If possible I would like help with a client I see on a 1:1 Basis. I have trained in Modified Pilates and teach in a remote island in Scotland.
My client has a history of thoracic back pain starting in 1988. He injured his thoracic spine at work, manual work with involved flexion and rotation. At the time it was diagnosed as muscular. He now gets occasional spasms with he treats with medication and bed rest.
When I am treating him any exercise in prone or 4 point kneeling involving his arms cause his to spasm which can cause disability for a week. He has a large kyphosis and lacks flexibility in his thoracic spine.
He also injured his low back 15 years ago and was treated with exercises by a physiotherapist which he still does routinely. He is very compliant with his Pilates programme and since starting in 2015 found it beneficial.
I am matwork only but any advice on exercises, positions or equipment that might be useful would be greatly received.

thanks

I would recommend just working with him in supine, standing & sitting position focusing on elongating/lengthening his spine, no arms overhead, thoracic cage expansion breath work focusing on spine length, & abdominal activation, low back release /stretches . hope this was helpful, good luck!