Category Archives: Healing with Exercise

Relax your back on a foam roller


I recently spent some time teaching private Pilates sessions at Sarasota Memorial Hospital. The population skews older with the average being in their 60s.  Part of my protocol is to gather information about health conditions and medications.

Whether your are an instructor or client – do not skip this part.

As I discovered, most of my Sarasota clients were taking multiple medications.  Some people were a little reluctant to reveal all but when I explained this informs what kind of exercises we should and perhaps shouldn’t do, they were more forthcoming. For example, I noticed an osteoporosis drug listed on a form but the client didn’t tell me she had the condition. This was really important to know because many Pilates moves involve putting some load on the spine in the “flexed” or forward position – which is generally not advised for those with osteoporosis or osteopenia.


advanced extension exercise performed on the Allegro 2 courtesy Balanced Body

Most exercises in Pilates ARE in a flexed position. When you’re working with the equipment, the springs put even more load on the spine.  But if your instructor knows what’s appropriate for your condition, you’ll have a wealth of “extension” exercise in your future that help your condition and make you feel better, stronger, more energized.

I tell my clients who in post rehab to ask their physical therapists for three exercises they should do and three exercises they should not do. Have your PT write it down and you give it your instructor.  It’s golden information.

If you have a low bone density and are taking a mat class, don’t roll on your spine as in “rolling like a ball”.  A well-qualified instructor will instead offer you other options such as balancing in the position and working the opposite forces where your arms and legs connect. You can also work the position by remaining in static ball position without wrapping your arms around your legs.  Both versions are challenging.  But if you don’t tell your instructor, that person can’t offer you an alternative.

As instructors, it’s up to us to stay informed on the most common chronic conditions and how to meet client needs with what we offer.  Knowing the exercises is only the beginning.  How to apply them to meet specific needs is a sophisticated, savvy skill requiring lifelong practice and continuing education. It’s a smart way to market too because it communicates an understanding that goes above and beyond common offerings.

Pilates for Buff Bones® is a unique, Pilates-based workout that uses bone-strengthening techniques while focusing on alignment and balance. It targets the rear-side of the body, giving the butt, hips, arms and back a terrific workout. This inclusive one-hour class is adaptable and challenging for people of all levels, and is also safe for those with osteoporosis.

Experienced instructors may also design their own classes that target special populations and conditions. That’s the beauty and magic of Pilates.  It meets you where you and takes you where you want to go.  As always, ask about the instructors experience and education.  Seek those who have at least 500 hours or training and several years of teaching clients – preferably some with your condition.

Jovanka JoAnn Milivojevic


Pilates Benefits: A Return to Life

What is Pilates and how will it benefit you?  I get that question a lot.  In short, it meets you where you are right now and takes you further than you can imagine. Need more strength?  Balance? Muscle? Coordination?  You’ll get it. Pilates is a way to more fully realize your potential.


the hundreds on the Pilates reformer

Recently, WebMD showcased a handful moves that are great for beginners. The post is well illustrated and accurately explained. Pilates can be done on a mat or machines, just be sure to find a well-qualified instructor.  

Pilates benefits every body at just about any time. Some hospitals and physical therapists integrate Pilates into their fitness programs to help patients with rehab and other health related issues. For example, Pilates works the pelvic floor and is quite helpful for women who have or want to help prevent pelvic floor disorders.

Pilates is a natural next step after physical therapy. Many Pilates instructors will work with PTs to ensure that you continue to strengthen safely post rehab. Muscles move bones. When muscles are developed and maintained correctly they’ll help keep those bones (and the rest of your body) properly aligned.

The medical community is finally promoting exercise as medicine.  And Pilates is an excellent healing modality as well as way to have fun discovering all that your body is capable of. It works if you work it



stroke took her movement away Pilates brought it back

Pilates can transform a life in many ways. Joseph Pilates promoted his system as a holy trinity — rejuvinating the mind, body and spirit. Indeed you will feel refreshed, re-energized, and realigned after your Pilates sessions. Get inspired by these stories featured at the Pilates Method Alliance’s Pilates is Health website.

For me, Pilates took away the debilitating pain of sciatica and brought me into a whole new world of healing for myself and helping others.

Got a Pilates story?  Share it here.








Pilates certifications can be snagged in a weekend or take several years and hundreds of hours to earn. I invested two years studying for my comprehensive certification which also included an apprentice program. I delved deeply into anatomy, biomechanics and how to work with injuries and limitations. It’s a fascinating and endless journey.

Ten years later, I am still teaching and still continuing to learn.

What to look for in a Pilates Instructor

Well-qualified instructors earn the equivalent of a Master’s degree.  For high quality instruction, look for:

  • Minimum of 300 training hours
  • Comprehensive and mat certifications
  • Several years of teaching
  • Ask about specialties. Some instructors focus on populations such as seniors, pre/post natal, back pain, rehab or high performance athletes.

Like yoga, Pilates has evolved through time. Today, there are a iStock_000008154512XSmallvariety of styles but core development is fundamental to them all. Among the most well-known trademarked brands are: Stott, Power Pilates, Balanced Body, Core Dynamics, PhysicalMind, Polestar, and Romana’s Pilates. But a trademark doesn’t necessarily ensure quality instruction.

“Anyone can take a list of exercises and teach them,” says Chicago-based Vered Arbel of Elements in Motion, “how you analyze and fit the exercises to the needs of the person requires anatomical and biomechanical knowledge. Really look for that.”

And it takes years of experience to assess a client’s need physically and emotionally. Clients have come to me with great stress, migraines and injuries.  I must create each session on the spot to meet the client’s needs on that day.  Fortunately I have been well-trained and joyfully continue my education. That gives me a deep repertoire of skills and tools from which to build each session.

Find Your Ideal Pilates Studio

A web search will result in lots of choices and can reveal a lot about a  place.  What’s the vibe?  Warm and welcoming?  Super intense high energy?  Look at the pictures and the language.  Do they communicate well?  What do the instructors say about themselves? Look for client testimonials and consult Yelp.

Do you want super private experience with no one else in the space? Many instructors have home studios where that kind of privacy is more possible.

When you speak to someone, ask questions that relate to what you are looking for (general fitness, weight loss, balance, flexibility etc).  Good instructors will ask you questions too.  That will reveal their level of experience and care about new clients.  Know that most studios are small businesses and you may have to leave a voice message. Don’t let that put you off. Leave a message. They should of course call you back in a timely manner.

Questions instructors  should ask you include:

  • What do you do for exercise now?
  • What attracts you to Pilates?
  • What are your fitness goals?
  • Any injuries?
  • Medical conditions?

Taking a mat class is an inexpensive way to check out a studio and discover if the place simply feels right to you. Also, many studios offer discounted rates for first time clients.

Benefits of Well-qualified Pilates Instructors

Fitness and counteracting the stresses of everyday life are among the main benefits of any exercise discipline.  Ultimately, Pilates can reduce stress, increase energy and help you feel at ease in your own skin. You’ll feel more balanced, flexible and lighter. Well worth the search for a quality instructor whose personality and experience matches your needs.

Reach out to me with any questions or comments about your search.  I’d be happy to offer what I know.



Pilates fuzzy boots and aerial yoga inspired me to hang a pink parachute hammock from the ceiling in my living room. I just mounted sturdy hooks right into the studs. It easily support my body allowing me to swing, stretch, and hang upside down. The anti-gravity feels great, especially after a long stressful day.  I even meditate in my little pink cocoon. It feels amazing!

In Pilates, one of the most blissful acts is to hang in the fuzzy boots. My clients love as an end-of-session relax.  It helps

Hanging Fuzzy Boots Pilates

Woman hanging from fuzzy boots on Pilates trap table. Image courtesy of Balanced Body.

the spine stretch, provides the benefit of reverse blood flow, and allows your hip sockets to release.

Turning the body upside to promote a healing effect is nothing new. It’s why yogis do shoulder stands, handstands and other upside down postures. From the standpoint of pure physics, inversions counteract the effects of gravity.  All day long gravity is pressing down on your body, including the spine and intervertebral discs. When we turn upside down, the spine is decompressed and surrounding muscles stretch.

You don’t have to be completely upside to experience the benefits of hanging. Simply having your torso below your waist you can feel the effects, even at -5 or -10 degrees. For those with back problems, hanging can really help.  But be careful -  fully hanging upside can overly stress discs and facet joints, and create too much slack within joints.  Work with a highly qualified Pilates instructor – ask them about their experience in work with clients with back pain.

The intervertebral disc is the largest organ in the body without blood supply. Most lumbar discs are the size of a watch face and have no arteries going to them. Discs rely on the surrounding bone for nutrients. These nutrients percolate into the disc much like coffee going through a filter. Some studies suggest that pulling the bones apart through inversion therapy may help this process by drawing more fluid into the disc. This allows greater nutrient flow and improves disc hydration and height. The Complete Idiot’s Guide to Back Pain

Inversion Tables

Inversion tables are primarily devices that you purchase for home use. Some physical therapists or exercise professionals may also have them.  An inversion table allows you to control how far over you will go. You lay down, securely fasten your legs, and tilt the machine backwards. You can move upside down in small increments from as little as a few degrees to fully upside down. Try before your buy.

If you have any health issues, talk to your doctor before doing inversion therapy. You shouldn’t invert your body if you have certain medical conditions such as high blood pressure, detached retina, or glaucoma. Inversion therapy can also exacerbate laxity of the joints or spondylolisthesis.

But if your back is fine, hang away wherever you can: with your kids at the monkey bars, off the limb of tree, or from your very own living room parachute hammock. (I got mine at Amazon) Your back will feel better and you’ll gain a whole new perspective on life too.

If you need any tips on hanging that hammock just ask.


Pilates for Plantar Fasciitis

From blisters to bunions, most of us will suffer from foot problems more than once during our lives. Some issues can be resolved with over-the-counter remedies, targeted Pilates exercises, reflexology and gently rolling your feet on a tennis ball.

But if the pain you feel is in your heel and it doesn’t go away within a week or so, Plantar Fasciitis, Heel Spurs, Heel Painsee your doctor.

The pain is usually caused by the inflammation of the plantar fascia, also known as plantar fasciitis, a chronic irritation due to abnormal biomechanics. Wait too long and you could be headed to surgery.  The pain often feels like you bruised your heel on a stone.  It can also radiate through your arch.

The triangular structure of the feet allows the weight of our bodies to efficiently spread out over a broad base. The plantar fascia is a tight band underneath your foot.  Its job is to prevent the foot collapsing out when you walk. When this band is overly stressed, it can tear, causing pain.

The most common cause of plantar fasciitis is faulty biomechanics (walking  abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. It can also be caused by walking, running, or jumping on hard surfaces; wearing poorly constructed shoes; or being overweight.

To learn more about heel pain and taking care of your feet, visit the American Podiatric Medical Association.


Despite the many psychotherapeutic and psychopharmacologic interventions, relapse rates for substance abuse and dependence remains high.  A 2011 European review article reported in The Scientific World Journal took a close look at affects of exercise on relapse prevention.  The outcomes show promise.

The authors scoured the databases of Pub Med, Medline, and Web of Science to find studies that investigated any form of exercise as a therapeutic intervention strategy.  They looked at smoking, alcohol and illicit drug abuse/dependence. Smoking cessation studies had the most scientifically stringent methods (the most randomized control trials) and clear outcomes. Exercise, however, showed promise in all three areas with respect to relapse prevention.


  • Neurochemical changes -dysfunctions in neurotransmitters that have been linked to craving; exercise may help reverse those faulty functions
  • Reduction in craving – in smoking studies, exercise reduced craving and withdrawal-related negative mood
  • Mood regulation – stress, anxiety and depression are major reasons for relapse, exercise was shown to improve mood so long as it wasn’t too intense or competitive (which worsened the effect)
  • Poor self-reliance – substance abusers have low self-esteem due to their lack of control.  Some study authors generalized that supervised training and positive fitness results can increase positive self image

As far as type of exercise both aerobic and resistance training showed similar positive results.  It was also important to introduce exercise after the acute phase, meaning after patients got through detox. What seemed to be most helpful was exercise at least 3 times a week for about 9 weeks.  Researchers will want to look more deeply into type, duration, timing and the many other ways one can slice and dice study designs.

At this point, however, it is clear that exercise does point to relapse prevention.  That alone should motivate more counselors and addiction recovery centers to help their patients find ways to include exercise as part of their life-long recovery strategy.



As a Pilates instructor, more than one of my clients have complained about menopause middle, that extra weight around the waist that women can get. How to get rid of it?  Exercise, good nutrition and sound sleep -  the traits of a healthy lifestyle at any age, are ever more important at middle age.

According to Nancy Clark, author of the upcoming new edition of the best-selling Nancy Clark’s Sports Nutrition Guidebook (Human Kinetics, November 2013), women do not always gain weight during menopause. “Yes, women aged 45 to 50 commonly gain weight as fat settles in and around the abdominal area,” Clark says. “But, these changes are due more to lack of exercise and a surplus of calories than to a reduction of hormones.”

Reduce Menopause Middle – Stay ActivePilates ball exercise

In a three-year study of more than 3,000 women (initial age 42 to 52 years), the average weight gain was 4.6 pounds. The weight gain occurred in all women, regardless of their menopause status. According to Clark, weight gain is not caused by the hormonal shifts of menopause, but by other culprits associated with midlife. That is lack of exercise and excess calories.

Middle age women (and men) tend to be less active which is especially unhealthful as we age.  We need to keep our muscles strong and flexible for many reasons: better balance, good bone mass, and for weight control.

more muscle = faster metabolism = increased calorie burn

No Magic Menopause Middle Diet

You’ve probably dieted a gazillion times by now. I know I have and I’m sick of it.  There is no magic bullet when it comes to food or fitness. There is however, a choice to lead a more joyful active healthy lifestyle.  I love to dance.  So I Zumba, Tango and Salsa weekly.

Eating fresh, whole foods that are nutrient dense is a smart way to go. Nutrient dense means foods that pack a lot nutrition for the amount of calories – think apple vs pretzels.  They may have the same calories but your body gets more satisfaction out of that apple.

Choose movement that you enjoy.  If you like boxing – great! Weight-lifting, Pilates?  Perfer bike riding to dancing?  Do what feels good.  Mix up some resistance training with activities that increase your heart rate enough so that you can talk but not sing while you are doing it and you’ve got a good aerobic pace.

exercise 3 – 5x/wk for at least 30-minutes.

Once you experience how good it feels to live in a strong, fit and healthy body, you’ll want to keep it that way. While shifting hormones can and do create changes in our bodies, we can mitigate some of it with wise choices.

You only have one body, one life.  It is mostly up to you how you’re going to feel in it.  Of course, you might reduce or get rid of the menopause middle too.  That’s just the bonus.  Feeling great in your own skin is the real prize.



Joseph Pilates was known to say that breathing is the first and last act of life. Can’t argue with that.  But breathing is not something we think about ordinarily;  it is mostly an unconscious biological function.  When we do pay attention, breathing can transform your Pilates workout and your life.


In Pilates, the breath is used to assist motion and to better activate the deep core muscle.  By following the natural exhale you find that your belly muscles compress.  Sneezing and coughing are an extreme example of how much your stomach work when breath is forced out of your body.  Go ahead, cough a few times and you’ll see what I mean.

Most of time in Pilates, we want to keep the belly actively pulled in. So how the heck can you breathe deeply while holding in your belly?  Lateral breathing.  It means using the full capacity of your lungs.  Try this simple exercise using a flexible flat band.  You can do this standing, sitting, or lying down.  It’s a great way to start your workout and relax at the end of your day.

  1. wrap the band around your body just underneath or breastbone, at the highest point of your six pack
  2. cross the band so that when you pull it tightens like belt
  3. inhale to prepare
  4. exhale our of your mouth and slowly pull the band tighter as you complete your exhale (notice how it deepens your belly)
  5. inhale to release tension on the band

Do this several times.  Repeat with the band around your waist and a third position, around your hips covering the hip bones.

For more on how to do this, check out this excerpt from Pilates Master Rael Isacowitz

Take care to breathe in through your nose and out of your mouth like you’re fogging up a mirror.  Do that consistently throughout your practice. You will notice a difference. As a Pilates instructor I know people can feel self-conscious about breathing audibly. At very least, you should hear your own breath.

Joe Pilates was asthmatic at time when there was no medication – he breathed his way back to life.   Someday we will all take our last breath – so breathe deeply and completely to get the most out of your life now.



Pilates does a body good in many ways. Improves balance, strength, flexibility, confidence and strengthens the pelvic floor. All that helps improve that most intimate of acts, sex.  Most people have heard of the Kegel method to improve a woman’s pelvic floor, but Pilates can be better.  So says this blogger/ Pilates instructor in the Huffington Post.  As a longtime Pilates devotee and instructor myself, I totally agree.

The Pelvic Floor IS Core

If you’re talking about the “core” of the body you can’t get anymore centrally located then the pelvic floor. It’s what helps you activate your “corset” muscle known as the transversus abdominis, the muscles that hug around your waist and help support your spine.   Strengthening the pelvic floor leads to better control and power in the Pilates studio and the bedroom.

Strength is Beauty

The stronger your core , the more confident you’ll feel.  And when it comes to attractiveness, confidence goes along a way. It’s why most ladies give a second look to those cocky cowboy types.

For my women clients, there’s nothing like the rush of mastering a new move like plank on the reformer, or teasers performed smoothly and slowly with control.  It’s elegance and power in motion. Many high fives in my Pilates studio after those moves are completed!

Men and Pelvic Floor

Many people, especially men, come to Pilates later in life because they have injured themselves. But why wait?  You can prevent injuries, get stronger and more flexible as you age instead of the reverse.  And guess what guys,  improving pelvic floor is not just for women. There are a lot reasons it can benefit you too.  For details, read here.

Enjoy the Journey


The bad news is that back pain will likely plague you at some point in your life, and probably more than once. The good news is there is a lot you can do to prevent, manage and relieve that pain. Heat and ice treatments work wonders and both bring easy, convenient, and fast relief.

You can treat any sprain/strain injuries with hot and cold packs because both help reduce muscle spasm and pain. There are differences in these temperature treatments though. Ice reduces blood flow thereby quieting swollen tissues. Heat, on the other hand, stimulates blood flow. The increased circulation brings more nutrients to the injured site and helps relax sore muscles.

At the first sign of an injury it’s recommended that you start with ice to calm the swelling. Ice the area for about 15 minutes then repeat the icing in about an hour. After 24-48 hours, move to heat treatments.

Note that alternating ice / heat is a general recommendation. Because both ice and heat are pain-relieving, do which ever makes you feel better. There’s no magic rule. Some people like to alternate hot/cold packs, while others prefer to stick one temperature.

There are a lot of products on the market today that make hot/cold back therapy easy. They can be conveniently heated in the microwave or cooled in the freezer. Look for those which are large and can be draped around an area. Some are specially made for the lower back and attach with Velcro much like weight belt.

No cold pack? A bag of frozen peas can do wonders in a pinch. Whatever your do, avoid putting ice directly on your skin, it’s irritating. Place ice cubes in a bag, wrap a towel around it and apply. Be patient. It takes a few minutes for the cold to come through. Likewise, you can heat up a moistened towel in the microwave for a comforting moist heat wrap. Again, take care when applying to skin. You may need a second towel wrapped around the first.

A strong healthy body with good core strength helps prevent back pain in the first place.  Pilates is all about the spine and among the best ways to keep your back healthy for life. There are some simple exercises to bring quick relief such as this easy to do anywhere anytime upper back release.