RMR1 Support Material Sample

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SUPPORT MATERIAL


JIM DAWSON © MERRITHEW CORP

JIM DAWSON © MERRITHEW CORP

A PROGRESSIVE APPROACH The STOTT PILATES® Rehabilitation Courses provide the most effective bridge between the worlds of therapeutic exercise and fitness conditioning. Carefully designed by rehab professionals for rehab professionals, these programs consist of 2

hundreds of exercises and modifications that are used throughout the rehabilitation process, from the acute stages to functional integration, ongoing maintenance and performance enhancement. The program content is targeted at professionals in the rehabilitation industry who

BENEFITS

assess, diagnose, treat and prescribe exercise for the rehabilitation and/or prevention

AN EFFECTIVE ASSESSMENT & TREATMENT TOOL

EFFICIENT STRENGTHENING OF THE MUSCULOSKELETAL SYSTEM

REDUCTION IN COMPENSATORY MOVEMENT PATTERNS

ASSISTANCE WITH POSTURAL RE-EDUCATION

HEIGHTENED MIND-BODY AWARENESS

IDENTIFICATION OF IDEAL MUSCLE ACTIVATION

PROGRESSIONS OR REGRESSIONS OF EXERCISES

EFFECTIVE SKILLS RE-ACQUISITION TECHNIQUES

INCREASED LUMBO-PELVIC & SCAPULAR STABILIZATION

EXTENSIVE EXERCISE REPERTOIRE

of injuries, providing them with training to integrate Matwork and equipment-based STOTT PILATES exercises appropriately into therapeutic conditioning. There are four individual modules that make up the full STOTT PILATES Rehabilitation program. RMR1—Spinal, Pelvic & Scapular Stabilization: Matwork & Reformer; RMR2—Peripheral Joint Stabilization: Matwork & Reformer; RCCB1—Spinal, Pelvic & Scapular Stabilization: Cadillac, Stability Chair & Barrels and RCCB2—Peripheral Joint Stabilization: Cadillac, Stability Chair & Barrels. Respected by fitness and health practitioners worldwide, STOTT PILATES mindbody exercise builds on the essence and principles of the late Joseph H. Pilates’ work by incorporating modern knowledge and understanding about the body. At Merrithew Health & Fitness™, our focus is on developing the safest and most effective programming available, and teaching people to become the most professional and successful instructors they can be.

1705A-1 SUPPORT MATERIAL: RMR1 SPINAL, PELVIC & SCAPULAR STABILIZATION: MATWORK & REFORMER

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THE MH&F DIFFERENCE Our team of experts strives to provide fitness and rehab professionals with access to thorough, scientifically-based programming, wide-ranging education options, quality equipment, and the ongoing opportunities and support that are important to your success and to the success of your clients, members and patients. Thanks to our uniquely integrated operation, STOTT PILATES Certified Instructors enjoy numerous benefits, including strong post-graduate support and preferred equipment rates, while our equipment customers have access to comprehensive training, instructional videos and manuals, and business solutions. At Merrithew Health & Fitness, our engineers and talented Instructors work together to refine and evolve our equipment so it continuously exceeds and challenges.

RMR1—SPINAL, PELVIC & SCAPULAR STABILIZATION: MATWORK & REFORMER This course introduces the STOTT PILATES Five Basic Principles and their application to modified Matwork, light equipment and Reformer exercises.

STOTT PILATES MANUALS The following manuals are available from Merrithew Health & Fitness: ◗

RMR1 SUPPORT MATERIAL

RMR2 SUPPORT MATERIAL

RCCB1 SUPPORT MATERIAL

RCCB2 SUPPORT MATERIAL

COMPREHENSIVE MATWORK

technical manuals that list the full exercise repertoire.

ESSENTIAL REFORMER

This manual is intended for those training at a Licensed Training Center, Corporate

INTERMEDIATE REFORMER

ADVANCED REFORMER

ESSENTIAL CADILLAC

INTERMEDIATE & ADVANCED CADILLAC

STABILITY CHAIR

LADDER BARREL

ARC BARREL

SPINE CORRECTOR

INJURIES & SPECIAL POPULATIONS

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Emphasis is on lumbo-pelvic and shoulder girdle stabilization and the role they play in rehabilitation and injury prevention. Included are identification of proper exercise execution and movement patterns, and the development of strategies for immediate application into the clinical environment. This support material guide is designed as a reference for exercises taught in the course along with the Comprehensive Matwork and Essential Reformer

Training Center or host site offering STOTT PILATES branded programming, under the instruction of representatives of Merrithew Health & Fitness.

ADDITIONAL SUPPORT MATERIALS To complement our technical manuals, Merrithew Health & Fitness also provides the following helpful support materials: ◗

WALL CHARTS Outlining the STOTT PILATES repertoire for each piece of equipment

CLIENT WORKOUT SHEETS Our repertoire in handy pads of 100 tear-off pages

WORKOUT VIDEOS Unparalleled instruction from beginner to advanced level

ALL AVAILABLE at merrithew.com


RMR1 Objectives 1. Learn the Therapeutic Foundations of STOTT PILATES for use in a rehabilitative setting. 2. Learn how to teach and apply the STOTT PILATES Five Basic Principles. 3. Learn the choreography, modifications, indications and contraindications for STOTT PILATES rehabilitation exercises on the Mat and Reformer. 4. Develop the ability to assess proper form for each exercise and to correct improper execution. 5. Learn and practice manual and verbal cueing for each exercise. 6. Learn how to integrate STOTT PILATES into clinical scenarios.

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1705A-1 SUPPORT MATERIAL: RMR1 SPINAL, PELVIC & SCAPULAR STABILIZATION: MATWORK & REFORMER


Table of Contents Introduction

2

Biomechanical Review

History

8

Back Care Level 2

21

Therapeutic Foundations

Warm Up

Integrated Model of Motor Control

Breathing

24

9

Leg Lifts

24

Categorization of Muscles as Stabilizers & Mobilizers

9

Matwork Exercises Half Roll Back

24

10

Spine Twist

24

Motor Learning Theory

13

Archer

25

Relative Strength & Mobility

13

Single Leg Stretch

25

Gives & Restrictions

13

Shoulder Bridge Prep

25

Side Kick

25

Functional Muscle Classification Charts

Five Basic Principles Breathing

14

Side Leg Lift 1

26

Pelvic Placement

14

Single Leg Extension

26

Rib Cage Placement

15

Heel Squeeze Prone

26

Leg Pull Front Prep

26

Scapular Movement & Stabilization

15

Back Care Level 3 Head & Cervical Placement

15

Warm Up

Back Care Level 1

Toe Taps

Warm Up

27

Matwork Exercises Breathing

16

Flex Elbows, Open Chest

16

Imprint & Release

16

Leg Slides

16

Hip Release

16

Cat Stretch

17

Scapula Isolation Elevation & Depression

18

Matwork Exercises

33

Front Rowing Preps

34

Arm Work on Long Box

34

Swan Dive Prep on Long Box

35

Arms Pulling Straps

35

Mermaid

35

Running

36

Hip Rolls

36

Single Thigh Stretch

36

Side Splits

36

Case Study

37

Clinical Reasoning Challenge

39

Appendices A Visual Assessment for Movement Dysfunctions

40

B Causes of Static versus Dynamic Winging

41

C Clinical Reasoning Parameters

42

Hundred

27

E Common Conditions

44

Obliques

28

F Be Kind to Your Spine: Back Care Level 1 Workout

45

Swan Dive Prep

28

Swimming Prep

28

G Pain-Free Posture: Back Care Level 2 Workout

47

Push Up Prep

29

H Standing Tall: Back Care Level 3 Workout

49

Footwork

30

Second Position

30

Single Leg

30

Reciprocal Weight Transfer

30

Sleeper

31

Bend & Stretch

31

Lift & Lower

31

Adductor Stretch

31

Short Spine Prep

31

Midback Series

32

Back Rowing Preps

32

18

Head Nods

Side Twist Sitting

43

17

18

33

D Clinical Reasoning Pathway

17

Arm Circles

Side Arm Preps Sitting

27

Reformer Exercises Hip Rolls

33

Breast Stroke Preps 2 & 3

16

Spinal Rotation

Back Rowing Preps in Kneeling Lunge

I

Matwork Exercises for Spinal, Pelvic & Scapular Stabilization

52

J Reformer Exercises for Spinal, Pelvic & Scapular Stabilization

61

K Add’l Reformer Exercises for Spinal, Pelvic & Scapular Stabilization 64

References

Ab Prep

19

Breast Stroke Preps

19

Shell Stretch

19

One Leg Circle

20

Mermaid

20

Spine Stretch Forward

20

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ACTION & FUNCTION

PHYSIOLOGY & PLACEMENT

Functional Muscle Classification Charts LOCAL STABILIZER

GLOBAL STABILIZER

GLOBAL MOBILIZER

◗ Many type I muscle fibers

◗ Many type IIa muscle fibers

◗ Many type IIb muscle fibers

◗ Deep, close to axis

◗ Deep or superficial

◗ Superficial

◗ Spans one joint

◗ Spans multiple joints and has

of movement

multiple functions at each; integrates adjacent joints

◗ Continual tonic force,

under 25% MVC ◗ Low frequency for recruitment ◗ Controls neutral zone;

constantly modulating force output throughout movement ◗ Anticipatory ◗ Responds irrespective

of direction of load ◗ Highly proprioceptive

◗ Phasic force production ◗ Medium frequency

for recruitment ◗ Controls inner and

outer ranges ◗ Primarily eccentric or

decelerators ◗ Postural, antigravity muscles

◗ High frequency

for recruitment ◗ Force with length change,

shock absorption ◗ Primarily concentric ◗ Activity is direction dependent ◗ Few proprioceptors ◗ Phasic force production

◗ Activity is direction dependent ◗ Highly proprioceptive

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DYSFUNCTION RECRUITMENT

◗ Fires best in neutral

◗ Recruited by low loads, closed

kinetic chain, slow movements and proprioceptive input

◗ Dysfunction tends to present

as reflex inhibition, decreased force production, reduced endurance, altered response to loading, improper recruitment ◗ Causes abnormal movement

and control at one segment

◗ Recruited by low to

moderate loads, closed kinetic chain, slow movements, and proprioceptive input and challenge

◗ Dysfunction tends to present

as decreased force production (underpull), reflex inhibition, altered recruitment pattern ◗ Causes problems across

several joint segments

1705A-1 SUPPORT MATERIAL: RMR1 SPINAL, PELVIC & SCAPULAR STABILIZATION: MATWORK & REFORMER

◗ Recruited by high load,

high speed, open kinetic chain, high coordination ◗ Proprioceptive challenge

◗ Dysfunction tends to present

as tightness, over-activity, or spasm, and becomes responsive to low frequency stimulation ◗ Causes problems across

several adjacent vertebrae or at a regional level


3. Archer Refer to Appendix I a. Seated on Rotational Disk i. Dissociate pelvis ◗ Dissociation of lumbar spine and hips from thoracic spine ii. Integrate pelvis ◗ When integrating pelvis: ◗ Initiate rotation from pelvis then sequentially through spine ◗ Rotate through whole spine, sacrum and pelvis; should see legs shift into postural adduction and abduction ◗ Focus on neutral sacral position to enable motion to occur and allow dynamic asymmetrical pelvic floor support ◗ Cue movement from ischial tuberosities ◗ Ensure sacrum is in neutral throughout; altered position will limit available range of motion and create shearing elsewhere 4. Single Leg Stretch Refer to page 48 of the Comprehensive Matwork manual and Appendix I a. Regular b. Modification 1. Head on Mat c. Modification 6. Shoulders on Arc Barrel – decreases the load of the torso and approximates the origin and insertion of the abdominals which may help to facilitate recruitment d. Modification 8. Hands behind head e. Flex-Band under foot, head up or down, arms in bicep curl f. Regular with arms to ceiling, head up or down g. Unilateral or reciprocal legs with all variations 5. Shoulder Bridge Prep Refer to page 59 of the Comprehensive Matwork manual and Appendix I a. Modification 1. Shoulder Bridge Prep / lift and lower pelvis b. Modification 2. Shoulder Bridge Prep / lift and lower leg c. Fitness Circle between knees d. Flex-Band over ASIS – can help with proprioception for pelvic control and increase resistance to glutes and hamstrings e. Prep with Rotational Disks f. One Leg Lift with Rotational Disks with or without lower and lift of the pelvis ◗ ◗ ◗ ◗

Glutes and abdominals are force closure mechanism for sacroiliac joint Ensure feet are flat on ground and pressing downward Watch for segmental shearing of lumbar spine and over-gripping of erectors Indicated for gluteal contraction, lengthen anterior hip muscles, tensor fascia latae, promote sacroiliac joint closure

6. Side Kick Refer to page 78 of the Comprehensive Matwork manual and Appendix I a. b. c. d.

Regular Modification 1. Flex bottom knee Flex-Band around foot – two hand placement positions: 1. Hand on hip, 2. Hand on Mat Bend & Stretch

Gluteus medius works as a stabilizer and mobilizer in this exercise Rotational control for lumbo-pelvic region Challenges cervical control Hip abductors hold pelvis in neutral and support weight of leg High-level exercise for clients with sacroiliac joint or lumbar conditions

◗ ◗ ◗ ◗

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5. Sleeper Refer to Appendices J and K ◗

Side-lying, Foam Cushion under head for proper position

a. b. c. d. e.

Top leg in parallel, lateral or medial Small range pulses Extension Straps or Flex-Band to assist supporting weight of leg (if necessary) Reciprocal weight transfer using Jumpboard (progression) Using Footbar; lower leg straight so adductor working in postural position

May need to adjust Footbar to position 1 or 2 depending on width of pelvis Can support lower leg on Toning Ball on rail Rotational control for spine and pelvis Gluteals, abductors and lateral rotators must hold leg up against gravity Watch for foot position (ensure ankle joint starts as neutral as possible)

◗ ◗ ◗ ◗ ◗

Functional patterns of recruitment: Works obliques on carriage side coupled with abductors of top hip and adductors of bottom leg ◗ Works calf and peroneals of top leg ◗ Co-contraction mechanism for rotational stability of pelvis and spine ◗

6. Bend & Stretch Refer to page 36 of the Essential Reformer manual and Appendix K a. Parallel b. Lateral rotation c. Medial rotation i. Modification 1. Keep ankles dorsiflexed ii. Small range of motion ◗ ◗

Dissociation of hips and lumbo-pelvic region Be careful with disc dysfunction

7. Lift & Lower Refer to page 38 of the Essential Reformer manual a. Parallel b. Lateral rotation ◗ ◗ ◗

Contraindicated with symptomatic sciatica and dural compromise Ensure proximal hip extensors initiate extension phase; watch for dominance of hamstrings Promotes hamstring flexibility and opens posterior capsule of hip joint

8. Adductor Stretch Refer to page 40 of the Essential Reformer manual and Appendices J and K a. Regular b. Unilateral ◗ ◗ ◗ ◗

Eccentric control of adductors Rotational control of spine Monitor segmental stability closely Be very careful with pubic symphysis and sacroiliac joint hypermobility

9. Short Spine Prep Refer to page 41 of the Essential Reformer manual a. Regular ◗ ◗

Challenges coordination and incorporates previous Feet in Straps exercises Higher-level hip disassociation challenge

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Case Study Assignment For each of the following case studies, write out: a. Factors contributing to the client’ s complaint b. Your goals with STOTT PILATES c. Ten to 15 exercises including appropriate props and modifications d. Five progressions

1. Sandi the Spondy with Subacromial Bursitis ◗

A former Olympic gymnast who now coaches the U.S. developmental team; she needs to be able to demonstrate basic moves L4 grade 2 spondylolisthesis Globally hypermobile Anterior pelvic tilt Incredibly taut TFL; initiates all movements with TFL

Incredibly short latissimus dorsi and teres major

a. b. c. d.

Contributing Factors Goals Exercises Progressions

◗ ◗ ◗

2. Kyphotic Kyle ◗

Kyle is a 6'4", 54 year-old architect with a significant non-structural kyphosis Left AC joint strain that is painful with all terminal abduction and weightbearing through the arm L4 extension give; discomfort with slow walking and prolonged standing Lumbar pain with Breast Stroke Prep on Mat Very motivated to learn and get better

a. b. c. d.

Contributing Factors Goals Exercises Progressions

◗ ◗ ◗

3. Peter Prolapse ◗

Posterolateral L5 disc prolapse with left L5 nerve root involvement Acute stage, unable to sit longer than three minutes before pain begins This is his third episode of serious back pain – he knows he needs to change his ways 35 year-old muscle-bound construction worker who must do heavy lifting and carrying Peter does 200 crunches every day for his abdominals and 45 double leg lowers Lordotic Braces everywhere

a. b. c. d.

Contributing Factors Goals Exercises Progressions

◗ ◗ ◗ ◗ ◗

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Clinical Reasoning Challenge Assignment 1. a. What defines a Local Stabilizer (level 1) muscle? b. What cues can you use to help clients recruit their local stabilizers? 2. a. Name seven STOTT PILATES exercises that can facilitate multifidus function. b. What indicators will tell you when the multifidus has fatigued? 3. a. How does pelvic floor asymmetry contribute to sacroiliac joint dysfunction? b. Name the level 1 and 2 stabilizers of the sacroiliac joint. 4. a. How does an accessory muscle breathing pattern contribute to scapular instability? b. What other conditions may result from improper breathing? 5.

How can you progress a client from only being able to recruit their transversus abdominis consciously, to having it become integrated into their unconscious control?

6.

What criteria will you use to determine if a client is recruiting the transversus abdominis correctly?

7.

Give five reasons or conditions where the use of imprint would be beneficial.

8. a. How can you use breathing techniques to mobilize the thoracic spine? b. What STOTT PILATES exercises facilitate lateral expansion of the rib cage? 9.

What are the local anterior, lateral and posterior cervical spine stabilizers?

10. a. How can you determine if your client is using their cervical stabilizers well? b. What can you ask them to monitor during their home exercises? 11.

Name six STOTT PILATES exercises you can choose to challenge rotational stability without rotating the spine.

12.

Name six STOTT PILATES exercises you can use to mobilize the hip and stabilize the lumbar spine.

13.

Give eight progressions for Scapula Isolation (from non-weightbearing closed-chain through weightbearing closed-chain, to higher-load open-chain).

14.

Design a home program for a client whose low back pain results from annular irritation due to tight hips and decreased thoracic rotation.

15.

Name six STOTT PILATES exercises to help correct a hypomobile kyphosis for a client with kyphosis-lordosis and lumbar pain with extension.

16.

Name eight STOTT PILATES exercises to stabilize lateral shearing of the C3 secondary to a downwardly rotated right scapula and dominant levator scapula.

17. a. What symptoms may result from perpetual counter-nutation of the sacrum? b. Name six STOTT PILATES exercises to help a client whose back issues result from holding the sacrum in counter-nutation habitually.

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Appendix A

Visual Assessment for Movement Dysfunctions General Spinal & Pelvic Mobility ◗ Guide for assessing movement and detecting gives and restrictions ◗ Use these parameters for assessing the execution of each STOTT PILATES exercise – Richardson, Von Gavel

◗ ◗ ◗ ◗ ◗ ◗ ◗ ◗

Roll Down – symmetry, at least 70° hip flexion, backwards body shift less than 2" Waiters Bow – 50° hip flexion before lumbar spine flexes Four-Point Kneeling, Rock Back – 120° hip flexion before lumbar spine flexes Seated Hip Flexion – 30° hip flexion before loss of neutral spine Side Bend – smooth curve Rotation – smooth curve without hip hiking or hitching or shearing Extension – smooth curve initiated in thoracic spine, movement then distributed through segments cranially and caudally with slight anterior translation of pelvis, hips in 10°–15° extension at end Standing Shoulder Flexion – 140° flexion before lumbar spine extends – Richardson, 2004; Von Gavel, 2001; Tunnell, 1996

Janda Dynamic Assessment ◗

Use these as examples for the application of the functional muscle classification.

1. Single Hip Extension: gluteus maximus, hamstrings, contralateral lumbar erector spinae, ipsilateral erector spinae, progressing up erectors, shoulder and neck muscles

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2. Single Hip Abduction: gluteus medius, tensor fascia latae, quadratus lumborum, iliopsoas, rectus femoris, abdominals 3. Shoulder Abduction: deltoid and supraspinatus, contralateral upper trapezius, ipsilateral upper trapezius, contralateral quadratus lumborum, contralateral peronei, ipsilateral scapular stabilizers for depression 4. Roll Up: look for articulation through spine and pelvis, and control of pelvic position – STOTT PILATES: Injuries & Special Populations Resource Guide, 2003

1705A-1 SUPPORT MATERIAL: RMR1 SPINAL, PELVIC & SCAPULAR STABILIZATION: MATWORK & REFORMER


Appendix D

Clinical Reasoning Pathway 1. Assess condition and contributing factors a. Determine areas and direction of gives and restrictions b. Determine positions of comfort c. Determine positions to avoid initially 2. STOTT PILATES Five Basic Principles (assessment tool and teaching tool) a. Assess extent to which breathing pattern is contributing to, aggravating or perpetuating condition b. Assess ability to recruit local stabilizers c. Assess ability of local stabilizers to function properly (anticipatory, tonic, endurance) i. To stabilize a segment statically ii. To move segment through range around the proper axis of motion d. Assess ability to control local area while moving adjacent segments e. Assess postural control 3. Neuromotor re-education and pain reduction through movement a. Choose exercises to reduce pain / pathology, recruit stabilizers b. Choose non-aggravating position c. Start as close to neutral as possible d. Avoid movement into direction of give or instability e. Use closed-chain, low-load, slow motions, lots of proprioceptive input and cueing f. If a client cannot stabilize with low-load, then increase initial resistance to provide increase compression and recruit level 2 and 3 muscles g. Begin with motion in a single plane of movement h. Develop eccentric control 4. Progress difficulty of exercises a. Challenge ability of level 1 muscles to dynamically control segment and challenge level 2 and 3 muscles ◗ Increase range of motion ◗ Increase repetitions ◗ Vary pace ◗ Decrease support ◗ Increase or decrease resistance ◗ Open chain ◗ Decrease proprioceptive input and cueing ◗ Proprioceptive challenge 5. Progress functional integration a. Multiplanar movements b. Faster pace c. Plyometrics d. Move into direction of give as able

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Appendix I

Additional Matwork Exercises for Spinal, Pelvic & Scapular Stabilization WARM UP

HIP RELEASE (Flex-Band, Mini Stability Ball, Stability Ball, Foam Roller) 1. BENT KNEE FALL OUT PREP

BREATHING (Flex-Band) 1. QUADRUPED on hands and knees (quadruped position), pelvis and spine neutral, hands directly under shoulders, knees hip-distance apart directly under hips in: expand sides and back of rib cage, ex: through pursed lips allowing rib cage to close (3-5 breaths) 2. FLEX-BAND AROUND RIB CAGE on hands and knees (quadruped position), pelvis and spine neutral, hands directly under shoulders, knees hip-distance apart directly under hips, Flex-Band around rib cage in: expand sides and back of rib cage, ex: through pursed lips allowing rib cage to close (3-5 breaths) NOTE: Can also be done in seated or supine position 3. SIDE-LYING side-lying, pelvis and spine neutral, knees and hips flexed, head resting on bottom arm or Foam Cushion, top hand on top hip

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in: expand sides and back of rib cage, ex: through pursed lips allowing rib cage to close (3-5 breaths)

supine, pelvis and spine neutral, knees flexed, abducted hip-distance apart in: prepare, ex: laterally rotate leg and allow femur to fall out to side, maintaining lumbar and pelvic stability, in: return to starting position 2. BENT KNEE FALL OUT PREP WITH FLEX-BAND supine, pelvis and spine neutral, knees flexed, abducted hip-distance apart, Flex-Band around one thigh in: prepare, ex: laterally rotate leg and allow femur to fall out to side, maintaining lumbar and pelvic stability, in: return to starting position 3. FULL WITH FLEX-BAND supine, pelvis and spine neutral, knees flexed, abducted hip-distance apart, Flex-Band around thigh in: laterally rotate leg and extend knee to slide foot away, ex: medially rotate leg and flex knee to return 4. FULL WITH MINI STABILITY BALL / STABILITY BALL supine, pelvis and spine neutral, knees flexed, abducted hipdistance apart, one foot on Mini Stability Ball, other foot on Mat in: laterally rotate leg and extend knee to roll Ball away, ex: medially rotate leg and flex knee to return

LEG SLIDES (Flex-Band, Mini Stability Ball, Stability Ball) 1. FLEX-BAND BEHIND LOWER THIGH supine, pelvis and spine neutral, legs abducted hip-distance apart, Flex-Band around lower thigh, holding ends of Band, elbows flexed in: prepare, ex: extend knee to slide foot along Mat, maintaining pelvic stability, in: flex knee to return 2. FOOT ON MINI STABILITY BALL supine, pelvis and spine neutral, knees flexed and abducted hip-distance apart, one foot (heel or ankle) on Mini Stability Ball, other foot on Mat, arms long by sides in: prepare, ex: extend knee and dorsiflex ankle to roll Ball away, maintaining pelvic stability, in: flex knee and plantar flex ankle to return to starting position

NOTE: Can be done with a combination of both Flex-Band and Mini Stability Ball 5. BILATERAL WITH FOAM ROLLER supine, pelvis and spine neutral, feet on Foam Roller, knees flexed, abducted hip-distance apart in: laterally rotate both legs and extend knees to press Roller away, ex: rotate legs to parallel and flex knees to return 6. BILATERAL WITH MINI STABILITY BALL / STABILITY BALL supine, pelvis and spine neutral, feet on Mini Stability Ball / Stability Ball, knees flexed, abducted hip-distance apart in: laterally rotate both legs and extend knees to press Ball away, ex: rotate legs to parallel and flex knees to return

NOTE: Can be done with Stability Ball or a combination of Flex-Band and Ball

continued >

1705A-1 SUPPORT MATERIAL: RMR1 SPINAL, PELVIC & SCAPULAR STABILIZATION: MATWORK & REFORMER


Appendix J cont’d

FRONT ROWING PREPS

1/2 OR 1 SPRING

seated, facing Footbar, pelvis and spine neutral

ARMS PULLING STRAPS

1/2 OR 1 SPRING

prone on Reformer Box facing pulleys, pelvis neutral, upper body flexed over end of Box, legs long and adducted

1. STRAIGHT FORWARD, arms down by sides, palms facing forward

1. BREAST STROKE PREP, hands on carriage, elbows flexed

in: prepare, ex: flex shoulders to reach arms forward, in: return 2. OFFERING, elbows flexed by sides, palms facing up throughout in: prepare, ex: reach arms forward, in: reach arms out to sides, ex: reach arms forward, in: flex elbows to return 3. PUNCHES, hands at shoulders, palms facing down, elbows flexed and lifted

in: lengthen spine to long line, ex: extend thoracic and cervical spine, in: return spine to long line, ex: return to starting position 2. PLOW, arms reaching forward holding ropes in: reach upper torso to one long line and start to pull arms, ex: extend upper torso, pulling arms all the way back, in: return to long line, ex: return all the way down 3. TRICEPS, elbows flexed by sides, torso neutral

a. UNILATERAL

in: prepare, ex: maintain neutral and extend elbows, in: flex elbows

b. BILATERAL in: prepare, ex: extend elbow, pressing one hand forward, in: flex elbow, bringing hand to shoulder

MERMAID

4. PUNCHES WITH ROTATION, hands at shoulders, palms facing down, elbows flexed and lifted in: prepare, ex: extend elbow, pressing one hand forward and rotating upper torso, in: flex elbow, bringing hand to shoulder, return torso to center

ARM WORK ON LONG BOX

1/2 TO 2 SPRINGS

1 SPRING

seated facing side, legs crossed, pelvis and spine neutral, one hand on Footbar, one hand on shoulder rest in: reach arm from shoulder rest overhead, ex: laterally flex pressing carriage out, in: return to vertical, arm overhead, ex: lower arm to shoulder rest, in: reach arm from Footbar overhead, ex: laterally flex, in: return to vertical, ex: lower arm

NOTE: Move Footbar to position #2 prone on Reformer Box facing Footbar, pelvis and spine neutral, hands against Footbar, elbows flexed and angled slightly back, legs long and adducted or abducted, knees flexed, ankles crossed 1. SCAPULA ISOLATION in: prepare, ex: extend elbows to press carriage out, in: keep arms long and elevate scapulae, ex: keep arms long and return scapulae to neutral, 3-6x, in: flex elbows to return carriage 2. ELBOW FLEXION & EXTENSION

in: prepare, ex: articulate spine off carriage from tail to upper thoracic, in: stay, ex: articulate spine onto carriage from upper thoracic to tail

2 SPRINGS ON ONE SIDE

standing, one foot by foot of Reformer, one foot against shoulder rest, hip extended, hands on Footbar

3. SINGLE ARM TRANSFER, one hand on Footbar, opposite hand on carriage

in: prepare, ex: press carriage back, in: return

in: prepare, ex: extend elbow to press carriage out, keep carriage out and change hands, in: flex elbow to return

2 SPRINGS

prone on Reformer Box facing Footbar, pelvis and spine neutral, hands against Footbar, elbows flexed, angled slightly back, legs long, abducted and laterally rotated in: prepare, ex: extend full spine and hips, in: stay, ex: return to starting position

2 TO 3 SPRINGS

supine, pelvis and spine neutral, heels on Footbar, hip-distance apart, hands resting by sides

SINGLE THIGH STRETCH

in: prepare, ex: extend elbows to press carriage out, in: flex elbows to return

SWAN DIVE PREP ON LONG BOX

HIP ROLLS PREP

SIDE SPLITS

1-1/2 TO 2 SPRINGS

standing facing side, pelvis and spine neutral, one foot on carriage, one foot on Wooden Standing Platform or Padded Platform Extender, arms out to sides 1. ABDUCTION, (more tension), legs long in: prepare, ex: abduct legs to press carriage out, in: return 2. ADDUCTION, (less tension), legs long in: abduct legs, ex: adduct legs to pull carriage in

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