Issue #369
Wednesday May 25, 2022
To side bend or not to side bend – that is the question
by Suzanne Martin
To side bend or not to side bend – that is the question
by Suzanne Martin
As a young dancer, I noticed that the sides of my waist were uneven. In those days, I taught aerobics as one of my five jobs as an independent dance/fitness teacher. The fitness fashion at the time was little running shorts worn on top of striped leotards. Students often told me that the seams of my shorts had been extremely twisted throughout the whole class. Oy! I had had back spasms in the past, but once I became more ‘fit’, my spasms ceased but my twisted shorts apparently continued, much to my bafflement and embarrassment. In ballet class, teachers would walk by and say, “Stand up straight, please!” In modern class, the teacher would say, “Where is your spine? Do you have a spine?”
Then came Pilates! Thanks to Michelle Larsson, my mystery started to unravel and so began the quest for the true unraveling – I could now strap my ankle underneath the reformer foot strap, lie on my side pelvis, and then elongate my waist on the short box, side reach and lengthen out each side independently.
Heaven.
With practice and guidance under some of our initial Pilates forebears, progression and acquisition of most Pilates vocabulary eventually came about for me. Mermaid was always a challenge, and unfortunately Snake was always out of the question. It still is. My spine and ribcage simply give me the big NO when the hands and feet are fixed and then I attempt to glide the carriage bed to twist inside of them. Practice not only made my movements much better but also made me much wiser following the Pilates principles of concentration and emphasis on continual centering.
With my focus drawn toward the asymmetrical spine and trunk, I attracted clients with asymmetries and related conditions. Decades later, I am grateful to continue to work with these clients and to spread the word to our community.
Lately, there was a question about side-bending, lateral flexion, for those with spine asymmetries. It reminded me of what the fitness industry once called “outlawed moves”. Some examples:
The trunk hanging over the legs, elbow to opposite knee while lunging side to side rapidly – lots of people getting disc issues from these quick, ballistic moves.
Standing, hips flexed, hanging over, with knees extended, straight legged hamstring stretches.
Not that these were inherently “bad”, but without focus, preparation and form, it was impossible to stay safe in the moves. Perhaps that idea is for another essay.
Why mention these “outlawed motions”? One instructor that I mentor said her Pilates studio “doesn’t allow lateral flexion” for those with spinal asymmetry. I think this is an idea worth unpacking.
First off, lateral spinal flexion is an automatic motion seen in all walking as well as in reaching up into a high cabinet. What Pilates teachers do is exactly that – help people acquire good functional motion. Although Pilates may look ferocious on the outside, IMHO we excel in breaking down simple motions to help people acquire better functional ability.
First, take the typical Mermaid. Yes, to perform a full Mermaid requires a good amount of spinal lateral flexion. Lateral flexion happens mostly in the lumbar spine since it does not rotate much. The thoracic spine and ribs are meant to rotate. Yet the problem is that a person with spinal asymmetry likely has stiffness in the ribcage in the area of the greatest lateral convexity and a tendency to not rotate conventionally, often due to other soft tissue compensatory patterns.
What is a teacher to do? One of my favorite exercises to start to understand the lateral flexion of the Mermaid is the thoracic mobilizer.
As a mat exercise, it reveals asymmetry in the lack of ability to rotate equally; it can also be modified as a chair exercise for those who cannot sit on the floor. For clients over 50 (who may be at greater risk for vertebral fractures), the range can be further modified by blocking the amount of rotation with props. In each instance, the main goal is to learn how to support the body weight through arm bracing on the mat (elongating out of the forearm on the mat), prop use (pressing down on the back or seat of the chair) or pressing against the rotation blocker (such as a gondola pole). Teaching someone with asymmetry or any spinal issue the skill of acquiring a true lateral flexion is a gift worth giving.
Another of my favorite exercises is also modifiable. One client learned it just recently – she is awaiting a hip replacement, is over 50 and has a moderate spinal asymmetry. This exercise uses weight against the head to teach side bending. It focuses on how far a spine can comfortably go, unaided, and uses gravity to enhance the proprioception of how heavy a torso is. If a person cannot sit on the floor in contact with the sitting bones, use a bolster, box or cushion. Being low is helpful, and a chair modification is also possible.
First establish the neutral position on the sit bones. My cue is to feel the imaginary hand stroke the skin of the low back upwards instead of just emphasizing the hinging of the low back to make a lordosis. Seated on the mat or a pillow/bolster, use one hand on the sacrum and the other to gently press the sternum backwards in order to find neutral verticality.
Start by just using the hands clasped behind the head and press the head back into the hands. Open the hips to a wide stance in parallel rotation/ knees up and the soles of the feet down with contact of the pads of the great toe downwards. Exhale out to prepare. Inhale and slowly reach the right elbow to the right knee. Exhale by pressing onto the right sit bone and pulling the left elbow up to stop at neutral, the ‘V’ of strength. The ‘V’ is formed by the 2 lines from the L4/L5, up through the lats, the triceps to the elbows. Alternate to each side about 4 times. If comfortable, add light weights (2 – 3 pounds; 1 – 1.5 kg) on the top/sides of the head to increase proprioception. To progress the range, straighten the legs with a folded towel or ball underneath the knees for comfort.
One modification is to sit on a chair, take a light weight (2 – 5 pounds; 1 – 2.5 kg) in each hand. Simply lean several inches to one side of the chair, turn the palm forward. Inhale as you sit up and bring the weight to the shoulder, then press the weight to the ceiling.
Find a way to teach your clients lateral flexion. It’s one more way we can help our clients to find strength and function, enabling perfection inside of imperfection.
Dr. Suzanne Martin has been practicing Pilates for over 30 years. She is a doctor of physical therapy, exercise physiologist and a gold-certified Pilates expert with a home studio in Alameda, California. An international presenter, she blends art and science, into her writing and instruction. She has been Lead Physical Therapist for over 20 years with Smuin Ballet. As founder of Pilates Therapeutics LLC she teaches worldwide on the subjects of spinal asymmetry, cancer restoration, foot management and performing arts enhancement. Look for her latest publication from Handspring Publishers, Spinal