It is not without significance to note that when Joseph Pilates ( a German National) was interred at the Isle of Mann in England during WW1, he was reputedly a hospital orderly who worked with prisoners, and aided in their recovery by attaching springs to bedposts, thus developing the historic precursor to the Pilates Cadillac machine.
Many people enter Pilates training after suffering some acute minor or serious injury. After the RICE phase ( Rest, Ice, Compression, Elevation), it is time for remedial exercise work, despite the human tendency to rest even more, which causes a downward spiral in muscle atrophy.
There are many contraindications or cautions surrounding Pilates exercise for the aging population, and getting the permission of the family doctor is not only preferable but often essential. Some of the most common conditions found in the elderly that require caution are those suffering from Osteoporosis ( where Advanced extreme Flexion exercises such as roll-ups and ball and teaser should be always be avoided, ) or high blood pressure where holding one’s breath in any exercise can cause a rise in blood pressure and the inadvertent precipitation of the Valsalva maneuver; pushups are being a notable example of a specific exercise to avoid… A gentler Pilates routine is necessary and there are many effective exercises that can just as effectively achieve the Pilates teachers’ objectives. Also, clients actively undergoing back treatments, as is more frequent with aging, or with bulging disks should get medical permission, and extreme Flexion or sideways rotation exercises avoided. However since the majority of people over the age of 50 years suffer from bulging discs, the key to whether they are symptomatic is whether the sciatic nerves are being impinged by a slipped disc. In most cases, when nerves have been calmed down, discs can be encouraged to slip back into place through extension exercises and also lubricating synovial fluid by backward and forward sliding motions that encourage cells to regenerate and produce more fluid, making the discs more “ juicy” again.
But the underlying premise to illness recovery is to fix the underlying weakness which caused the injury in the first place. This is where Pilates comes into its own. This means strengthening and improving the flexibility of muscle groups starting with the Core. It is a weak core that plagues the older and sedentary population and who are most likely to complain of back problems, which becomes very visible in the way they walk. We all know of the “ Elderly Waddle”.
The diagnosis of osteo-arthritis causes many older people to throw up their hands in despair, but in actuality, even severe arthritis can be largely nonsymptomatic. The remedy is counter-intuitive because the advice is to keep moving. But armed with a strong core, an early morning hot shower, and a Pilates routine, arthritis may be merely something noted in the doctor’s chart and not a source of pain or a deterrent to movement.
Pilates provides a fast road to recovery after the body has been injured, which includes post-surgical recovery. My own personal favorite example of this is recovery after breast cancer surgery. Breast cancer is not an illness confined to aging, but its frequency dramatically increases over the age of 50 years. The history of Pilates and post breast cancer surgery recovery dates back to some of the earliest work of Joseph Pilates and Eve Gentry, a dancer who had a double mastectomy and regained full range of motion. One of the common misunderstandings about post-surgical breast cancer is that once surgery has been completed, that after the requisite period of rest and recuperation, that the cancer patient’s problems are over. This is far from being true. Twenty percent of patients suffer from lymphedema in their arms, there is pain around the hardening scar tissue and those who have had lymph nodes removed will probably experience a considerable degree of difficulty in range of motion in the arm and shoulder area. The good news is that complete range of motion can be restored. This doesn’t mean that a person will be left pain free or will not have to work diligently at keeping scar tissue stretched out, but it does mean that the student of Pilates does not have to resign themselves to a life of restricted mobility. Even simple exercises like arm reaches with lifting from one’s core, and rotational torso exercises where arms are also used can be helpful.
There are many medical conditions not mentioned here which afflict the elderly with more frequency than the young. The important takeaway is that the aging body is not a lost cause and a Pilates exercise regimen can be designed to ameliorate the effects of medical issues, improving both by lessening pain and increasing strength and flexibility.
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