Help! My client can’t……..

Pilates for Special Populations: Navigating Challenges with Expertise

As Pilates instructors, we often encounter clients with specific physical limitations or conditions that require thoughtful modifications. While Classical Pilates offers a comprehensive and adaptable system, understanding how to tailor sessions for unique needs is crucial. In this post, we’ll explore three common challenges: working with clients who cannot forward flex or have limited flexion, those with vertigo or postural hypotension, and clients dealing with shoulder impingements or frozen shoulder.

 1. Working with Clients Who Lack the Ability to Flex Forward

Forward flexion is a key element in many Classical Pilates exercises, but some clients may have conditions—such as osteoporosis, spinal stenosis, or certain back injuries—that contraindicate this movement. Here’s how to approach these situations:

Focus on Neutral Spine and Extension

• Replace forward flexion exercises with those emphasizing flat elongated spine and spinal extension. For example, substitute The Hundred in flexion with a  spine variation.
• Incorporate exercises like Swan, Swimming, and Breaststroke to strengthen the posterior chain and promote spinal stability.

 

2. Clients Working with Vertigo or Postural Hypotension

Clients with vertigo or postural hypotension face challenges with exercises that involve rapid changes in position or head movements. Safety and comfort are paramount when designing sessions for these individuals.

Stabilize Head Position

• Minimize exercises requiring frequent head lifting, such as Head Nods and Neck Curls. Instead, focus on keeping the head supported with props or in a neutral position.
• Avoid exercises where the head is lower than the heart, such as inversions or Roll Over.

 

3. Working with Shoulder Impingements or Frozen Shoulder

Clients with shoulder impingements or frozen shoulder often experience limited range of motion, pain, and discomfort. Gentle, progressive movement is key to improving mobility and reducing symptoms.

Avoid Overhead Movements

• Skip exercises like Arm Circles or Pulling Straps I & II if they cause pain or discomfort. Instead, work within the client’s pain-free range.
• Use modifications such as side-lying arm work or assisted shoulder stretches with the Tower or Reformer.

Focus on Scapular Stability

• Exercises like Push Through with Bar (keeping arms below shoulder height) or Seated Arm Work can help stabilize and strengthen the shoulder girdle.
• Cue clients to draw their scapulae down and away from their ears to reduce strain.

Incorporate Gentle Mobility Work

• Start with small, controlled shoulder movements, such as shoulder rolls or pendulum swings, to increase circulation and range of motion.
• Gradually introduce exercises like Chest Expansion and Rowing (only within a pain-free range).

Integrate Core Engagement

• Many shoulder issues stem from poor posture or lack of core support. Strengthen the Powerhouse with exercises like Leg Pull Front – Support Only or Elbow Planks (modifying as needed to avoid excessive strain on the shoulders).

Use Props and Assistance

• Incorporate TheraBands, foam rollers, or a magic circle to provide support and feedback during shoulder-focused exercises.
• The Tower’s spring-loaded resistance can offer gentle assistance and help guide the joint through safe movement patterns.

Conclusion

Every client brings unique needs to the Pilates studio, and as instructors, it’s our job to adapt Classical Pilates principles to support them safely and effectively. By understanding the specific challenges of clients, we can help them build strength, mobility, and confidence in their bodies. Remember, the key is to prioritize safety, move mindfully, and celebrate progress, no matter how small.

To learn what to focus on, what to incorporate in a lesson, how to cue and use props for these issues join the workshop, “Help My Client Can’t ___________!” on February 14th, from 2:00-4:00 EST. This session will be recorded and you will have 2 weeks viewing time.

To register in the USA / Asia: https://peakpilates.com/help-my-client-cant-______-virtual-workshop-february-14-2025/

To register in Europe/ Middle East/ Africa: https://peaku.peakpilates.eu/p/help-my-client-cant?instance=67851353077619e94e0d356a