Pilates

Working with Clients with Breast Cancer

Polestar Educator Amy Dixon has an extensive fitness background spanning over 20 years, including experience working with breast cancer survivors. Through classes and private sessions, she helps survivors rehabilitate and reexperience positive movement experiences. Amy shares her experiences working with Cancer clients along with useful insights on what to expect teaching this population and how to make the sessions the best they can be.


23 years ago, I was working as a personal trainer while working through issues resulting from 2 herniated discs. I began working with a Pilates teacher and was amazed to discover that this practice alleviated my pain. Because of this, I was inspired to train to become a Pilates instructor myself and after a few years, I found Polestar and completed their Transition program. It was after Polestar that I was drawn to work with more complex clients, using Polestar’s principles to navigate their varying needs. Throughout my career, I have had the opportunity to work with a lot of people with breast cancer diagnoses. I have seen the full range of symptoms breast cancer sufferers experience, from diagnosis to post mastectomy. These symptoms include:

  • Decreased shoulder range of motion and strength
  • Fatigue
  • Pain
  • Poor posture
  • Peripheral neuropathy
  • Increased risk of premature osteoporosis
  • Increased risk of lymphedema and sarcopenia
  • Impaired ability to perform daily tasks

These issues are compounded with emotional stress and varying frames of mind, which can irritate the symptoms further. Post-surgery breast cancer patients tend to limit their movement to the point that they set back their recovery. Many also develop guarding habits, such as raising the arm on the affected side to protect against being touched or jostled, which can cause further mobility problems in the shoulder area. This is where Pilates can retrain some of these potentially adverse compensations to expedite recovery and avoid the adverse movement patterns from becoming habitual. For example, it is more difficult to restore shoulder mobility in patients who stay guarded in a sling for six to eight weeks than it is to begin the mobility process as soon as lesions are healed.

Clients with a positive outlook and a willingness to progress tend to have better results with this kind of focused movement. It can be scary for the client to move, so much encouragement and compassion are needed! Private sessions are ideal for this type of client in the beginning in order for them to feel more comfortable and to participate in Pilates without feeling self-conscious.

To reintroduce patients to everyday movement, it’s best to start with low-intensity Pilates routines that focus on the upper body. During cancer rehabilitation, the concepts of breathing, pelvic and lumbar spine alignment, rib cage placement, shoulder mobility and stability, and head and neck alignment can be applied to any Pilates movement. Bringing awareness to posture can be the first step in improving daily activities. Putting the body in a position where it moves and reacts more efficiently can take away unwanted stress and strain. Developing proper movement patterns will also allow the body to heal in a way that reduces the likelihood of compensatory injuries.

When dealing with cancer patients, you must be aware of their progress as well as keep in close communication with their physical therapist. It is important to know the types of issues they are dealing with, and by keeping good communication with their PT, you can ensure the proper contraindications are noted before creating a program for these clients. Watch for fatigue, swelling, limited range of motion, and pain while working with these clients.

Ultimately, our Pilates practice can greatly improve the mobility, range, and posture of survivors. Creating a positive movement experience is key.


For more information on Amy and her studio, click here.

Polestar Graduate Highlight: Lorna Jarrett MS, LPTA, AIB/VR-CON, NCPT

What is your movement mantra?

LJ: Your purpose is fulfilled as it is lived in your best body.

How did you first hear about Pilates?

LJ: As a personal trainer and dancer, Pilates was part of my personal workout and training repertoire at the gym. I enjoyed how it connected to traditional dance choreography and I valued its ability to challenge my expert movers and support my special population clients.

Why Polestar Pilates?

LJ: I am a Polestar Graduate (Rehab track) and NCPT. I chose Polestar Pilates because for me there was no other option. I researched many certifications. Polestar certification discussed the founder Brent Anderson along with his background. The focus of the certification coincided with physical therapy practices and evidence-based research. This is what interested me. I am a Physical Therapist Assistant with a corporate business background and wherever my career took me I needed my education and practice to be sound.

What is your Teaching Philosophy?

LJ: I specialize in those with neurological disorders and the special population i,e, Myotonic Dystrophy, MS, Stroke, Parkinson’s, spondylolisthesis. Most of my clientele have chronic conditions. During our sessions, we focus on movement potential. This approach allows my client to redirect and discover that they can still have joy in movement no matter the diagnosis. This practice creates an opportunity for me to instill hope on an ongoing basis.

How has Pilates impacted your life?

LJ: Pilates as a tool has allowed me to serve a cross-section of the population with varied needs and abilities. Its principles have provided a level of discipline and organization to my own movement. It has provided a common theme to which I have built lasting relationships. It’s an industry that is rooted in tradition but remains progressive, contemporary, and relevant.

What is your favorite apparatus?

LJ: My favorite apparatus for the last two years is the Core Align. It allows me to challenge every client and support the principles in a standing position. I am excited to complete Core Align for Rehabilitation at POT Rehab Summit 2020.

What is your favorite thing about your Job?

LJ: What I love most about coming into the studio, is creating an environment of peace and tranquility so that clients can have a pain free, enjoyable yet challenging mindful movement experience. An atmosphere, where every sense is impacted, to evoke mental, emotional, and physical change. In creating this environment, I myself get to experience it over and over again. I value being able to help people improve their abilities. Movement ability is taken for granted and this work reminds me of what a blessing it is to move.

What is Unique about your studio?

LJ: I co-founded Whole Pilates studio with two physical therapists. It is unique in that we offer an integrated and holistic approach to our studio. Utilizing music and essential oils assist with focusing the senses. We partner with a Doctor of Naturopath, who provides complementary alternative therapies in our studio space i.e. infrared sauna, vibration plate, IMRS table. Therefore, our clients can receive nutritional counseling along with complementary alternative therapies with their Pilates training. Our staff is certified in Pre and postnatal Pilates, so we value meeting the needs of every season. We value education and our offerings based on an integrative and holistic approach are real and very important to us.

What do you find intriguing?

LJ: The concept of the mind and thoughts determining gene expression. The fact that the brain can rewire and change the physical state of the body.

What are you reading?

LJ: I am reading about Decision making in healthcare leadership as I am completing my Doctor of Health Science with an emphasis in leadership and organizational development from AT Still University, Osteopathic Medicine/College of Health Studies. I am an entrepreneur and have developed a non-profit and wellness business. I realize that effective leadership is at the foundation of any cultural change or initiative. So, one day I decided instead of writing another proposal that instead, I would become the decision-maker.

Also, I am reading “The Bridge Across Forever: A true love story” which is a book about experiencing your soul mate.

What are you excited to learn about?

LJ: As a rehab practitioner, I have completed CEUS for stroke therapy, certification as a Stroke Recovery specialist, Pilates for MS and other neurological conditions, Vestibular Rehabilitation and Concussion Management Certification/ American Institute of Balance 

What is something Unique about yourself?

LJ: I love chocolate! I have jumped 15,000 feet with a parachute, Arizona mountains make me feel like I am coming home, I am my happiest when I am dancing, I believe a new thought precedes any new experience.


Read more from Lorna on the Polestar Blog:

Mentor Highlight: Vikki Harris, Polestar Pilates UK

Located in Burgess Hill and London, United Kingdom, Vikki Harris is a Polestar Pilates Mentor for Polestar UK, Franklin Method Back and Spine Trainer, Contributor on the Polestar International Blog, and holds a Diploma in Dance Education AISTD STC RAD. You can find Vikki on social media @vpilatesstudioburgesshill.


Describe “the Spirit of Polestar”…

VH: A guiding ‘Pole star’, a map, territory, and landscape to be explored. Fostering an experience, to develop color, depth, individuality, and authenticity. Opening a perspective that embodies the true spirit of ‘aliveness” of human existence.

What Three Words come to mind when you think of “Polestar Pilates”

Potential

Community

Joy

What do you love about teaching Pilates and owning a Studio? 

VH: What I love about teaching is being a witness to developing insight and the opportunity of self-reflection for not only my clients but for myself. I feel honored to walk alongside a process and hold space for someone to exist. Opening my own small studio was part of my liberation to ‘being’ rather than ‘doing’, becoming aware of the ‘self’ and the individual.

Where did you take your Training and who was the educator?

VH: I trained with Polestar Pilates UK in 2012 on the Comprehensive, Reformer, and Mat courses with Liz Bussey and Diane Nye as my inspiring educators. I feel full of gratitude and appreciation for the compassionate holding through the process from all, including my mentors and Carl and Julia Moss of Polestar Pilates UK.

What are your current Inspirations? What do You love about them?

VH: I am inspired by the optimizing of health finding balance in spirit, physically and psychologically. I am fascinated by human behavior, interaction, and psychology. Behind every behavior is a feeling, behind every feeling is a need. As a Mentor to Polestar Pilates students, I feel honored to witness and be part of growth and inspired to overcome what we think we can’t do and step forward with courage into life.

Why Pilates? How did you find the practice?

VH: Initially, I found Pilates in 1999 as a professional dancer and teacher. I loved discovering and embodying the bio-mechanics through the Pilates repertoire and the process of strategy and problem-solving. Understanding the “why and how” changed and developed my skills as a dance teacher. Personally, my own Pilates practice was a transition from performing and enjoying the playing of a role, to becoming my own person. The real benefits came after an injury stopped me moving and the supportive studio equipment gave me my freedom back.

Why Polestar Pilates? How did you come to join the Polestar Community?

VH: I originally trained in Mat and Reformer with Body Control Pilates in 1999 and found the Polestar Pilates Studio Comprehensive training in 2012 as I became interested to develop the rehabilitation potential of the work. My own personal journey very much influencing my desire to support others.

What do you hope to convey in your teaching?

Choice and potential.

Do you have a favorite quote you live by?

“Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

Viktor Frankl

What is your Favorite Apparatus or favorite way to move?

VH: I’m not sure if I can choose a favorite piece of equipment as each gives me a different connection and experience. I love the sense of flow the trapeze offers in sequences of movements, yet the stimulation and containment of the reformer.


Read more from Vikki on the Blog:

Supporting Dancers within the Pilates Environment

The Gift of Opportunity and Authenticity

Located in Burgess Hill & London, United Kingdom Vikki Harris is a Polestar Pilates Mentor for Polestar UK, Franklin Method Back and Spine Trainer, and holds a Diploma in Dance Education AISTD STC RAD. You can find Vikki on social media @vpilatesstudioburgesshill.

Patient and Client Safety

Written by Polestar Pilates Rehab Practitioner Lorna Jarrett MS, LPTA, AIB/VR-CON, NCPT


Do you have an incident reporting system in your studio?

How safe are your instructors when taking in new clients alone? We can glean insight from patient safety interventions practiced in hospitals and ambulatory settings. One solution is an online universal portal, which can be used for incident reports of misses and near misses. It also captures recommendations for improvements. An online example is the Agency for Healthcare Research and Quality (AHRQ.gov).

Thinking about safety, how safe are grippy socks when working with a client with gait dysfunction? Just as ill-fitted socks in the hospital can be hazardous, I have found them to be hazardous, as the feet can slide within the socks preventing solid footing. I switched one client to socks with toes to avoid her feet sliding within the socks. These are the types of discussions that could be shared across a national platform.

These days our practitioner roles reach beyond minimum exercise planning and include meeting the extensive needs of the client.

Every year when we renew our liability insurance, we’re reminded of this truth. From the beginning, the administrative intake should focus on assuring that clients receive the care they need and prioritize identifying those who are not receiving proper care. Staff meetings and managing the practice population are priorities. An objective of meetings is to create an opportunity for team input and build a culture of buy-in and involvement to address the evolving needs of the clients (Wachter & Gupta, 2018). One of those evolving needs is patient/client safety.

A studio practitioner may view this information as only for an inpatient or outpatient medical setting. However, client safety should be a concern for our studios just as patient safety is a concern for hospitals or outpatient settings. If our outcomes were publicized as hospitals were, what kind of changes would we be willing to make? I will discuss solutions suitable for large organizations, however, the information can be tailored for any size organization, as the stakes for safety are equally as high.

Key steps would include: making a commitment to performance improvement, reviewing root cause analysis of misses or near misses to direct improvement, presenting analysis to the team or board to execute the plan, selecting appropriate tools suitable for the organization, generating an in-house marketing plan to support the initiative, naming leaders and stakeholders, establishing training curriculum and materials, determining an ongoing training schedule, and empowering safety coaches to mentor and foster changes in staff, patients, and the community (Brilli, McClead, Crandall, Stoverock, Berry, Wheeler & Davis, 2013).

The leaders of the safety system would include those who are empowered and educated to provide oversight and input into the areas of quality control, risk, compliance, and IT. A vigilant, emboldened team is needed to implement a safety system and any cultural change (Wachter & Gupta, 2018). One such method to embolden a team can be seen in establishing medication safety champions to model and point out positive and negative safety practices within the organization. (Brilli, McClead, Crandall, Stoverock, Berry, Wheeler & Davis, 2013; Wachter & Gupta, 2018). 

Safety Tips for the Pilates Studio

1.    View the facility from curb to front door and assure that there are no safety obstacles. Initiate the conversation with your patient/client regarding their home safety and community ambulation when necessary. Have resources for referral, such as a certified NAHB Aging in Place Specialist who can review their home and make recommendations for ADA compliance.

2.    Our Pilates programming should support and promote dynamic functionality outside of our space.

3.    Establish an incident reporting method within your studio without punitive repercussions. Our studios can learn from large medical organizations who have found that anonymity, along with recommendations for improvements, encourages reporting. The data collected is discussed regularly and provides a learning opportunity for all.

4.    Create a team culture of open communication. This takes mature leadership, and while it is not developed easily, it must be an organizational objective.

5.    Do a curb to front door observation, and then check from front door to each piece of equipment. Remove items on the floor that are not adhered to the ground i.e. half foam rollers, rugs, etc.

6.    With the flu, coronavirus, or airborne infections or viruses, utilize hand sanitary measures and ventilate the studio with fresh air once a day.

7.    Establish a safety program within your studio. Latest research can be shared with clients/patients to educate them and empower them to play a role in their own safety.

8.    Create a Fall Risk Screen for your studio:

  • Do you use any assistive device to ambulate?
  • Do you need any physical assistance with standing or walking (ie, walker, cane)?
  • Do you have periods of forgetfulness or don’t know where you are at times?
  • Have you had a fall in the past 6 months?

Whichever patient safety approach is taken or whatever risk mitigation is at the forefront, the ultimate objective is to be an organization of high reliability (Chassin & Loed, 2013). 


References

Brilli, R. J., McClead, Jr., R. E., Crandall, W. V., Stoverock, L., Berry, J. C., Wheeler, T. A., & Davis, J. T. (2013, December). A comprehensive patient safety program can significantly reduce preventable harm, associated costs, and hospital mortality.The Journal of Pediatrics, 163(6), 1638-1645.

Chassin, M. R. & Loeb, J. M. (2013). High Reliability Health Care: Getting there from here. The Milbank Quarterly, 91(3), 459-490.

Wachter, R. M., & Gupta, K. (2018). Understanding Patient Safety. [3rd Edition]. McGraw Hill: New York, NY.Surveys on Patient Safety (n.d.). retrieved from https://www.ahrq.gov/topics/surveys-patient-safety-culture.html

The Gift of Opportunity and Authenticity

A Catalyst to Potential Health and Wellbeing – By Polestar Pilates Mentor Vikki Harris

So what supports a catalyst for personal transformation?
Sometimes a massive wake up call for existence shows up in the form of a disease or pathology. Currently, our environmental climate is in crisis and there is an absolute need for rebellion to call for action now, not in the future, to prevent both human extinction and our planet’s destruction. Are we listening and acting on the call? What about our own individual environmental climate? Are we inflamed, stressed, under-resourced physically, emotionally, and spiritually, and potentially ignoring it? What will it take to be heard and listened to? If we tune in and observe ourselves what may we discover? When we’ve been conditioned to say “yes,” and forgotten how to say “no,” for example, our bodies may end up saying it for us in some form.

Gabor Mate writes in his book When the Body Says No: The Cost of Hidden Stress, “It’s about input, output, and understanding “flow”, the bio-psycho-social model where many processes form together in the creation of disease or health. Healing is finding a balance of flow and harmony.” 

The negative effects of stress on health are well-documented. There are many definitions of stress from both eastern and western philosophies and academic disciplines, including psychology and physiology. The paradigm of research is shifting toward a holistic approach in which the whole is greater than the sum of the parts. The healthcare provider considers the whole person by addressing their symptoms as well as the underlying causes including the mental, physical, emotional, and spiritual components of wellbeing. 

The Pilates studio is an environment where awareness of the whole individual can be supported through an integrative and experiential approach. With intention and autonomy, the “self” can be heard and directed by the client’s experience rather than by the teacher. My teaching and presence change as I look within myself and find integrity beyond the connectivity of body parts and systems, to where there is a wealth of potential learning and health. 

The focus in research on stress-disease models appears to be divided into the following areas:

  • Genetic predisposition
  • Energy medicine
  • Subtle energy anatomy

There has been an intuitive association with stress and disease for centuries but scientists from several disciplines have come together in the last decade to form a field of study called psycho-neuro-immunology.

Stressors have been characterized into three groups:

  • The bio-ecological influences of external influences, some of which are outside of our awareness, including sunlight, gravitational pull, solar flares, and electromagnetic fields that affect our biological rhythms.
  • The psycho-intrapersonal influences of perceptions of stimuli through our own interpretations, thoughts, values, beliefs, attitudes, opinions, and our identity or ego.
  • The social influences where individuals are unable to cope with their given environment, overcrowding, boundaries, and major life changes.

If we view the mind and body as two separate things, dividing that which is inseparable, we attempt to understand the body in isolation from the mind, describing human beings as if they function in isolation from their environment where they develop and learn. The unexamined assumptions both determine and limit what we will discover. If we become specialized in parts, theories, or knowledge, we become interested in only those parts and not on the whole where the parts reside, taking on a dualist binary approach. 

“Our present state of scientific knowledge suggests we can solidly affirm that kindness and compassion to the brain are what breath is to life.”  

Daniel Siegel

Presence, attunement, and resonance with yourself and your client create an environment that supports an open, non-judgmental potential of awareness. The attuned approach is where the gold lies. The guiding pole star helps us with a map, yet the territory and landscapes need to be explored, felt, and acknowledged to bring color, depth, individuality, and perspective that embody the true spirit of “aliveness” of our human existence. 

How To Be A Highly Effective Pilates Studio Owner: The Team

The continued success of a Pilates Studio relies, in large part, on its ability to keep its most precious asset motivated: the team! To cultivate relationships with team members, and encourage their creativity and loyalty, you must start with yourself. As a studio owner or manager, you need to have a disciplined strategy.
Regardless of the number of instructors who make up your team, getting full involvement for effective results is in your hands. A solid investment in self-improvement will make you a better manager. When doing well, your team members will pick up on this and will motivate you to excel. In our blog post, The Art of Communication, we discussed building rapport with clients. Those techniques can also be applied to how you interact with your staff. By building a good relationship with employees, such as Pilates teachers, reception and cleaning staff, etc. you will foster an inviting and thriving studio environment. We must go further if we want to have a highly effective team. Invest in your Pilates professionals’ advancement. If there are areas of improvement (i.e. a new skill or practice) that your employee would like to pursue, encourage them. Seek out how best to furnish their needs and possibly subsidize their new training. If you combine good services, a studied strategy and quality training, your success will be guaranteed. Remember that your Pilates teachers should be well trained, so skimping on training may mean not being up to par. Your clients will perceive it as well, so invest in the future. This approach sounds great, but you may not know how to go about it. Stephen Covey summarizes in his best-selling book, 7 Habits of Highly Effective People, a set of rules that can help in such situations. It discusses improving areas around personal management, leadership, and empathetic communication. Covey’s 7 habits guide you to change your behavior by modifying a series of paradigms that will help you understand the world differently. The 4th habit, for example, focuses on being an effective leader. “leadership is communicating others’ worth and potential so clearly that they are inspired to see it in themselves.” We recommend this reading in the hopes the lessons will manifest in your studio. These habits give us a taste of the characteristics that a successful Pilates studio manager embodies. In our next post, we will identify 7 tips for becoming a successful Pilates entrepreneur. If you dare to take the first steps to become a highly effective Pilates studio manager, you will be putting yourself and your team at the forefront of your profession.

On the Blog: How do we know we’re teaching a great class?