2020 WTF??? Where's your head at?

2020WTF???? Where’s Your Head at???
Well, it's been a while.
The second half of 2019 saw me struggling with life. The word 'much' came to be the one that best described what I was experiencing. Not 'too much', or 'so much', just 'much'. Everything was just MUCH. So towards the end of 2019, I decided to prioritise getting my mental house in order. I contacted my GP, described what I was experiencing and with a diagnosis of moderate depression made a few decisions. First, I set out to find a therapist to help me navigate my way back to a more optimal state of mind. Second, I stepped back from Pilates Therapy and left it in the capable hands of Bonnie, my evil twin and our superstar Maria. Hence, no blogs from me for a while. Here we are, 26 therapy sessions later; a global pandemic; lockdown here in the UK; closure of my studio for six months; all our Pilates Therapy courses moved online and a broken ankle later; and I'm back in the flow of life as we now know it.
Someone got on my vagus nerve. I had been in the process of writing a blog about the vagus nerve back in October of last year. It's a big complicated subject. Having had a preliminary draft shared with someone I didn't know, I was stopped in my tracks by their comments. Unfortunately, rather than help me improve it, they decided not to. I wondered why, if they felt it was so inaccurate, that should it have been published, they would have reported it and had it taken down, would they not help to improve it with their feedback? Let's say, that confused the hell out of me and in my then mental state, was enough for me to drop the whole thing. The irony that the reaction to a blog about the nerve, credited with regulating our fight, flight and freeze response was enough to send me into shut down, is not lost on me. When you are in the dark place of depression, it doesn't take much to shut you down. Thankfully, I have found my way back to the light.
First blog of 2020-Mental Health. I have a list of subjects I would love to blog about relating to Pilates as therapy, but for this first one of 2020, mental health seems like the right place to start. Today we are a global community of humans struggling to meet our most fundamental of human needs, the need for certainty. The one thing few of us have at the moment is any control over our life situation. We all react differently. Some will worry, some will get angry, some will panic, some will deny, some will shut down, and some will get on with life. Living in a global pandemic, this will apply to every client walking into our studios as well as us as Pilates teachers. So, have you checked in with yourself? How are you doing? What is your relationship with the voices in your head? Are you giving yourself and your client's space and permission to be dealing with the shit-show that is 2020 in the most supportive way possible?
WTF can we control? One thing the current situation has made incredibly clear to all of us is that life is not within our power to control. What we can control is our breath, our focus, our thinking. JP said in 10 sessions you would feel the difference, 20 see the difference and 30 be different. The same applies to psychotherapy as after 26 sessions, I am a different person.
Finding the positives. The one significant positive for me has been the way we have all adapted to finding ways to stay connected. I had never heard of Zoom before, and now, it's a part of our lives. I've been fortunate enough to have learned how to assess clients via video calls with Diane Lee which has enabled me to work with clients old and new, to help them through the months of not being able to see people face to face. The belief that 'online' courses were substandard to 'in person' ones has changed. Online courses have enabled many of us to learn from the comfort of our homes. Many of us have found the unexpected quiet time an opportunity to clear out cupboards metaphorically and physically. Some have needed to 'be' while others have gotten busy getting projects finished that had been on their to-do list for ages. There are positives to this crazy time; we need to pay attention to find them.
What do course whores in confinement get up to? - taking courses of course. When "le Confinement" began here in the UK ( I prefer the French phrase for 'Lockdown' as it's a much softer word) we, here at Pilates Therapy, took advantage of the proliferation of courses suddenly transferred online. The first one we took was with Peter Levine of the Somatic Experiencing Trauma Institute hosted by Embodied Philosophy. He is one of the world leaders in working with victims of trauma through breath, touch and movement. Sounds a bit like what we do in our Pilates sessions. He was raising awareness that there will be many who are going to suffer from trauma due to the current world situation. If you want to learn more, there are loads of free resources on their website so when you’ve finished reading this, head on over.
It’s Trauma, duh! Therapy revealed that I had unresolved issues with trauma from my childhood, a revelation to me. I thought it was just 'normal' until I heard myself describing it out loud to my therapist. The body can store trauma. I worked through my buried trauma in a somatic way. I let my body lead the way back to balance by revealing what had remained hidden in my cells for decades. Humans are hard-wired to survive, but we don't always have the skills to reset back to a place of balance and peace. When we are under stress, we experience tension; when we are tense, our breath and movement change. We may need to spend a little more time than usual allow clients to centre themselves, check-in with how they are, and to reconnect with their breath before their regular Pilates practice.
Pilates offers our clients the opportunity to reconnect with their bodies, their breath, and to focus their minds. We share the gift time out from what is happening in their lives and this crazy world. For the time they are with us in our classes and studios, we give them space to reconnect with themselves. I wish all of you excellent Pilates teachers and therapists the best of luck for your wellbeing and livelihoods. This storm isn't over yet. Look after your mental as well as physical health. It's like when they take you through the safety briefing on a flight, put on your oxygen mask before helping others. Find what works for you to help you stay grounded and create a self-care routine for your body, mind and spirit. We do this for our clients; we must do the same for ourselves.
We need to remember to be kind to one another. While we may have clients happy to get back into the studio, others will be struggling and may not be so willing to physically share space with others while this virus is still transmitting among us. I am hoping we all can look after each other in the best way possible while realising that some of us will be reacting from a place of fear and mental unrest. Remember to be gentle with yourselves and others. What therapy has taught me while I've worked through my depression is that I am not responsible for the emotions of others, only my own. We cannot control how others are behaving during this weird dystopian time, but we can step back and give them space to 'do them' while we 'do us' and ride the waves until things settle down.
The following can be found on the Somatic Experiencing Trauma Institute website:
Signals that the nervous systems are in a state of stress:
  • Heart rate, is it high?
  • Breathing, is it shallow?
  • Do you want time alone, are you feeling uncomfortable socialising? What is going on in your head?
  • Is your inner voice on overdrive, with thoughts bouncing all over the place like you've had way too much caffeine?
  • Physical tension - how much are you holding in your body?
  • Fatigue despite having slept, or are you having difficulty sleeping?
  • Are you talking fast, or for those other New Yorkers like me, more quickly than usual?
  • Do you feel numb, or disconnected?
These are some of the signals that the nervous system could do with some attention.

SCOPE = a safety aid to stabilise the physiological stress response and helps us cope with a crisis.
  • Slow down - ground yourself by focusing on the sensations in your feet while you walk - or at the start of a pilates session take your awareness into your feet if standing or where your body connects to the ground if you start lying down.
  • Connect to your body - hug yourself, cross your legs and let your chin rest on your chest and breathe
  • Orient - take a moment to notice what's around you, colours, shapes and focus on something comforting or pleasant and have a micro visual vacation - I've got a beautiful view of my garden outside my studio. Still, a poster of something or somewhere fab could work just as well.
  • Pendulate - find somewhere in your body that feels easy and comfortable, then find somewhere you can feel the tension. Shift your focus back and forth between ease, tension, ease … even if its just your little finger or the tip of your nose.
  • Engage with others - find someone who can support you - you can be this person for your clients, but you need to find someone who can help you too.
* Click on the links to take you to videos demonstrating each step

All our Pilates Therapy courses are now available online at considerably discounted prices. Check out our website for more information.

If you would like to understand more about the neurobiological principles and practical practice of Somatic Experiencing there is a wealth of resources on their
website.

Accreditation yes or no?

Accreditation yes or no? Where do the Outliers go??

So, we at Pilates Therapy have stepped well and truly outside the box and leapt into the void by offering courses to Pilates teachers that upscale their skills to cover objective screening and manual therapy tools that are not covered or included in most traditional Pilates education programs in the UK - that we know of…

The here and now.
Why this blog about accreditation you ask (or maybe not)? We have been continuously asking our teachers to spread the word and let others know about our courses so we can spread the love. We have also been asking why people may hesitate to come along to our sessions and one question that occasionally comes up is ‘who are they accredited with?’ So we are asking: how important is accreditation to you when deciding to take a course? What does being accredited add to a course? Does it represent value, credibility, instil trust that the people you are parting with your hard earned cash for and giving up your precious weekends with are worth it? Please tell us…..

Brief history lesson.
What has happened over the years within the Pilates industry has been interesting. When I trained with Body Control Pilates (BCP) and the Physical Mind Institute in NYC, there were no accredited courses on either side of the pond, none, zip, zero, nil, nada. In fact, in the USA teaching organisations could only say they taught exercises based on the teachings of Joseph Pilates. They couldn’t say they taught Pilates until the trademark lawsuit in the USA was settled in NY in October 2000 and Pilates was ruled a generic term, like Yoga. Since then the PMA (USA based but welcomes international members) has worked to self-regulate our industry and has created its own accreditation. Here in the UK, we were protected by the Atlantic from the lawsuit, so BCP and the Pilates Foundation (PF) were free to market their teaching programs as Pilates. They also accredited their own courses as this was in the days before the Exercise Register here in the UK and the PMA over there. The most important thing for these organisations was that those who went through their training programs were able to obtain insurance to practice teaching.*

Fellow outliers (noun: a person different from all over members of a group or set).
Those who have jumped with us and taken our courses have been incredibly complimentary about what we have been teaching and the phrase ‘why don’t we get taught this’ has been mentioned more than once. We are non-judgemental and recognise the challenge for most Pilates educators is that they have to leave stuff out to cover what they believe is essential and it is also possible that many Pilates educators may not know some of what we are teaching themselves.

Just a pair of Pilates Geeks.
We are just a pair of Pilates geeks who don’t believe we know all there is to know and are driven by growth and an ongoing thirst for more knowledge. We are addicted to learning and love to share what we have found useful in our teaching with our clients. We are also not afraid to dip our toes outside the Pilates pond and into anything that might help our clients move better, more quickly and with more ease. We also want to ensure our courses are recognised as being of a very high standard. One of our students had completed a degree not long before joining our Level one Bridging course and has told us what we are teaching is of a comparable level. We know Pilates teachers are smart and highly skilled and are not likely to waste their time on rubbish courses.

That’s enough for now, more to follow in the next blog posting……

* For the record, when BCP decided to become accredited with an outside organisation it aligned itself with REPs (Register of Exercise Professionals) in 2006 it invited those of us who had trained with them to attend a one day workshop to meet the requirements of the Pilates national standard and register as Level 3 Pilates teachers. I’ve never been asked if my training was accredited by any of my clients. I do recognise I only worked briefly for fitness centres and this was in the days before REPs existed (pre-2002). PF set up its own accreditation for courses run by its members.





Back again, now where were we??

Accreditation = Quality??
The question about accreditation has got me thinking about the courses we've taken, and I wondered how many are accredited? We love learning, and often the most useful courses we've attended have not been certified, but they are insured. Diane Lee and her ISM recognised as CPD for physios (I snuck on and blended in with the physios). John Gibbons and the Bodymaster, nope, CPD for each course and insured by Balens but the whole thing, not accredited but an excellent course for assessment and management of MSK (Musculoskeletal) issues. AiM with Gary Ward, not a chance, these guys love pushing boundaries and challenging conventional thoughts about gait and the joint mechanics in the body. NKT and David Weinstock, mind-blowing course and you guessed it, not certified or accredited. Eric Franklin, yes for CPD credits but not accredited but again one of the most useful courses I've ever attended as a Pilates teacher to help me understand and communicate optimal biomechanical movement to my clients.

Accreditation = Value??
The truth is when it comes to some of the accredited courses I've participated in recent years, one organisation went bust before I finished and the other was of a rather low standard. In both these cases, the educators ticked all the boxes to get their course recognised and paid no small sum of money to be accredited, but it didn't guarantee high standards of information or reliability. Shoot me for saying this but from what I've heard from teachers who have attended our courses (many of whom have decided to retrain in Pilates with us) is standards of Pilates courses have gone down since accreditation came in. Ticking boxes to meet criteria for certification means a lot of educators can get away with leaving out a lot of what was taught back in the day on Pilates courses. This doesn't equal high quality to me.

Educators need qualifications, but do the courses they offer require accreditation?
Bonnie and I have been fortunate to learn with some of the best educators around. We have attended courses taught by world-renowned experts in their chosen specialties of physiotherapy, osteopathy, massage therapy, movement, manual skills and of course Pilates. These generous experts are willing to share their knowledge and skills with those of us who are fortunate enough to have access to their courses. It's honestly never occurred to us to worry about accreditation. What we are doing is sharing our expertise of 40+ years between us to pass on what we know works with our clients. We are pushing out the sides of the 'Pilates' box. Who would accredit our courses - not the world of Pilates, nor the world of massage? What we are offering sits somewhere in between - bridging the gap, where the magic can happen.

We’re listening so tell us what you think.
Personally, Bonnie and myself don’t really worry about the courses we take being accredited as long as they offer high-quality education and we are insured to practice what we have learned. We usually find out about most of the courses we attend by recommendation from others. We recognise that new and innovative educators are often ‘outside the box’ and don’t necessarily fit into a specific industry which can make it difficult to find a body to accredit them. Like BCP and PF all those years ago, we are offering something new. We are bridging the gap between Pilates and therapy. So we are asking those of you who have taken the time to read this to tell us what you think.

Accreditation - yea or nay...

Confessions of a 'Course Whore'

Confessions of a ‘course whore’.
I have always believed I can improve, grow and continue to learn. Why? To help me 'fix' more people, be a better Pilates teacher and improve my client's experience of their Pilates exercises during their sessions. Now, I am not a perfect Pilates teacher and Pilates isn't a perfect exercise system. I never feel I know enough and it has taken me years to accept that I cannot 'fix' everyone (personally and professionally) and I am actually ok with all of this.

But I’m lucky. It’s possibly annoying to read that, but I am. I'm not bragging just stating a fact. If you are still reading, thank you! I say this because in my years of experience, of being insecure and second guessing myself, I’ve now reached a stage where I am grounded in who I am and where I am.

And you may ask yourself, well, How did I get here? I trained as a dancer from the age of three. I love moving. I didn't have a professional career as a dancer but trained until the age of eighteen when I had a tantrum, gave up dancing and went to university to play with food and fabric. Pilates, however, had gotten under my skin as a dance student in NY and in the late 1990's fate threw me back into Pilates and movement when I trained with Body Control in London. I was back in my body, moving, and didn't think anyone would want to take any classes with me but I was wrong. I'm lucky, remember?

Teach me more, teach me more. My need to know more has guided me to train with most of the Pilates Organisations in the UK and a few in the USA too so I am entitled to call myself a qualified Classical or Contemporary Pilates teacher. I have acquired additional manual and assessment skills by attending courses taught by physiotherapists, osteopaths, and massage therapists. All these wonderful tools have supported my ability to help improve my client's ability to get more out of their Pilates sessions and move better, feel better and more quickly than when I only included Pilates choreography in their sessions. I am lucky to be able to indulge my addiction to learning and satisfy my need to attend new courses and continue to add 'tools' to my 'toolbox' to use with my clients during their sessions.

Now I call myself a Pilates Therapist. I made the title up as I was struggling with my elevator pitch at parties in an attempt to define what I do. People now at least think they know what Pilates is when you tell them. Introduce yourself as a Pilates teacher and you get a knowing 'oh, maybe followed with 'I tried Pilates', or 'I've been told I should start taking Pilates lessons'. But I don't just teach Pilates to my clients. I integrate all sorts of other skills into my sessions, I'm stopping them mid-exercise to screen them, doing some massage, or MET's, playing with some imagery while they squat and stand to explore the 'movement' of their pelvic bones to free up their hips or understand how their sacrum belongs to their spine and just lives in their pelvis, maybe re-screening them and then getting them back on the equipment to do their exercise again and see if they find it easier, harder, better. Not sure if others will think this is a good or a bad thing, I won't lie, part of me cares a little bit what others think so I am hoping it's seen as a good thing. Hey, at least my clients are happy and they are the most important people in this story.

Time to pay it forward. Our courses include the skills myself and my fellow 'course whore' Bonnie Southgate has found the most useful to integrate into our sessions with our clients. Bonnie and I want to pass on our combined 40 plus years of experience to other Pilates teachers so they too can add more 'tools' to their 'toolbox'. If they too find they want to know more. Be a rebel with us and step outside the Pilates box and join our tribe of fellow skill seekers. We both continue to attend courses and as we find great new skills we will share them with those other Pilates therapists so they too can help more clients move better, with more ease and less pain. Now, I'm off for a little medication to calm down my inner critic who is freaking out that she may be judged by the Pilates police in daring to say this is who she is...a lucky course whore who calls herself a Pilates Therapist.

Lovely Bones...they follow rules

Lovely bones….they follow rules
Years ago when I was a newly qualified Pilates teacher I heard about a book written in the early 1990’s by Bruce King (someone trained by the man himself in NYC back in the late 1960-70’s) called Rules of the Bones: Exercise Theory and Program for Correct Body Usage a title that trips off the tongue (Pilates teachers have often seemed to like to use lots of words)! This book was written during the years when teachers avoided using the name Pilates as there were legal challenges taking place which have thankfully been resolved. I am a compulsive book buyer (and reader) and already had devoured Your Health: A Corrective System of Exercising That Revolutionizes the Entire Field of Physical Education and Pilates Return to Life Through Contrology by Joseph Hubertus Pilates (JHP). Somehow I managed to acquire a copy of Bruce’s book before Amazon existed and when it arrived was surprised to find it was more of a booklet than a fully fledged book but It is still one of my most prized Pilates books in my library.

Who was Bruce King and why do we care what he had to say? He was a dancer (weren’t most of them) who was one of of the precious few trained by JHP and he opened his own studio in NYC in the mid 1970’s. Today he is classified as one of the elders along with Mary, Carola, Ron, Kathy, Romana, Eve, Lolita and the others. According to Mary Bowen, who studied with him, a knee injury had led him to Pilates where he was only allowed to do three exercises for 6 months on the Reformer perfecting the alignment of his legs and feet. His experience of staying focused on precision and alignment gave him an understanding of the importance of the bones being in the right place during movements and allowing the muscles to follow. This is where I believe we should always start our Pilates practice.

Why do we care about the bones? Optimal organisation results from the positioning of our bones. Knowing the bones, their relationships and their movements is integral to Pilates. When we can feel the weight of our bones our body lightens and we feel where we are while we move. The focus on the bones has always resonated with me as a teacher, we can easily identify them and observe their relationships while our clients move. Understanding their positions and studying their movement is key for me in my work as a Pilates Therapist. Movement happens in the spaces between our bones (our joints). Bones should not touch each other, when they do they are said to have degenerated and movement becomes painful.

Classical Pilates evolves into Modern Pilates. According to Mary Bowen John Claude West (a student of Kathy Grant) was one of the first in the Pilates community to start working with Physiotherapists and studying anatomy and biomechanics. He was a thinker who wanted to understand more about the body and how it worked. Classical Pilates focuses on students following the sequence, the pattern of the exercises, first Reformer, then the Mat, this exercise follows the one before. Mary has said that JHP didn’t mind you changing the order, or invention, as long as you used your whole body.

Does understanding optimal biomechanics and joint actions inform our teaching of Pilates?
The core principles of Pilates include precision and alignment. From the start of my training as a Pilates teacher in 1998 I have continued to study in an attempt to understand optimal biomechanics and joint actions. Our bodies are comprised of soft tissues and without our bones we would be a pile of jelly. Bones give us form and an ability to move on our lovely planet. When we understand the bones, joints and their actions were are in a strong position to facilitate optimal changes with our clients. Issues stemming from sub-optimal biomechanics can be resolved when we teach from the bones.

Do you know your PSIS, from your ASIS and your AIIS? Pilates Therapy courses focus on deepening our understanding of the bones, joints and biomechanics. We teach the movements of the pelvis as it relates to the hip and the spine. Understanding the mechanics of the spine (Fryettes laws of spinal mechanics) when it is in neutral and non-neutral. Spoiler alert: the laws are not the same when the spine is not in neutral. Did you realise the bones of the spine move in different ways during flexion, neutral and extension? Knowing how the bones should move gives us an opportunity to cue them in ways that support optimal joint mechanics. Screening objectively helps us identify those who’s anatomy is not optimal. There is nothing we can do to change the shapes of our bones - structural scoliosis, a cam or pincer in the hip, will not change with exercise. Being able to identify these individuals allows us an opportunity to work with their bodies, allowing us to support them as they are. We can work with their anatomy and know when to refer this population on which raises our standards as Pilates teachers and improving our reputation with the medical practitioners we share our clients with.

Maybe it wouldn’t have taken 6 months of repetitions for Bruce’s legs to return to optimal alignment had he been screened, and manual skills been integrated into his Pilates sessions. What makes Pilates special is the fact that we get to see our clients moving their bones, when we screen them objectively we can objectively identify what is moving and what is not (iliosacral or sacroiliac), is the spine responding to what is happening at the hip or is it the other way around? This deeper understanding enables us to facilitate changes more quickly. Pilates Therapists also have additional skills to help identify who needs to be referred on. It isn’t our job to diagnose anything but knowing what are not likely to change, saves time for us and our clients.



References and Links:
http://jeanclaudewest.com
YouTube: Mary Bowen Shares Her History and Love with Pilates and Bruce King, Author of
Rules of the Bones

A Pelvis, Hip and Spine Story

A Pelvis, Hip and Spine Pilates Therapy story…with a happy ending!

The following blog is based on a real patient

How JP first came to me
JP first came to see me after New Year January 2014 having never done Pilates before. She grew up in a family of runners and had been a long distance runner until December 2012 when she had to stop due to low back pain. Her diagnosis was L5-S1 disc herniation and was presenting with nerve irritation and altered sensation in her right foot (numbness in her big toe joint and down the outer aspect of her foot). Walking, swimming (breast stroke surprisingly) and hot baths were the only things that seemed to ease her discomfort but sitting, bending and lifting all made it worse which made her job as a nurse difficult. Her neurologist had given her a steroid injection in June of 2013 after diagnostic testing identified her disc issues and she was referred to me by her Osteopath who often sends me the patients he believes will benefit from Pilates. She had replaced her running with swimming and walking twice a week as being active is part of her who she is.

What do I, as a Pilates Therapist, do that is different from other Pilates teachers?
I screen my clients objectively and utilise therapy skills acquired over 20 years of teaching and continuously taking courses to add more tools to my toolbox. All with the goal of being able to help my clients move better, with less pain and without having to cue them constantly to ‘adjust’ and ‘correct’ their movement. Pilates is an amazing movement system but on its own, sometimes isn’t enough to get them there. I appreciate this a controversial opinion but if Pilates ‘cured’ all movement related dysfunction we could charge what we liked for our sessions. I work with other like minded practitioners and professionals who also recognise there are no ‘therapies’ that solve all puzzles which is why I refer clients to them, and they refer clients to me. This is how I came to start working with JP at the beginning of 2014.

When I first meet a client one of the questions I ask is ‘what is their goal’?
What would they like to be able to do that they are not able to now. In JP’s case she wasn’t confident in setting the goal to be able to run again and was happy with reducing her pain and being able to get through her days without discomfort. One my beliefs is when working with movement we can set goals with an open mind, without limiting expectations. JP was afraid to imagine she could run again (spoiler alert, May 2015, she did and recently completed a 5K run and beat a family member who regularly runs marathons - a very happy day!).

What did we do during our sessions that helped her get there?
We screened her from day one to evaluate what she was and was not able to do. We started with focusing on screening her pelvis and found her right PSIS was lower than her left and the sulcus on the left was deeper than on the right suggesting her sacrum was twisted to the right. She also presented with a functional a leg length difference with the left leg longer (this made sense as her left ilium was anteriorly tilted relative to the right). If this is all gibberish, come and join us because this is what we are teaching on our course.

Objective evaluation for JP was key
Knowing how to evaluate the pelvis, hip and spine objectively and address what is found before starting a Pilates practice means our clients are moving better from the start. Putting her on a reformer before we had addressed the pelvic issues would not have been helpful. Using muscle energy techniques, soft tissue and neural therapy skills we evened things out, calmed down what was overworking and woke up what had been asleep. It is a ‘do with’ process and she has done her homework and earned a body that is now more balanced and free from neural symptoms and most importantly, she is enjoying running and has her active lifestyle back. Her disc issues were her bodies way of getting her attention. It worked, but the disc problem was the result of unresolved pelvic dysfunction we uncovered that went back to her two pregnancies over twenty years earlier.

The luxury we have as Pilates teachers is that we get to spend an hour with our clients and we get see them move, most other practitioners don’t. The additional tools we have as Pilates Therapists makes our time with our clients even more productive as we can screen, intervene and then get them moving.

“When you have exhausted all possibilities, remember this: you haven’t.” Thomas Edison