Pilates for the Octogenarian

Latoya Mckelvin August 2019

Costa Mesa 2016

Table of Contents Abstract

Instruction

Anatomical Description Case Study Workout Plan Conclusion Bibliography

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Abstract

According to the 2010 US Census 2% of the US population is over 80 years old and

with the continued advances in healthcare that number continues to grow. Many

Americans are living longer but what about the quality of life in later years? This is a

question of importance as more and more people are living well into their 80’s.

The human body is ever evolving. This extremely evident in later years of a lifetime

when many physical and cognitive changes occur. Of course, the how and the speed of

the aging process is dependent on genetics and lifestyle. But no matter what, it’s safe to

say that by the time we hit 80 we’ve done a lot of living. Healthy lifestyle choices like a

healthy diet and regularly exercising can have a big impact on the quality of life of an

octogenarian. Finding an effective workout for this mature population can be challenging

because by this time in life things like illness treatment, surgery, or physical impairments

can be compounded. Because of this octogenarians may have difficulty finding an

exercise modality that’s accessible to their abilities and meets their specific needs.

That’s where Pilates comes in. It offers a great low impact form of mild resistance

training, targeting all of the needs of the octogenarian’s physical health; core strength,

mobility, stability and strengthening the mind body connection

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Introduction

The aging process has a total effect on the physique, mind, and emotions.

- Hormones

As the body ages, a decrease in the amount of hormones produced has a major effect.

The changing hormone is different depending on the sex. After women go through

menopause their body produces less estrogen which helps to regulate bone density,

cholesterol, body temperature and skin elasticity.

For males there is a reduction in testone, which regulates bone mass, muscle mass

/strenght, fat distribution, sex drive, and the production of redblood cells.

- Muscle

The decrease in hormones in both sexes has an effect on muscle mass and strength.

So universally as we age the body loses lean muscle mass (age-related sarcopenia)

and the ability of muscles to contract decreases.

- Joint

Body joints experience natural wear and tear over time. Cartilage can be worn away,

ligaments lose elasticity and the body produces less synovial fluid. These all have an

effect on the “health” of the joint and can lead to a decrease flexibility/mobility.

- Bone

As we age our bones lose minerals and density. In severe cases this is called

osteoporosis.

- The spine

The aging spine can cleary showcase all of the previously mentioned and the vertebrae

begin to wear down. Over time gravity takes its toll on the aging spine and pathologies

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like kyphosis,herniated disc, osteoporosis, and spinal stenosis are common among the

elderly population.

- Cognitive

A decrease in cognitive ability is inevitable and can manifest is different ways such as

forgetfulness, the ability to focus, and solve problems. The cognitive decline can be

linked to a change in hormones, isolation, or other factors.

Case Study

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Anthony is an 83 year old male. When he came to me he was enjoying a pretty regular

gym routine where he was able to work on his arms and legs. He had three tangible

goals in mind; 1) to be more stable while standing on his feet 2) to be able to put on his

socks and shoes without any assistance 3) reduce the pain and stiffness in his back. He

had suffered a severe fall 5 years ago. The fall coupled with is aging facility left him with

a herniated disk in his Lumbar spine between L4 and L5. According to his doctor the fall

herniated an already bulging vertebrae and affected a nerve causing mild numbness in

his left foot. This numbness still persists and his mobility drastically decreased. Tony’s

back became so rigid that forward flexion was minimal. He declined surgical intervention

opting for Pilates instead. Tony’s imparied balance is also the result of a

mastoidectomy, procedure performed in his early 20’s to correct a severe case of

mastoiditis. Leaving him partially deaf in left ear. Even with a colorful medical history

Tony is an active healthy older gentleman who experienced the normal evolution of the

body that came along with getting to your 80s. Conditions such as a rectus diastasis

that was about 2 fingers wide due to the weakening of the abdominal walls, severe

varicose veins, loss of lean muscle mass, and finding it harder to balance on two feet. In

order to achieve the goals that Tony set we had to focus on increasing stability of the

power house (abdominals, back extensors, glutes, and hip flexors) As well as

strengthen the quads and hamstrings. We also had to work on increasing the mobility in

his hamstrings, hip joint and spine specifically the lower back.

Tony’s Pathologies

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Rectus Diastasis Herniated Disk Mastoiditis

https://online.thetummyteam.com/diastasis-recti-men/

https://tricitiesspine.com/spine_problems/herniated_disc.html

https://www.topdoctors.co.uk/medical-dictionary/mastoiditis

Goals

Strengthen Core Muscles Mobilize Muscles to the Spine Strengthen & Stretch Legs

https://principlepilates.com/why-pilates-will-make-a-diff

erence-to-your-sporting-life/

https://corewalking.com/erector-spinae-muscles/

www.anatomynote.com/human-anatomy/extremity-anatomy/leg-muscle-anatomy-posterior-leg-muscles-diagram-photo-album/

Exercise Program

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Block Apparatus Exercise Muscle Focus Goal

Warm-up Mat Roll Down Spine Twist Supine Chest Lift Chest Lift with Rotation

Back Extensors Abdominals Obliques

Establish neutral pelvis Discover and engage TA

Foot Work Reformer ● Parallel Heels ● Parallel Toes ● Small V ● Open V Heels ● Open V Toes ● Calf Raises ● Prances ● Single Leg Heels ● Single Leg Toes

Quads Hamstrings

Maximum resistance Focus on ankle mobility striving for full extension of the legs and engaging quads

Abdominals Spine Corrector

Chest Lift Reach Overhead stretch

Abdominals W/ a focus on Transverse Abdominal

The spine corrector offers great support. Provides tactile feedback to promote efficient abdominal engagement and gives a great thoracic stretch.

Strap Work Reformer Frog Down Circles Up Circles Opening

Hamstrings Adductors

Reinforce pelvic stability. Explore range of motion in hip joint with a focus on external rotation and adductor strength.

Spinal Articulation

Mat Cat Stretch Abdominals Back extensors

Typically a back extension exercise. With Tony’s limited spinal movement I used this as a gentle way of

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stretching and articulating his entire spine (extensors and flexors)

Stretch Reformer Standing Lunge Hip Flexors Hamstrings

Exploring the mobility of the hip joint and stretching the muscles in the front and the back of the leg

Full Body Integration

Mat Front Support Leg Pull Front

Scapular Stabilizers Abdominals

This is an opportunity to work on stabilizing/ balancing the body.

Arms F2 Chair Arm Series ● Chest Expansion ● Biceps ● Rhomboids ● Hug-a-tree ● Circles up ● Circles Down ● Salute

Latissimus dorsi Biceps Delts Rhomboids Pectorals Triceps

The chair offers great tactile feedback, it’s a reminder to engage the abdominals, back extensors and shoulder stabilizers. The springs provide a nice challenging amount of resistance

Full Body Integration (After Session 10)

Reformer Reverse Knee Stretch Abdominals Another opportunity to practice hip disassociates. Focus on pelvic lumbar stabilization. Engaging TA

Legs Mat Gluteals Side Lying ● Side Leg Lift

Hamstrings Gluteal Medius

Strengthening of the glutes and

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● Forward and Lift ● Forward Drop

Adductor Squeeze

Adductors adductors while maintaining pelvic lumbar stabilization to help improve balance when standing.

Lateral Flexion

Wunda Chair Side Stretch Abdominal w/ oblique focus

Due to Tony’s herniated disc the range of motion for the exercise was kept small while stretching the lateral flexors and stabilizing the abs and obliques

Back Extension

Wunda Chair Swan Basic Back Extensors I chose this exercise to to stretch his spine and engage the back extensors. It also reinforces stabilizing the trunk.

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Conclusion

While Pilates cannot cure the inevitable aging process and it will not turn back the

hands of time. Pilates with its wide range of repertoire can add to the enjoyment of the

twilight years of octogenarians because it brings healthy movement to a population that

may be physically limited due to their advanced age. Pilates can help to improve

flexibility, muscle strength, balance and cognitive function, some of the common issues

that are magnified in a mature population.

By incorporating Pilates into his movement routine twice a week Tony, an 83 year old

man who was restrained by the physical limitations multiple pathologies was able to

have access to a challenging full body workout. With the BASI Block System™ I was

able to give Tony exercises tailored for the needs of his body and goals. There has

been a noticeable increase in his overall flexibility. He would be excited to share that he

is closer to touching his toes with his legs straight. Tony is able to put his socks on

without the assistance of a shoe horn and his balance has improved. We used the Bosu

Ball as a means to measure his balance improvement. He is now able to stand on the

Bosu Ball for 30 seconds, that’s 20 seconds longer than he was able to when we started

our sessions together. I am also happy to say that I have seen increased movement in

his left toes. I believe that Pilates is helping to strengthen the signals sent from Tony’s

brain to his foot allowing for small movements.

There is no doubt that Pilates can help to improve the quality of life and offer a level of

confidence to others who live well into their 80s.

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Bibliography

Isacowitz, R. and Clippinger, K., 2011. Pilates anatomy. 1st ed. United States of America: Human Kinetics

Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts and Science International, 2013.

“Age-Related Cognitive Decline Overview: Life Extension.” LifeExtension.com, www.lifeextension.com/Protocols/Neurological/Age-Related-Cognitive-Decline/Page-01.

“Aging Changes in the Bones - Muscles - Joints: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, medlineplus.gov/ency/article/004015.htm. “Estrogen's Effects on the Female Body.” Estrogen's Effects on the Female Body - Health Encyclopedia - University of Rochester Medical Center, www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P00559. Siparsky, Patrick N, et al. “Muscle Changes in Aging: Understanding Sarcopenia.” Sports Health, SAGE Publications, Jan. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC3874224/. Harvard Health Publishing. “Preserve Your Muscle Mass.” Harvard Health, www.health.harvard.edu/staying-healthy/preserve-your-muscle-mass.

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