HYPERLORDOSIS & PILATES TREATMENT

Transcription

1 HYPERLORDOSIS & PILATES TREATMENT Grace Tiangco 3/18/

2 Abstract Sacramento/Mountain View Lordosis or Hyperlordosis is defined as a postural type in which the natural curves of the spine are exaggerated. The shoulders are seen rounded forward and lower back (lumbar spine) with a deeper curve and the pelvis is in an anterior tilt. The neck is in hyperextension with a forward head and knees are slightly hyperextended. This usually means that abdominal strength is lacked for not supporting the lumbar spine and the lower back muscles are tight. It is recommended to strengthen abdominal muscles, lengthen the back muscles, stretch the hip flexors, and strengthen the hamstring and glute muscles. Severe lordosis requires surgery, otherwise it can be corrected with rehabilitation exercises and be reduced in 3-6 months. This posture is common in young dancers and gymnasts. Pilates is a great form of exercise and rehabilitation to help correct this postural type and realign the spine. A consistent Pilates exercise regimen will create balanced muscular development and proper skeletal alignment which is vital to live a physically healthier life.

3 TABLE OF CONTENTS 1. Title Page 2. Abstract Page/Research Summary 3. Table of Contents 4. Anatomical Description 5. Introduction 6. Case Study 7-9. Conditioning Program 10. Conclusion

4 Anatomical Description Hyperlordosis of the lumbar spine is known commonly as swayback, where the lower back experiences extra stress and is arched slightly or dramatically. This is a common postural position in dancers. The areas affected are the lumbar spine (L 1-5), the abdominals, back extensors, hip flexors, and hamstring muscle groups. A tightness is apparent in the back extensors and hip flexors and the hamstrings and abdominals become weak because muscles that stabilize the pelvis work in a way to support the lordosis of the spine. The pelvis is in anterior tilt and so the abdominals and hip extensors are lengthened, and hip flexors and back extensors are shortened. Causes & Risk Factors Common in ballet dancers because ballet requires a sufficient amount of external rotation and when not enough hyperlordosis happens and the anterior hip ligaments stretch to increase the turn out. Trunk bending movements can also affect spinal hyper- pressure. There are also many medical conditions that cause the spine to curve like this. Some of these

5 conditions include obesity, pregnancy, tight lower back muscles, osteoporosis, achondroplasia, discitis, kyphosis, spondylolisthesis and tight lower back muscles. Symptoms Symptoms include pain and discomfort in lower back, a large gap between the lower back and floor when lying supine, and a C- shape when looking to the side making the buttocks look more prominent. Diagnosis To diagnose if someone has hyperlordosis a doctor will perform a physical exam and take the patients medical history to see issues of when the excessive curve became noticeable, changed or became worse. The doctor will feel the spine for abnormalities, and ask the patient to move forward and side to side to gage range of motion. The doctor may also order a neurological assessment of where the patient is having pain, spasms or weaknesses as well as x- rays of the spine. Treatment Some treatments to treat hyperlordosis include painkillers to relieve discomfort or back pain, wearing a back brace, weight loss, surgery, vitamin D supplements, and exercises where a Pilates training program and physical therapy can come into great use.

6 Case Study: Sarah, a 25 year old woman with hyperlordosis who is a retired professional gymnast. Conditioning program: The conditioning program I devised is to help her engage and recruit her abdominal muscles more as well as her hamstrings and glutes. I include enough stretches for her tight hip flexors and lower back muscles. The goal of this program is to reduce and try to correct the lordosis of the lumbar spine and to help her find posterior tilt and naval to spine. She has difficulty finding this and keeping this position due to her weak abdominals and hamstrings. I've devised a 12 week program where Sarah comes in twice a week using mostly mat and reformer exercises but have incorporated pieces of other equipment as well. Shes had some Pilates experience in the past and an athletic background so I chose an intermediate level program. Weeks 1-4 Warm Up: Foot Work Abdominal Work Fundamental Warm up Supine: Pelvic Curl, Chest Lift, Chest Lift with Rotation, Single Leg Lifts, Leg Changes Reformer: Parallel Hells, Parallel Toes, V position toes, Open V Heels, Open V Toes, Calf Raises, Prances, Prehensile. Reformer: Hundred Prep, Hundred, Double Leg, Double Leg with Rotation Focus on drawing naval down to spine in pelvic curl. Recruit abdominals and hamstrings when articulating the spine. scooping the belly and bring naval to spine. Encourage her to really feel the lumbar spine on the mat Engagement of hamstrings. Pelvic Stability. Focus on imprinting lower back into carriage in double leg/rotation. Abdominal strength. Pelvic lumbar stabilization in hundred. Hip Work Frogs, Circles, Openings. Hamstring strengthening Spinal Articulation Stretches Bottom Lift, Bottom Lift With Extension Standing Lunge Cat Stretch Hamstring Strengthening. Hamstring stretch. Hip Flexor Stretch, much needed for lordosis. Cat stretch for flexion and

7 extension of the lumbar spine. Full Body Integration 1 Elephant Hamstring stretch abdominal strength. Arm Work Full Body Integration 2 Leg Work Shoulder Push Shoulder Push Single Arm Not including Full Body 2 Single Leg Skating Hamstring Curl (long box) Works triceps. Lat stretch. Maintain back extension. Glutes strengthening Hamstring strengthening Lateral Flexion Mermaid Abdominals with obliques Mobile spine Scapula stabilization Back Extension Breaststroke prep (long box) Back extensor strength Weeks 4-8 Warm Up: Foot Work Abdominal Work Hip Work Spinal Articulation Fundamental Warm up: Pelvic Curl, Chest Lift, Chest Lift with Rotation, Single Leg Lifts, Leg Changes Reformer: Parallel Hells, Parallel Toes, V position toes, Open V Heels, Open V Toes, Calf Raises, Prances, Prehensile. Reformer: Hundred Prep, Hundred, Double Leg, Double Leg with Rotation Frogs, Circles, Openings, extended frog Bottom Lift, Bottom Lift With Extension Focus on drawing naval down to spine in pelvic curl. Recruit abdominals and hamstrings when articulating the spine. scooping the belly and bring naval to spine. Encourage her to really feel the lumbar spine on the mat Engagement of hamstrings. Pelvic Stability. Focus on imprinting lower back into carriage in double leg/rotation. Abdominal strength. Pelvic lumbar stabilization in hundred. Hamstring strength Hamstring Strength Stretches Kneeling Lunge Hamstring stretch. Hip Flexor Stretch, much needed for lordosis.

8 Cat Stretch Cat stretch for flexion and extension of the lumbar spine. Full Body Integration 1 Down Stretch Strengthens the abdominals and back extensors Avoid pressure on lumbar spine. Trunk stablizer. Arm Work Arms Supine Series: Shoulder extension and Extension, Adduction, Up circles, adduction stretch. Down circles, triceps Full Body Integration 2 Up Stretch 1 Abdominals Back extensors Leg Work Single Leg Skating Hamstring Curl (long box) Glutes strengthening Hamstring strengthening Lateral Flexion Side over on Box Abdominals with oblique emphasis Back Extension Pulling Straps 1 on long box Back extensor strength Shoulder Extensor Strength Weeks 8-12 Warm Up: Foot Work Abdominal Work Hip Work Fundamental Warm up: Pelvic Curl, Chest Lift, Chest Lift with Rotation, Single Leg Lifts, Leg Changes Cadillac: Parallel Hells, Parallel Toes, V position toes, Open V Heels, Open V Toes, Calf Raises, Prances, Prehensile. Cadillac Warm Up Series: Roll up with Roll up Bar, Mini Roll Ups, Mini Roll ups oblique, Roll up Top Loaded Frogs, Circles, Openings, extended frog Focus on drawing naval down to spine in pelvic curl. Recruit abdominals and hamstrings when articulating the spine. scooping the belly and bring naval to spine. Encourage her to really feel the lumbar spine on the mat Cadillac for footwork in this session is more challenging than reformer. Engagement of hamstrings. Pelvic Stability. Abdominal control Pelvic lumbar stability Obliques Focus on flexion of lumbar spine Hamstring strength Spinal Articulation Short Spine Hamstring Stretch Spinal Articulation

9 Stretches Full Lunge Cat Stretch Hamstring stretch. Hip Flexor Stretch, much needed for lordosis. Cat stretch for flexion and extension of the lumbar spine. Full Body Integration 1 Down Strength Strengthens the abdominals and back extensors Avoid pressure on lumbar spine. Trunk stablizer. Arm Work Reformer: Arms Sitting Series: Chest Expansion, Biceps, Rhomboids, Hug- A- Tree, Salute Trunk stablization Shoulder extensor strength Elbow extensor strength Full Body Integration 2 Up Stretch 2 Abdominals Back extensors Trunk Stablization Scapulae Stabilization Leg Work Single Leg Skating Hamstring Curl (long box) Glutes strengthening Hamstring strengthening Lateral Flexion Side over on Box Abdominals with oblique emphasis Back Extension Pulling Straps 1 and 2 Back extensor strength Shoulder adduction strength Conclusion: This 12 week program taken consistently 2-3 sessions a week can dramatically improve a lordosis spine. Each month the exercises become a little more challenging as the client gains more abdominal and glute/hamstring strength, as well as flexibility. Since Sarah grew up athletic she already had some body awareness and conditioning programs. At the end of the three month program she demonstrated the movements more with ease as her abdominals, glutes, and legs became stronger. She looked and felt more aligned as she contracted her abdominals and back extensors correctly. By re- educated her body and mind starting with fundamental exercises and consistent practice in the BASI Block System, she was able to reduce her lordosis spine effectively.

10 Bibliography: rs&source=bl&ots=utvjpv9hf5&sig=qzmxcoheaiet1ra6lnl5aksteog&hl=en&sa=x&ei=xfcdv bhtl4zooas_z4gqaq&ved=0cdsq6aewbw#v=onepage&q=hyperlordosis%20dancers&f=false