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Episode 68: Promoting Movement Optimism
1.3k Plays6 months ago
Welcome to Episode 68 of the Movement Logic podcast! In this episode, Sarah is joined by soon to be Doctor of Physical Therapy Adam McAtee, founder of Evidence-Based Pilates, a continuing education platform for Pilates instructors. Sarah and Adam discuss long and lean, whether Pilates can contribute to bone density improvement, and why the hundred is Sarah’s least favorite one.
In this episode you will learn:
- Common myths often heard from clients and instructors alike about Pilates, including using lighter springs to strengthen smaller muscles
- Why Pilates instructors confuse aesthetics and functionality and how freeing it can be to let them go
- How the variety of Pilates styles now available is a positive, not a negative
- The relationship of Contrology to modern day Pilates
- Why it’s not that useful to your students and clients to name where all of your exercises come from
- The difference between instructor-centered care and client-centered care
- The importance of meeting clients where they are, even if you’re uncomfortable
- What heavy load could look like on a reformer instead of the typical endurance based exercises
- If anyone can make accurate claims about what the Hundred is for
- How any Pilates exercise might be useful for one particular population
And more!
Sign up here to get on the Wait List for our next Bone Density Course in October 2024! It’s the only place you’ll get a discount on the course plus fun free bonus content along the way.
References:
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Transcript
Introduction to Movement Logic Podcast
00:00:02
Speaker
Welcome to the Movement Logic podcast with yoga teacher and strength coach Laurel Beaversdorf and physical therapist, Dr. Sarah Court. With over 30 years combined experience in the yoga, movement, and physical therapy worlds, we believe in strong opinions loosely held, which means we're not hyping outdated movement concepts. Instead, we're here with up-to-date and cutting-edge tools, evidence, and ideas to help you as a mover and a teacher.
Introduction to Adam Macatee and His Mission
00:00:35
Speaker
Welcome to the Movement Logic podcast. I'm Dr. Sarah Court, physical therapist, and I am joined today by my very special guest, soon to be Dr. Adam Macatee. Adam is based in Long Beach, California, and he is the founder of Evidence-Based Pilates. Evidence-Based Pilates is a continuing education platform for Pilates instructors, and their mission is to allow
00:00:57
Speaker
science-based education to be affordable and accessible for Pilates instructors. With over a decade of experience, he has a BS in exercise science and is currently in his final year of physical therapy at the University of St. Augustine. Adam's passion for education inspired him to share his experience by bridging the gap between research and the Pilates studio. To him, knowledge is power and it is essential to remain open to new information while maintaining the ability to adapt over time.
00:01:26
Speaker
Which, dear listeners, if you've been paying attention, sounds an awful lot like strong opinions loosely held. Which is our tagline. If you're like, what does that even mean? He is very quick to point out all of the myths around what Pilates can do for your body and what it can't. And I've been wanting to have him on for a while because Laurel and I are both come from a yoga background, not a Pilates background. And even though I am now trained in rehab Pilates as part of my job as a physical therapist,
00:01:54
Speaker
I didn't come up, so to speak, in the Pilates world. So Adam is here to help debunk all of the myths about Pilates that have become commonly accepted. Adam, thank you so much for joining us today. Thank you for having me. It's a pleasure to be here.
Debunking Pilates Myths
00:02:10
Speaker
So I just want to dive right in and ask you, what are the top three myths about Pilates that you find yourself constantly having to debunk? What are the things that your clients come to you with? And you're like, nope, that's not true. Nope, that's not true. Nope, that's not true.
00:02:29
Speaker
Yeah, no, it's a good question. And I think it's both clients and Pilates instructors alike, as my main role is a Pilates educator nowadays. So like my clients, I really are Pilates instructors looking to learn and grow. But both, I think they're different kinds of myths, I would say. One of these, and I'm totally freestyling this, forgive me if I go, I'm like, damn, like, this is my eighth myth.
00:02:53
Speaker
The first one that comes to mind is just the essence of alignment protocols and that being a necessity for injury prevention and movement quality and improving the functionality of someone's life. And that is that you have to have appropriate alignment or what we deem as proper alignment prior to adding load, which is another myth that I'll get to.
00:03:17
Speaker
What is load and should we do it? What's also really like interesting is like with the alignment, it's like it's based on qualitative assessments from a visual perspective from a Pilates instructor that generally hasn't been taught how to do movement assessments. It's like, does it look pretty? And it's not the Pilates instructors fault. It's not. It is an educational problem because you should never feel guilty about applying what you paid thousands of dollars to learn.
00:03:46
Speaker
You should never feel guilty about that. It's not your fault. And this isn't a blame game. It's just a,
Functionality vs. Aesthetics in Pilates
00:03:50
Speaker
it's okay. Be open to information. Take it what you like, like leave what you don't. But something as simple as allowing like the heels to go inward towards the midline during planar flexion. We're taught that's not allowed, right? No. You know, but then it's like, but then you see it and it's like, oh, it's happening again.
00:04:12
Speaker
I have to fix this, right? So we put like a ball in between or you pull with your hands like you're doing unknowingly doing like a manual therapy on their heels, where it's like, when you learn and you grow, right, you understand that like, oh, that's, that's how the human body works during plantar flexion, your heels go towards the midline, like, it's just, it's so freeing.
00:04:36
Speaker
And then even outside of that, that's just an example of like where we're misguided, but based on a confusion of aesthetics equals functionality. And so with that, it can be so freeing to be like, I can't let that go.
00:04:54
Speaker
I can, yes, like you can just let people move because what happens is like with these aesthetic rules based on alignment protocols being confused with safety protocols, we end up creating more movement rules and barriers to movement, which when you have more movement rules, you have less movement.
00:05:13
Speaker
And as a movement educator, the net result of someone's time with you should be more movement, more movement and volume and more movement options. And if you limit options, that's the opposite of what the net outcome should be.
Critical Thinking in Movement Education
00:05:26
Speaker
So I know it's a rabbit hole, but like, I think we just went into four different myths, but the first, I mean, I'm listening to you talk and I was just like, you know,
00:05:34
Speaker
I was like, well, first of all, he's just like summed up our entire mission at move a logic, but then also like it made me think of, cause I, I don't teach, uh, similar to you. I don't teach yoga classes anymore, but I teach yoga teachers, like go into teacher trainings and teach anatomy. And all I do, I do this thing in the training sometimes where I'll like stick up a picture on the wall of somebody doing a pose that like from a yoga teacher's perspective would be quote unquote wrong because aesthetically it's not very pretty, you know,
00:06:02
Speaker
And then I'll be like, all right, well, what do you want to change about this? And I'm not trying to do it in kind of a gotcha way, where I'm like, oh, you're dumb and wrong. But it's more that if somebody says, OK, I want them to straighten their knee, for example. And then I might be like, well, why?
00:06:20
Speaker
Usually the answer is something along the lines of it looks nice. So it's the same idea, right? It's this idea of like, well, the reasoning behind making any of these, you know, alignment, quote unquote fixes is not because the person is going to hurt themselves necessarily. It's got nothing to do with that. It's got to do with like, this is what the person with the most flexibility in the world, when they took a picture of it, this is what it looked like. And then we all somehow have to also be in that shape.
00:06:45
Speaker
But you're also not allowed to straighten your knee. Don't lock it. Yes, God, never lock it. Straighten it, but don't straighten it too much. Yeah, that's always a fun one. But that just goes back to, again, understanding a screw-home mechanism of the knee. It's literally designed to lock. It's an evolutionary advantage. But that's its own topic.
00:07:08
Speaker
So before that, like alignment protocols being deemed as helpful and it's not wrong to help someone with their alignment. I think a lot of it has to do with the language and our reasoning behind it. Like if you're doing a hip hinge and you want someone to be in more of like what we perceive as a flat back, it's not wrong.
00:07:25
Speaker
It's just like, what does it mean? Well, now it means that maybe we're working on kinesthetic awareness. Do you know? I feel like it's helpful if someone knows the difference if they're around it or not. And then also, why are we isometrically contracting the erector spinaire or the spinal extensors? You just know you're doing that. And that's where it's like, there's so many ways to win. And that's one of the missions. That's a mission within the mission of what I'm trying to teach. There's so many ways to win.
The Myth of Lighter Springs in Pilates
00:07:51
Speaker
There isn't just the one way that we've been
00:07:52
Speaker
attached to, that's one way to win. And then you can also win by like picking up a kettlebell, right? And so another like myth is that like lighter springs will get you stronger, lighter loads will get you stronger because then smaller muscles and that's going to protect the bigger muscles that you're never actually allowed to exercise. Wait, sorry. Can you, cause I, I, that's a new one to me. Can you
00:08:18
Speaker
And this isn't just Pilates wide. I'm only one person. It's totally anecdotal, but I've done four trainings or been a part of four trainings, like either as the trainer or the trainee. And I've also taught Pilates for 14 years and you're in the studio and you hear things that small, like lighter springs are how you get the body stronger because then we're biasing smaller muscles, which is completely wrong. And this is oftentimes taught like,
00:08:46
Speaker
the rotator cuff is a really good example, right? So for the rotator cuff, it's taught that like,
00:08:53
Speaker
This is where knowing a little bit of anatomy and biomechanics is helpful. It's often taught that we need to work to get, in order to get the rotator cuff stronger, you have to use it as a prime mover. So you have to do like internal, external rotation of the shoulder, but it's actually, anytime you're like moving your arm and loading it, you're working your rotator cuff. So like a pushup is a rotator cuff exercise. A dolphin pushup, am I speaking yoga? A dolphin pushup is a, that's just, don't get impressed. That's all, that's the only yoga taco.
00:09:22
Speaker
rotator cuff exercise, pulling, it's a rotator cuff exercise. So actually smaller muscles get stronger with more load, just like bigger muscles. And then if they didn't get stronger with bigger load, why do you need to work them? Like, are you having a problem picking up a can? Or are you having a problem picking up all the groceries, right? Like, you know what I mean? Like at different layers, like if you're allowed to question it,
00:09:45
Speaker
Then it falls apart, which is a really big thing as well. I don't know how it is in the yoga space, but as
Yoga and Pilates: Educational Parallels
00:09:51
Speaker
a teacher trainer, I've taught teachers in training programs at Breathe Education for the past, I think, three years. I don't know, a long time.
00:10:02
Speaker
And a lot of it, a lot of the feedback we get is that it's so freeing that they're allowed to ask questions because a lot of times you're not allowed to ask questions. It might be like you're allowed to like on the, on the website. So you sign up, but then you go in and you're not actually allowed to, because if you do, then you get told why you're wrong rather than promoting critical thinking, which is a way better skill than understanding normal range of motion of the knee.
00:10:29
Speaker
Like learn and foster critical thinking. Any teacher trainers out there do that. So I think that that's a lot of these movement rules are these ideas that were taught. They get passed through because they're never questioned because we respect people we paid $10,000 to and we're not actually allowed to ask the questions. We're just supposed to figure out why they're right. Yeah. I mean, that reminds me so much of, you know, my very first yoga teacher training that I did at Jiva Mukti where it was like,
00:10:58
Speaker
And I sort of understood it from their perspective because they were teaching a room full of a hundred people. And if everybody got to stick their hand up and ask questions, they would never get to the material. But it was immediately clear that you were just supposed to accept everything. And basically like you were sort of exhausted to the point where you just started. It was very culty because you sort of got exhausted to the point where you just gave in and started accepting everything because that was the easiest option of all of the options. The other one was like leave. But again, then you'd spent
00:11:26
Speaker
It's like seven or eight thousand dollars at the time. I know it's more now. And I wonder also if, you know, it's sort of like in reverse, like we respect them because we paid them eleven thousand dollars, not we respect them. And then we think that respect is worth eleven thousand dollars. Right. It's like, well, I don't want the sunken cost felt like I don't want to lose out on this money. So they must be right.
00:11:48
Speaker
Yeah. But like, why are we go to a training that doesn't have a hundred other people? Well, yes. I know that now. At the time I was like, well, it must be good. A hundred people are here.
Pilates' Origins and Misconceptions
00:11:59
Speaker
So many people want to do it. What I think about it in the yoga world is it's in terms of like how the misinformation is passed from teacher to teacher. It's sort of this like Westernized, demented game of telephone where it gets slightly incorrect each time, but it's this,
00:12:17
Speaker
imitation of the indigenous guru model of teaching, right? So the authority of the person saying it just makes it true. It less than, oh, this is something that is accepted worldwide. I mean, you think about something like Anusara Yoga, which no longer exists, but they had what they called universal
00:12:41
Speaker
think it's universal rules of alignment or something. And it was all these like, you're supposed to circle your kidneys back and then rotate your chest for it was all there's a lot of like circle them forward, twisting and all these kinds of things. And it was very bizarre. But everyone we all just sort of agreed because, you know, it was popular and
00:13:00
Speaker
the, it just sort of became factual. I mean, is it, is it sort of the same way in Pilates? I mean, you know, what, what Joseph Pilates was teaching was contrology. So how much is it sort of like, that's where the game of telephone happened between that and what we call Pilates today. And it's actually like, couldn't be farther away from like the beginnings of it. Does that make sense as a question? Yeah. Yeah. It's like, whoa, there's so many directions to go. That's me. I like to ask very long questions that could go anywhere.
00:13:28
Speaker
Cool. So yeah, so the origin of Pilates now I'm not a Pilates historian, but I I've been around a long time where and I can have a I can have a nice cocktail party conversation about it. It's not a strong interest of mine because it doesn't
00:13:41
Speaker
change any clinical, it doesn't change my clinical decision making. So I don't really value it. Um, but it is good to know. So the origin of Pilates, it was called contrology and by the founder and creator, Joseph Pilates. What is now the Pilates has gone through different eras. If we were to summarize it quickly, it would be like the classical era, which is post like, like post Joseph Pilates with the closest thing to it. Then we went to like a contemporary era, where it's like very like,
00:14:09
Speaker
fear-based physiotherapy, like go contract your popliteus, but not too much. And then now there's like this new era of explosion, right? Which is taken on very many different, you know, colors.
Problem-Solving in Pilates
00:14:24
Speaker
What is often confused is that classical Pilates is contrology.
00:14:28
Speaker
That's not true. You can just go into the book and be like, nope, there's all kinds of shit in here. That's not the same. Go on YouTube and look at Joseph Pilates. It was not gentle. It was the opposite of gentle. And so all Pilates is contralogy inspired.
00:14:44
Speaker
you can be a one degree away from contralogy you can be ninety degrees away from contralogy and for me i'm like how awesome is that like there's so many ways to win there's so many options for people my partner you would never go to a classical quality classy be he would be so bored you would never do it and i'm there's i'm just throwing him under the bus because he's
00:15:05
Speaker
There's so many other ways. I was working with someone the other day in the clinic. She's like, oh, I do Pilates. And I was like, oh, tell me more about it. She's doing Ligri, whatever. That's the only thing she'll do. She's like, that other stuff is boring. For people who don't know what it is, can you explain what Ligri is?
00:15:22
Speaker
Yeah, I mean, like I've done like one class. So like the degree is just like, it's like a fitness routine on their own equipment that kind of sorta like if you were from outer space, you'd squint and you'd be like, Oh, it looks like Pilates, but they also market that they're not Pilates. You know, it's but the consumer, they don't know the difference. Right. Right. But what matters is like, is this person moving? And are they getting healthy?
00:15:44
Speaker
Like to me, that's all that matters. There's a lot of times it is seen that if you are close, kind of like organic foods, like organic foods are like superior to other things. It's like organic Pilates. Like if you, if you are teaching what Joseph Pilates taught, then you're correct.
00:15:59
Speaker
Like, and that's not to be questioned, right? If Joseph, like the common narrative is if Joseph didn't teach it, it's not Pilates. I'm like, well, Joseph didn't teach Pilates. Joseph taught Contrology. So like, it's a, it's a very monotheistic point of view that is following a recipe rather than going from the mindset of the creator.
00:16:18
Speaker
and then continuing to solve problems for people in front of you. So for me, I like to speak to this conversation, but then in terms of when I'm in the clinic or from an applauding studio, it has no merit on my decision making. We're here to help people.
00:16:32
Speaker
Should you know Pilates and the origin of it? Absolutely. Should your treatment be inspired by it? Sure, if it's appropriate. But then also you should, another step into the career is like, when can you detach from this? Like you have permission to do something that you weren't taught in your teacher training to help the person in front of you. The person in front of you doesn't care if it's Pilates or not. And you don't need to say, this exercise is not Pilates.
00:16:59
Speaker
That's not helpful, because sometimes that happens. Trainers are like, yeah, I do that. I just tell them this isn't Pilates when we do a squat. And it's so weird. Do you tell your patients, if you taught Mackenzie, this is the Mackenzie method, okay, now we're doing this yoga exercise.
Client-Centered Care in Pilates
00:17:19
Speaker
I think it's so weird. It's like, just teach them movement.
00:17:22
Speaker
I'm going on total tangent. But it's true. It's like we can get so caught up in this idea of like, oh, no, but I have to credit where I got this from. It's like, I mean, in some circumstances, sure. But in your session with your client and you're doing a child's pose on the reformer somehow or something, you don't have to be like, well, this is originally a yoga movement, but I learned how to modify it. They're going to be like, I don't care. I just want to feel better.
00:17:49
Speaker
Yeah, in a good way to do this would be like, if you were to confuse the crap out of your client or patient, what would you do? Well, I would tell them all of my thoughts about the exercise. I would tell them all of the joint movements that are happening. And I would definitely speak a lot of anatomy. I would tell them the history of Pilates. And then with that, I would also let them know that I'm probably wrong because I don't know everything about the history, right?
00:18:15
Speaker
or anatomy or biomechanics, right? So then it's like do the opposite. Be confident, just get them moving, collaborate with them, provide client-centered care. But if they have a question, right? If they're like, what's this bone called? I do think you should be able to educate them on that because they ask the question.
00:18:33
Speaker
Definitely and I think as well. I don't know. I was gonna say once you've been working long enough, but it might be just obvious from the beginning you can tell the clients who have a like more than like a layman's understanding of the human body, you know, so you can choose the ones where you go into a little bit more detail or the ones who want to know the why like why am I doing this and honestly like
00:18:55
Speaker
If you don't know, they'll just ask you because there's been times when I've been doing stuff with patience and just like, you know, going along, okay, let's do this. And then somebody like, why are we doing this? I'm like, Oh, okay. Yes. Good point. I should probably be able to communicate that to you.
Marketing Myths in Pilates
00:19:09
Speaker
So yeah, definitely, you know, not confusing people by, by having to get so deeply into the origin of every movement. And it's the kind of thing that I think movement teachers of whatever ilk, whether it's yoga or Pilates, where it has a long,
00:19:23
Speaker
background, and it's gone multiple directions, there's a place for that within the community of the instructors. Because those are the only people who give any amount of shits. And your average client or patient, to your point, really doesn't. They just want to feel better, they want to move.
00:19:41
Speaker
Yeah. And so that's the difference between instructor centered care and client centered care. So instructor centered care is like, let me share everything that I know with you and let me educate you and you need to move this way because I like it. Like I remember last time I worked at a Pilates, the last time I was staff at a Pilates studio and I walked in there just trying to be open minded and I was not breathing correctly. I think I was doing it out of my mouth.
00:20:07
Speaker
or something. And I had to stop the movement. They're like, I'm really into breath. So you need to breathe this way when you're doing your exercises. In the moment, I was just like, all right, let's do it. And then just walking away, I'm like, wow, that feels so shitty. There's such a lack of autonomy. It's the opposite of motor learning. Lack of autonomy. It's authoritarian. It's like, I have to serve the instructor.
00:20:31
Speaker
But it's so easy for clients or patients to go into that because if you admire your instructor, you want to serve them, just like us as instructors, the person who taught us, we want to serve them. They assume they know better. They're the instructor, right? They're, they're the ones who know what they're doing. So I must be breathing wrong. Yeah. That's how most information spread. I want to switch topics a little bit because Laura and I are doing a three-part series of episodes this season, all about the phrase long and lean.
00:20:57
Speaker
Just saying those words together, I just, I can feel like the ire starting to burn in my gut. But anyway, I'll try to stay calm. I know that, I don't know if we know exactly the original source of it, but I know that it does come up a lot in Pilates, as in Pilates will make you long and lean. So I wanted to find out from you, what's your take on that phrase? Why do you think it became so popular? And then how do you see it playing out in things like the kinds of choices teachers make in class in terms of the
00:21:27
Speaker
exercises they choose and how difficult they make it or the language and the queuing that they use, things like that. Yeah. I think it's marketing, leveraging the insecurities of individuals and mostly of female, you know, females, but it can also be females. So I think it's just trying to leverage insecurities to make money. And with that, it's an aesthetic. It has nothing to do with function. Like it's like the opposite of my interest in terms of like what, like it's like, that means nothing to me.
00:21:53
Speaker
You want to get back to doing, right? It's like function, you know, what's meaningful to you. When I hear the terms long and lean, I hear aesthetics, right? There's something about appeal to other people or appeal to yourself in the mirror based on the opinion of others.
00:22:08
Speaker
So then immediately I go into more of like a psychosocial dynamic and I'd be really interested within that human if they asked for that, right? I'm like, well, what does that mean to you? So it's like, sorry, like I go into like an ORS framework and start to like ask open-ended questions. Like what does that actually mean to someone long and lean? And that can open up a whole world to other people. But in terms of the Pilates teacher and the Pilates instructor, that can be an easy trap as a novice instructor to go into that. And as you start to learn more,
00:22:36
Speaker
You start to just learn how it's not really a thing. And it, and it keeps us away from loading bodies because it's like we're, if, oh my God, if you put on that extra spring, your triceps going to pop out of your t-shirt, like it's really hard to accidentally get ripped. If anyone knows how to do it without injections, like.
00:22:53
Speaker
Please let me know like I've been trying and it's not working. I mean it's working, but I'm not like, you know, it's not happening accidentally. We would be billionaires if somebody knew how to accidentally get ripped. Yeah, and I'm sure there's like some genetic person, you know, there's always genetics where it's like, oh, you get stronger, easier, whatever. But there's like, there's always outliers. I'm talking about like the 99.7%.
00:23:15
Speaker
I, you don't, you really don't need to worry about it. Um, but I think that that it, it scares people into loading because it's like, I don't want to look like a super rip, like that person in the magazine. Well, that person in the magazine is disciplined beyond comprehension.
00:23:30
Speaker
And that is, that is in every aspect of their life. And after that photo shoot, they probably don't look like that in two months, right? If they breathe out finally after that photo shoot. Yeah, you know, but it's totally fine. There's nothing wrong with going for that aesthetic and being that determined discipline. That is a discipline that I don't have.
00:23:49
Speaker
But for the common folk, it's misinformation that we want to look this way. And there's nothing wrong with wanting to look a certain way. I think there's so many ways to win. It's like, well, what's important to you? Is that important to you? Why is that important to you? And getting to the human inside of that thought. And that's where my interest immediately goes.
Shifting Focus to Strength and Movement Options
00:24:11
Speaker
for the instructor, I think we need to turn that into the value of loading at full muscle length and loading at full range of motion and just changing that language, right? Because I thought at times that's what we end up doing, but it's that idea of like we do this movement thing and then we put a label on it. So you can still do the movement thing, but just change the language and it's completely, it's like totally empowering.
00:24:37
Speaker
So that's one of the beautiful things about Pilates is like we can, we can load joints at full range of motion so easily with the pulleys. That's part of the beauty of it. And you can change your orientation to gravity and load so well. And then if we just take like the long and lean crap out of it and just saying like, like something to do with like health and wellness and things of that nature, like that could be really helpful for the consumer. Um, however, um, just to play devil's advocate, if the consumer comes in and says, I want to get long and lean, sometimes you meet them where they're at.
00:25:07
Speaker
Right. It's okay to speak their language for a little bit and get them to do the Pilates, but over time, changing it to like educating on like, Hey, we're going to get you stronger. And then things of that nature at full range of motion. Do you feel how you, how you can get your arm all the way over your head with resistance? I started to think about like how you can just strength train at full range of motion and get the same flexibility benefits as stretching. And so like going with that. But in terms of the long and lean, just to summarize that.
00:25:36
Speaker
I feel like it's marketing to exploit insecurities. I don't promote it. You'll never see it from me, but you will see things like load and load at full range of motion and to explore as many movement options as possible, because if you can.
00:25:51
Speaker
load your shoulder at full range in all directions. You're going to have more movement options. You're going to be able to do things that are great and you're going to feel better and achieve more things. And then before you know it, the client who achieves that won't be using the term long and lean. They're going to talk about how good they freaking feel. And that's why I say sometimes you just got to meet them where they're at because that is client centered care. So many people come in and they're uncomfortable. They walk into Pilates studio and they're like fucking torture chamber. Sorry. I don't know if I'm out of cusp. You absolutely are. Careful what you wish for.
00:26:20
Speaker
So like, you know, torture chamber, like they're so uncomfortable. And these machines and like pulleys and it looks totally insane. They're willing to meet us with their discomfort and they come in and they say these triggering things like, I want to get long and lean. Are you willing to get uncomfortable with them?
00:26:37
Speaker
That's client centered care.
Community and Learning in Pilates
00:26:39
Speaker
And I'm not saying to promote it, but I'm saying to speak their language a little bit and like, okay, Tom, you know, and just like have a conversation about it because it's so easy to shoot it down. Right. Right. Then that's that's putting up a wall and saying I won't go where you're at.
00:26:53
Speaker
I think that's really nice. You obviously push back against this. I know Anula Meiberg, who are listeners, also pushes back pretty strongly against the typical, quote unquote, Pilates body, which is that kind of long and lean dancer aesthetic. Do you see a lot of pushback generally with other instructors? Or is it like the equivalent of the yoga world would be, you know, there are the people who are like, Asana is all you need. Asana is the only thing.
00:27:18
Speaker
It needs to look like this just sort of focused on the aesthetic of it all the time. And then, but there is, but there's sort of a split between the people who are still doing that. And then the people who are like, Oh, actually, yes, I do yoga, but now I also do some strength training because there's insufficient load in yoga. Like, do you see more and more people moving away from like the, the aesthetic of being a Pilates instructor or the aesthetic of Pilates or is it kind of 50 50 or what do you think?
00:27:44
Speaker
Yeah, and one thing that's great to identify with that as any answer I'll give you is based on my own sampling bias of people who I choose to click follow and people who I choose to click unfollow. And I think that's really helpful for any listener to hear is that what's your interest? What do you want to be inspired by? And there are people doing that. And so what I can say is that within what I see and who I communicate with, there is a shift.
00:28:13
Speaker
in, in loading more and getting away from the aesthetic aspect of this. And there's nothing wrong with the aesthetics. Like maybe you are a dancer and maybe you do need an aesthetic part of your art, then go do it. But it has to do with like, it's the aesthetic of you're not good enough unless you, unless you fit in this aesthetic. And that's something that I stand strongly against because you are good enough and like you're a fucking big deal.
00:28:35
Speaker
you let me cost you what happened. It's like, anyone, it's like, you are a big deal. And you're like, go be a big deal. And like, how do you want to be a big deal? How do you want to win? And with that, in my exposure, like I've worked with John Gary, where we had like dumbbells that were so big that I couldn't even lift them at the time in the Pilates studio. I work with Ralph Bender and Heath Lander and the whole Breathe Education crew. So like, we're just teaching Pilates instructors day after day, load, load, load.
00:29:00
Speaker
So in my exposure, it's becoming more normalized to have weights in the studio and not like the highlighter weights that you buy in Amazon that gets shipped to your door, but like freaking kettlebells that are heavy, or dumbbells that are heavier, meaning they are heavy enough to generate an adaptation response and progressively load.
00:29:20
Speaker
over time. But I do also work with instructors that might be new to the circle that I'm accustomed to where this is transformational for them and they may reject it and they may accept it.
00:29:32
Speaker
And I think that's important to recognize is there's always going to be contrast, right? And there's always, and then that's where it's like, you're always going to have value. If you're an instructor out there that's like promoting load, there's always going to meet, be people that need to hear that because, you know, they're told that their heels can't go inward when they point their toes or you're like.
00:29:51
Speaker
Don't put on the extra spring because their spine isn't too neutral even though we can't see it or that it matters. You know, there's always people to help. I'm just speaking from my experience but I've chosen to surround myself with people that are like-minded but also smarter than me so that I continue to grow, you know, in a direction that's inspiring to me and I would encourage anyone listening to do that. I'm very active on social media. We can hang out.
00:30:17
Speaker
That's such a great approach, not just with a circle of people where we're all just yes, and ending
Inclusivity and Equipment Limitations
00:30:22
Speaker
each other, right? Where we're all sort of, but actually to find the people that are smarter than you are or have more experience that you can learn from. And then also to be that person for other people. I do want to say though, a traditional reformer.
00:30:35
Speaker
by traditional, what do I mean? Like a marathon stop reformer or like a balanced body reformer. Those are the only ones that I know. But they're made for smaller bodies, not just weight smaller, but like height smaller, breath smaller. I have a, this is a plug for Flexia who are not paying me, but I have a Flexia reformer mostly because a lot of the private clients I work with are men.
00:30:56
Speaker
And it's however much wider and however much longer the carriage is. And for me as well, I mean, I'm six feet tall, a regular reformer. I am like scrunched up in a ball if this, if it's anywhere closer than like the fourth gear, you know, it's sort of like there's a bias in the equipment in a way. Do you know what I mean? Like, and I wonder how much that is discussed or questioned or
00:31:21
Speaker
Or is it just sort of like, oh, if the person is tall, just like gear it out a little further and they'll be, have them stick their butt out or something and they'll be fine or? Yeah. I'm, I'm a tall person. I'm six foot one. I don't know how many centimeters that is. Sorry, people. Um, like 180 centimeters or something like that. Cool. Yeah. Something like that. So if I had any idea, just totally made that up. Yeah. So six foot one. So, so for me, like a classic example is the exercise like semi circle.
00:31:45
Speaker
which is like your arms are over your head on the shoulder blocks and you push the foot bar out. So like the length of the reformer would require that for it to be as long as I can reach my arms over my head with straight legs. So I just don't experience that movement like someone who might be
00:32:02
Speaker
Five foot three for that, you know, I would say as a, if I were a studio owner, which I'm not, and I don't, I currently don't have a desire to be, you know, there's, there's, there's this thing of like, what reformers do I get? Like I would, I would at least have like one or two that are much larger as in wider and longer than the norm because it feels really like we're trying to promote more movement. Right. So to promote more movement, you want to have it be.
00:32:28
Speaker
you wanna have as little barriers as possible kinda like business right you wanna have your website designed words as little clicks as possible for purchase so we don't wanna have these barriers to entry and so someone is a larger or longer body. Right and then you have a barrier to entry on the size of the equipment that sucks.
00:32:46
Speaker
And regardless of the height or the size or any other aspect of a human, they should have the equal opportunity to move. If you have the means and the space and all that, I would highly recommend getting at least one or two reformers that are available to all individuals. When I first trained, my first training was a classical training. There was an instructor there that taught some of the ABP volleyball players and some NBA players.
00:33:09
Speaker
and so I'm in Southern California so they're around and she had a she had a larger reformer specifically for that because there is no like Luke Walton used to come in if anyone knows that he's like six nine there's no way you think you and I Sarah have a hard time
00:33:24
Speaker
Yeah, no way. But in terms of gearing out, I haven't found the gearing out to be as problematic because now, since learning more about movement, I peg that shit in all the way. I'm like, how much can you bend? We're going in that far. For me, I'm probably 110 degrees and hip flexion to start footwork. Whereas before, it was like, don't bend past 90. If you get in your car, then it's safe. Don't round your back unless you're putting your bags down, and then it's fine.
00:33:51
Speaker
Yeah, yeah. And then we can't even see it anyways, so I'm just fine. Right, exactly. Okay, so let's talk about Pilates in terms of strength training. And you already referred to that you're working with and training alongside and training people who are now getting used to things like having meaningful weight. I like that you called it, what did you call it? Fluorescent weights?
00:34:11
Speaker
Oh, like the highlighter ones. The bright pink, the bright yellow. You know, Lowell and I talk about how with yoga, traditional yoga, when you're not adding anything to it, is body weight only, obviously. So it's very low resistance. It might initially be something that is strength building for someone who's severely deconditioned, but pretty quickly
00:34:35
Speaker
It's no longer going to be enough in terms of load to impact that person's strength, whether it's strength endurance, whether it's strength more in the power kind of discussion of it. I wonder with Pilates in terms of progressive overload, like there's a limit. You're going to run out of springs at some point. You see in terms of the Pilates instructors that you come into contact with through your work that most of them believe that the reformer is sort of enough for strength training.
00:35:03
Speaker
Well, a lot of clients don't know what to believe, so they just believe the instructor. You know what I mean? Like, that's what they're
Progressive Overload in Pilates
00:35:10
Speaker
paying you for. So I think there's an assumption, and rightfully so, that if someone's paying $90 an hour to take a private Pilates session or $20 an hour to take like a group class, that they assume that the Pilates instructor has adequate knowledge on
00:35:23
Speaker
basic exercise science principles in addition to Pilates exercises. And that's where I'm on a mission to make science-based education accessible and affordable to Pilates instructors because in my experience here in the United States,
00:35:38
Speaker
the trainings are missing the whole exercise science part. So we're taught choreography and with anecdotal reasoning that oftentimes flies in the face of science. So I think what's important before it's like, should you add a spring or not, is that we have to justify it to someone. So we talked about removing barriers for clients. We also need to remove barriers and internal resistance for instructors, instructors that were taught alignment protocols.
00:36:06
Speaker
So for that, we need to know what strength is. Strength is not, this exercise is difficult to do. Strength is not my muscles burn. Strength is the, the maximum force that you can apply into an object one time, right? Which we generally do that. Like the, generally how we would train that on a Pilates space would be you can't do this exercise more than 10 times. You can't do more than 10 reps, just like a very like gray baseline.
00:36:33
Speaker
You can then add some load. And what I mean by you cannot do this exercise is not the knee starts to wiggle. It's not that your clients makes weird facial expressions or that it burns. It's that they literally can't open the springs. The building is on fire and it will not be on fire anymore if they open the springs and they still can't do it, right? You're like at failure.
00:36:55
Speaker
And I think that's really important to learn because that's generally not taught on a program and it's not a poo poo, it's just a truth. And so, and that's an okay to know because we're oftentimes taught endurance exercises which are extremely healthy.
00:37:10
Speaker
In a Pilates space, it is rare to have the tools available to really add a lot of load. And honestly, that's not only Pilates, right? Like there, I've been in, you know, clinical rotations where the, my CIs will be like, wow, you're inspiring me to buy heavier weights. Cause I tie two kettlebells together. And then I have someone stand on a band that I also tied to the kettlebell for a shoulder strike. I'm like, shit, like how can we get 50 pounds? This guy's huge. Like he could lift me.
00:37:39
Speaker
And then you're like handing them like a 10 pound kettlebell because all we have. So anyways, so it's not just a Pilates thing, right? It's just exercise things. If we're going to get our clients stronger, we need to give them a stimulus to adapt to. Strength is, it's a little bit nuanced, but I would, but in terms of like what we're looking at, it's not about having proper form.
00:38:02
Speaker
Okay, now there's a certain alignment where you might bias a muscle a little bit more, absolutely. But when your client is getting tired, tired enough where they are generating a strength adaptation, oh shit, you should see their alignment.
00:38:20
Speaker
it did not look like the first or second rep. Maybe they start out good. Like they understand the movement. Like maybe it's that hip hinge that we talked about and we wanted to have the back flap by the seventh or eighth or ninth rep where they're going down. Oh man. Yeah. They're starting around a little bit. Their knees are shaking and oh yeah. Oh, they almost fell on the eighth one. You know how they, how your hip hinging, the knee come up and they, they have just like a stepping strategy.
00:38:45
Speaker
Yeah, you want to see that right? Like so like strength trainings like ugly or are not aesthetically pleasing. That's a better appropriate way to say that. Yeah.
00:38:56
Speaker
It's okay. That's where it's like we have to get past these barriers of a aesthetic based Pilates and have it be more like client centered care Pilates. If your client comes in and says I want to get stronger, you should know how humans get stronger. That's why I don't really look at Pilates literature that much. I just look at literature on results of like
00:39:16
Speaker
Because your human physiology doesn't matter, it doesn't matter the modality of fitness. Like your body doesn't know the difference between a strength, a band or a weight. It knows stress applied to the system. So there's a huge bit of biggest barrier I believe for Pilates instructors to get into the strength is understanding that it's okay if they come out of alignment. In fact, it's preferred at the end.
00:39:40
Speaker
Because if that knee isn't wiggling during like a squat at the end, you better add some load. This is getting stronger. Yeah, they're getting healthier. Hell yeah, they're getting healthier. Any movements better than no movement, but like, it's okay during certain parts of class.
00:39:56
Speaker
to add some load and just know that the result is their facial expressions are going to get weird. Your client's going to be like, and then if it's like legs, their legs are going to wiggle and it's okay. Right. Like it's like they have ligaments. That's why it came back. Yeah. That's how you're going to stress the ligament. And you know what happens to a ligament that you stress appropriately. Same thing as a muscle, like you get stronger.
00:40:20
Speaker
And I see that as well in the PT
Adaptable Teaching and Avoiding Rigid Rules
00:40:23
Speaker
space. I see that in the rehab space where so often people are just being chronically under loaded. In the clinic where I work, we have a clinic side and then we have right across the other side of it is a full gym with like barbells and plates and the whole thing, which is important. Not least because then we're saying to people like, okay, when you're done with the rehab space, here is where you're going to transition or we can't help you transition into this world. But I just did a new patient intake yesterday.
00:40:50
Speaker
woman in her sort of upper 50s and what I see constantly women sort of in that in that particular age range what I see a lot of is They've had a life and they get this is Southern California, but they've been spending a lot of time hiking they've spending a lot of time going to Pilates and Going to yoga and I look at the menu of things that they they're like I'm active I do all these things and I see this gaping hole of There's no load. There's no like
00:41:18
Speaker
progressive overload, there's no meaningful progressive overload of load that you have been doing. And that is going to be a disservice if we don't correct that. And so I really do see that in all of the movement world, and especially with the women that I see in the PT realm. And I see people underloading older population as well, and that drives me nuts. I'm working with a woman who had a replacement who's in her 70s,
00:41:47
Speaker
And we've been, you know, with footwork, we've been working our way up to like every time I'm like, I'm going to put a quarter spring more on, you know, and she started at like, this is on the Marathieu reformer. So I know that colors and things are different, but on that one, she started on like one red and one blue, and now we're up to three red. We're just, you know, pushing it. And she is like, last time I saw her, she was like, I feel strong. I feel good. She's motivated. She's like getting out into her life.
00:42:09
Speaker
And I, she may be a harder sell for me to now be like, and now let's get the barbell. But I do, I do try to sell it as best I can to all of them. What happened to the long arc clients? The longer I know, right? Why am I not doing total new extension? Like, Oh God, all that stuff. But anyway.
00:42:27
Speaker
One thing I want to speak to just because I didn't quite touch on it was the idea of progressive overload because I know when I was a younger instructor, I would hear these things, but it didn't quite have a clear picture. So for progressive overload, it means that we're adding load over time to an individual. So it's like.
00:42:42
Speaker
footwork a lot of times are taught that it's three springs. You might have been taught 3.5 or 4 or 2, right? But let's just say it was 3, so then it never changes, right? And that's fine if you're using it as a warmup, like you don't really, you don't need to progressively overload your warmup. But if you're using footwork to get a leg stronger, you start at three springs, and then you go to 3.5 over time, and then you go to 4, and then
00:43:05
Speaker
Let's say you only have four because some reformers have that. If you have five, then you go to five, but then you do it on one leg, but then you eventually run out of springs, right? And I'm not the strongest person. Like I'm like healthy. I'm a healthy 35 year old who's, I feel obligated to exercise because I teach it to other people. So it's like, so I can do five springs on a reformer, right? And if you, and if the music is right and I've had enough coffee, I could probably do over like 20 or 30 of them and I can keep going.
00:43:32
Speaker
So for me, like, I'm not going to get my leg, like it'll be more challenging for me to get my legs stronger on a reformer, my quadriceps. So then I have to get up right. And I have to use like a kettlebell and do squats. And then I have to do other things. Two things with that one is like, if we're doing strength based exercises, the spring needs to change over time.
00:43:53
Speaker
It has to. You might get someone stronger from baseline because they did nothing. So doing something is more than nothing. And therefore, you see these results. They buy a 10-pack. They love you. They buy you chocolate and all that. And you keep teaching them. And it's fine. It's healthy. It's exercise. You can meet activity guidelines. You can extend the quality and quantity of their life. You're doing good. But if their goal is to get stronger, you should know what that means and that you have to do progressive overload.
00:44:18
Speaker
And so for certain exercises, not everything, right? You don't need to like progressively overload leg circles, although you can. You know, for certain exercises, you just have to add the load. If you can't add load, you can still progressively overload them by adding reps, right? I would bias just adding load because it's less annoying. Like you only have 45, 50 minutes. Like if someone can do 25 reps and you have to like progressively overload it to 30, it's boring.
00:44:48
Speaker
For everybody. Like it's boring to watch too. I don't have to make conversation. Just upload it's easier. But you can't add reps. Like there is literature just for. Yeah, definitely. To me, the fall of adding reps is that you're just spending more time with that like.
00:45:04
Speaker
lactic acid burning feeling in your, like it just hurts more to add more reps versus adding load and reducing reps. Just feels better. So if you have it, it's like the easy one is add load because you're right. Like you might buy it, you'll likely stop due to discomfort rather than due to actual muscle failure or getting really close to it.
00:45:23
Speaker
But sometimes we just don't have it. So like, I know there could be like an instructor in Wisconsin and they don't own, they, and there's like no other studio and there's only the one studio down the street. They don't own it. So they can't buy stuff and bring it there. It's like, what do I do? I want to apply this. Well, if you run out of Springs, do more reps or start teaching weights.
00:45:41
Speaker
I used to just like break down the door in the Pilates studio and I had my Bowflex weights and I was like, we don't have shit. The Bowflex weights are like the adjustable ones. They give me 50 something pounds. I used to just go in there and I was, I dare you to stop me. I'm walking in and I would just put it next to the reformer I was using that day and then I would take them and leave.
00:46:00
Speaker
Like when you were a student in a class? I was an instructor. So I was working, you know, someone is, they needed to do step ups and they needed to get their laundry up the stairs. I had been to their house, right? And so it's like, you have two stories. Like this is not going to go well. So hold this. We're going to enter a section now that I call random questions that I have about Pilates. And my first core, random question about Pilates is what the hell is up with a hundred?
Reevaluating Traditional Pilates Exercises
00:46:24
Speaker
Why am I flapping my arms?
00:46:27
Speaker
And is it to distract me from the world's longest crunch made worse by the fact that my legs are in the air as well? Can you tell that I don't like the 100?
00:46:34
Speaker
Yeah, I can tell. It's to justify that you're a real instructor. Because are you teaching Pilates if you don't teach the 100? Now, I don't have a thing against the 100. Like, it's fine. But it's also when you look at it from just a movement perspective, like if it wasn't the first exercise and return to life, which is just a Pilates literature, and it wasn't like a staple of Pilates, and you're just looking at it from like a not attached to any modality.
00:46:58
Speaker
It's pretty easy to justify doing another exercise. Like I've never been in the clinic and had someone do the hundred, right? Could you, uh, for people who don't know what it is, could you just explain what the hundred? Oh yeah. So you're supine. That means you're on your back. Um, you can have your legs, let's just say bent to start.
00:47:15
Speaker
Like tabletop or something, you curl forward so now you're in spinal flexion, don't worry, it's safe. And then you have your arms straight and you beat your arms up and down and you do it a hundred times. You breathe while you do that and supposedly you inhale for five pumps and you exhale for five pumps because clients are so accurate with that and we can totally see it. And then if you make it harder, you just extend the lever at the hip.
00:47:40
Speaker
So you can straighten your legs up towards the ceiling, you can lower the legs, the lower the legs are, and the more horizontal they are, the more stress applied. And you're going to work your abdominals by doing that. But that gets boring when we start talking about biomechanics and stuff. So anyways, it gets harder with your legs straight. But you beat your arms up and down. So it's one of those things that we just kind of do, and I teach it, I don't hate it, but I also don't
00:48:03
Speaker
I'm not attached to it either. You know, it's just it's oftentimes taught just as like a warm up and in a like to warm your abs up or something. But this is where it gets confused. It's just a whole nother conversation. It'll get taught as cardio. And it's like, are you fucking kidding me? Like, cardio doesn't burn your abs, right? Cardio makes you breathe harder. And then if you oh, by the way, if you ever want to know if an exercise is cardio, your client probably has a smartwatch if they're like
00:48:31
Speaker
50% of population at least here in LA, you can just check the heart rate. So yeah, the exercise like you if you don't like the hundred you officially have permission to not teach it. Someone to tell me I don't ever have to do it again. And the arm flapping is for what?
00:48:47
Speaker
I think, oh, it's to promote blood flow, which is my, which is my favorite, my favorite claim ever for any exercise. It's like, if you don't know what the hell to say in exercises, just say it promotes blood flow because there's no exercise that doesn't promote blood flow. So whenever you like, yeah, go on the phone rolling website, and then I get promotes blood flow. Well, like, yeah, when you're taping with your hands, yeah, you're promoting blood flow to your hands. If you use muscles, you're promoting blood flow.
00:49:22
Speaker
You need to go get that checked out. That's a good question. I don't know if I would say that there's a dumb exercise. I would say that any movement is good movement.
00:49:37
Speaker
And I would just promote that. I think that there are misguided movements that are taught and expressed as having heightened importance. For me, it's like the pelvic clock.
00:49:52
Speaker
I don't know if you've ever seen that. But there could be a reason to do it for someone, right? But for me, I think a lot of times we teach special population exercises to normal populations. Maybe if someone's in a pelvic floor, and this is outside of my scope of expertise, if someone's in a pelvic floor physical therapy, maybe you're doing some more pelvic work and doing a pelvic clock and working on contracting because there's incontinence. There's always an outlier where it's like,
00:50:18
Speaker
do it, right? Even the hundred, I don't know, maybe shoulder rehab, right? Like you need to do like repetitive movements because you work on a jackhammer or something. We just justified the hundred. So anyways, there's always a way I just love playing devil's advocate, but I think there's this misguided stuff. So I think it's like going like a lot of like the pelvic floor activation exercises,
00:50:43
Speaker
preceding movement, right? So I think that those are the things where it's like, and it's not, it's not a harmful thing. It's just, it's just taught as like so important. You like, you don't have permission to move until you can track these muscles that I can't see. And that even if you confirm it, you're not, you, we don't know that.
00:51:01
Speaker
So I think that those are the ones where it's like a lot of the public floor stuff. I can't see if your public floor contracted from outside, like the public floor physical therapist can confirm that through their modalities and techniques. I think it's a lot of, a lot of that stuff. And we just, we confirm it with ways that are not valid. I think that's my beef and not everyone needs to contract their public floor, even people that have
00:51:22
Speaker
public floor conditions sometimes do the opposite. So that's my shout out to refer out. I will say I use public clock work in the clinic, not just for public floor issues, but also when I see someone who
00:51:36
Speaker
is having issues with rotational movement, like learning how to sort of unlock their pelvis and actually move it in that kind of direction. My head was going to being in like these group classes where it's like, we're like all teacher trainees and we had to like do the pelvic clock before we were allowed to do footwork.
00:51:57
Speaker
That was more like my head, but there's always like a one-on-one scenario where like I would do almost anything. I mean, you know what I mean? You can always pick out a special population and that's where it's helpful when you start to like rebel against your training. That's the common thing of like, we're going to not use the highlighter weights, right? We're going to flex the spine under load.
00:52:19
Speaker
And then sometimes you can go so far right and be against everything you learned. And then as time goes on, you end up in the middle somewhere. And so that's one thing. So even though I said an exercise that you do, I'm sorry. No. But that was your point about special population versus teaching something in a group class. I really like what you're saying about that sort of rebellion. Because I think we all do go
Addressing Bone Density and Health in Pilates
00:52:42
Speaker
through that. And you end up in a place in the middle where you're like,
00:52:46
Speaker
rather than rejecting the tools that I learned originally for these new tools that are more right or something. It's just more useful. You have more ability as a teacher to just expand your toolbox so that it has everything in it.
00:53:01
Speaker
Then you have some, because there's always, there's always somebody who does not respond to something the way you think they would or think they, or like it's supposed to. And then you're just sitting there with like your thumb up, you're asking like, well, I guess I'm going to do some static stretches, even though apparently they do nothing for nobody and they're not good and nobody needs to do them. And then it turns out like that changes the person's whole. They're recommended for older adults and they see guidelines. And like, you don't have to worry about losing power unless you're about to go sprint in the next two hours.
00:53:31
Speaker
I feel this way with core stability, right? I used to be like all about it. And then I was like totally against it. And now I'm somewhere like in the middle, but, but even if I were to teach it, like when I learned it before it was like, we have to stabilize the spine and we need to reduce low back pain.
00:53:46
Speaker
and stuff like that and now I might be like, well, it feels good for my client. They don't exercise, this is an exercise they can do or maybe it's just low load because they're in the acute phase of a low back pain episode and this is the thing that doesn't hurt and they feel successful doing it. Or maybe it's because I'm gonna teach the 100.
00:54:07
Speaker
Your reasons change over time to become more sophisticated. Exactly. And having multiple options is, is part of what lets you become more sophisticated with your choices, right? If you've completely thrown out old things that you knew how to do it, it actually leaves you as limited as you were before. Okay. Adam, I've saved the big, the big question for last because, uh, moving logic, we're very much about debunking myths around building bone density, reducing or reversing osteoporosis, osteopenia.
00:54:36
Speaker
who actually needs to be worried about this and who doesn't, all that kind of stuff. So here's my question for you, specific to Pilates. Is there any research that you have come across to suggest that Pilates alone can increase bone density and reduce osteoporosis or osteopenia? That's a good question.
00:54:56
Speaker
And of course, I'm going to get nuanced with this. When Pilates research is usually very poor quality, and I personally don't care if the research shows that Pilates is helpful for bone density or not, because I can tell you that if I have someone with osteoporosis, I'm not just going to give them Pilates. Hell no.
00:55:17
Speaker
I have, I have, you know, it's under, I have a Cadillac right next to me. You know, it's under them kettlebells and behind it a barbell. Right. So I start to look more like this is where I don't get attached to modalities. And I would just, I would encourage anyone to just learn movement and then apply it to your modality and what's going on already in your modality will make a lot more sense. So what I can say in regards to research and like the, like, of course, like the lift more trial, it comes straight to my mind of loading.
00:55:45
Speaker
Okay. Loading individuals, uh, with osteoporosis and doing so at, um, you know, you want to build them up, but doing so at higher velocities is going to be helpful. So when I think of, um, an osteoporotic client, I think of get them upright. You don't need to have, like, cause if you're upright, you're going to be bought, you're going to be weight bearing right away. And I think of, of adding in the, the weight training. So in the lift more trial, it was, it was just like 80, I was a 80 or 85% RM and they, they not only.
00:56:14
Speaker
reduced bone density, but they, I'm sorry, they not only stopped the progression of osteoporosis, but they started to reverse it in some individuals. And if anyone, if anyone has not seen the YouTube video of the interview for that trial, holy shit, they were lifting barbells up. They were the most kyphotic client. You would be like, we need to do extension and rotation and all these things. Nope. They were doing deadlifts.
00:56:40
Speaker
There is a systematic review that I was prepared with. It's called The Effectiveness of Pilates and Yoga to Improve Bone Density in Adult Women, a systematic review of meta-analysis by Fernandez Rodriguez. They found that there are non-significant results and that the bone density maintenance in the postmenopausal populations. Can you explain to people who don't understand
00:57:00
Speaker
What that means? Non-significant results means that even though you might have a statistical significance, you might have improved. Let's say you improved bone density and the New York Times will say, Pilates improves bone density. Then Kelly Clarkson will come on and there's going to be a photo of her doing Pilates and then everyone's going to do it. Non-significance means it doesn't matter.
00:57:25
Speaker
Right. There is no different. Right. And it's not, it's not a good headline. It doesn't get people to buy more magazines, but non-significance means that like it didn't really make a difference. But what this is where it doesn't matter. If I look into the trials, which I didn't take the time to do. So I'm sorry. If I look into the trials and I look at it, they're going to be doing like the one leg circle. They're going to choose exercises where I'm like, why the hell would you do that? You need to have them like do step ups and stomp on the box. That's where.
00:57:52
Speaker
It's really fun to grow because when I look back and I look, and if I were like to come out of myself and look at myself, I'm like, you're not even talking about Pilates, dude, because I don't care. It's like, I care so little about the Pilates. It's, it's not that it's that I care so much about what that client needs that I'm, I can, I don't care about my value in the Pilates. It's, it's like, it's client centered care. If I were to just give them Pilates, that's about me.
00:58:18
Speaker
But if I give them what they need, which is load and impact training, I know how to do that with the tools around me and the reformer is right there. So if I'm doing footwork, we're doing more than three springs. Throw them on, get them to 10 RM, but I would also have them stand up right. We would be doing squats, we would be doing lunges, we would be doing hip hinges, we would be doing step ups. And I would do the step up on a Pilates box, so it's called Pilates.
Maintaining Movement vs. Building Strength
00:58:47
Speaker
I don't have to look at the trials. I can tell you that they didn't do squats, lunges, hinges, and above holding heavy shit in a Pilates based trial. Right. Yeah. It's like the Lauren Fishman one that everyone's obsessed with in the yoga world. It's like these 12 yoga poses will reduce your osteoporosis, which is not true. One of them is Shavasana where you are lying flat on your back. So there's nothing about that. That's going to increase any bone density for any human at all. It's sort of the same thing. It's like, why did you pick leg circles? That's got nothing to do with anything.
00:59:15
Speaker
Now there's a difference between like this is going to help your osteoporosis or this is a great movement for a human who has osteoporosis, right? So an individual with osteoporosis has the same physical activity guidelines as someone who doesn't have osteoporosis, which is two to three resistance training sessions per week, plus 150 minutes of moderate intensity aerobic exercise.
00:59:38
Speaker
So with that, it's like, yeah, single leg circles are great, but it's not going to stimulate bone density. It's going to create circumduction in their hip, which is great because that could be helpful for fall prevention if they're having like limited range of motion. Um, and also like a big thing, like this is where yoga and Pilates can be actually extremely valuable for someone with osteoporosis, even just as it is preventing falls because osteoporosis, the biggest problem with osteoporosis is that you fall, you get a fracture, right?
01:00:07
Speaker
So then if you fall less, you have less fractures. So a big thing is just fall prevention. So it's a guess we want to stimulate bone density, but the path of least resistance is also improve your balance. Right. The other thing that like circles does, as you of course know, is it increases blood flow to the area. No, it doesn't. In all seriousness, here's where I think a lot of people get confused around this topic.
Conclusion: Movement Optimism and Client-Centered Care
01:00:32
Speaker
because to my understanding, and you can correct me if I've got this wrong, there's a fair amount of sort of special population education that you get as a Pilates teacher that you really don't get as a yoga teacher. But within that special population education, it's more about here are the ways, it's kind of cover your ass-ish, like here are the ways to not make this person's condition worse. And so a lot of what is being taught is
01:00:58
Speaker
don't let the osteoporotic person flex or rotate their spine ever. And it's all of these things that are not about helping the condition. It's about avoiding potentially creating more injury. And so then when you come in and you say, oh, no, no, you need to load. You or I come in and say, no, no, no, you need to load. You need to be able to do all these movements. But I think a lot of teachers have been taught, oh, no, you can't do that. I mean, I remember a Pilates teacher
01:01:23
Speaker
who's also a physical therapist, that we were in this rehabilates training thing together, and she had osteoporosis in her spine, and we were sort of talking about, like, she was like, oh, no, spinal, no, never, full, you know, neutral spine, all the time. That's what I have to do. And I'm like, all right, well, that sounds like it's going to be a really big problem for you in about five to 10 years when you can't move anymore.
01:01:43
Speaker
What I can say is I've had very similar experiences. And then at Breathe Education in the Department of Clinical Pilates, we do provide the most up-to-date research on this. And so we are helping Pilates instructors. But that's like an advanced education for Pilates.
01:01:59
Speaker
instructors. So in their like assessment, they are we're like stomping, we're doing squats, we're like pick up some heavy shit. So it is out there, but it's few and far between in my first teacher training job actually had a big problem with it was the whole special populations aspect because guess what guess what it was missing references.
01:02:15
Speaker
Oh, no. So like, can we we should normalize citations, right? And especially when it comes to special populations. And so what's helpful to recognize, right, with just if we were to go down the rabbit hole with like spinal, like for osteoporosis, let's say lumbar spine.
01:02:30
Speaker
is that, well, what are we trying to prevent? This is the critical thinking part, right? What are we trying to prevent? We're trying to prevent a wedge fracture, right, from my understanding. Okay, what's a wedge fracture? Well, it's a compression fracture at the anterior aspect of the vertebral body. Okay, so then we wanna, logically, we wanna reduce compression there, right? We don't wanna add to it. And there isn't a trial where we've compared flexion exercises to neutral because no one's getting approval to go break some spines, possibly.
01:02:57
Speaker
So it's based on biomechanics. So then, for example, what about extension? That's better than neutral based on that model. That would be better than neutral is to do extension. Because in extension, you're actually going to decompress the anterior aspect of the vertebral body while you are compressed in the posterior aspect. But that's not where wedge fractures happen. And then what about sign bending?
01:03:22
Speaker
There's so many things you can do in the ACSM guidelines and also other guidelines that are out there. They're super vague because we don't have clinical trials on this, right? They just say like avoid excessive bending and twisting. Okay. Well, what's excessive to me in like 2010 is way different than excessive to me here in 2024. Right. And also like, oh, so how do I get in and out of the car if I'm not supposed to rotate or bend my spine?
01:03:46
Speaker
Like, how am I supposed to do? You have to move your leg to the side. Wait, what is that? Oh, I'm talking yoga. You go into chair pose. That's right. You go into chair pose and then you AB docked one leg at a time. That's right. You heard it here first, people. That's how you get in and out of a car. I think that is sort of, you and I kind of speak the same language and we're working on changing a lot of common beliefs out there. And I think one big piece of it is helping people
01:04:11
Speaker
navigate this nonclinical space, right? Because they can't be saying that they're healing or they can't be prescribing or all of that stuff. But at the same time, we know how invaluable movement is. We know how valuable load is and to start to change the model for people who are movement instructors, but not clinicians. So it's not just, okay, yeah, I'm going to teach this class and I'm going to avoid
01:04:37
Speaker
XYZ movements because potentially that could hurt someone versus I'm going to include all these different kinds of movements because ultimately that's what everybody should be able to do and of course if there's somebody in the room that needs a modification or something fine but this idea of all of the don'ts don't do this don't let your knee go past 90 don't flex your spine under load all of these things that we know not to be true really start to encourage
01:05:02
Speaker
all of the movement teachers out there of any modality to just sort of expand their understanding beyond just don't do this because it's a, you know, let's cover your ass and not hurt anybody versus Oh, how am I actually going to make meaningful change happen in this person's life? Yeah, it's promoting movement optimism.
01:05:19
Speaker
Yeah, exactly. All right, Adam, thank you so, so much for taking the time to talk to me. It's been awesome. I'm going to steal a lot of your phrases, including the highlighter weights for sure. Can you let the people know where to find you? Absolutely. I'm very active on social media. You can find me at
01:05:36
Speaker
Adam Makati Pilates on Instagram. And on that platform, I shared tons of evidence-based information and ways to just inspire movement instructors to become more movement optimists and just have exposure to research. And I also, you know, I'm the founder of evidence-based Pilates and I invite any instructors
01:05:57
Speaker
To join the VIP membership, you get a two-week free trial, and this is a continuing education platform made for Pilates instructors who are looking to learn and grow using science-based tools. We have workshops. I do research reviews. Of course, there's Pilates classes, programming support, and you get to be a part of a growing community right now over 200 Pilates instructors. Amazing. Awesome. Thank you so much.
01:06:23
Speaker
Yeah, thank you. Okay, well, I hope you enjoyed this episode. You can check out the show notes for links to references we mentioned in this podcast. And if you are a regular listener, please do us a huge favor and express your appreciation for the time and energy that Laurel and I put into this podcast by subscribing, rating or reviewing anywhere that you get your podcasts.
01:06:49
Speaker
And don't forget to sign up for the bone density course lift for longevity that we are doing again in October, 2024. The mailing list is the only place you're going to be able to get the discount. And that's something you want. All right. We will see you in two weeks.