Sammy’s joy of movement

There are many types of Pilates. Joseph’s original Pilates was antifragile, often standing, military style, which was fast and bouncy. He created the resistance machine, AKA the reformer, to build strength and mobility, helping people overcome movement dysfunctions and to positively self-manage health conditions, chronic pain and injuries. It is thought that his style evolved through the years and that he possibly adapted to the individual, which may explain why many people have a different take on his style. Studying movement was his passion in life and he created something incredible, that has evolved and morphed into the many styles today. I am new to the Pilates teaching world and have huge respect for the experience, knowledge and various schools of thought within the industry, my intention is to express the way I have been taught and why I resonate with this modern Contrology 2.0 Pilates.

From the books I have read Joseph was very ahead of his time! Similar to Tom Bowen (Bowen Therapy) he incorporated aspects of various professional modalities and came up with his own method now called Pilates. Despite being ahead of his time, there are aspects of his teachings which are not in line with current evidence-based sport science literature (naturally). Many schools and Pilates teachers are incorporating a variety of exercises outside of the traditional Contrology and have moved away from some of the teaching principles, in favour of new styles which benefit the clients to achieve inclusion, confidence, more enjoyment, encouraging (fearless) movement and recently incorporating hand weights and sport science principles to build functional strength, stability and mobility and this is what attracted me back to Pilates. I wanted to facilitate rehab / clinical exercises in a fun way. The course has added to previous training, supporting me to creatively layer exercises to ensure EVERYONE can exercise despite injuries, chronic health issues or disabilities.

The classical era placed strong emphasis on aesthetics, working with highly trained dancers and gymnasts, they executed every move with precision, it was a time when Pilates was popular with gifted athletic groups. Following this came the contemporary era, emphasising a strong biomechanical influence as Physiotherapy became heavily involved bringing a clinical exercise model, which reduced the range of motion partly due to fear of injury. It placed a strong emphasis on cueing complex anatomical jargon and muscle activation, as well as specific timing of breath, strict alignment and a highly controlled environment which allowed people to do a set of exercises that needed to be executed / mastered according to the principles before being taught the next set, making Pilates a life-long commitment which was hard to master and widely respected.

All three styles have fantastic results and continue to contribute to the health and well-being of individuals around the world. Pilates styles are now a personal preference. Some people like highly controlled environments and anatomical cueing and aim to achieve contemporary or classical principles while others prefer modern Pilates which is more attainable, uses less complex cues or imagery cueing, is self explorative, empowering, fearless and emphasises strength and fitness principles. Many incredible master teachers are using a range of all three styles to adapt to the people in front of them and this is my long term aim, much like my bodywork style. Choosing your teacher will come easily once you have asked what is important to you.

I am writing this blog, partly because blogging is a huge joy for me, as an introvert. It allows me to write about the things I spend my time studying. I am also writing due to some fears. I have joined the Pilates world at an exciting time, but also during what feels like a huge war. I have experienced many viscous, negative community online group arguments where highly educated people, who have invested a vast amount of time and money into training and gaining experience within contemporary and classical teachings, are understandably hurt, angry and wish to defend their teachings and businesses, beliefs and values, in response to a surge of new physical activity / health papers demonstrating that the population needs to first and foremost get moving for good health, as well as many other findings which go against much of the previous teachings. This has meant that Pilates principles have been watered down and changed beyond recognition to enable more people to meet the physical activity guidelines. I truly empathise with the Pilates teachers who are going through this! I believe that our vibe attracts our tribe and hope that regardless of how we teach, people come for psychosocial support, to move, make friends and work towards achieving their personal best execution of an exercise, regardless of how that looks, regardless of class style.

I have noticed whilst talking to people, that everyone has a very different idea about what Pilates is to them, so I thought I should share my kind of Pilates, so that individuals know before signing up.

My passion is supporting people to move, gain strength through progressive overload and positively self-manage chronic health conditions or injuries. So I am trying where possible to call my work Strength Classes, Mat Work, or Exercise as I am combining clinical exercise, weights, clinical yoga and any exercise that helps individuals gain whole body strength, or to positively manage chronic pain and injuries. I have been making a library of videos for a variety of conditions and although I am choosing not to teach general exercise classes, I am currently working with people on a one to one basis and through the personalised videos I make for clients. I hope to come up with a title which fits my style and respects the contemporary and classical Pilates soon.

So after my ramblings, here are the latest findings from systematic and metanalysis reviews (gold standard repeated and tested trails), which has guided my style of teaching so far…

Based on the best quality, most recently available scientific research into motor learning, pain/injury and exercise recommendations for human health and longevity I prioritise:

  • Load management over form (appropriate layers mean all clients succeed and receive challenge relative to their current capacity)

  • The three ‘C’s of motor learning: build Confidence, provide Choice, easy to understand Cueing (focus on the outcome of the movement).

  • Antifragility - applying appropriate stress to the human body makes it stronger and more resilient, for example; striking the feet during jogging promotes bone growth and strength (btw…it’s vitally important children build the strongest bones possible through impact exercise, so that the base of decline is advantageous into older years… I digress :)).

It wasn’t long ago that Cancer patients were told it was dangerous to exercise. Now studies consistently evidence exercise to increase the efficacy of treatment, reduce negative side effects, as well as improving psychological wellbeing. In some cases it has reduced tumours and we know for certain that exercise alongside an anti- inflammatory diet and limiting environmental toxins reduces our risk of getting Cancer significantly.

Disc bulge patients were told to take to their beds and rest, now we know this is the worst possible thing to do and gentle movement supports blood, oxygen and lymph flow to the area and reduces the fear of movement causing patterns of chronic pain cycles. Exercise has shown to reduce chronic low back pain and reduce acute episodes.

Up to date evidence shows that specific muscle activation does not improve safety / strength output / learning.

(However it is fun to play around with trying to be more efficient and relaxing muscles not needed for movement and to build body awareness)

Evidence shows that exercising with a flexed/extended/laterally flexed/rotated spine is absolutely safe (Osteoporotic clients are a notable exception to this).

(Moreover, it is good to build strength in lots of different positions and regularly change and explore body positions. This reduces the risk of repetitive strain injuries as well as an empowered way for you to discover your personal preferences)

When you breathe (timings) has no known effect on movement efficiency, motor learning or exercise safety.

(However….different breathing techniques are great to explore and play with, breathing cues act as a great reminder to relax during movements, give a focal point and breathwork patterns may become more important when working at a high level or when working in rehab. Diaphragmatic breathing helps to calm the nervous system and feed muscles during work as well as eliciting feelings of post-class bliss). I am personally a fan of cueing breathing, but am mindful not to overload individuals new to exercise and aim to keep things simple and encouraging.

I focus on movement rather than muscles (because load is the reliable predictor of injury NOT form)

(This bold statement just means that according to the latest reviews of clinical studies internal cues - such as glute activation (“squeeze your glutes before executing the movement”) and core activation (“brace your abdominals”)- are not effective for force generation and they do not make a movement more or less dangerous; load is the predictor of injury rather than form. In layman’s terms; you do not need to cue “squeeze your glutes before moving” for the general population because our bodies do this unconsciously when load is applied. Paradoxically, experience of working with clients on a one to one basis clearly shows that when individuals have injuries, health conditions and balance issues, it is a very important to cue things like engage your abs during many exercises, to assist with balance whilst executing movement patterns. There are always nuances and grey areas and never a one size fits all approach. I will always use multiple ways to support an individual to get the best results.

The national guidelines recommend 150mins of moderate or 75mins of vigorous exercise a week of cardio and 2 x resistance sessions. Pilates falls into the strength and mobility category, but more recently has exploded in the fitness world for some HITT style Pilates workouts which incorporate a lot of movements not in the original Pilates repertoire. I believe if Joseph could see the impact he would be immensely pleased with all the different styles and proud of the impact it has had across the world in all of its positive forms.

But why do we care so much?

Resistance training benefits your blood sugar level balance, acting as a resistance against obesity, metabolic syndrome & diabetes by 39%.

It also acts as a barrier against sarcopenia (muscle wastage, over 40), therefore increasing strength, independence, health and vitality into our older years).

Impact exercise (foot striking the floor e.g. hiking) stimulates new bone growth.

Cardio exercise supports the cardiovascular system reducing cardiovascular disease by 60% and heart disease by 35% (BHF, 2023).

As well as supporting the lymphatic system (secondary circulatory system), which picks up fluid around blood capillaries, waste from organs and tissues around the body to filter and protect us (immunity). It also helps to control inflammation.

It supports the endocrine system (correct dose is important….overtraining or not enough stimuli are important factors) for homeostasis and health.

As well as reducing the risk of cognitive decline and improving sleep quality…..exercise when done alongside an 80/20 whole food balanced diet, moving from a sitting position every 20 mins and reducing long term stress has shown in many contemporary systematic reviews to reduce chronic pain significantly.

According to (Zhang et all., 2021), you can reduce all cause mortality by 55% if you :

1) Don’t smoke

2) Don’t drink alcohol

3) Eat a balanced (rainbow) diet, (avoiding ultra processed foods)

4) Do 150mins moderate or 75mins of vigorous cardio sessions. Roughly 3 x 30min strength, 30min cardio per day if needed broken into 3 x 10mins per day to start, aim to include mobility & Neuromotor (balance challenges) = 44% reduced risk of death in the next 10 years.

5) Maintain a healthy weight. 150mins = roughly 2,000 kcal’s per week. Walking 30mins per day can halve all cause mortality by 50% in the next 10 years, according to (Lee et al., 2011).

According to (Wang et al., 2020), increasing half of your moderate 150 to a vigorous intensity reduces mortality by a further 17%.

My message is that EXERCISE IS SAFE, my aim is to build slowly according to your individual needs, layering so that you can do as little or as much as you can, create goals, increase the load incrementally according to your physical and confidence levels to build strength and improve quality of life. I aim to empower you to listen to your body, to provide inclusivity, confidence and fun, so that you can find the joy of movement.

A quick demo of how I work. I am improving the filming and editing side as I go. Its been a big learning curve :).

References

Artus, M., van der Windt, D. A., Jordan, K. P., & Hay, E. M. (2010). Low back pain symptoms show a similar pattern of improvement following a wide range of primary care treatments: a systematic review of randomized clinical trials. Rheumatology, 49(12), 2346-2356

Ashton, R. E., Tew, G. A., Aning, J. J., Gilbert, S. E., Lewis, L., & Saxton, J. M. (2020). Effects of short-term, medium-term and long-term resistance exercise training on cardiometabolic health outcomes in adults: systematic review with meta-analysis. British Journal of Sports Medicine, 54(6), 341- 348
 Barry, V. W., Baruth, M., Beets, M. W., Durstine, J. L., Liu, J., & Blair, S. N. (2014). Fitness vs. Fatness on All-Cause Mortality: A Meta-Analysis. Progress in Cardiovascular Diseases, 56(4), 382-390. doi:https://doi.org/10.1016/j.pcad.2013.09.002
Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., . . . Chou, R. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451-1462
Burgess, R., Mansell, G., Bishop, A., Lewis, M., & Hill, J. (2020). Predictors of functional outcome in musculoskeletal healthcare: An umbrella review. European Journal of Pain, 24(1), 51-70
Capodaglio, P., Narici, M. V., Rutherford, O. M., & Sartorio, A. (2000). Physical exercise in the elderly: Its effects on the motor and endocrine system. European Journal of Physical and Rehabilitation Medicine, 36(4), 205.
Carnes, D., Parsons, S., Ashby, D., Breen, A., Foster, N., Pincus, T., . . . Underwood, M. (2007). Chronic musculoskeletal pain rarely presents in a single body site: results from a UK population study. Retrieved from
Che, X., Cash, R., Ng, S. K., Fitzgerald, P., & Fitzgibbon, B. M. (2018). A systematic review of the processes underlying the main and the buffering effect of social support on the experience of pain. The Clinical Journal of Pain, 34(11), 1061-1076
Dolezal, B. A., Neufeld, E. V., Boland, D. M., Martin, J. L., & Cooper, C. B. (2017). Interrelationship between sleep and exercise: a systematic review. Advances in preventive medicine, 2017
Dolezal, B. A., Neufeld, E. V., Boland, D. M., Martin, J. L., & Cooper, C. B. (2017). Interrelationship between sleep and exercise: a systematic review. Advances in preventive medicine, 2017
Farina, N., Rusted, J., & Tabet, N. (2014). The effect of exercise interventions on cognitive outcome in Alzheimer's disease: a systematic review. International Psychogeriatrics, 26(1), 9-18
Fernandez, M., Ferreira, M. L., Refshauge, K. M., Hartvigsen, J., Silva, I. R., Maher, C. G., . . . Ferreira, P. H. (2016). Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis. European Spine Journal, 25(11), 3495- 3512
 
Firth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., . . . Jackson, S. E. (2020). A meta-review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry, 19(3), 360-380
Geneen, L. J., Moore, R. A., Clarke, C., Martin, D., Colvin, L. A., & Smith, B. H. (2017). Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. The Cochrane
Gordon, B., Benson, A., Bird, S., & Fraser, S. (2009). Resistance training improves metabolic health in type 2 diabetes: a systematic review. Diabetes research and clinical practice, 83(2), 157-175
Green, D., Lewis, M., Mansell, G., Artus, M., Dziedzic, K., Hay, E., . . . van der Windt, D. (2018). Clinical course and prognostic factors across different musculoskeletal pain sites: A secondary analysis of individual patient data from randomised clinical trials. European Journal of Pain. Retrieved from
Hanel, J., Owen, P. J., Held, S., Tagliaferri, S. D., Miller, C. T., Donath, L., & Belavy, D. L. (2020). Effects of Exercise Training on Fear-Avoidance in Pain and Pain-Free Populations.
Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., . . . Sieper, J. (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356-2367
Hernández, S. S., Sandreschi, P. F., da Silva, F. C., Arancibia, B. A., da Silva, R., Gutierres, P. J., & Andrade, A. (2015). What are the benefits of exercise for Alzheimer’s disease? A systematic review of the past 10 years. Journal of aging and physical activity, 23(4), 659-668
Kelly, G. A., Blake, C., Power, C. K., O'Keeffe, D., & Fullen, B. M. (2011). The association between chronic low back pain and sleep: a systematic review. The Clinical Journal of Pain, 27(2), 169-181
Lavin, K. M., Perkins, R. K., Jemiolo, B., Raue, U., Trappe, S. W., & Trappe, T. A. (2019). Effects of Aging and Lifelong Aerobic Exercise on Basal and Exercise-Induced Inflammation. Journal of Applied Physiology
Lee, D. C., Sui, X., Ortega, F. B., Kim, Y. S., Church, T. S., Winett, R. A., . . . Blair, S. N. (2011). Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all-cause mortality in men and women. Br J Sports Med, 45(6), 504-510. doi:10.1136/bjsm.2009.066209.
Lee, D. C., Sui, X., Ortega, F. B., Kim, Y. S., Church, T. S., Winett, R. A., . . . Blair, S. N. (2011). Comparisons of leisure-time physical activity and cardiorespiratory fitness as predictors of all cause mortality in men and women. Br J Sports Med, 45(6), 504-510. doi:10.1136/bjsm.2009.066209.
Leopoldino, A. A. O., Megale, R. Z., Diz, J. B. M., Moreira, B. d. S., Lustosa, L. P., Pereira, L. S. M., & Ferreira, M. L. (2019). Influence of the number and severity of comorbidities in the course of acute non-specific low back pain in older adults: longitudinal results from the Back Complaints in the Elders (BACE-Brazil). Age and ageing.
Linton, S. J., Nicholas, M. K., MacDonald, S., Boersma, K., Bergbom, S., Maher, C., & Refshauge, K. (2011). The role of depression and catastrophizing in musculoskeletal pain. European Journal of Pain, 15(4), 416-422
Martinez-Calderon, J., Flores-Cortes, M., Morales-Asencio, J. M., Fernandez-Sanchez, M., & Luque-Suarez, A. (2020). Which Interventions Enhance Pain Self-efficacy in People With Chronic Musculoskeletal Pain? A Systematic Review With Meta-analysis of Randomized Controlled Trials, Including Over 12 000 Participants. Journal of Orthopaedic & Sports Physical Therapy, 50(8), 418- 430
Martinez-Calderon, J., Zamora-Campos, C., Navarro-Ledesma, S., & Luque-Suarez, A. (2018). The role of self-efficacy on the prognosis of chronic musculoskeletal pain: a systematic review. The Journal of Pain, 19(1), 10-34
Meints, S., & Edwards, R. (2018). Evaluating psychosocial contributions to chronic pain outcomes. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 87, 168-182. Retrieved from
Miller, L. M., & Gal, A. (2017). Cardiovascular system and lymphatic vessels. Pathologic basis of veterinary disease, 561.
O'Donoghue, G., Blake, C., Cunningham, C., Lennon, O., & Perrotta, C. (2020). What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta-analysis. Obesity Reviews
Pacheco-Barrios, K., Gianlorenço, A. C., Machado, R., Queiroga, M., Zeng, H., Shaikh, E., . . . Fregni, F. (2020). Exercise-induced pain threshold modulation in healthy subjects: a systematic review and meta-analysis. Principles and practice of clinical research (2015), 6(3)
Paolucci, E. M., Loukov, D., Bowdish, D. M., & Heisz, J. J. (2018). Exercise reduces depression and inflammation but intensity matters. Biological psychology, 133, 79-84
Petersen, M. W., Schröder, A., Jørgensen, T., Ørnbøl, E., Dantoft, T. M., Eliasen, M., . . . Fink, P. (2020). Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD. Scientific Reports, 10(1), 1-10.
Petersen, M. W., Schröder, A., Jørgensen, T., Ørnbøl, E., Dantoft, T. M., Eliasen, M., . . . Fink, P. (2020). Irritable bowel, chronic widespread pain, chronic fatigue and related syndromes are prevalent and highly overlapping in the general population: DanFunD. Scientific Reports, 10(1), 1-10
Physical inactivity - BHF
Picavet, H. S. J., Monique Verschuren, W., Groot, L., Schaap, L., & van Oostrom, S. H. (2019). Pain over the adult life course: 15-year pain trajectories—The Doetinchem Cohort Study. European Journal of Pain, 23(9), 1723-1732
Shailendra, P., Baldock, K. L., Li, L. K., Bennie, J. A., & Boyle, T. (2022). Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis. American journal of preventive medicine.
Tschudi-Madsen, et al. (2011). A strong association between non-musculoskeletal symptoms and musculoskeletal pain symptoms: results from a population study. BMC Musculoskeletal Disorders, 12(1), 285.
Vina, E. R., Ran, D., Ashbeck, E. L., & Kwoh, C. K. (2020). Widespread pain is associated with increased risk of no clinical improvement after TKA in women. Clinical Orthopaedics and Related Research®, 478(7), 1453
Wang, Y., Nie, J., Ferrari, G., Rey-Lopez, J. P., & Rezende, L. F. M. (2020). Association of Physical Activity Intensity With Mortality: A National Cohort Study of 403 681 US Adults. JAMA Internal Medicine. doi:10.1001/jamainternmed.2020.6331
Wertli, M. M., Rasmussen-Barr, E., Held, U., Weiser, S., Bachmann, L. M., & Brunner, F. (2014). Fear-avoidance beliefs—a moderator of treatment efficacy in patients with low back pain: a systematic review. The Spine Journal, 14(11), 2658-2678
Wroblewski, A. P., Amati, F., Smiley, M. A., Goodpaster, B., & Wright, V. (2011). Chronic exercise preserves lean muscle mass in masters athletes. The Physician and Sportsmedicine, 39(3), 172-178
Zhang, Y.-B., Pan, X.-F., Chen, J., Cao, A., Xia, L., Zhang, Y., . . . Pan, A. (2021). Combined lifestyle factors, all-cause mortality and cardiovascular disease: a systematic review and meta-analysis of prospective cohort studies. J Epidemiol Community Health, 75(1), 92-99.
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Bodywork for pain, conditions & prevention