PILATES Fatigue Posture and the Medical Technology Field Marybeth Kane May 2014 Course: 2014, Pacific Palisades, CA 1
ABSTRACT A medical laboratory scientist (MLS) (also referred to as a medical technologist or clinical scientist ) is a healthcare professional who performs chemical, hematological, immunologic, microscopic, and bacteriological diagnostic analyses on body fluids, and blood as well as other specimens. Medical laboratory scientists work in clinical laboratories at hospitals, doctors offices, reference labs, biotechnology labs and non-clinical industrial labs. This occupation requires standing or sitting with head, neck and shoulders flexed forward for prolonged periods peering through a microscope or manually distributing samples to a micro testing plate. This static positioning and repetitive motion often lead to muscle imbalances causing postural weaknesses referred to as Fatigue Posture. With the BASI Block System and principles of Joseph Pilates, we will emphasize strengthening hip flexors, abdominals (Transversus abdominis muscle and external obliques), upper back extensors, and neck flexors; together with creating length in the hamstrings, internal obliques and pectorals. Our approach will help reposition the posteriorly-tilted pelvis, open up the chest, and realign the ribcage over the pelvis. 2
TABLE OF CONTENTS ABSTRACT... 2 TABLE OF CONTENTS... 3 ANATOMICAL DESCRIPTION... 4 CASE STUDY... 6 CONDITIONAL PROGRAM... 7 CONCLUSION... 11 BIBLIOGRAPHY... 12 3
ANATOMICAL DESCRIPTION The Fatigue (Sway Back) Posture is a passive posture that takes very little energy to maintain. Characterized by pushing the pelvis forward (Posterior Tilt) causing the hip joint to extend. Other key attributes are listed as follows and shown on the illustration below: Head: Forward Cervical Spine: Slightly extended Thoracic Spine: Increased flexion (long kyphosis) Lumbar Spine: Flexion (flattening) of low lumbar area. Pelvis: Posterior tilt Hip joints: Hyperextended causing anterior displacement of pelvis. Knee joints: Hyperextended. Ankle joints: Neutral. 4
As a result of this fatigue posture, these impacted muscles can be: Elongated and Weak: Hip flexors, external oblique, upper back extensors, neck flexors Short and Strong: Hamstrings, Internal oblique Strong but not short: Low back muscles 5
CASE STUDY Lucy is a 38 years old female, who has been working as a Clinical Technologist for over 15 years. Physically active, she enjoys running, biking, rowing, swimming, and weight training. Five years ago, experiencing tightness in her neck and shoulders with stiffness in her lower back, she started to practice yoga hoping to alleviate some of her discomfort. When these symptoms persisted, Lucy went for Physical Therapy and was introduced to Pilates. Lucy decided on taking two private sessions per week for six weeks. The following pages provide a sample session. This program will begin and end with a standing roll down allowing the client to connect with specific areas as I do a quick assessment. We will then go over breath, pelvic placement (neutral spine and imprint), ribcage, head, and cervical placement, along with scapular stabilization to familiarize the client with these new terms and stress the importance of each. I will first work in imprint and thoracic flexion to strengthen obliques. Progressing to work in neutral and strengthening upper back extensors. Using a pillow under the head for supine exercises to help open the shoulders and using a foam cushion for seated exercises to align the rib cage over the pelvis. I have chosen some Intermediate exercises because of her fitness level, good muscle memory and coordination. I will also provide the client with exercises/ stretches that she can do throughout her work day to help alleviate discomfort and to keep her focused on her posture. 6
CONDITIONAL PROGRAM Block Equipment Exercise Muscle focus/ desired effects Client observations and achieved results Start the session with a Standing Roll Down Warm Up Mat (warm up) Pelvic curl Spine twist supine Chest Lift w/ Rotation Abdominals, hamstrings, spinal articulation, pelvic lumbar stabilization Abdominal control w/ oblique, spinal rotation Abdominal strength w/ oblique emphasis, pelvic stability I chose the Fundamental warm up due to the newness of these exercises and to start working her obliques. Foot Work Reformer Foot Work Hamstrings, quadriceps, hip extensor strength Assess her gait and tracking while strengthening short, tight Hamstrings. Head rest up Abdominal Work Reformer Hundred Prep Abdominal strength, trunk stabilization, Shoulder flex/ext. control Coordination Abdominal control, pelvic lumbar stabilization, shoulder ext. control Exercises done without Thoracic flexion to lengthen upper back with head rest up 7
Hip Work Reformer Frog Hip adductor strength, knee extensor control Circles Down/Up Hamstrings, hip adductor strength, hip extensor control Openings Hip adductor strength & stretch Focus on hip disassociation. Head rest up Spinal Articulation Reformer Bottom Lift Abdominals, hamstrings, spinal articulation, hip extensor control Bottom Lift w/ extension Stretch Reformer Standing Lunge Hip flexor & hamstring stretch Head rest down! Full Body Integration F/I Reformer Down Stretch Abdominals, back extensors Cadillac Sitting Forward (push through series) Side reach (push through series) Sitting on a foam cushion to align rib cage over pelvis. Abdominal- Hamstring stretch-spinal mobility Abdominals/obliques-oblique & shoulder Adductor stretch Arm Work Cadillac Arm standing Trunk stabilization 8
series Chest expansion Latissimus dorsi-shoulder extensor strength Hug a tree Pec Major- shoulder Adductor strength Circles up/down Punches Biceps Shoulder extensors - Adductors Triceps Biceps-stretch anterior aspect of shoulder Leg Work Cadillac Squats Quadriceps & Bicep strength Wunda Chair Hamstring Curl Hamstrings pelvic lumbar stabilization Hip Opener Hip external rotators pelvic lumbar stabilization Added squats because they are a girl s best friend!!!! Lateral Flexion /Rotation Wunda Chair Side Pike Abdominals - oblique emphasis Deltoids, scapular stabilization Back Extension Wunda Chair Swan Basic Back extensor/strength scapular stabilization Mat Cat Stretch Abdominals, Mid/upper back extensor strength Rest Position Stretch lumbar spine, relaxation of lower back 9
End the session with a Standing Roll Down I also provided exercises and stretches to do throughout her work day to alleviate neck tension, open chest, lengthen upper back, stretch Pectorals and Hamstrings. 10
CONCLUSION After four sessions, Lucy is thrilled about the way her body has responded. Noting improvement in her posture, feeling stronger and taller while experiencing less discomfort, Lucy has added Pilates to her ongoing exercises. The daily exercises and stretches have increased her awareness of her posture while at work and daily life. The program emphasis to strengthen one-joint hip flexors, external obliques, upper back extensors, neck flexors; while stretching hamstrings, internal obliques, and low back through the BASI method have proven effective. 11
BIBLIOGRAPHY BOOKS Kendall, Florence Petersen (P.T. F.A.P.T.A); Muscles: Testing and Function, Fourth Edition (1993) Isacowitz, Rael and Clippinger, Karen; Pilates Anatomy (2011) Isacowitz, Rael; Pilates, Second Edition (2014) Jarmey, Chris; The Concise Book of Muscles, Second Edition (2008) Body Arts & Sciences International (BASI); Comprehensive Study Guide (2000-2013) WEB Iowa State University Environmental Health and Safety King Abdulaziz University; Human Posture, www.kau.edu.sa/files/0052891/.../1- HUMAN%20POSTURE.PPT Spencer Systems 1952, Chapter 1: General Information, http://haabet.dk/spencersystem1952/1.html 12