Dystonia – Let’s Learn!

June 3, 2012 at 1:36 pm 8 comments

medieval-dystonia-lady-bust

Medieval Dystonia Lady Bust

Dystonia is neurological disorder that shows itself in considerable muscle spasms. It has no known cure, though there are several treatments to reduce severity of symptoms. However depending on which type and the intensity of the dystonia a person has, these treatments may or may not be effective.

Dystonia Medical Research Foundation defines it: “Dystonia is a movement disorder that causes the muscles to contract and spasm involuntarily. The neurological mechanism that makes muscles relax when they are not in use does not function properly. Opposing muscles often contract simultaneously as if they are ‘competing’ for control of a body part. The involuntary muscle contractions force the body into repetitive and often twisting movements as well as awkward, irregular postures. There are approximately 13 forms of dystonia, and dozens of diseases and conditions include dystonia as a major symptom.”

You can find a lot of information about dystonia online. Even Wikipedia (not known to have the best info) is a great place to start learning about it. The article on Wikipedia is very clear…a good place to begin: http://en.wikipedia.org/wiki/Dystonia

Other great resources are the wonderful foundations that have been created to help those with dystonia. One of my clients founded and leads the great organization The Bachmann – Strauss Dystonia and Parkinson Foundation. If you go to the website, you can learn even more. www.dystonia-parkinsons.org. This is a great site to send your clients with Dystonia to for more information on doctors, treatments, support groups, latest advances. Truly, if you do an internet search for “Dystonia” or the specific type of Dystonia your client has like “spasmodic torticollis” you’ll find countless sites full of resources for your clients to reach out to, though relatively limited information for you to wrap your mind and hands around as a personal trainer/Pilates teacher.

Now,what do we do with our clients who have this condition?

Get Information:

1 – First you study the resources I’ve listed, then you dig for more.

2 – Then you ask your client many questions:

Where exactly are your spasms?(While you will see much, you might not see all. Some are deeply internal.)

– How long have you had Dystonia?

– What brought it on?

– Do others in your family have Dystonia or Parkinson’s?

– Do you receive any treatments? (You’ll see that there are several management treatments including physical therapy and massage, Botox, trigger thoughts or touches that calm the muscles/nervous system, pain management and even surgery.)

– Does your condition bring pain to the direct area? Surrounding or related areas?

Now, Dystonia happens in many parts of the body. So, get as much information from your client as possible and then…

Then…your job is simply to teach Pilates. That means you both avoid the area of Dystonia and go right into it.

What?!

You avoid by not trying to go cure it and go right into it with exercises that will aid in stretching that area…if possible

Exercise is listed as a major source of relief and management of dystonia…know that you can be extremely helpful to your client by delivering a great workout designed expressly for her/his needs.

My client who has spasmodic torticollis, Dystonia of the neck, does an incredible Pilates workout. Her condition tightens her neck pulling (rather than tipping) her head back (the opposite of forward head posture) and twisting/tilting a bit to the right. The only alterations to the workout are that we add common physical therapy shoulder and neck stretches (that take all of 3 minutes) to either the beginning or end of the session and I add cueing to remind her to lift through her neck. Especially when she is laying down on the mat, I have to ensure that she looks straight up to the ceiling. What we do avoid is lifting her head and chest for exercises like The Hundred and The Abdominal Series of Five. Ultimately, in my ideal of progression for her, I do think it would be great for her to lift her upper back like that, but she feels it’s too compressive for her…in which case it is…and it’s most important to make sure your client is comfortable. There’s a time and place for “pushing” things. When your client is plagued with spasms…you don’t push these things. So, how does she get the abdominal intensity on those exercises? I cue her (and other clients who don’t lift their head and chest up) to pull her abdominals in and up as though she is doing the hardest gut-wrenching crunches ever! Maybe to imagine that she is the model on the cover or a muscle magazine…they always have a ridiculous six-pack…that we’re not trying to get in Pilates, but that effort is what I want from a client whose head is down. And…all the while encourage length in her spine.

Sometimes your clients with Dystonia will have related or compensatory issues. My client with spasmodic torticollis has a stiffer lower back because of it. (often when any client has lower back trouble, she has neck trouble and neck trouble brings lower back trouble…stiffness, that is. So we take that into account when choosing what to do and what not to do in the session.

Now, my client has a relatively manageable form of dystonia in that she doesn’t feel the need for any of the treatments that I mentioned earlier. She works out with a fitness trainer two times a week, takes Pilates once a week, plays golf and lives a very active life. That’s certainly not the case for all. Depending on the intensity of the ailment you’ll have to adjust.

What to remember is that you are a Pilates teacher, not a specialist in physical therapy for dystonia.your job is always to work around an ailment…ailment in the effort to make the 99% of the body that is healthy even healthier so it can support the 1% that is struggling. This is our job! Please do not try or claim to cure dystonia or anything. Just give your client a 55 minute workout that is appropriate to what parts of your client work well and work around what parts are facing struggles.

If your client has such intense dystonia in any particular area that you don’t have enough of a vocabulary of exercises to create a 55 minute session, maybe you do a 30 minute session. Then reach out to me and we’ll consult…I’ll gladly teach you more exercises within the Pilates idiom!

The Shoulder and Neck stretches I use:

Always start with Shoulders first – shoulders may loosen neck Keep torso/spine stable
Do not force – It’s muscular action, but you must not push their Range of Motion (ROM) – Go only as far as you can without pushing limits

Shoulders:

Up/Down – 4 – 8 sets

Front/Back – 4 – 8 sets

Circles – 4 in each direction

 

Neck:

Right/Left – 4 – 8 sets

Ear to Shoulder – 4 – 8 sets

Down – Double Chin and down, not up – 4 – 8 repetitions

Half-Circles – 4 sets

More resources:

The Bachmann – Strauss Dystonia and Parkinson Foundation:
http://www.dystonia-parkinson.org

Very interesting symposium with conversations with those who have dystobia from a Bachmann-Strauss event:
http://www.dystonia-parkinson.org/index.cfm?fuseaction=home.viewPage&page_id=C3B631AE-9FC1-DC2B-C53F8E928AFCF169

National Spasmodic Torticollis Association:
http://www.torticollis.org/

Dystonia Medical Research Foundation:
http://www.dystonia-foundation.org/

National Institute of Neurological Disorders and Stroke: http://www.ninds.nih.gov/disorders/dystonias/detail_dystonias.htm

American Association of Neurological Surgeons: http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Dystonia.aspx

While these are USA-based, but there we organizations all over the world for you and your clients. You can web-search for local organizations or reach out to these for assistance.

Again, if you have specific questions, please reach out to me. Let’s do a consultation sessionabout this or any questions you have regarding Pilates and your clients.

Workshops:
Register early and bring your teacher friends for workshops that exceed your normal expectations. It’s time you really got what you need from workshops…I work to provide! Your time and money are precious. Let’s give you what you need.

See full details below for:

New York, NY – June 9 – Please note that this date just changed to June 9
New York, NY – June 16 – (Just Added!)
San Francisco, CA – POT- July 14 & 15 – see discount info
Florida (in the works) – July 27-29
Hamburg, Germany – August 4
New York, NY – Aug. 19 – Please note that this date just changed to Aug. 19
Sao Paolo, BRAZIL – early Sept.
Boston, MA – POT – Sept. 15 – see discount info
Sweden (in the works) – likelyearly Nov. (New date)
Iasi, ROMANIA – Oct. 26-28
Madison, CT – Nov. 11

(and more to follow!)


June 9 – (please note that this date is updated) re:AB – New York, NY

Back Issues: Coccyx to C1
2:30p-5:30p

3PMA CECs

With 24 moving vertebrae, discs, muscles, ligaments tendons and nerves…there are bound to be problems from time to time. Some severe, some minor, but all painful and annoying. In this workshop, we’ll work to understand the most common conditions of the back including herniated discs, L5-S1 issues, SI trouble, scoliosis and weak necks and how to address them with Pilates. Bring your questions and basic understanding of the anatomy of the spine and pelvis and an open mind!

For registration and additional information, contact Emilie at center@reabnyc.com

June 16 – New York, NY – Pilates Reforming NY

Spice Up Your Reformer with Shari Berkowitz!
3-6pm
3PMA CECs (pending)

Most of your clients will become and stay Intermediate in their Pilates life. There are countless exercises in our modern world of Pilates…in this workshop, we’ll explore the remarkable variations Mr. Pilates created on his own standard exercises that many have never seen or are often forgotten and lost…especially as we teach group classes . Beyond the exercises, we’ll work through and understand the challenges of different levels in a group class, how to advance and work within groups, private and shared sessions…all of the situations you encounter in your teaching life. Full of immediately useful information, these 3 hours are far more than a bunch of exercises that you’ll soon forget! You have a long career ahead of you…let’s make the most of it!

Registration: http://clients.mindbodyonline.com/ws.asp?studioid=-726&stype=-8&sTG=20&sVT=32&sView=day&sLoc=4&sTrn=100000161&sDate=6/16/2012

July 13-15 in San Francisco, CA – Pilates on Tour

Saturday, July 14 –

Morning Mat Class – 1hr

Beyond The Everyday: Archival Apparatus on the Apparatus – 3hrs

3PMA CECs

Joseph Pilates created somewhere between 500-600 exercises. You know some of the repertoire…it’s time to learn more. In this workshop, you will learn rarely seen and immediately useful exercises on multiple apparatus (Mat, Reformer, Cadillac, Wunda Chair, Standing Arm Springs) all created by Joseph Pilates. You’ll leave feeling confident in the purpose and technique of teach exercise, have time to do exercises, practice teaching and ask questions. You’ll walk away with your own special archive of exercises for your strong intermediate clients…and yourself!

Sunday, July 15 –

Morning Mat Class – 1 hr

Archival Mat and Standing Exercises – 3hrs

3PMA CECs

There are many more versions of Mr. Pilates’ exercises than we see today. Variations, modification, combinations of multiple exercises in one! Fascinating, challenging and all the rest! These versions should not just live in the memories of those of us who had access to them years ago. They ought to be living, breathing exercises for those who need the modification or challenge! Experience this material, then teach it so we never lose track of these great exercises!

Click HERE for more information and registration.

POT Discounts:

If you register using my code, you can get $50 off of registration at any POT.

$50 Discount Code: SHARITOUR12

The discounts must be used when registering and are valid for any Pilates on Tour in 2012.

July 27-29 – Florida (Northern) – Stay tuned for much information!
August 4, 2012 – Studio 1880 – Hamburg, GERMANY
2 Semi-Private Sessions
Beyond The Everyday: Archival Exercises on the Apparatus – 3 hrs

3PMA CECs

Joseph Pilates created somewhere between 500-600 exercises. You know some of the repertoire…it’s time to learn more. In this workshop, you will learn rarely seen and immediately useful exercises on multiple apparatus (Mat, Reformer, Cadillac, Wunda Chair, Standing Arm Springs) all created by Joseph Pilates. You’ll leave feeling confident in the purpose and technique of teach exercise, have time to do exercises, practice teaching and ask questions. You’ll walk away with your own special archive of exercises for your strong intermediate clients…and yourself!

Flow & Rhythm – 2 hrs
2PMA CECs
Flow is much more than moving quickly through a list of exercises. Let’s figure out what flow is and how to create it within each move, reception and exercise. Flow has a lot to do with how you think of the workout and how you use your voice to set rhythms, give accents and emphasize certain points of each exercise. It will change your teaching for the better.
Mat Class of Flow & Rhythm – 1hr
1 CEC
Here is the studio’s announcement:

Special Guest- Workshoptag mit Shari Berkowitz am 04.08.2012 im Studio 1880 in Hamburg!

Am 4. August 2012 wird Shari Berkowitz im Studio 1880 unterrichten. Ich freue mich sehr, dass wir es geschafft haben Shari endlich nach Deutschland zu holen. Neben einer Advanced Matclass unterrichtet sie folgende Workshops, Archival Exercises – Beyond Everyday und Classical Pilates it is a workout – Flow and Rhythm, unterrichten. Wer möchte kann auch an einer der zei Semi- Privates teilnehmen. Die Unterrichtssprache ist englisch.

We have limited space available! Registration starts on the 16th of april. Open to all teachers of all levels and all schools! Course language will be english.

For more Information regarding pricing, lodging, travelling, CECs etc. please call Power Pilates at +49 40 52570172 or e-mail us info@powerpilates.de. We are happy to answer your questions.

August 19 – Form Pilates – New York, NY

Time and Fee TBA

BioMechanics: How Our Bodies Really Work and How to Cue That Reality – 6hrs

6PMA CECs

While your physical intuition is an important asset in teaching Pilates, intuition is not enough. To sincerely take care of your clients, you must know the truth of how the body works. Cue the reality, not the myths or mistakes. Being a confident teacher depends on it…demands it. We’ll work to understand the biomechanics and functional anatomy surrounding the pelvis, spine, shoulder girdle and how to apply this information to your teaching. Knowing and understanding is the only way.

To register or for more information, contact Lindsay at formpilates@yahoo.com

September in Sao Paolo, BRAZIL – Much information to come.

September 14-16 in Boston, MA – Pilates on Tour

Saturday, September 15

Morning Mat Class – 1hr

Beyond The Everyday: Archival Exercises on the Apparatus – 3hrs
3PMA CECs

Joseph Pilates created somewhere between 500-600 exercises. You know some of the repertoire…it’s time to learn more. In this workshop, you will learn rarely seen and immediately useful exercises on multiple apparatus (Mat, Reformer, Cadillac, Wunda Chair, Standing Arm Springs) all created by Joseph Pilates. You’ll leave feeling confident in the purpose and technique of teach exercise, have time to do exercises, practice teaching and ask questions. You’ll walk away with your own special archive of exercises for your strong intermediate clients…and yourself!

Archival Mat and Standing Exercises – 3hrs

3PMA CECs

There are many more versions of Mr. Pilates’ exercises than we see today. Variations, modification, combinations of multiple exercises in one! Fascinating, challenging and all the rest! These versions should not just live in the memories of those of us who had access to them years ago. They ought to be living, breathing exercises for those who need the modification or challenge! Experience this material, then teach it so we never lose track of these great exercises!

Click HERE for more information and registration

POT Discounts:

If you register using my code, you can get $50 off of registration atany POT.

$50 Discount Code: SHARITOUR12

The discounts must be used when registering and are valid for any Pilates on Tour in 2012.

mid-Oct. – Sweden (in the works)

All Dates and Information TBA! Check back soon!

Oct. 26-28, 2012 – Iasi, ROMANIA – Pilates Convention

The workshops are not set, yet, but date, presenters and location are! Are you in a neighboring country…come to Romania for great workshops and workouts!

Here is what they wrote in their Facebook:

www.pilates-convention.com gets bigger this year!!!!!!!!!!!!!!!!!!!!!!

Get also functional and well burned out with aerobics. The new theme of instructors are waiting you on 26-28 October: Shari Berkowitz, Orlando Fit Lopac, Mirela Anic, Giorgio Radici, Antonella Riviera, Mirjan DoubleTrouble, Laura Wilson, Gil Lopes, Paula Drosescu, Tatiana Chesalina, Judith Szereday, and more.

We’ll invite you to learn how to take care of the spine, of the hole body, of the mind, how to have fun with the kids teaching them how te exercise, special population trainings, and so many other things!!!

Looking forward to see you at the convention!!!!!!!!!!!!!!!

In a wihle we’ll up-date the location, prices and shedule!

Thill then, don’t make other plans for 26-28 october, 2012!!!!

I’ll post more information when I get it to share with you!

Nov. 11, 2012 – Pilates Barn – Madison, CT

All information TBA – Check back soon!

**************

And so many more workshops to come…we can do one at your studio, too!

****Please share this information and tell your Pilates teacher friends and colleagues to come on over for workouts and workshops that will get your Pilates-teaching-juices flowing.****

Again, these are not your typical workshops where you might get 1 useful tidbit. You will leave full of new teaching skills and ways to look at Mr. Pilates work. You will have a new perspective on Pilates that will enliven your teaching and your own workouts!

Shall we set up something at your studio or the one you work at? Clearly, I travel to teach and enjoy it! Read below for more info!

Workshops in Your Studio:

If you are interested in my teaching workshops and/or semi-private sessions for your teachers at your studio, please contact me at info@TheVerticalWorkshop.com

I’ll be thrilled to put together a program with you for your needs!

While my vocabulary is classical Pilates, the principles behind my teaching and workshops apply to every style of Pilates.

We have countless topics to play with within technique workshops of classical Pilates and teaching skills workshop that apply to all!

*******
Sessions:
If you’re in NYC and want a Pilates session e-mail me at info@TheVerticalWorkshop.com
And I’m Westchester, NY on Thursdays.

Workshops:
If you’d like a workshop and/or semi-privates at your studio, e-mail me at info@TheVerticalWorkshop.com I travel all over the world and would be thrilled to come to you!

Consultation:
If you’d like to set up a meeting on the phone or in person to ask questions about teaching or building/maintaining your business, e-mail me at info@TheVerticalWorkshop.com

****Thank you, as always, for taking the time to read this blog! I hope you’ll search around the blog and find articles that appeal to you, write comments, ask questions…I hope you’ll really make use of this! Then…I do hope to work with you in person, too!

Enjoy!

– Shari

Entry filed under: Uncategorized.

Workshop Updates – as of May 23, 2012 Sharing A Client Between Teachers: Client Exercise Cards

8 Comments Add your own

  • 1. Eloise  |  June 3, 2012 at 10:44 pm

    Thank you as always for a super interesting/ important/ informative blog entry! I was wondering how you react when a client exhibits this kind (or other) pain and doctors could not come up with a diagnostic. On one hand, it scares me to death to risk to injure them more because I don’t know what they have (and it’s not my job or place to know), on the other, I want to help where others failed. Would you try and work around the injury/pain/condition anyway? Or find another condition that seems close enough to the one you’re facing, so to use it to help adjust your work based on something known?

    I guess my real question is: what you don’t know what you’re dealing with, how do you react in term of movement (without quitting on those clients)

    Reply
    • 2. theverticalworkshop  |  June 7, 2012 at 10:07 am

      Eloise,

      Thank you, indeed, for this great question. I do believe it needs to be the topic of my next article/post, but I will give you a brief set of guidelines, now:

      When you don’t know what the exact ailment your client has, you simple start by asking where s/he has pain, what actions cause pain and check range of motion of affected joint as it would apply to Pilates. If a knee:
      Which knee?
      Do you feel pain on the front inside outside or middle of knee cap?
      Do you feel pain in the back of your knee?
      When does it hurt? When you walk, go up stairs, down stairs, sit, stand up from sitting?
      Can you take weight on it?
      How far can you bend it when you’re not bearing weight on it?
      Can you kneel on it?
      Can you straighten it?
      Then…you work around the area of injury and pain choosing exercises that don’t affect it or include it and choosing or creating modifications for others that do include the injured/affected joint.
      Then you write down that particular ailment and you look it on up the Internet, ask doctors (you need a go-to doctor to ask many questions. Have this be your general practitioner, your chiropractor, your orthopedist) and you learn learn learn!
      You can connect with your client’s doctor and physical therapist and ask them to give you more information.
      Then pick and choose exercises and modifications that apply with this new information!

      Does that help?

      All the best, Eloise!
      – Shari

      Reply
  • 3. Amit  |  June 4, 2012 at 6:42 am

    Thank you Shari for a very interesting article. I have known about Dystonia for a while but never had a client with D and so never considered what to do/ not to do… hope you are well. Let us know when you make plans to come back to London 🙂 Amit x

    Reply
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  • 6. Upcoming Review - CoreBody Reformer - Fitness Diva Blog  |  August 5, 2012 at 5:03 pm

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  • 8. The Vertical Workshop's Pilates Teacher Blog  |  December 6, 2012 at 10:22 pm

    […] Dystonia – Let’s Learn! […]

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