Pilates vs. Yoga Kierstin Elliott, Certiﬁed in Stott Pilates
As a pilates instructor, I am often asked the question, “How is pilates diﬀerent from yoga?” Although there are many similarities between the two practices, such as developing strength and ﬂexibility, the diﬀerences are quite substantial.
Yoga is an ancient practice that has long been established throughout Indian culture. One major factor that sets yoga apart from pilates is the spiritual element. For many, yoga promotes an environment of self awareness in mind, body, and spirit. Although there are various styles of yoga, ranging from the lively ﬂow of Vinyasa to the meditative holds of Yin, you have the freedom to explore and evolve the limitations of your body and mind within the practice.
Pilates is a more recent method of movement created by Joseph Pilates as a form of rehabilitation and was introduced to the States in 1920. Pilates wanted to create a practice in which injured soldiers could quickly rehab with bio-mechanics. Therefore, the apparatus’ used in the practice such as the Cadillac and Reformer, closely resemble hospital beds with springs, pulleys, and slings. Pilates is focused primarily on restoring the natural curves of the spine using these 8 founding principles: breath, concentration, control, centering, ﬂow, alignment, precision and relaxation.
Both pilates and yoga oﬀer numerous health beneﬁts for the mind and body in addition to complimenting each other quite well. If you are looking for a more spiritual or meditative connection through movement, yoga is the choice for you. If you are looking to strengthen your core and improve posture, pilates will be right up your alley. Give them both a try and see what makes the most sense for your body. Finding a practice that not only feels good, but one that you also enjoy, is important for maintaining consistency and progress. Only with commitment and dedication to your practice will you discover the stronger, healthier, and happier version of you!
Kierstin Elliot currently teaches Pilates at Beyond Basics Physical, Flex, Kinespirit, and offers in home training. Call the office at Beyond Basics at 212-354-2622 for more information on Kierstin!
Earlier this summer, we discussed the nature of pain. In Putting Pain Into Context, We discussed how pain is comprised of two distinct components: the physical stimulus and how our brain interprets that stimulus. Both meditation and yoga are helpful techniques to help retrain how your brain responds to pain.
Join us on October 13th at 7pm for an introduction to both restorative yoga and meditation. Learn more about the science and try it out yourself with Anne Taylor, yoga instructor specializing in chronic pain and Ryanne Glasper, Physical Therapist and yoga instructor. Come find out how these techniques may be helpful for you!
In honor of National Women’s Health and Fitness Day ,September 28, we are exploring the benefits of regular exercise for women as well as addressing some pitfalls (pelvic floor included), that female athletes can fall into too. It is far too often that women find themselves sidelined from their favorite sports and fitness routines secondary to issues like orthopedic or sports-related pain or incontinence. Although all the issues outlined in this blog can occur to both genders, many of these conditions are more likely to happen to females, secondary to their pelvic structure and physiology.
Exercise and Its Benefits
The benefits of exercise are too numerous to discuss every single one here and span the physical to the emotional. There are a number of conditions that have profound effects on the health of women nationwide. Let’s explore some of exercise’s specific benefits for these conditions together.
According to the American Heart Association, Heart disease is the number one killer of women in the US and is responsible for 1 in 3 female deaths. Exercise and a healthy lifestyle have been shown to reduce the risk of heart disease by 80%. The American Heart Association recommends 150 minutes of moderate activity or 75 minutes of vigorous activity to stave off heart disease.
Osteoporosis is unfortunately a common affliction among white and asian urban dwelling females. It is characterized by reduced bone density, which causes bones to be fragile and increases the risk of fracture in individuals that have osteoporosis. Exercise has been shown to be helpful in both reducing the risk of osteoporosis as well as improving the bone mineral density of those who already have osteoporosis.
Other benefits of regular exercise include:
Reduced risk of diabetes
Reduced risk of colon cancer
Improved psychological well being
Maintenance of healthy body weight
Remember, it is important to consult with a trained healthcare professional before commencing a new fitness routine.
The Female Athlete Triad- Aka the Downside
All things in moderation. Although exercise is beneficial it is easy to over do it. It becomes easier to slip into an unhealthy relationship with exercise, especially in women who are training at elite levels, have eating disorders, or body dysmorphia issues.
The female athlete triad consists of three disorders that can have severe health consequences in both the near and long term. The three disorders that compose the female athlete triad are:
Ammenorrhea (absent periods or periods that are irregular)
The female athlete triad is often attributed to the expectation that women keep a slender appearance. Girls and women who have body image issues may be at greater risk. The female athlete triad is dangerous and has the potential to be deadly. Osteoporosis can result in fractures and eating disorders can seriously impact fertility, or even throw off the delicate balance of electrolytes in their system, putting them at serious risk for a cardiac event.
Warning signs of the female athlete triad include:
Yellowing of skin
Rapid fluctuations in weight
Development of baby hair over skin
Daily vigorous exercise to an excessive level
The female athlete triad requires a multidisciplinary approach from medical, to psychological to nutrition. It is important for someone who is suffering from the female athlete triad to seek help in order to safeguard their health and emotional well being.
Athletics and The Pelvic Floor
Like any muscle, the pelvic floor can get fatigued, strained, or even go into a painful muscle spasm. The thing about the pelvic floor muscles, is that they have to work in almost every athletic pursuit. They work in partnership with the multifidus of the back, the transverse abdominus of the belly, and the diaphragm to stabilize and protect your spine. They also contract with every step during running activities to prevent your pelvic organs from dropping down in your pelvic cavity and to prevent urinary and or fecal leakage. Things can go wrong when the pelvic floor or other core muscles don’t function properly. Athletes’ pelvic floors can become tight and restricted, preventing closure of sphincters and support of pelvic organs. They may go into spasm from working too hard to stabilize the spine, if one of the other core muscles is failing to pull its weight.
Recently there has been more work to investigate the link between athletes and pelvic floor dysfunction. A recent study found that self identified female triathletes suffer from urinary and fecal incontinence at rates as high as 37.4% and 28.0%, respectively. Similar results were also found on a group of runners. Of the triathletes studied, nearly a quarter of them fit the criteria for female athlete triad, discussed earlier in this post.
Does this mean you have to give up your penchant for running? NO! (hellooooooo the author of this post is a runner), but if you find yourself experiencing incontinence, pain, constipation, and or painful sex, something is wrong and you must intervene in order to protect your long term health and your ability to participate in your favorite sport. At Beyond Basics Physical Therapy we combine orthopedic and pelvic expertise to help return athletes to their sports in a more functional and less painful condition. We relax tight muscles of the pelvic floor, train the core, including the pelvic floor if needed, to do its fair share, and return normal postural and structural alignment to our patients. We work one on one with you to develop a home exercise plan to help you reach your goals and prevent a reoccurrence of your pelvic floor or core disorder.
Stampfer M, Hu F, Manson J, et al. Primary prevention of coronary heart disease in women through diet and lifestyle. The New England Journal of Medicine. 2000; 343(1). 16- 22 Todd J, Robinson R. Osteoporosis and exercise. Postgrad Med J. 2003; 79:320-23
October is around the corner! And a busy month for many. Whether you are getting back into the swing of school or work after summer vacation, preparing your Halloween costume or getting ready for all the upcoming holidays right around the corner – there is a lot going on!
This time of year is also an opportunity to do good and give back. October is National Physical Therapy Month, where physical therapists celebrate their amazing field of healing and getting people back to optimal function. In addition, many of the PT’s throughout the U.S. give back to their communities during this month. This year we are taking it up a notch. Physical therapists WORLDWIDE are getting involved for the second annual Global PT Day of Service Saturday, October 15th. Whether it is by hosting a pro-bono clinic, serving in a soup kitchen, participating in a 5k for a cause, or cleaning up a community garden – physical therapists globally as a profession are coming together to make a positive impact on the world around them.
At Beyond Basics, we have decided to host a pro-bono clinic Saturday, October 1st to give back to those in the New York City area who may not have insurance or access to physical therapy. We are providing 30 minute one-on-one evaluations and recommendations for home programs to up to 30 participants. For more information and to sign up please visit: http://signup.com/go/Nu1T4Q
You can also check out PT Day of Service here and follow on twitter (#PTDOS) to see how the day unfolds! http://ptdayofservice.com/
The American Physical Therapy Association (APTA) is also involved in hosting National Physical Therapy Month. This year the APTA’s focus is on it’s national public awareness campaign, #ChoosePT. This campaign lets consumers know about the risks of opioid use and that physical therapy is a safe, non-opioid alternative for managing pain.
I encourage you to check out educational resources provided by the APTA (www.apta.org) and Move Forward PT (http://www.moveforwardpt.com/Default.aspx). Learn all about how physical therapy can help you overcome pain without the use of opiods, improve mobility and maintain independence throughout your lifetime.
What would you ask a pelvic floor physical therapy expert about exercise, or about the pelvic health as an athlete, if you had the chance? Don’t miss Amy Stein, founder of Beyond Basics Physical Therapy and author of Heal Pelvic Pain answer some commonly asked questions in a webinar hosted by well-renowned Jessica Drummond of Integrated Women’s Health Institute. Jessica is a nutritionist specializing in abdomino-pelvic health and dysfunction. She will be interviewing Amy on the athlete and pelvic floor dysfunction, treatment paradigms, and practical tips for relieving the under active and the overactive pelvic floor.
For a while you could find me strolling around the clinic with a little fitness tracker on my wrist. I used it to track my steps, sleep, and heart rate. I’m a girl who loves gadgets and apps. From Venmo to Spotify, technology enriches my life and makes it easier. So when Elvie sent their kegel trainer to Beyond Basics, I jumped at the chance to volunteer myself guinea pig, to try out this new fitness tracker.
Unboxing, Aesthetics, and Set Up
Man, oh man is the product design gorgeous on this one. It comes in a beautiful silver embossed box with the tagline “ your most personal trainer” ( wink, wink, nudge, nudge). Inside there is an inch diameter cylinder “vessel” for lack of a better term, which houses the Elvie tracker. The vessel functions as both a carrying case and a charger. It’s pretty slick looking.
The Elvie itself looks like a little tadpole with a tail. It’s about an inch long and half an inch in diameter not counting its little tail. There is also an optional cover provided in the box, which may be more comfortable for some ladies.
The whole set up: The tracker had the feel of opening an iphone, in that the directions provided in the tracker were kept pretty minimal. There was a small pamphlet with cleaning instructions, on charging, how to insert, and exercise. As a pelvic floor physical therapist, I definitely felt that the instructions on how to properly kegel left a lot to be desired. The instructions were literally two bullet points instructing the user not to hold her breath or tighten her buttocks, while she lifts her “pelvic floor”. For many of my patients, I find that they come to me with little knowledge of how to properly kegel or are doing it wrong, “lift the pelvic floor” is rarely a cue that allows for a fully correct kegel.
My next step was to download the Elvie app. I have an iPhone 6. You need a smartphone to run the elvie. They recommend iPhone 5 or later or Android phones running version 4.3 or later. The app download was easy. It was time to get started.
Elvie: Day 1
The moment of truth had arrived. Time to insert one of the cuter inanimate objects I had come accross “up there”. “Bye, little guy. Safe travels” I thought as I bid Elvie adieu. Insertion was no problem. For me, it was pretty comfortable, the caveat being, I have a pretty healthy pelvic floor. The one thing I did not like was that Elvie’s tail kept bopping me in the clitoris, which wasn’t very comfortable. Other than that no complaints.
The first thing I did was try and trick Elvie into thinking I was kegeling when I wasn’t (I really want to ensure this thing is fool proof). Elvie is unfortunately a gullible little thing. Bulging my pelvic floor, ( mimicking the action you would do to have a bowel movement, essentially the opposite of a kegel) and thrusting my hips tricked Elvie into thinking I was doing a really good job when I wasn’t. My favorite activity to trick Elvie was to do a little dance around my bedroom, while wiggling my bottom. Thank goodness my doors lock.
But enough goofing off, it was time to give Elvie a good old honest college try. The package recommends either standing or lying to do your kegel exercises, but they say to pick a position and stick with it. I chose lying down.
The minute I got on the bed, Elvie’s connection was lost. Poor Elvie! It was deep inside a strange place with no connection to the outside world. The app instructed me to move my phone closer to my vagina, which restored the connection but was pretty awkward, kind of like my lady parts were trying to facetime someone.
Once I got through the technical difficulties, I loved the way the exercise program was set up. They have 3 different stages that work on pulsing or “quick flicks”, endurance, and pure power. I was mediocre at all three, but it gave me a good start to go with.
Elvie Day 2:
Today was the day I decided to experiment with how distracted one can be while using Elvie. We all like to multitask, so I decided to try it out while continuing my current Netflix binge. It was a bad idea, I missed a lot of my targets and kept forgetting to keep my legs open to allow Elvie to stay connected. It was clear to me that Elvie requires your full attention to get any benefit from it. I did improve on my ability to pulse and my endurance, which was super gratifying.
After I was done with my workout I spent some time exploring the app. Nestled in the “help” section, were much more detailed and helpful directions for performing a correct pelvic floor contraction. I wish this was more easily accessible. I think the lack of concise directions was a major failing of this product.
Elvie Day 3:
I decided this would be my last day using Elvie. I run on the tighter side of things, and I know from my clinical experience that doing kegels on an already tight pelvic floor can cause a whole host of issues from constipation, fecal leakage, painful sex, even urgency urinary incontinence!
I decided to give my all out full attention to the vagina workout ahead of me, but first I would try and cheat again. Lying down I tried my old tricks, wiggling my butt, thrusting my hips, but Elvie was not fooled! It appears that lying on your back is a way better way to train your pelvic floor using Elvie.
My last day, I really had the hang of things. I had no connectivity issues and was able to complete the whole workout uninterrupted. The only bummer was that on two of the three measures, I regressed!
Thoughts on Elvie
My thoughts on this device are mixed. It is so rare that I see someone walk into the clinic only needing strengthening of the pelvic floor. Usually there is some component of tightness or boney (structural) malalignment that needs to be corrected before kegels can be done effectively or safely.
For those patients who only require strengthening, I think Elvie can make an excellent motivator to regularly do your kegel exercises. I would eliminate the pure power part of the Elvie exercise program. Doing a max contraction of the pelvic floor usually does more harm than good. In a perfect scenario, I see Elvie being used by patients under the guidance of a pelvic floor physical therapist and only doing the “pulse” and “hold” portions of the program. These are patients who have been screened for any tightness or trigger points that may need treatment before starting out with strengthening
Pros and Cons of Elvie
Not appropriate for everyone
Poor connectivity to iphone
Not always consistent in measuring a true kegel versus a fake one, especially in standing
Requires a later model smart phone
Only brief instructions easily accessible
Max contraction not very helpful
Charts on the App to track your progress
Incredibly adorable product design
Much more comfortable than many other biofeedback sensors
Structured training program to target many components of muscle function
Pro Tips for Elvie
Use Elvie lying down; it’s way more accurate that way
Use a water based lube for insertion, silicone lubricants usually don’t mix with instruments designed to go into the vagina
If you have pain, Elvie is definitely not for you. Even if you don’t have pain it is wise to consult with a pelvic floor physical therapist to ensure that your muscles are not in fact, too tight and that you are doing the exercise correctly.
Disclaimer: Product was provided by Elvie. No other form of compensation was provided by Elvie for this review.
This week the BBPT team went back to BASICS with exercise programming. Ryanne, one of our staff PTs, led us through basic routines and their progressions with a focus on different manual and verbal cues that can be used with each exercise. Every patient begins physical therapy at different levels of exercise experience, as well as differences in body awareness. When starting patients on an exercise program, even if they are avid exercisers, it is important to start with the BASICS to see HOW exactly they are performing them and to be able to screen for any dysfunctional movement patterns:
.We went over different ways to facilitate the core to allow the for symmetrical engagement in exercises like pelvic tilts, bridging, and planks. Through the use of facilitation, we can actually CHANGE the motor plans (how one moves) of our patients to more efficient ones, thereby reducing their symptoms. These techniques are useful for patients that are recovering from injury and even those wishing to return to high level fitness classes.
Below, Ryanne is leading us through a basic bridge exercise with different manual and verbal cues, resistance and progression
We encourage you to work with a physical therapist to begin or perfect your exercise routine!