Can we talk about spinal flexion? It's one of my favorite topics, I'm borderline obsessed with it and I want to, at the very least, raise your awareness about it and perhaps set you off on the same quest I've undertaken; to always teach proper flexion. It's a hefty goal but one I'm sure we can achieve if we're mindful of why it's so very important to the safety of our spines.
It will really help if you wipe the slate clean, setting aside any biases you may have, formed either from what you've been taught, or more probably weren't taught in your Pilates training or that you've developed from your own teaching experience.
In case you're not aware of it, the Pilates method is often the target of criticism from the medical community because it's such a flexion dominant form of exercise. In the PilatesNun.com article titled "Flexion Flexion Everywhere" I explain why Pilates is so biased toward spinal and hip flexion (short answer: humans are biased toward spinal and hip flexion and Pilates is based on natural ranges of motion), but what I'm talking about now is different than that.What I'm talking about now is why flexion can be bad for our backs. And, making matters much, much worse, poorly taught flexion is really really bad for backs.
I see an awful lot of poorly taught flexion, I've certainly been guilty of it myself but right here and right now, we've got to put an end to it. It's a double whammy; Pilates is over 80% flexion and when flexion is taught poorly, all the problems that accompany compression in the spine are exacerbated. That ain't good.
Poorly taught flexion is what the medical community is talking about when it recommends against Pilates. We can't have doctors and physical therapists talking smack about Pilates.
We just can't.
In order for our profession to be respected and for us to have the opportunity to help those who stand to benefit most from Joe & Clara's work, we must have the support of our doctors, physical therapists and other care providers. We have much work to do in order to professionalize our ranks; we must all continue learning as much as we can from as many as we can and we must bring those teachers with too little training up to PMA Certified standards. All that begins with understanding a whole lot about the spine, when it's safest and how Pilates is designed to protect it, not contribute to its degradation.
Also, we must understand that, because Pilates is based on natural ranges of motion, it's got a very high transfer rate. What we pattern in the studio very easily stays with our clients outside the studio. If we teach well, that's a great benefit. If we don't, it isn't.
Precisely and technically, we're going to cover what happens in the spine when it's put into flexion and how to safely teach spinal flexion. Ready? Let's go!
Do you have a copy of Anatomy of Movement and Anatomy of Movement Exercises? If not, go to Amazon right this instant and order yourself up a cheap used set. Every Pilates teacher should have these books and know them well. Anatomy of Movement is one of the books recommended as a reference in the Pilates Method Alliance Study Guide so you need a copy of it anyway.
In the AOM Exercises book, read pages 76 - 80. In those few pages, the authors, Blandine Calais-Germain and Andree' Lamotte, teach us pretty much everything we need to know about how to safely flex the spine.
Page 76. "The straight spine position is the only one that is risk-free for lifting, pulling, or carrying heavy objects. With a straight spine, there is no pinching or squeezing of any intervertebral disc."
What this means for Pilates: When we flex the spine and load it (Tower, Short Spine, a ton of other exercises, etc.) we compress the discs and the spine is at risk. If our spine is not lengthened to its maximum against that loaded resistance, those exercises are actually increasing compression, accelerating the deterioration of our discs and the stretching of our ligaments.
Page 77. "Coordination with bending. In these exercises the spine is bent anteriorly (flexion), posteriorly (extension) or laterally. We are not looking for large ROM (range of motion) in these bending exercises. We wish to avoid compressing the discs, e.e., avoid pinching on the concave side. For this purpose, we will use the braking action of the opposing muscles on the convex side."What this means for Pilates: When we hang heavy on the fronts of our spines on exercises like Spine Stretch Forward, Neck Pull and Teaser, we're compressing the anterior discs and stretching the posterior ligaments.
Page 78. "General Principles: Movements close to the vertical line use mostly the deep muscles. As movements get farther away from the vertical line, the superficial muscles are increasingly solicited. When the arms are held away from the body, both deep and superficial muscles are active."
What this means for Pilates: Large ranges of motion, the very thing most clients covet, recruit superficial muscles which are the ones we're supposed to use sparingly in Pilates and never in place of the deep intrinsics. Using the arms as moving resistance, cantilevered away from the torso which is hugging the vertical line, is an excellent way to use both the deep Pilates muscles and the superficial ones.
The smaller ranges of motion along the vertical line are the ones most strengthening for the spine.
A specific example of this principle applied to a Pilates exercise would be on Saw if we only twist slightly so as not to trigger a hard engagement of the obliques, then let the movement of the arms away from the torso be the trigger for the superficial muscles to do some work.
Another specific example of a Pilates application of this principle is the Lift Twist & Reach on Short Box. If we stay deeply engaged and lifted, we don't need to twist very far in order to work to our maximum capacity. When our spines sink, we can twist farther but at a terrible cost - you can just feel those poor discs getting squished.
When you get the book, check out the picture in the lower left hand corner of page 78; the gentlemen pictured is showing us a well lifted spine in a position identical to a safely performed Spine Stretch Forward. I'm not talking about his shoulders or his arms, I'm talking about his spine. See his spine? See how lifted he is off the front of it? See how the base of his rib cage is lifted away from the top of his pelvis? And check out that scoop - whether he knows it or not, he's got a Pilates Powerhouse onboard!
Page 79: "Exercises to avoid. Do not try to stretch the hamstrings or lumbar spine by any of the following: leaning forward with straight legs, same position, without outstretched arms, same position with another person leaning on your back. All these techniques put excessive stress on the lumbar intervertebral discs. For safer stretching of the lumbar spine, see pages 49 , 55 - 59. For safer stretching of the hamstrings, see pages 164 - 167."
What this means for Pilates: The picture on page 79 are of the positions the authors are recommending against and are identical to the way almost everyone performs Spine Stretch Forward and the other sit ups in Pilates. Def Con FIVE!! DANGER, WILL ROBINSON!!
Here's the bottom line. You cannot keep your spine safe while compressing it.
When we sink on the fronts of our spines in Pilates, that's identical to our poor posture while we sit all day at our desks, in our cars and on airplanes. We know that's bad for our backs. We know that alone can cause back pain and permanent damage to our backs. Why, why, would we permit clients to perform an identical or similar pattern of compression - on purpose - in an exercise?
Pilates taught that way is bad for our backs. It will hurt backs that are sensitive and it will accelerate the deterioration of a healthy back.
Let us pray: Lord, we didn't know! We weren't
told about this! We had no idea! How can we be innocent and guilty at
the same time? Help us immediately and completely implement the proper
teaching of flexion, starting with our very next session, and please
help us lead our clients through the difficulty of learning such a deep
and powerful technique. In Joseph's name we scoop, Amen.
There's great news mixed in with this rather ominous message; when we teach proper flexion, not only are we protecting the spines of our clients but in order to stay up off our discs and to protect the posterior ligaments and discs from being stretched, we use our deepest back muscles and a balanced engagement of all of our abdominals so deeply that our clients will love how hard they're working it and they'll almost certainly be nice and sore in their deep back and tummy muscles the next day.
Here's how to teach proper flexion, regardless of the exercise. Anytime the spine is flexed, the base of the rib cage should be held away from the top ring of the pelvis as far as possible. Try to balance the roundness of the base of the rib cage above the roundness of the pelvis so you don't crack into that thoracolumbar hinge, where the base of the ribs meet the lumbars; that's where we all take a beating.
I hammer this home in every one of our mat classes and you can see some of them on WorldWidePilatesMat.com. Hearing and seeing how we handle it in the studio might help you understand it a little more thoroughly.
Also study the pictures of Joe from Return to Life and you'll see how hard he worked at keeping length in his low back. In all but the super stretchy, super advanced exercises, his low back is mightily long. When he went for it on the forward reach, he definitely dropped the anterior base of his ribs but you can see that, even then, he was working like the dickens to make the longest line possible.
Goodness me, he could sure pull himself apart.
We should all aspire to that level of dedication, attention to detail and unadulterated hard body work. If we do, our backs will be as strong and supple as Joe's. That's his promise. That's his truth.
I'm going to go do 5 Roll Ups and I'm going to try super hard not to give a fraction of an inch of lumbar length away to my flexing spine. I'll be thinking of you while I'm doing them. God Bless!