POST Rehab: one on one training
Post Rehab workouts, after medical clearance. After PT and with very clear protocals that are cleaared with the help of the current PT.
“Paolina has been my Pilates instructor for the past 2 years. Due to my back surgery and lumbar fusion, I need one on one instruction. She has been patient, knowledgeable, concerned, and very professional. I am now stronger and healthier, despite my limited back motion. I look forward to my sessions with Paolina.”- Nawal S.
For many years Paolina has worked with clients, post-rehab physical therapy. Paolina’s clients range from hip replacement surgery and ACL repair, to those with osteoporosis, respiratory and heart conditions, shoulder injuries, bursitis and tendonitis and spinal injuries. She works with clients post rehab after surgery rehab AFTER PT, but she is often floored by the range of polulations who walk through the doors of the YMCA. A 20 something spinal fusion, a person recovering from cancer. Each person steps into a pilates mat class and it’s an accident waiting to happen. So most of the time it’s just about grounding everybody and teaching them to settle and find a do-able place to work from.
Pilates exercises are whole body exercises. Pilates ‘re-programs’ neuro-muscular firing patterns. So, when a client is doing something ‘incorrectly’ it just means they are not aware that they are using a strategy that doesn’t help, like a bio-mechanical compensations ( for example if the illiopsoaz keeps gripping or if the hamstring or toes cramp right away). So we work on centering the movement and reinforcing better movement patterns. We do this by strengthening the mind-body connection and teaching the client to consciously fire the right muscles.
The goal is to get to the point where the client is unconsciously competent. In an exercise like a simple Bridge, for example they fire the gluteal muscles first, reach into the heals to lift the pelvis, as they articulate their spine off the mat, ideally ‘imprinting’ as they extend the hips and lift their lower body off the mat.
Corrective programs are NOT really REHAB. Paolina is NOT a physical therapist, she is ONLY a pilates teacher. However Paolina’s continuing education included a post rehabilitation workshop with Robert S. Gotlin, DO. from the Center for Health and Healing. One of the easiest things she learned from his was to understand ‘reciprocal inhibition” and the relationship of opposing muscles, the agonist and antagonist, and then how the synergists muscles work. She learned about muscles shutting down and other ones taking over. And then she went case by case to memorize the protocols for various programs. However she always needs medical clearance and often has worked with PT’s who give her a clear range of motion guideline and tell her what to work on.
Pilates can be very helpful when there is MEDICAL CLEARANCE i.e. it is safe to do. You focus on strengthening the deep supporting structures of the body, and then progress to more complex movements then teach the weaker point how to move through different planes of motion. The reason is that Pilates is mainly about eccentric movement. About controlling the way the springs pull your body back.
People have started to say to her that Pilates doesn’t have enough spiral motion and doesn’t work on a transverse plain. First of all, most of the time we are trying to align and stabilize the pelvis and we want to stop it from yanking you off course. Or a renegade leg, or some part of our body that we don’t breathe into. Also, there is a huge amount of rotation in Pilates. But Pilates isn’t about “liberating ” the body! or ” freeing” the body. This is ridiculous. Pilates is precise conscious movement. It is a discipline used to train you to not collapse into one side of your ribs and not sink down into one side or stop protracting on one side. Or starting to create more motion and articulation through the upper back and create space in the thoracic junction since we all sit. Or we had children, or we decided to go try some wacky new class.
We are often dealing with a criss cross effect on the skeleton, so we ALWAYS consider rotation. Especially in joints like the knee and ankle. You don’t have to literally twist to be working on rotation Just learning how to track the knee properly involves a lot of forces pulling and torquing in opposite directions, rotating in one way and out the other, to dynamically stabilize a joint. To track properly on the tibial plateau, to not collapse the ankle. It’s not transitory movement, it’s deliberate; and also for shoulder it’s compound movement! So when you are doing Mermaid for example your main concern isn’t twisting your ribs, it’s keeping your lateral line by gathering your shoulder around your ribs, moving your arm from your back or deepening your abdominals within the ipsolateral rotation.
Pilates is never seen from the outside. We cant think that just because someone is moving they are actually doing it right. Dancers twist a lot. That’s how they end up with dislocated shoulders and hip tears. We have to pass through conscious movement to get something into our muscle memory, so it’s done with deep awareness, not zoning out or stirring. We are alert, even more awake, so that when we do have to twist, it is coming from the correct place, since we already memorized and mastered how to do it.
Paolina started Pilates as an 11 year old athletic child at the recommendation of Dr William Liebler, pioneer dance doctor of American Ballet Theater to address knee injury.
Throughout her life she healed from various injuries, most recently knee surgery.