Correcting Teenagers' Kyphosis through Pilates

EMMA PENG

JAN 15TH, 2018

2017-2018 BODY IN MOTION, CA

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Abstract

Kyphosis involves an increased thoracic curve of the spine, it reduce the load

capacity of the spine. Nowadays, the teenagers’ kyphosis phenomenon is

becoming more and more common in China and presents a trend of low age.

Kyphosis not only affects the personal image temperament, but also affects the

normal growth and development of the spine and even affects the health of the

body.

The main reason for the Kyphosis of Chinese young people is to keep the

incorrect posture for a long time, lack of exercise, and have too much mental

pressure. That cause their weak thoracic extensors and tight anterior shoulder

muscles. Based on my research, I was able to develop a safe Pilates program for

teenagers to correct the kyphosis using the BASI Block System which has

dramatically improved their posture and self-confident.

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Table of Contents

Anatomical Description…………………………………………………………………….4

Introduction…………………………………………………………………………………..6

Case Study..................................................................................................................9

Conditioning Program .................................................................................................8

Conclusion………………………………………………………………………………….15

Bibliography ..............................................................................................................16

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Anatomical Description

Kyphosis is an abnormally excessive convex kyphotic curvature of the spine as

it occurs in the cervical, thoracic and sacral regions.Kyphosis can be called round-

back or Kelso's hunchback. It can result from degenerative diseases such as

arthritis; developmental problems, most commonly Scheuermann's disease;

osteoporosis with compression fractures of the vertebra; multiple myeloma or

trauma. A normal thoracic spine extends from the 1st to the 12th vertebra and should

have a slight kyphotic angle, ranging from 20° to 45°. When the "roundness" of the

upper spine increases past 45° it is called kyphosis or "hyperkyphosis".

Scheuermann's kyphosis is the most classic form of hyperkyphosis and is the result

of wedged vertebrae that develop during adolescence. The cause is not currently

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known and the condition appears to be multifactorial and is seen more frequently in

males than females.

In the sense of a deformity, it is the pathological curving of the spine, where parts of

the spinal column lose some or all of their lordotic profile. This causes a bowing of

the back, seen as a slouching posture.

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Introduction

My program is focuses on the kyphosis which caused by poor posture, it called

“postural kyphosis”. It is the most common type in the Chinese teenagers, they are

often has a lot of homework to do, and keep wrong sitting position for all day. And

they do not have time to do the work out. For young people This can have a

significantly detrimental effect on their lives, as their level of activity is curbed by

their condition; they may feel isolated or uneasy amongst peers if they are children,

depending on the level of deformity.

They are lack of muscles strength especial the back extensors and it can be

reversibly by correcting muscular imbalances.

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Case Study

One day a girl came to my studio with her mother, she is at age 17. Her mother

told me that her daughter looks so tired everyday, and she don’t like to talk to people.

Her mother asked me if I could help her to correct the wrong posture. I found that

the girl had a very serious kyphosis, and she is really quite. I knew some

informations about her from her mother: she is in high school and her major is

painting. She always draws over 10 hours per day, and her mother want her to be a

student of a really famous art school in China, so she gave her daughter a lot of

pressure.

At the very first introduce session, I found that she is lack of strength for the

whole body especially the back extensors and she almost loss 50% of the joint

flexibility. I suggested she commit to doing Pilates 3 times a week, and do some

simple stretch at home every day to increase her joint flexibility.

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Conditioning Program

As we talked, the girl came to take the private session with me 3 times a week,

and doing stretch at home every day. For the private sessions we focus on improve

her muscles strength and every time at the back extension work we do double

times until her abdominal muscles and her back muscles are balanced. I change the

equipments for different sessions in order to let her feel things are interesting. But

the goal in each Block is almost same, so here are two examples for the program

which are in different period for progressive layering.

1-10 sessions

BLOCKS EXERCISES COMMENTS

WARM UPMAT: pelvic curl- spine twist supine-chest lift-chest lift with rotation

When doing the pelvic curl I try to avoid the lumbar pressure. And it is difficult for her to doing the chest lift and the chest lift with rotation without any help, so I always get a magic circle or my hand to help her lifting with deep lumbar flexion.

FOOT WORK REFORMER

I focus on keep her spine and shoulder in neutral position, it is already hard enough for her when she set up well. I like to lift her head rest a little to let her feel comfortable of her neck and it is the better way to let her have the sense of lengthening her neck. Also I need to focus on the knees and the ankles alignment.

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ABDOMINAL WORK CADILLAC: warm up series

Since she is lack of muscles strength, it is better for her to doing the abs work with a bar, which can help her get the deep lumbar flexing and a pure rotation without lateral flexion

HIP WORK REFORMER: leg supine series

I focus on the set up of the supine posture every time. Letting her lying at a neutral position is quit difficult, sometimes I let her pumps facing up since her tight anterior shoulder muscles. And I try to keep pelvic still when leg circling, that makes her realize her hip’s range of motion is limited

STRETCHES CADILLAC: shoulder stretch prone

I always like to to the shoulder stretch for her during the stretches block, because she did a lot of leg stretch everyday

ARM WORK REFORMER: arms supine series

I still focus on neutral position when doing the arm work specially the scapular. I only use one blue springs in order to let her doing the work more precious. She feels her back sour every time she finish the arm work

LEG WORK LEG WEIGHTS: gluteals side lying series

It is more easy for her to to do the leg work when she can get a lot of support, that makes her feels more of the muscle focus

1-10 sessions

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After several sessions when she get stronger and more flexible, I change my

program as below:

LATERAL FLEXION/ROTATION MAT: side lift

I let her legs come forward a lit bit as a banana shape, incase her lumbar feels uncomfortable and that can let her feel more on the oblique muscles, at the very beginning I let her hands touch the mat to get more support

BACK EXTENSION AVALON: swan prep

Since her thoracic’s extension motion is limited, so I use Avalon to active her back extensors from the flexion position to the neutral position. Always remind her to engage abdominals when doing the back work.

1-10 sessions

11-20 sessions

BLOCKS EXERCISES COMMENTS

WARM UPMAT: pelvic curl- spine twist supine-chest lift-chest lift with rotation

When she supine on the mat I can see it become easier for her to keep spine and shoulder in neutral position. Andshe can do the deep lumbar flexion now so I let her focus on keeping pelvic still as neutral position when doing the chest lift. Some times I put a ball between her knees to engage more inner side muscles.

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FOOT WORK CADILLAC

Her flexibility improved so that she can use Cadillac to do the foot work with neutral position, I try to use Cadillac to let her feel more stretch, and also she can check her knees and ankles alignment when at a supine position

ABDOMINAL WORKAVALON: chest lift-reach-overhead stretch-reach Avalon-hundred prep Avalon

Use Avalon to do the abdominal work can let her have the thoracic extension, I use to let her lying on the Avalon for a while to stretch her thoracic and shoulders

HIP WORK CADILLAC: supine leg series

Since she already familiar with the move pastern on reformer, I use Cadillac to balance her legs muscles.

SPINAL ARTICULATION MAT: rolling a like a ball-spine stretch

I always like to let her doing the spine stretch with a wall, that can makes her feels the way that how to articulate her spine

STRETCHESLADDER BARREL: shoulder stretch 1-shoulder stretch 2

I repeat 5 times to enhance her shoulder’s range of motion, and rehabilitate her shoulders imbalance cause form painting

FULL BODY INTEGRATION F/I

REFORMER: scooter-round back-flat back reverse knee stretch

I focus on C curve, she need to deepen her lumbar flexion and reduce the flexion of her thoracic.

ARM WORKREFORMER: shoulder push-shoulder push single arm

When she did this arm work, it also can active her back extensors, and also let her know the feeling of scapular stabilization. The single arm exercise can balance her arms muscles.

11-20 sessions

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Except the regular training I suggested her not keeping sitting position for more

than 1 hour, and drink more waters. After 2 months training, she is four centimeters

taller than before, and has a better thoracic curve. The most important thing is she

become optimistic, we talk more than before during each sessions.

LEG WORK REFORMER: single leg skating

She can do the leg work without that much support, and can keep her trunk and pelvic stable. Also she need to focus on keeping neutral spine when standing on the reformer

LATERAL FLEXION/ROTATION

AVALON: spine twist supine-side lift-side over with extended arms Avalon

I like to use Avalon to do this group, I always do some shoulder stretch after finish the work on Avalon

BACK EXTENSION Mat: back extension

Since she increase her range of back motion, so I let her to do the back exercise from neutral position to extension position

11-20 sessions

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Conclusion

The girl’s kyphosis was not a severe case but it was limiting her activity and how

she viewed herself. Since she commit to come 3 times a week, she found that she

don’t need to drawing 10 hours per day, Pilates gave her a lot of fun and let her

escape the pressure from the school and her parents. When she is on the way to

studio she can get a lot of fresh air and that makes her more creative when drawing

things. Now she already doing pilates for more than 3 months, she feels that she is

full of energy everyday and her friends and her family said she becomes more

pretty. Her abdominal strength and back strength has improved a lot but we still

need to work with that, and the next step for us is to correct the alignment of her

ankles and knees and some other imbalance.

It is so important for younger people to have a good posture, not only for their

physical health but also for their mental health.

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Bibliography

Wikipedia

Isacowitz, Rael. Reformer: Movement Analysis Workbook. Costa Mesa, California:

Body Arts and Science International, 2013.

Isacowitz, Rael. Auxiliary: Movement Analysis Workbook. Costa Mesa, California:

Body Arts and Science International, 2013.

Isacowitz, Rael. Wunda Chair: Movement Analysis Workbook. Costa Mesa,

California: Body Arts and Science International, 2013.

Isacowitz, Rael. Mat: Movement Analysis Workbook. Costa Mesa, California: Body

Arts and Science International, 2013.

Isacowitz, Rael. Cadillac: Movement Analysis Workbook. Costa Mesa, California:

Body Arts and Science International, 2013.

Isacowitz, Rael & Clippinger, Karen. Pilates Anatomy. Human Kinetics, 2011.

Conversations with Professionals

Dominique. BASI Pilates

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