Class #4167

Strength Training Concepts

45 min - Class
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Description

Dr. Sherri Betz guides us through the first class of her series Frail to Fit. She classifies a "fit" older adult as someone who can get up and down off of the Mat without assistance, and a "frail" older adult as someone who can't. The first half of the class is strength training for the "fit" older adult who wants to build bone density, and the second half of the class focuses on the "frail" older adult who needs assistance in the same exercises. The props you will need for this class are a chair, 1 or 2 dowels, a sturdy object such as a couch, a stool, dog leash, Theraband, Yoga Strap, Yoga Block, and a box filled with weight such as water bottles. This class can also be applied to teachers looking to gain better understanding of how to help their older clients build strength and work their way up to a more traditional Pilates Class.
What You'll Need: Mat, Yoga Strap, Yoga Block, Wall, Table Chair, Pilates Pole, Theraband

Transcript

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Hi everybody. It's Kristi Cooper. Welcome to "Pilates Anytime" live. Usually, the garage sessions, but today we're gonna get out of the garage. We are going to Monroe, Louisiana to be with Dr. Sherri Betz. I'm so excited, and she's kicking off her series, "Frail to Fit," and I'm really excited to learn more about, and sometimes these days I feel frail myself.

So I can't wait. Sherri has been on "Pilates Anytime" many times. Hope you take her classes, this series, and those on the regular site too. Without further ado, let's just go over there and say hello in Sherri's space. Hi Sherri. How are you today?

Hey Kristi, great. Nice to see you. Just really happy the power came back on in time for the class. Just came on about 15 minutes ago. (both laugh) Woo. I can tell you, we're all real happy about that too.

Tell us what you're gonna be doing in this series. I'm really excited to kind of get the framework for strength training, for different types of clientele. You know that when people walk into your studio, sometimes they are having difficulty getting down to the mat, back up. They're not really appropriate for a Pilates mat class, but how do you help those really, really at risk people with strength training, helping them to get more functional so that maybe they can get down on the mat to do a more class, a class for fit people. So, I think of the fit population being someone that can get down to the mat and back up again, and the frail population being someone that would need assistance with that.

Either a person to assist them, or they'd have to use a chair to climb up on, to get up and down off the mat. So in the series, we're gonna start with doing some strength training principles. I'm gonna start with three basic exercises, working with the fit older adult with bone loss, or wants to build their bone density and strength. And then the frail older adult will be focused on in the second half of the class. We'll take those same exercises and show you how to use strength principles for them, using mostly principles of assistance.

Then in the four-part series, I'm gonna teach two classes that are focusing on the fit older adult. And, that will be like a whole mat class, getting down on the mat, standing next to the mat, back up, and doing balance work, strength work for their legs, and then core work. And then, on the second two classes, I'm gonna do a whole class for the frail older adult sitting in a chair. I know a lot of people have asked for that. They want a chair class.

So there'll be sitting in a chair, standing next to a chair, working on strength and core control in the more vertical position for them without getting on the mat. That starts July 10th. We have a break next week because of the July 4th weekend. So, all Friday mornings in July, starting July 10th, is when that series starts. Can't wait. It sounds so good, Sherri.

And just really what I certainly need, for myself even some days, but also just always learning more from you and really appreciate it. So without further ado, I'm just gonna hand it to you. Have a great class, everybody. Thank you so much for being here, Sherri. Thanks, Kristi.

Yeah, so I think sometimes people say that my frail class is harder than my fit class and they have a hard time with that exercise class, even when they're really fit. So, you'll need a lot of props for this class. We're gonna start with a dowel, and if you have two sticks, that's even good. But if you don't, that's all right. We're gonna improvise.

You'll need a chair to sit in, and then I'm gonna have a sofa that I pull in. You can see the corner of it here, for using for balance, for a sturdy object. 'Cause you wanna really hold something sturdy for the second half of the class. And then you'll need a stool, and then a dog leash, hopefully two dog leashes, maybe, and a yoga strap would be great. And then some TheraBands, and a box to put some weights in.

So, I'll guide you through all of that as we go along. There's a lot of props for the class, which is why we listed them before you registered. All right, so the most important exercise for human function, the most important movement, the most important activity, concept, skill, whatever you wanna call it, is the hip hinge. And I can hardly ever teach a movement class without the dowel. And I don't wanna turn people into a box on legs.

So, you don't use a hip hinge for every activity that you do. You do need to move your spine in healthy ways. And I'll be addressing that in the class. We're gonna talk about bridging coming up. But, you wanna be able to have a stable spine anytime you're lifting something.

So, it's very important. I had a client yesterday who asked me, "Should I do some kettlebell side bending exercises?" And I thought, "You know, that's a slippery slope," because if you get too heavy in a kettlebell exercise and you're doing side bending, twisting, with your spine loaded like that, that's gonna be very risky for some of the delicate structures of the back. So, when you are loading the spine, you wanna really know what your neutral is, and be very mindful of your spinal alignment as you lift, to keep your disc healthy, to keep your ligaments healthy, your muscles strong, so you don't strain your muscles, and also you don't break any bones, collapsing the bones in the spine. So, putting the dowel on your back sometimes is difficult for people, if they have shoulder problems. Placing the dowel on the head, mid back, and sacrum, and then you have your thumb in between the stick and your low back.

So sometimes this is problematic for the shoulder. If you need to switch arms, that's perfectly fine, but I would love for you to be able to get that stick, or that thumb, in between the stick and your low back. And then from here, we're going to hinge at the hip joints, keeping those three points of contact. Often clients will look like this, right? So you're letting the tailbone come, or the stick come off the tailbone, and rounding at your back.

And that is what we're trying to prevent. So when you hinge, you're hinging at the hips, but you're also bending the knees a little bit. It's not a bow, like that. So, I know a lotta people like to do it like that, but you wouldn't wanna lift like that. If you're doing strength training, you gotta bend at your ankles, you gotta dorsiflex at your ankles.

You gotta bend at your knees and at your hips, especially. So a lot of times hip motion is stiff and that creates problems for the back. All right, then, we're going to let go of the top arm and just hold the stick with one arm. And the goal is to be able to keep your feet about shoulder width apart and touch the mat. So can you touch the floor with your feet shoulder width apart, and then having your feet pointed straight ahead, right?

And separated. Now, you can turn your feet out just a little bit, if that's easier on your hip joints. 'Cause sometimes that's hard for people to flex. Getting down that low is sometimes very challenging for people. If you cannot touch the floor with your hands, right, right.

You shouldn't be picking anything up off the floor, if you cannot touch the floor without losing those three points of contact, or maintaining those. So, maintaining those three points of contact, touching the floor, that's one of the first things I do to warm up for lifting. And that way you make sure you're in the right alignment, your nervous system is really embodying the alignment of your spine. You're really getting used to that, and how that feels, because you're not gonna be able to use the dowel when you lift, unless you tie it to your back. So I have had people stick one in their bra strap or in their t-shirt, in their waistband, and then tie it to themselves.

So you can actually do that if you wanna keep the dowel on your back as you practice, which I do recommend that people do if they have a hard time. So I'm gonna put the dowel aside now, and this is where you'll need something to lift. So, I've got a little file box over here that I'm going to come over here, place it on my mat. Now, I've got a few pounds in here. So what I would suggest for you to do, you can use a suitcase or a box of wine, some people do that.

Any kind of, you know, cardboard box to put some things in. So, you'll laugh. I've got water bottles in here. Those weigh a pound each. My soup cans weigh about a pound. I've got a bag of rice that weighs two pounds.

I have a dumbbell, random dumbbell you got in your house, you can stick that in your box. Bags of beans, you know, whatever, but count up how much you're gonna put in here. So right now, I've got about 10 pounds in my box. And if you're worried about your back, if you have pain in your back already, you do not load a painful pattern. So do not lift with pain.

And you wanna get good at just the hinge, really working on your back. Then when your back is not painful, you're good at that hinge, then you can start practicing lifting. Now, the first thing is, if you have handles on the top of your box, that's really convenient, it's very nice. But a lot of times, Amazon will deliver something to your doorstep and it doesn't have handles on it. How are you gonna get it inside, right?

So you're gonna have to tilt it to the side, and then lift. So what I would suggest if you do have handles, is that you try lifting first. So one of my rules about lifting is to get in the hip hinge first, eyes and chest forward so that you're not rounding your back. So eyes forward, chest forward. And then, we're gonna do just a shoulder retraction.

So I'm gonna explain that in just a moment, why we're doing that. So, shoulder retraction first, not elevation, but retraction. So pulling those shoulders back. Then, if you can do that with the box, then you're probably ready to lift it, okay? If you can't do that, if it's too heavy and you cannot lift it up like that, don't lift it, right?

You're gonna hurt yourself, or you may hurt your back. So, you don't wanna let the shoulders protract. Here's what people do a lot of times when they pick up something heavy, they'll let the shoulders protract, that also adds thoracic flection, and then they lift the object. It's easier to do like that. You're hanging from your joints, but that's not safe.

So we're gonna tilt that box to the side, see if I can get down to the bottom. Now that requires a lot of hip flection. Look how much hip flection I'm in. So if I'm gonna pick up something from the floor, I've really gotta work on that hip mobility. Chest forward, eyes forward, shoulders retract.

You're gonna feel those glutes really working, and then loving targeting those glutes. Then you put the box down right between your toes. So your hands are right between your toes. Chest is lifted, eyes forward, and we're gonna repeat. All right, so now we're gonna talk about how much weight should you be lifting?

'Cause sometimes people do an arbitrary amount of weight, or suggest, "Don't lift more than 20 pounds, don't lift more than 25 pounds." It's all individual. So, when you determine how much to lift, you use a concept called one repetition max. So that means that you're gonna use an arbitrary amount of weight. Ideally, you see how much you can lift one time, safely with good form and alignment. However, that's not safe.

You don't wanna put a hundred pounds in a box and then try it for the first time. So you put an arbitrary amount of weight in a box. You bend forward, right? Hinge at your hips, get your alignment, shoulders retract, stand up and you repeat 15 times, okay? If you cannot make it to 10, you can only do say, six, seven repetitions, that is gonna be too heavy for you.

If you can make it to 15 to 20, and do that pretty easily, it's too light to build strength. You're building endurance when you start doing 15, 20, 30 reps of something. So you wanna keep it between eight to 12 repetitions within your strength training zone. That means 70 to 80% of one repetition max. So say I could lift a hundred pounds one time.

Then I would wanna take about 75 to 80 pounds, and do that 10 times, and then that's gonna help me build strength the best and most safely. If someone is very weak, and if this is their first time to start even doing any lifting, you're gonna back it down to maybe 40 to 60% of their one repetition max. And then that way they are a little bit safer. They can do more reps at first, as they're getting more strong. So, with a more fit person, you're gonna aim for 15 reps.

See how many you can do. If you start to round your back, you start to kind of compromise a little bit, you stop the reps, right? So any compromise of alignment, you stop the reps. Okay? So that's how you're gonna figure it out. You're gonna keep putting weight in your box each day.

Add a little bit more. If that was really easy for you, then add a little bit more, add five more pounds, and just keep adding. And my goal with a human being is to be able to lift 50 pounds. You should be able to put your own suitcase on the scale at the airport. So, being able to lift 50 pounds is a great goal for everyone to be able to do women, men, any age.

I want a 90 year old to be able to lift 50 pounds. So, your goal is 50 pounds. If you're wanting to really get better at it, you wanna lift your body weight, actually. So, that's an ideal sort of amount of weight to be able to lift, is your body weight. For that, you wouldn't use a box, you would use a barbell.

And so we can talk about that later. (laughs) All right. So now we're gonna pick up our box, shoulder shrug, and stand up, and then I'm gonna take it over to the side and get rid of it for right now. Put it back down, and get it out of the way. Okay, so did you use good body mechanics when you brought it to the side?

'Cause a lot of people, they forget about their body mechanics when they're just putting the box aside, or they're going to get their box. So I like to really focus on that as I'm working with clients, and anybody individually as well. Okay, now, we're gonna go to another exercise, which I think is one of the quintessential exercises that you should have in every program, and that's the heel raise. So I'm gonna take my shoes off for that. One of the things I didn't mention before was that I had my shoes on because I don't wanna drop a weight on my foot.

I don't wanna drop anything on my feet. (laughs) So, taking your shoes off now for your heel raise to work your feet. And again, best, best, best exercise you can do for getting the calves strong, balance, strengthening the whole leg, and certainly, bone building. The calf is like your second heart. If you don't have good calf strength, you're not gonna be able to take long strides when you walk and push off very well. You also, if you sit too much, and you don't work your calves enough, a lot of times you'll get pooling in the feet.

You'll get swelling in the feet. And then also, a lot of people have plantar fasciitis and things like that. And, that usually is either due to strong feet, over-strong feet, tight feet, or it could be also due to weakness in the foot and the arch. And, the calf has a lot to do with function of the foot and plantar fasciitis. So, getting that strong is gonna be very helpful.

All right, so we're gonna start with the feet together, and then I've got two dowels here. So we're gonna just be really safe with two dowels, and rising up. Now you can just hold something, or stand next to the wall, or use one dowel if that's okay. And then, I wanna make sure that your alignment is good before you start. So your heels rise up, and you keep your heels together.

If you have valgus in your knees, you're gonna put a little ball or something between your heels, so that you can feel the heels squeezing together as you rise up and down. And, you wanna have that alignment of the ankle. 'Cause again, you always want to strengthen in the best alignment possible. Now I'm gonna put all my weight on one leg, lifting my other leg up high. Now, I don't like it down here because I feel like it just kind of is loading that leg.

You're not really working through the pelvic musculature. It activates the abdominals a little bit more when you lift the leg high. So I really like the leg to be lifted high. And now we're gonna try a heel raise, up and down. Then we lift one dowel.

Then we lift the other dowel. And guess how many you're supposed to do at age 65 or older? So, a 65-year-old person should be able to do 25 heel raises all to the same height. So when I'm doing my heel raise, I wanna make sure that every one of them is the same height. So if I start doing them at two inches high, and then eventually I come down to one inch high, then they don't count, right.

It only counts if you're doing the two-inch heel raise from the first one to the last one. Okay, that's the standardized test for the heel raise or calf strength. Okay, so now, once you can do that, I'm gonna take the dowels away, and then start with your feet together, that narrows your base of support. It's the gluteus medius working. Now we're gonna lift one leg and rise up.

And then we work on our balance. You can see the ankle sort of wobbles a little bit. You get a little more play in your posture, a little more wiggly ankles. And, rising up and up. And you're gonna start to feel that calf burn, and up and up, okay.

So we won't do all of them today. I just wanna share with you the principles of it. Once you're good at that, then you're gonna take your weights and add resistance. So once that gets easy, once you get to 25, you can start to add resistance. So then, you can take some tote bags.

These are my favorite little weights here. These are just bags of sugar and bags of rice. And then, make sure you put plastic bags around them, 'cause my bag of sugar broke one of the other days, and then I had sugar all over the floor. Okay, so now lengthening up, rising up, up with the weights. Now, you might not add 10 pounds at first.

You might just add two pound dumbbells, water bottles, something small, and then work on that heel lift. And again, once you start adding weight with it, you're gonna go back to that one repetition max concept and add weight as you get better at it. 15 is your goal. Once you can do 15, that's when you know you need to go up on the resistance. So you just keep adding resistance, by the time you get to 15.

Then after you get a really heavy weight, you go to eight to 10 repetitions, maybe 12, stay there at that weight. Once you can do 15, that's your barometer to move forward to the next resistance level, adding more weight. Okay, so now for that one, that, we're gonna talk about that with the older adult who can't do one of these, okay. Gonna be in the second half of the class. All right, next favorite exercise is the lunge.

And, I like to do the lunge preparation thinking of long-stride walking. So, I've got my feet, hip width apart, about three inches apart at the end of my mat. Take my dowels forward. Step one foot forward, both legs straight. Okay, so that's a pretty long stride.

Normal walking, if you're walking three, say, to four miles per hour, ideally, walking pretty fast, if you walk pretty fast, even if you're short like me, I'm only five, three, your stride length's gonna be about 36 inches. So I'll actually put a ruler on the mat, put a ruler at the back toe, all the way to the front toe. So I'm measuring from toe to toe and that should be 36 inches for someone five-feet to six-feet tall. If you're over six-feet tall, you're gonna go even farther, so maybe up to 40 inches. And then stretch the heel down and back, and up and forward.

So you can really see that that's gonna be really tough on that back heel to get down. And then keeping the pelvis straight ahead, very important so that you don't turn outward, because when you turn outward, you lose the hip stretch. So right here, we're just trying to prepare our body for a really good lunge and great long-stride walking, stretching the back hip and the back calf at the same time. So both legs straight on this one. And that's also that calf work that we did earlier too.

Now the next step is, can I bend one knee and not drop my pelvis, right? So, bending one knee. Again, always trying to manage our body weight first, before we add resistance. Then I'm gonna bend the front knee. Can I bend the front knee without moving my torso down, up, or forward, or backward?

So no movement, no dropping. So this is what I usually see, dropping the hip like that. So, really keeping the pelvis level and allowing the knee to swing underneath like a pendulum. Okay, so now bending both knees, and we're gonna go a quarter of the way down and back up. So just as tiny little movement.

Again, I've got my two dowels, lot of assistance right now. And most of the time people need this. Fit people need it too. So, what also is gonna be a hindrance is stiffness in the great toe. So, if you come all the way down and your great toe is like, wow, that doesn't feel good, then you'll wanna put shoes on.

And sometimes that diminishes how much you have to dorsiflex through that great toe on the back foot. 'Cause sometimes that can be the issue. It'll allow you to roll up on the toe a little bit. Okay, so from here, we do our lunge and we get to where we can do, how many times did I say? 15 reps. So we wanna get to 15.

Starting with our 10 as a barometer, or our starting point. So make sure you can do at least 10 of it. Once you get to 15, I'm gonna take one of the dowels and take it away. Right. Then I'll do it just one dowel, up and down. And then I'm gonna take that one away. Right?

And see if I can do this. Now, what happens a lot of times with people is they're like, "Oh, I can't do it." Right, what do I do? Even fit people. So, what I love to do, it's one of my favorite things, is I, this is my Pedi Pole. So my doorframe here is my Pedi Pole. I'm gonna take one dowel in my hand, and I'm gonna put my back against the doorframe, okay.

So I'm gonna open this door a little bit so you can see. Okay, and then I'm gonna put one foot back behind, and then parallel alignment, straight ahead. I'm in the doorframe there. Open it up a little bit more. And then, I'm gonna slide straight down, and up.

That gives me the alignment in my spine. That feedback for my head, mid back, and sacrum to be against the doorframe. I get a little bit of support. And then most people can begin to do it. One thing I love to do is take a yoga block and put it either vertically like this underneath the back leg, so it gives you a little bit of a, and you touch your knee to the yoga block.

And then you turn it this way, and then touch the knee to the yoga block. And then finally, you take it the most flat way. So you've got three levels, and then touch the knee, sliding up and down. Okay, so then, after you get rid of the yoga block, you can use maybe a shoe box lid, you know, something really small, something really thin, and then use that as something to aim for. Starting with two dowels possibly, going to one, going to no dowels.

Then seeing if you can go all the way down and up, and then once they can get there, they take the two dowels back to the mat, do your two dowel lunges, get rid of one. Yup. And then get rid of the other. All right, then now what? Now what happens? Right, so, after that, you get to a point where you need resistance because you've got your body weight, you've managed that. You can do your lunges. That's beautiful.

Now what? You can add dumbbells, kettle bells, water bottles. Soup cans, so I've got my soup cans here. Got a water bottle, and now I'm gonna do my lunge with a little extra weight. So this is a couple pounds.

I'll start with a pound in each hand, and get to the point where I can do 15 of those. Ready to move forward now. I'm gonna get my tote bags of rice and beans. Do my lunge, working up to the 15 reps, starting with at least eight. So if you can't make it to eight, it's too heavy.

So you wanna back down a little bit. And if you start having pain, a lot of times people's pain will kick in. And if you have pain, then what happens is, it's either too much load, right? So back it off. And if you notice that when you back off the weight, and then you can do the exercise without pain, it's a strength problem, that strengthening will actually help the pain.

So very important to remember that, don't just not do when you have pain, because the joint needs strength. 80% of the shock absorption for the knee comes from strengthening and from muscle. So, you wanna have that shock absorption around the joints when they're not strong. 'Cause people will just baby a joint that's painful, and that's the worst thing you can do. So you wanna add those assistance principles that we're gonna talk about in the second half of the class.

Okay? So that was hip hinge with a dowel, turning that into a dead lift, right? That's what's called a dead lift. And then we did the heel raise, beginning to add weight with that, if you are ready for that. And then we did the lunges.

So those are my three very, very favorite exercises for building bone in the leg and building muscle in the legs. The deadlift also builds muscle and bone in the spine. Okay, so now we're gonna shift gears, and I wanna talk to you about what do you do with the person that comes in using a walker, that is not able to get down to the floor and back up again, that has difficulty getting out of a chair? So the best thing you can do to determine who goes in what type of class, is to ask your client to stand up out of a chair. Okay. So I'm gonna get my chair.

This is a special chair. This was my grandfather's chair. And, I received it after he passed away. It used to be a rocking chair, and he had it in his study and removed the rockers because he really enjoyed sitting in it. It's just a gorgeous chair. All right, so, first thing I ask people to do is, "Can you stand up without using your hands?" There's a really cool test called five times, sit to stand.

And the five times sit to stand test, I start a timer. I have someone sitting, and I ask them to stand up and sit down five times as fast as they can, safely. So, it would be like this, one and two and three and four and five. So it took me like 10, 12 seconds, right? So, if you can do that in under 15 seconds, you're usually pretty strong, in that you wouldn't need the more remedial work.

Most of the time, what I see, is when somebody is weak, they have to use their hands to stand up, or they do the exercise so slowly that they can't, you know, get out of the chair very fast because they're really trying to figure out how to get out of the chair, right? Or they do this. They straighten their legs first, round their back, then stand up. So every time they get out of a chair, their back is at risk for injury. And, it just is a great sign of leg weakness.

Other thing that they do is, one foot forward, one foot back, and then stand up. So that means they're standing up using the strong leg. They're putting the weak leg forward. People are sneaky like that. They'll do that a lot of times.

Or when they stand up, they can feel like they lose their balance. So again, the first thing for even an older adult, or a frail person, is hip hinge. So I'm standing, I'm sitting in my chair, I'm trying to get my dowel against my tailbone, mid back, and head. Thumb in between the stick and the low back. And we practice this in sitting first.

So again, almost every client does this, right? So letting the dowel come off the back and rounding the back. The other issue with this one is a lot of times people have decreased balance as they get older, and their head, they don't wanna push their head forward over their toes because that just really feels like it makes them dizzy, or they're fearful of falling. And that changes the way they move. So hinging at the hips like this is our goal.

Now, the other problem with this is that a lot of people are very kyphotic and they can't get their head to the stick without looking up, or they can't grip the stick with their hand, their shoulder, they can't reach back. So, you can do it with eyes forward, head forward, and just touch the two points of contact. That still is a useful exercise. You just keep their eyes forward and chest lifted as much as possible, and just let go of the head position. Okay?

All right, so once they can do that, then you have them practice nose over toes, or even in front of toes, and then stand up. And if that's still difficult, there's a couple of things that you can do, okay? So once you get them to the point where they can hinge at their hips, you're determining, do they have enough hip mobility to be able to stand up and sit down properly? What you can do is use principles of assistance with them, because sometimes people can't manage their own body weight, so they need actually assistance to get stronger. It's like they just stopped doing anything.

And then they get weaker. We lose 1% of our leg strength every year after age 50, if we don't exercise and strengthen and stay strong. People do less and less as they get older, and then they, their strength just continues to decline. So, I'm gonna show you a really cool way to use assistance at home with things that people already have, okay? So I'm gonna use a dog leash.

So, two dog leashes would work great. A yoga strap works really well. I'm gonna unhook this yoga strap, then I'll show you how this will work. Okay, I just gotta get it unbuckled here. All right, so, taking the dog leash, you're gonna fold it in half.

And then, about a third of the way down, you're gonna make a knot. I knew you were wondering what I was gonna do with a dog leash, right? Always has to have a dog involved for me, so. All right, so there's your loop. And then, I'm gonna open this door.

Now, you have to use a door for this exercise that you're gonna close toward you. So I'm gonna put the dog leash over top of the door with the knot on the outside of the door. So this makes like a wall anchor, and there, and pull it tightly closed. Okay, now make sure that it closes, yeah. And then I pull on it, the knot's on the other side, it's super, super tight.

And I just realized I did this backwards. It's gotta be this side. The loops gotta be on the inside. The best laid plans, you know. All right. Okay, now I've got the loop on the inside. So, that loop right there is gonna be where you're gonna either thread a TheraBand or a yoga strap.

Let me tell you what happened yesterday. So ironic. I was showing everyone what I was gonna be doing with the Pilates Anytime team. I used a TheraBand, that thing broke. And I thought, okay, well, that's good to know that that happens. And I sure don't want a TheraBand to break and have somebody fall down.

So I like using a strong strap to start with. And, then I'm gonna pull the chair a little bit closer so I can actually reach it. I want the chair on a non-skid surface. So it needs to either be on carpet, or it can be on a yoga mat. So, this is close enough to where I can sit down and still reach the straps.

So I put the strap together, hold onto the straps first, step back until my knees are touching, the back of my knees are touching the chair, and then I'm gonna sit back, and then stand up, and I'm gonna use whatever I need to, for my upper body to help me with the movement. So I'm practicing my good alignment. And then, once that gets easy, I try to use less assistance as I go along, and try to keep the straps loose, eventually. Now, the other thing that you can do to progress is to stop using the straps, and then use TheraBands. So, I'm gonna use two TheraBands just in case one breaks.

So I've got a blue and a green. Those are usually heavy enough to give enough assistance. I'm gonna loop both of those through the loop here, and use those just like spring-assisted squats on the trapeze table. It's one of my favorites. I love that. So I can choke up on the straps as much as I need to, and then sit down, and now I don't get as much assistance coming up because of the elasticity of the straps.

All right, then, I can take one of the straps. I'm gonna go to the blue. The blue is the heavier of the two. Take the blue, and then do a few like that until I can get to, how many did I say? 15 times in a row.

Once I can do 15 times in a row, then I'm gonna go to the green. Lighter resistance, less assistance. Right? So I'm using these as assistance. And then finally, I use no assistance doing the sit to stand. Okay, then, taking the chair back, and I'm actually gonna turn, let's see, how do I do this?

Turn the chair this way. And I have this sofa here, and it's on really great sliders. So, I'm gonna use good body mechanics. I'm gonna pull the sofa in, and I'm going to use the edge of the sofa as a sturdy surface, to practice my heel raises. Okay. So, I want my hands in front of my shoulders.

I never want people to stand with their hands behind them because that puts a lot of stress on the shoulder. And if they lost their balance, they might hurt their shoulder. So I want you to step back enough to have your hands in front of you on the surface that you're using for support. All right, so feet together. We're starting the same way we started with more of the fit person.

And then we rise up and down using the supports. And then maybe we let go of one hand. And then we see if we can let go of two hands. Working the two feet. Two feet is so different than one foot.

Two feet is so much easier than one foot, that so often, when they've transitioned to one foot, it's super hard for them to make that segue. So then going to one foot, trying to rise up. Sometimes even with the help of upper body support, on two sturdy surfaces, it's still too hard. So you can certainly use another little tool, little stool here. So it doesn't have to be this high.

I like it this high because when I put my foot on this stool, my knee is about the height of my hip. So, I can't put as much weight on it. So, I really like the kind of chair height. You can just pull up a dining room chair or whatever in the area, and then do your stand to sit. I wanna make sure my hands are in front of me.

And then I rise up and down with my hand on the stool, foot on the stool, (laughs) sorry, foot on the stool. Now I may just put my toe, my ball of my foot, on the stool. And, you notice that I'm in bare feet with this. Some people have tenderness as they get older, the fat pad underneath the foot diminishes, and they might need to use their shoes for some of these standing exercises. That's perfectly fine.

I like bare feet because I want the feet to work more. And I want them to feel the nerves of the feet, and really get sensitive on the bottom of the feet, especially if they have decreased balance. So doing that, then again, let go of one hand, let go of the other hand, and see if you can practice that. Again, starting with eight to 10 to 12 reps, going up to 15. Once you can do 15, you're gonna either take a hand off, and then maybe take the foot here.

And then if they still can't really do the lift, you can move the chair, and I'll move the couch back, and the stool. I can use a dowel and the chair, once they get to the point where they can do it that way. And then maybe just lift a hand off the chair. So in my community-based classes, this is what I did a lot of because they always had a chair, they always had one dowel, and we would hold like this for the first couple. And then I would ask them to hover, just one inch off the chair.

So it's there if they need it. And then could they possibly hover the dowel? And it's, they've got the assisted devices here if they need them, if they lose their balance. Then they can just keep going and touch down and then lift back up again. Okay. So that is heel raises for the weaker person.

All right, now, lunges. I'm gonna take this back just a little bit and put the dowel over here for a moment. I'm gonna turn the chair just a little bit so you can see what I'm doing. But, it's very interesting 'cause a lot of times people will say, "Oh, I can't do this, 'cause I have handles or arm rests on my chair." But you actually can do it with a chair with arm rests if you tilt it to the side. So again, lunge preparation for the frail person looks like this.

You sit towards the front of the chair, turn your body so that the arm rest is not in the way. And then you're really trying to just get your knee right under your hip. And this is exactly the position that I would be doing for the lunge, if I were doing it in standing without any assisted devices or the chair to sit in. Lotta times what needs to happen is that hip needs to get more mobile. And so sometimes they can't even get in this position.

So you wouldn't wanna do a lunge with somebody that doesn't have enough hip mobility to get an extension. Hip extension is what I call one of those fountain of youth movements. We're gonna take the leg back, and then forward, and then stretch it back, and forward like that. So they may not get that far at first, and the back may arch. So you really wanna keep pulling up through the pubic bone, and maybe put your hand here as you stretch back, and forward.

The other thing that may be a problem is the great toe dorsiflexion may be limited. And so they might have to do it with the toe pointed, stretching back like that to really get that hip to extend. I just love that. And then, stretching the arm over and adding that additional stretch to the other end of the psoas muscle. It feels really good. It's a really nice stretch.

So you can do that one to help them prepare for lunges. Okay, then, I'm gonna bring the chair back over here and then I'm gonna go ahead and use the sofa again, bring it back. And I wanna put my hand on the sofa, hand on the chair. And, I would normally turn the mat, but I'm not going to right now. I'm gonna put my heel against the wall back there and then front foot forward.

So I'm trying to get as long a stride as possible. Almost every older adult that I work with that has balance disorder, or weakness in the legs, does not wanna do a long stride. They don't like to take those long strides. They walk with very short steps, and this is such an important exercise for them to do. So, here is how I would do it for someone that is very fragile, weak, has poor balance.

Here, up and down. And now, I'm gonna turn to the side and show you what that looks like sideways, so you can see better. And then my chair is gonna be over here. And then I have my chair. Remember my surface should be in front of me, so that when I step, I step back into the movement.

I don't wanna do this, and have my arm behind me. That's putting that shoulder in a very vulnerable position. So I wanna be back from the chair, stepping forward, and then stretch down, and up. Stretch down, and up, like that. And just working on that long stride.

And so, you might even use a dowel, like I said, or another surface, to get them prepared for that. And that's all, like, you don't even bend the knees. Until someone can take a long stride, that 36-inch stride, do not do the lunge. You don't wanna do a lunge with these small little, little stride length, because that's gonna put a lotta stress on the knees. And especially if they have knee problems, you don't wanna overstress the knees until they have good hip extension with that.

It's that rectus femoris that, if that's tight, then it's gonna pull that kneecap against the femur. And so that can cause some painful patellofemoral symptoms. All right, so stretching out, back and forth like that. And then they might start doing a small little knee bend with, obviously, the assistance. But the great thing about the TheraBands or the straps from above, it's also a great tool to use for the lunge.

So I'm gonna bring the chair back just a little bit. So it's back there if I need it, but I don't really want it involved. So I'm gonna put my foot under the chair back there, and then one foot forward, one foot back, and then I could start doing a little bit of assistance with the lunge. So again, shoulders down and back, body vertical as best you can, and using the straps. And the other thing I do with the older adults, again, is getting against the doorframe, and they can do their heel raises with one leg against the doorframe for good feedback of their alignment.

And then they can also do their lunges with the two dowels against the doorframe. So again, mostly for the weaker person, you're using principles of assistance to get them stronger. Because you're trying to create a segue between doing the full exercise, and then where they are at the moment in their strength, okay. So I'm really excited about sharing this information with you, and I hope that you find it useful for your teaching, for your own practice, for strengthening your own body, for working through issues with hip, knee, foot pain, lower body pain. So in our next class, July 10th, we're gonna be doing all of these principles for the fit older adult that wants to build their leg strength, spine strength, bone density, and just posture, overall balance, dynamic balance, into a full mat class.

So we'll be doing the standing work that we did today. Then we'll be getting to the mat to do some core exercises and some thoracic spine targeted strengthening exercises. All right. So, thank you so much for joining me. This was really fun, and I hope everybody had a good experience with the technology and was able to get online and learn a lot from the session. So, thank you.

Comments

1 person likes this.
Love this! Thank you so much Dr. Bertz!
Fantastic! I learned so much, thank you!
So glad you loved the session!
1 person likes this.
So interesting and informative Sherri! Can't wait to join the next classes! 
1 person likes this.
Brilliant stuff, as always. Thank you Sherri
1 person likes this.
Really informative, thank you. I enjoyed the practical use of at home props to provide stability and weight. I was particularly interested in the frail chair to standing exercises for my 83 year old Dad who struggles to get out of his rocking chair. Beautifully presented and clearly  explained. Thanks so much!
1 person likes this.
Thanks so much Sherri, this is just what I need. I am looking forward to the program.
2 people like this.
Hi Sherri,
enjoy you classes. so practical and essential. I am about to restart classes for seniors and will incorporate your ideas., especially those modifications for the client who has not been able to do classes for the last 4 months.
one question about the lunge: if the client can not bend the back knee to go into a lunge position, due to muscle weakness, do you suggest that they stay doing the extended stride position , lifting and lowering the back heel.? What other modifications do you suggest  for strengthening the knee?
1 person likes this.
This is wonderful.So informative.I am a Pilates teacher .I’d love to know more.I’m UK based.Is there any reading you could recommend please? Judith
1 person likes this.
Great to have a chance to redo this class, found it so useful when I joined you 'live'!
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