Today, we are seeing an increase number of larger size people, more abundant bodies, both women and men entering our studios. We wish to give all new clients a positive experience in Pilates however, there are new challenges working with a larger body. We need to support them physically, emotionally and spiritually providing the environment of positive self image, compassion and safely challenge them physically. In the Pilates studio, the needs of an abundant body are specific and personal that if addressed well will give them a positive outcome.
First of all, realize that it is a big step to walk into a Pilates studio. They see fitter bodies, people moving in complex ways that they may have never seen. It can be intimidating to say the least. The initial contact is so critical to easing their potential anxiety. The other challenges are the equipment size and to work with a greater weight distribution with longer limbs.
The use of the term “abundant” rather than overweight, obese, or large size is to support the idea that there are many shapes and sizes of bodies that do not fit the fashionable image of skinny. And the term begins to change people’s perspective about what a healthy body looks like. A slim person may not be fit or healthy. A larger body can be fit and healthy. Getting healthier is important for every body but especially the abundant body. The ways to look good following the media choices (severe dieting and over exercising) is not going to make you healthier. To begin the journey of becoming healthier focus more a normal and natural weight for the person’s body frame and genetics is a sound approach.
First Session or Class
On the first meeting, be compassionate and welcoming. Be non-judgmental and practice total acceptance. Your attention needs to be broader and awareness heightened concerning all aspects of the person in front of you. Focus mainly on what they can do rather than what they can’t.
Do not jump quickly into the physical work without a proper postural assessment and tune into their mental being. Take the time to get to know the client. Build an individual profile of their history of injuries, previous experience of exercise and relationship with food. If working with a woman in the weight range of 180-350 or man 200-350 lbs, a medical clearance is necessary before beginning due to potential risk factors.
Evaluating their tolerance for exercise is important for program design. Many overweight people have a low tolerance for exercise. Meet the person where they are.
Every client has a unique personal background
Clients may have deep-rooted issues with exercise that go back to childhood. Understanding their perception of exercise, gives you insight into how to help overcome the negative feelings and change to a positive one. Finding exercises the client enjoys, especially in the beginning of training allows them to have a positive experience, which will reinforce that movement is fun and enjoyable. In every session, build an opportunity for success where the client has a challenge but realistic goal. You can figure out what attracts or motivates the client to stay the course so change happens through listening and positive reinforcement. Teach perceived exertion scale to learn and feel the amount effort needed to perform the movement and self reference their bodies.
Perceived Exertion Scale
The scale is 1-10, 1 is sitting on the couch and 10 all out running. The level 10 is a relative one matching what movement is a maximum exertion, which for some people may be walking up a hill. Choose an appropriate 10 scale to teach a felt sense of effort. Use the scale to motivate the client by asking them to perform the movement as a 3 then as a 6. If they accomplish good form in the effort of 6 they will feel meeting a challenge. It let’s them feel the control of their body.
Self Creating Barriers
Barriers are real life situations that are perceived to get in the way of client exercising. Look at issues such as childcare, time management issues and no motivation. Help clients to devise strategies to solve the barrier. Be creative with ideas. If time is an issue and they are not compliant then look at their activities and suggest a way to make it exercise movement. For instance, if sitting at the computer, set a timer to remind her to stand up and do a series of small squats, or perform arm movements to extend the upper spine and shoulders. Another idea to suggest is when grocery shopping walk faster throughout the store. Or park the car further away so that he or she has a longer walk.
All the exercise in the world will not create long-term change unless the client has dealt with personal, professional, lifestyle and social factors that led them to weight gain.
Stay within your scope of practice and be mindful not to offer counseling services or nutritional information. Connecting with the client and allowing them the space to open up and share their feelings, fears, concerns and frustrations with you will provide valuable insight into their mindset and barriers they are facing. Recommending a qualified practitioner, a nutritionist, or counseling therapist can help overcome these barriers.
Overview of standing: spine/pelvis looking at kyphosis/lordosis and pelvic position
- Movement Skills to Observe
- Standing upright bend and straightening of the knees
- Standing to sitting in a chair and standing again
- Are they able to move down to the floor and up again
- Shoulder motion: can they reach behind their back, and watch arm abduction to overhead observing their scapulohumeral motion
- Observe for the areas of hypermobility such as the knees and elbows
- Tend to be lateral chain dominant, helping them align their legs use the props or tactile cueing
- Arms tend to be wide, so have them rest their arms down and supported to be able to feel the scapula and upper back work
- Difficult to find bony landmarks, teach the client how to palpate their bony landmarks to gain a deeper awareness of the bones for shifting the perception that there are bones and the cueing coming from the bone images
- In general the posture is shifted forward from the feet to the head placing pressure on the structures of the small bones of the feet, knees, low back, shoulders and neck.
- Tend to hang on their joints with no support so core engagement especially TrA for spine support.
- Increased strength is needed for the legs
- Work on posture and provide a home practice for daily reminders of good posture
- Upper back strength
List of props and modifications to consider:
- Longer therabands and yoga belts
- If unable to support legs with a band or strap then use a physioball or box (unable to stabilize the spine and work in their center line)
- Use physioball for moving the legs in and out as in double leg stretch
- Try using the ball on the reformer to support the legs during 100’s and arm series. Place the ball under the back of the thighs where it can move along with them.
- Wedge pillows for a mechanical advantage
under the hips with incline sloped towards pelvis, this lifts the pelvis making the weight of their legs lighter
under the head and shoulders so they are able to lift the torso
- Yoga blocks or larger balls for inner thighs assisting bringing the legs closer to the midline for the inner leg line into pelvic floor
- Pole or stick to use as an assist to sit up or roll up
Be sure to test the prop on your own body or use a volunteer body to practice so that you are comfortable with using the props and know that it is supportive so you can be authentic with your choices.
Be aware of the client’s safety and your safety.
Your own biomechanics:
- Hands on with these clients is important for support of a limb or assisting the trunk be mindful of your body mechanics
- Example, supine arm springs-place foot on the bottom of reformer to hold it there then have them rest their legs on your leg; release the holding and move with them
- To assist in sitting up as in rollup, use the stick to hold on to and help them sit up
- Instead of adding a spring to the reformer because they are unable to be supported, step in and help control the carriage until they develop the strength, slowly decrease the help and just guide and eventually let go completely
- Lend a hand or shoulder for assistance
- Weight of limbs
- Length of the limbs
- Girth size
- Breast size
- Gluteal size and lumber spine
- Height of person
- Lying flat they can’t breath with all the weight on the body
- Flexion movement becomes a gut issue
- Bridge breast in the face can’t breath, can they lift the weight of the pelvis
- Knees: the force exerted on the knees (3 to 6 times a person’s weight is exerted on the knees while walking) need to consider movements such as squats, running, standing and kneeling
- Joint stress like we do not experience, ankles, knees
- Spine: compression of the spine, back pain; the weight can cause excessive kyphosis and lumbar compression or discomfort lying on spine for a period of time
- Their trunk takes up the space on the reformer so no room for their arms, they spill over, tell them where to place their arms, suggest arms across the abdominals so the chest stays open and avoids stress on the shoulders or hold the strap pegs being sure of the angle of the elbows not below the carriage
- Hyperextension of the knees
- Awareness of the their body: lacking the awareness and potentially the feeling of the body working; try to teach a felt sense and reference that you see and touch to feel the area engaged, have them touch to feel it
- Finding flow in the body, the abundant body is use to hurling the body through space, the apparatus provides the support to experience movement from a centered place, flowing which is different than what he or she does everyday
- Poor balance
- Poor proprioception
Concept of Long lever
- Not just the legs but arms too. Try to work more proximal
- Long torsos and arms think of short box series (initially use the hands on the box for support, progress to arms crossed)
- Springs on the apparatus, heavy enough for support but not too heavy that the movement is created by the weight of the springs rather than the body
Examples of good choices
- Give the client plenty of time to get up and down or on and off the equipment
- Limit time spent supine, after Foot and Leg work change the body to seated work
- Do mat work on the Cadillac or raised mat
- Be sure Reformer is studio or clinical height not on the floor
- Reformer head rest plus pillow or folded towel under the head so the client does not suffocate
- Invest in a solid spine corrector that attaches to the reformer to use as a back support
- Work on the Cadillac or chair for a good proportion of the session (a moving carriage is less supportive)
- Quality of life improves, being able to move better, less stiffness and pain
- Mood is up lifted
- Self confidence
- Getting in touch with the body
- Conrtol- control of the body empowers control in other aspects of life
- Heightened body awareness
- Confidence to move more and eat less
- Improved orthopedic health
- Gateway to more active life
- Improved posture and breathing
- Improved balance
- Improved stability
- Improved flexibility
- Relaxation in the body lowers salivary cortisol
- Changes their view of their body
Research to date
Few, well organized studies in Pilates and weight loss is available. Listed in the references are three studies each lacking good research designs, have limited standardization in measurement techniques, insufficient or no control of the nutritional status, and inconsistent instructor qualifications.
If you want to reach the abundant body population, embrace the whole person.
- Recognize anatomically which Pilates exercises are appropriate for a particular client on the particular day
- Be flexible in your choices to ensure the movements match your client’s physical and energetic needs
- Be compassionate
- Don’t assume the client weight gain came from over eating, until you know the history, it could be from disease, medication, accident, or emotional issue
- See beyond the weight and help create a positive experience
- Know they have the same bones and can be palpated
- Give an association between exercising and an activity of daily living or quqlait of life point
- Protect your own body, use good biomechanics and safety
- Treat them with respect, truth, fairness and integrity
- Introduce other health aspects such as walking for a cause
- Ask permission to touch. At first use touch sparingly over touching too fast may disconnect the client from their body, start furthest away from the abdomen, hands and feet to build a sense of safety
All the benefits that Pilates provides a smaller body type are available for the abundant body. Most importantly is the feeling of the joy of moving your body.
Black, Madeline, Pilates Anytime Work with Abundant Bodies Workshop 2337
Arián R. Aladro-Gonzalvo, Lic; Míriam Machado-Díaz, MD et al; The effect of Pilates exercises on body composition: A systematic review Received: December 10, 2010; Received in revised form: May 27, 2011; Accepted: June 2, 2011; Published Online: July 04, 2011 Journal of Bodywork and Movement Therapies 2012 issue
Fatma Arslan, Evrim ÇAKMAKÇI et al; 2012 Evaluation of the effects of Pilates mat exercise program on some fitness parameters and weight loss of middle aged perimenopausal sedentary women; Niğde Üniversitesi Beden Eğitimi Ve Spor Bilimleri Dergisi Cilt 6, Nigde University Journal of Physical Education And Sport Sciences Vol 6, No 1
Pawlow & Jones 2002, The impact of abbreviated progessive muscle relaxation on salivary cortisol. Biological Psychology, 60 (1) 1-16
Pedro Jesús Ruiz-Montero,1 Alfonso Castillo-Rodriguez, 2014; 24-weeks Pilates-aerobic and educative training to improve body fat mass in elderly Serbian women; Clinical Interventions in Aging. 2014; 9: 243–248. Published online 2014 Jan 31. doi: 10.2147/CIA.S52077