you in advance.

Answer:

Hi there – A very complicated issue. It is difficult as I have not got the client in front of me and can study her alignment, her gait, her feet and cervical spine/head placement.  Also, if she has attended Pilates group classes in the past and maybe not been “corrected” and picked up bad habits? BUT I am sure you will have seen this by now, so I assume she understands the basic Principles.

What comes first – the instability or the muscle imbalance?

The SI-joint function is depending on a great amount of variables – breathing (diaphragm/psoas-connection) – could be an ascending problem, or a descending problem – stress from organs – or a combination of them all.  Complex!!!

Has she been checked to see if she has a slipped disc in the back? You know that also degenerative arthritic joints in the spine can cause back pain, or a hip problem.  When the body is experiencing pain, muscles tighten & compensate, causing asymmetry & misalignment of joints. Huge force onto the discs when tight.

Pain caused by the psoas (tighter one the one side?) often shows up as lower back pain, because other muscles have to overwork to support the spine.  The force of the tight psoas putting pressure on the lumbar spine can cause the discs to pinch, and causing the QL to really over work on one side and strain, and hence the difficulty with standing up (spinal extension).  The QL and Psoas oppose each other.  A tight psoas makes the QL work that much harder.

Handling of the issue is therefore not an “easy fix” – its lifestyle ( Stop lifting / carrying children on the hip/twisting–and the rest.- It’s like going on a diet – it only helps when you’re on it.  Home work, as in; Be aware how she ‘bends/twists/unloading the dishwasher/washing machine/putting child in car seat etc.  Sleeping positions etc..

It is about muscle-imbalance – stretching and strengthening – plus an occasional adjustment. CORE strength and stabilization is the key. Is there a difference in leg length? Check or see if anyone has checked this.

Is there a mild Scoliosis? This can affect her pelvis and SI joint stability. CHECK or see if anyone has checked this…

Post natal women may have loose ligaments for a long time or the “rebound” after pregnancy when the relaxin has left the body and the ligaments start to tighten up again, the SI joint might become hypo mobile, maybe on just one side, and then an imbalance occur and there might then be a restriction of movement, and this will cause other muscles to compensate.

Some people have more movement of the joint than normal. Maybe she is very mobile in other joints too.

The primary stabilizers of the SI joint are the ligaments of the pelvis. The secondary stabilizers are the muscles which surround the pelvis, the hip, and the spine. Strengthening these muscles can provide stability to the SI joint, as we cannot strengthen the underlying ligaments….but focus on releasing and breathing and super correct any misalignment.

Go slow and build…

This is how I would approach it if she came to me with this issue, but like I said, it is hard as I haven’t assessed her and have her in front of me, so I can only offer the advice below…..

  • Avoid asymmetric loading through the leg or pelvis—-
  • Focus on gait and posture retraining—
  • Bi lateral work; Breathing and releasing of the psoas—She needs to practice abdominal or belly breathing.
  • Work gently and focus on really good alignment—
  • Avoid excessive spinal movement
  • Focus on TVA  and  pelvic floor work— and make sure that she does activate the obliques when necessary
  • Side lying exercises/ Unilateral work might not suit everybody
  • Try to go back to very basics…
  • Cranial sacral therapy may also provide relief
  • Check her leg alignment and feet when on reformer/( NO heavy springs)

Depending upon the level of pain & range of movement, bodyweight exercises such as a supported squat (adapting the depth of the squat & how far she can open her legs) will also improve strength & stability.

Hope this helps a bit.  Take care and go slow and be precise…

 

If you’d like to ask Madeleine a question please email it to office@pilatestreemagazine.com

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