Set Up: Lying supine on the mat, press your back into the mat, legs in table top with hands behind the head.
Execution: Inhale to prep, exhale to curl head to your chest, neck and shoulders off the mat driving your naval closer to spine. Inhale to extend your right leg out 45 degrees and left leg straight up to the ceiling. Switch legs, with continuous emphasis on length and control from the psoas. Inhale for two kicks and exhale for two kicks.
Focus: Focus on stabilizing your pelvis and lumbar spine with your core while lengthening through energized legs. Your neck and shoulders should not be holding any tension.
Importance: Stability and strength! While this is primarily a core exercise, the psoas gets the opportunity to strengthen and lengthen with each kick as well.
Modifications: For extra assistance, bend the knees slightly to lessen the load for the core. You could also keep head on mat and place hands under pelvis for greater lower back support.
Set Up: Stand with right foot in front and left in back, hip distance apart. Pelvis should be square to the front. Weight is primarily in the front foot while the back heel is lifted acting as a kickstand. Hinge forward from the hips slightly to maintain neutral pelvis.
Execution: Inhale to bend both knees as you angle the tailbone to the back wall sitting back into a squat-like position- keep lengthening through the spine. Exhale to stand following the same forward angle that keeps the crown of your head in line with the back heel, squeezing gently into your right glute. Repeat 10x and switch to left foot in front.
Focus: Primary focus is the right glute. Keep front knee stacked over ankle the entire time. Be sure to maintain length in lower back while keeping lower abs engaged. Taper ribs toward hip bones while keeping hips square/level.
Importance: Great exercise for glute strengthening, balance, and stability.
Modifications: To make it easier, use a chair, or wall to hold onto until balance improves. To make it harder, add free weights to incorporate some arms simultaneously, or simply transfer weight solely to front leg as you stand floating the back leg off the floor for a little extra balance challenge!
What is it? Abdominal bracing is an activation of the core muscles that help provide support and stability for your trunk. This brace is commonly called upon in almost every single Pilates exercise and is essential for building tone within the deep and superficial layers of the core. Let me take you through two different scenarios where the core should naturally brace on its own.
Scenario one: Imagine kneeling on the floor with one foot forward and back toes tucked. Now if you were to lift the back knee two inches off the floor, how do you prep for that movement? I bet you would find yourself naturally bracing your core as a response to your body calling for additional stability to lift the back knee. Try it. If you do not feel the core engage naturally, it may take some deliberate asking from the brain to activate the core.
Scenario two: Imagine you tripped, but caught yourself! Chances are your whole body tenses up and your abs engage. Your body has to instinctively muster up as much stability as it can manage to prevent you from falling. This is another example of abdominal bracing.
One common question I get when introducing abdominal bracing to clients is, “How do I breathe when I’m bracing?” Don’t expect to get a full belly breath while under an abdominal brace, but do allow your abdomen to stretch and fluctuate a bit to accommodate to the task at hand. If the task is strenuous, strive to find a three-dimensional breath. Expand through the back of the ribs on your inhale. On the exhale while you exert the most force, start to knit your ribs together, draw your pubic bone up and gently pull navel toward spine (finding your brace). This will provide adequate support for your system. If you need prolonged stability throughout an exercise, your breath pattern may feel a bit short and more shallow than a full expansive breath.
Note from a PT
An abdominal brace is a useful tool for you to support your spine and pelvis during moments where you may have to lift something heavy, stabilize yourself from a jossle or bump, or to allow you the stability through your body for explosive athletic movements. That said, it is important not to grip constantly, that can invite a whole host of issues including pelvic floor dysfunction! A good abdominal brace is really like a seasoning. Think cilantro, it may be tasty in small doses on top of a burrito, but you certainly don’t want to eat a salad of it! We are often taught to grip because it pulls in our flab and men and women alike have been taught that “fluffiness” around the waste line is icky for some reason. But it is truly important for your health to let go when you are at rest.
Breathing under an abdominal brace directly impacts our intra-abdominal pressure which leads me to another common question I often get when asking clients to brace, “Is it safe for my pelvic floor?” Yes, bracing but not gripping is safe for your pelvic floor. In fact, not bracing for certain movements could lead to hernias, prolonged diastasis, or more severe pelvic floor issues. Learning the proper way to activate the various layers of your core and then coordinating that activation with proper breathing techniques will take you far; not only in functional daily movement, but in all of your active fitness dreams! If this peaks your interest, or you find it hard to find an abdominal brace on your own, schedule a session with me at Beyond Basics Physical Therapy, and we’ll have some fun exploring abdominal bracing!
Wait! Marie Kondo has you throwing out your favorite jeans because the joyless saggy bottoms that your tushy cannot manage to fill out? We are seeing an epidemic flat butt among mamas, plumbers, barre fanatics, and office workers—all with strangely similar symptoms—pelvic floor dysfunction, low back and sacroiliac pain, and a tucked under pelvis. In this blog we will explore why the position of the pelvis, the maker of flat butts and the maker of less flat booties, is important and how to more easily move out of this position for benefit beyond your behind.
Besides needing a new wardrobe, why should I care about my flat bum?
The flat bum or preference towards posterior pelvic tilting shrinks the distance between the front and back of pelvic outlet which changes pelvic floor muscle tension. The body needs access to the full range of the pelvis and pelvic floor muscles. Over time, this position could cause excessive pelvic floor activity to compensate for the loss of resting tension. Think of the pelvic floor muscles simplified as a rubber band between two points, the pubic bone and tailbone. When the distance between the two points decreases, the rubber band loses its stability from resting tension. Changes in pelvic position alters stability from the pelvic floor muscles. This posterior pelvic tilt position also decreases the accessibility for hip extension and therefore the upper glute muscles get sleepy. As the top of the pelvis moves back, the sacroiliac joint in the low back opens and decreases its bony stability. Translated into everyday life, the flat butt position increases the potential for incontinence, pelvic floor muscle tension, sacroiliac pain, and decreased efficiency in movement.
The Flat Bottom. Only in the eye of the beholder?
The disagreement of the “neutral pelvis” or zero-point causes confusion when describing pelvic tilt—anterior pelvic tilt, posterior pelvic tilt, and neutral pelvis. Some argue that the neutral pelvis is when the ASIS’s (front hip bones) are level to the PSIS (back butt dimples). Others say that the pelvis is neutral when ASIS’s are in the same plane as the pubic bone. Or for those with X-ray vision, pelvic tilt is the vector of the sacral angle at S2 in relation to the vertical axis. But often, neutral pelvic position is subjective to the observer and relative to other parts of the body—namely the spine/rib cage and thigh bone. Clinically, this “neutral pelvis” is hard to find because 1) pelvis’ are shaped very differently, 2) left and right pelvis on the same person can also be quite different, 3) feeling these bony landmarks have been shown to be remarkably unreliable, 4) the neutral pelvis should be on top of vertical thigh bones. See how the eyes can be tricked confusing spinal curve focusing on pelvic tilt without also including rib position.
The inability to move in and out of posterior pelvic tilt and anterior pelvic tilt decreases efficiency and possibly results in pain and instability. Anterior pelvic tilt is when the front part of the pelvis moves forward/down. Posterior pelvic tilt is when the front part of the pelvis moves back/up. A neutral pelvis on top of vertical femurs and happy rib cage should correlate with better muscle performance.
Do I have a flat butt?
Aside from the saggy jeans, the flat butts of the world have a few other correlations.
1. The Tailfeather Test: Stand comfortably and squeeze the gluts.
a. Neutral pelvis: Thigh bones rotate.
b. Posterior tilt-ing pelvis: The butt will further tuck under and mainly access the lower glutes.
c. Anterior tilt-ing pelvis: The pelvic floor muscles will do most of the work.
2. You bear weight more in the heels
3. Back of your rib cage is behind your pelvis
4. Your Thigh bones are angled so that your pelvis is front of your knees
5. Your lower belly pooch
6. You Sit with pressure more on the sacrum/tailbone vs. sit bone
7. You have Overactive and possibly overworking pelvic floor muscles—the front to back pelvic distance decreases with your posterior tilted pelvis and loses the resting tension from length. As described earlier, this is similar to tensile strength of a slightly stretched rubber band vs. rubber band without pull/tension. Therefore, your pelvic floor muscles have to work harder to keep some type of tension for purposes like continence, stability, etc. The inability for the pelvic floor muscles to work optimally can lead to incontinence, pain, and constipation.
9. You have Breathing and abdominal pressure problems
10. You have Sacroiliac joint pain. As the pelvis tips back, the sacrum moves away from the ilium decreasing the bony stability. The hip muscles have to work harder, but as felt in the Tailfeather Test, the glut muscles aren’t in a good place to work.
Is there a better fix than butt implants?
Bodies have and love variability for posterior, anterior and “neutral” pelvic positioning. The brain likes positions where muscles and nerves work with ease and stability—life shouldn’t be so difficult—but it needs the chance to choose and learn it. Folks working with bodies have traditionally “corrected” spinal curves by changing pelvic position. From what has already been discussed, spinal and pelvic position can be altered many different ways—from the changing weight-bearing area in the feet, to position of ribs and range of breath, and even head angles with visual and vestibular input. Consider these hacks into pelvic stability until the brain learns how to access this stability in many situations and positions.
1. Standing. Bring your chin down to your neck and keep looking down until you see the front of your ankles. You’ve just untucked your pelvis and brought your ribs over your pelvis. This one is courtesy of my colleague, Stephanie Stamas. Or check in to feel where the weight is going through your feet. The front to middle of the foot is a good place to start and then do the Tailfeather Test. You might have to toggle other parts of the body because of how the body will compensate in the chain.
2. Sitting. Get your hips as far back as possible. Or put a pillow in the back of the chair so that your hips can find the pillow and you are sitting on top of your sit bones. Then, relax the trunk into the seat back/pillow. Again, you’ve untucked your pelvis and brought your ribs over the pelvis.
3. Better squats/lunges/burpees/stairs/ab work. You can do 5 sets of 20 squats, but still no junk? Take care to see if your pelvis is tucking under in the movement. If so, use an inhale to keep the pelvic floor lengthening as your hips bend in movement. Later, the movement should be dissociated with breath pattern (as long as you are breathing.)
4. See a physical therapist. Often times, the habits of pelvic tucking are a little more complicated because it is a protective and compensatory mechanism for stability. A physical therapist can help with seeing the bigger picture and how different parts of the body relate to each other. They can also help facilitate better movement through manual therapy and specialized movement.
As an avid high intensity exerciser, I am always looking to push myself in my workouts. When pain gets in the way of my progress, it can be extremely frustrating. For years, I have been struggling with chronic hip and sacroiliac joint (low back) pain. These symptoms intensified about two and a half years ago when I fractured a lumbar vertebra weight lifting. Recovery was hard, and during that time I was told by doctors, friends, and family that I could not or should not return to the things I loved: lifting heavy weights and running outside. I was devastated. I tried swimming, biking, the crazy looking stair treadmill at the gym, and while I was able to get some exercise in, I still felt like I had lost one of the things that brought me the most joy.
Months after my injury, I finally started listening to my body and my physical therapist friends rather than the limiting and negative advice I had gotten. I started returning to weight lifting and running and began trying not to judge myself for the strength I had lost. The more I did, the better I felt. I was scared, but I felt liberated at the same time. But despite making some initial progress, I started to hit a wall. I couldn’t deadlift as much as I could before, I couldn’t lift as much overhead, and I was too afraid to run on concrete or to get in a squat rack, which was where I had hurt myself all those months ago. I started to feel that hip and sacroiliac (SIJ) pain again after every workout, and I knew I had to change something about what I was doing.
Enter: Pilates. Pilates and weight lifting are both forms of resistance training, but there are key differences between them that make Pilates an effective form of cross training for a weightlifter. When you do any singular form of exercise, your body is learning how to complete a task one way. Introducing a different form of exercises gives you variability, and teaches your body to work under lots of different conditions using different muscle groups. The more options our bodies have for how to complete a task (like a deadlift), the stronger we become.
Here at Beyond Basics Physical Therapy, I had the opportunity to work with Kierstin Elliot,a certified Pilates instructor with a wealth of experience working with clients who struggle with orthopedic issues, including pelvic floor dysfunction. “In Pilates,” Kierstin explained, “subtle nuances matter and you have to be a stickler for form and alignment.” Weightlifting athletes, on the other hand, generally focus more on larger, more powerful movements. Because of these differences, Pilates can make a big difference when it comes to increasing strength and decreasing injury in people who typically exercise with high resistance. In the months that I spent working one on one with Kierstin, I achieved personal bests in my squat and my deadlift and could feel that I was much more steady in any single leg weight lifting activity.
If you like to lift weights and you want to see your performance improve, here are 5 specific ways that Pilates can up your weight lifting game:
While weight lifting certainly helps to develop core strength, Pilates does so using lighter weights and more eccentric contractions. Eccentric contractions require muscles to work and lengthen at the same time. Typically, weightlifting and other forms of exercise will strengthen the core in a concentric way, meaning the muscles are asked to shorten and tighten in order to build strength. While both are effective, the best option is a combination – variability is key. Eccentric contractions are also a great way to increase mobility.
Increasing Mobility in the Spine and Extremities
The demands on the spine are very different in weight lifting versus Pilates. Lifting heavier weights requires you to maintain a certain amount of stiffness in the spine to protect it against a heavier load. While that is an important skill (think about how hard it can be to lift a heavy suitcase, stroller, car seat, etc.), it is also important to be able to manage resistance at times when our back can’t be in a “neutral” position, like when you’re putting a baby in a crib or digging things out of your storage unit. Pilates exercises are done at lower resistance and in various different spinal positions: flexion, extension, side-bending, and rotation. This allows you to learn to move well under tension in lots of different positions.
Pilates is also a great way to increase your hip and shoulder mobility, both of which are important for weight lifting. Squatting, deadlifting, and overhead movements were the things I was having the hardest time progressing back to, and these all require good shoulder and hip mobility. Pilates exercises are often done with the trunk supported, and with resistance applied to the limbs by springs. This means that there are more eccentric contractions involved (working and lengthening at the same time), which can be a great way to improve strength and mobility at the same time.
Weightlifting focuses on powerful movements. These types of movements will require increased work from our larger “global” muscles which tend to be longer and move lots of joints at the same time. While strengthening these muscles is important, using Pilates to strengthen the smaller “stabilizing” muscles is a great way to enhance the strength of the global musculature. When we do a big, powerful movement, we need the smaller stabilizing muscles to automatically fire too – this enhances our overall strength, improves our balance, and makes us less prone to injury.
Training for increased endurance means training at a lower weight and performing more repetitions. In weightlifting, the goal is to work at a higher percentage of your 1 rep maximum, meaning the greatest amount of weight that you would be able to lift once. In Pilates, on the other hand, lighter resistance is used for more repetitions.
Increasing Body Awareness
Proprioception is the sense that allows us to know where our bodies are in space. Exercises that are done in a closed chain – meaning one of your body parts is in contact with a fixed surface – enhance this sense. Because reformer Pilates includes spring tension with your feet or hands in contact with a surface, almost all exercises are done in a closed chain. This can be a really great way to ease into a movement after an injury. The support of a closed chain exercise allows you to tailor the movement to your current level as you progress back towards more traditional open chain (no contact with a surface) weightlifting movements.
Thanks for reading! I hope this blog post helped you understand how you can take your training to the next level. If you are interested in experiencing what Pilates can offer or how physical therapy can maximize your athletic potential, please call our midtown (212-354-2622) or downtown office (212-267-0240) today!
Check out what Kierstin has to say about Pilates here!
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Phrompaet S, Paungmali A, Pirunsan U, Sitilertpisan P. Effects of pilates training on lumbo-pelvic stability and flexibility. Asian journal of sports medicine. 2011;2(1):16-22.
Queiroz BC, Cagliari MF, Amorim CF, Sacco IC. Muscle activation during four Pilates core stability exercises in quadruped position. Arch Phys Med Rehabil. 2010;91(1):86-92.
Valenza MC, Rodriguez-Torres J, Cabrera-Martos I, Diaz-Pelegrina A, Aguilar-Ferrandiz ME, Castellote-Caballero Y. Results of a Pilates exercise program in patients with chronic non-specific low back pain: a randomized controlled trial. Clinical rehabilitation. 2017;31(6):753-760.
Almost all postpartum women experience some degree of diastasis recti, or separation of the rectus abdominis or 6 pack muscles. Think about it, your abdomen is stretching continuously for a solid nine months! Something’s got to give. The linea alba (line of connective tissue that splits your rectus abdominus right down the middle) separates as a result of a growing baby. On some women, this separation naturally heals itself within the first year postpartum. In other women, the separation is so severe that they need a little extra attention and care to fuse their rectus abdominis back together again.
Once you’ve given yourself enough time to heal the inflamed tissues from giving birth, usually about 6-8 weeks, then you can start implementing some basic Pilates principles into your routine. Drawing attention to the breath, the transversus abdominus (TA), and the pelvic floor without creating excess pressure throughout your system, will be essential while moving towards healing your diastasis.
Connecting to your breath and your TA should be the first step. Deep three-dimensional inhalation to the back of the ribs and mindful exhalation, tapping into the TA will be crucial. During the exhale you should feel as if your abdomen is hugging or wrapping around your waist like a belt. This is TA activation. Once you’ve established the TA activation, focus on drawing your bottom ribs towards your naval and narrowing your ASIS (hip bones) towards each other. Imagine a drawstring; when you pull the drawstring, the opening of whatever object you’re trying to close, draws together from all sides evenly. That is the effect we are trying to create with the abdomen. Visualize your naval as the center of the opening and your exhalation pulling the drawstring closed.
Once you’ve mastered connecting breath to the TA, shift your focus to the pelvic floor. The easiest way to achieve this is by lying on your back with a neutral pelvis with knees bent and feet flat on the floor. Visualize the tailbone unfurling and your sits bones widening as you inhale allowing the pelvic floor to gently stretch and relax. On the exhale, as you engage the TA and obliques, feel the pelvic floor tighten slightly and if appropriate (after a pelvic floor check from your PT) find a kegel. The ultimate goal is to be able to contract and release your pelvic floor without any problems. After practicing this breathing exercise every day for about 8-10 reps, you should start to feel stronger throughout your core and find some closure or firmness in the linea alba.
This first step is HUGE. After 2-3 weeks of consistent breath work and core activation, layering more extensive exercises will become safe and accessible. Keep in mind that it is not wise to go from zero to one hundred, but rather continue to build and progress slowly. It may feel tedious, but I can’t stress enough how imperative it is to lay this foundation and rebuild your core after birth. Once you feel you’ve made considerable progress with breath work, add in marches (leg lifts) targeting lower abdominal stabilizers and add in a side lying series to challenge pelvic and core stability while also strengthening glutes. Try a side plank starting on knees and then progressing to feet. Any exercise in quadruped is a safe bet that targets shoulder stability, core, glutes, and hamstrings!
One thing to note is that women with more severe cases of diastasis should avoid abdominal curls, rollups, or flexion of the rectus abdominis until there’s been a considerable amount of progress with the deeper core muscles. If you fall under this category and constantly wonder if you’ll ever close your diastasis, yes! You can! And you will if you dedicate the attention and mindfulness to connecting to your body. Think you’re doing everything right, but still feel like no progress is being made? Feel free to book a session with me at Beyond Basics Physical Therapy! I’d be more than happy to help you out on closing your diastasis and transitioning you back into the wonderful world of pilates 🙂
Set Up: Stand with one foot on the carriage and one foot on the platform with weight distributed evenly between both legs. Slightly turn out your legs to help engage outer rotators and glutes. Lighter spring setting will focus on adductors (insides of legs) while a heavier spring setting focuses on abductors (outsides of legs).
Execution: The breath for this exercise changes based on adductor or abductor focus. For adductors- inhale to push carriage away from the platform and exhale to pull carriage back in. For abductors- exhale to push carriage away and inhale to control the carriage back in. Move the carriage out only as far as you can go while maintaining good form, as soon as neutral pelvis shifts to a tilt or a tuck, you’ve gone too far.
Focus: Be sure to keep the integrity of your form throughout the entire exercise. Keep a tall, stacked spine with ribcage over hips, neutral pelvis, and lifted arches. Think of a string lifting you up from the crown of your head. It’s common for the arches of your feet to drop, causing pronation. Keep that pinky toe connected to the machine. This will also keep the knees in correct alignment.
Importance: Great postural exercise. It’s meant to focus on either adductor or abductor strengthening depending on desired resistance. As a whole, it draws attention to weight placement and how that affects your alignment while standing.
Modifications: If you are apprehensive about balance, grab a pole or a long dowel and place that on the floor right in front of you while standing on the machine. If this exercise bothers your knees, keep a slight bend in them the whole time.