Heads Up on Your Body

Lacking a Rectus Abdominis

Here is an email I received recently from a pilates instructor named Bonnie about one of her clients. It is a very interesting dilemma:

I just love your Pilates articles on your blog. I find them extremely informative and thank you for providing this information for Pilates instructors!

I have a question…I recently moved from the east coast (MA) to the west coast (NV), and started working at a studio in my area. One of the clients I picked up (she had already been working with an instructor but was given to me to work with) has no rectus. Have you worked with anyone with this issue? Do you know what their limitations would be? Can they even do flexion with no rectus? Any ideas/suggestions of exercises for her to do would be greatly appreciated.It amazes me the many issues people have. I am always learning something new (which I love). -Bonnie

I’ve never had a client with this specific problem, but I do know that certain injuries and cancers (specifically breast cancer) require soft tissue from elsewhere in the body to be removed and, for example, used to reform the area that was affected by cancer.

The rectus is one muscle that can be used. Other possible muscle candidates the Latissimus Dorsi and Tensor fascia lata. If you’re familiar with anatomy, you know that these muscles we’re talking about are essential to most every movement.

To answer Bonnie’s question, spinal flexion is possible without a rectus abdominis, though spinal flexion in pilates is not recommended for people lacking a rectus abdominis. That means anything with a rounded back. In pilates, we know that means many, many movements aren’t possible! However, there are still certain movements that are possible, so let’s focus on those.

Here are a few exercises that should work for someone in this type of situation:

-standing or kneeling arm work on the tower
-leg springs on the tower
-side leg kicks on the mat
-footwork on the reformer
-single leg circles on the mat
-kneeling knee stretches with a flat back on the reformer
-short box with a flat back
-leg pumps on the chair

Its a limited list, but its been my experience when working with clients with injuries that new exercise possibilities present themselves with time.

Even more importantly than trying to give the client many, many exercises, I think its important to focus on the positive with someone who wants to do pilates after they’ve been through cancer and abdominal surgery, despite the limitations they may face.

Work on focusing on the breath- before, after, and during the exercises. Aim for a flowing, smooth breath that helps the body move through the exercises.

Stress that all pilates exercises, even the arm and leg work, is really core work. Someone in this type of situation might feel bad that they can’t do Pull Ups on the chair, for example. Instead, teach them that its all core work. Make that lesson, along with the breath, the focus of the sessions.

Sometimes, when someone is in a predicament like this, they can easily start talking about the things they used to do, what they wish they could do now, what they will never be able to do, what other people in the studio are doing that they can’t do…. they may also act like any acheivements or accomplishments they’ve made with pilates since their surgery is really no big deal, or not as good as it should be.

As instructors, its our job to refocus their mind on the positive. Don’t let those negative comments hang in the room. Remind them of what they’ve accomplished so far, and how proud you are of them.

Most importantly, remind them that, on the road to recovery, they must practice living in the moment. What is true right here and now is really all that exists. Focusing on the breath can be a great way to practice living in the moment. Anytime we hear or speak a defeatist comment, our progress is taken down a notch.

We should all, injured or not, try our best to keep UP!

Here is a link to emedicine health, with a detailed description of the whole process:
http://www.emedicinehealth.com/breast_reconstruction/page4_em.htm

Here is another post I wrote on Spinal Stenosis, which is also a condition where clients should avoid spinal flexion:
http://headsuponyourbody.blogspot.com/2008/04/pilates-and-spinal-stenosis.html

If you enjoyed this post, please consider to leave a comment or subscribe to the feed and get future articles delivered to your feed reader.