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

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