Issue #413 – Wednesday, October 25, 2023
Pilates for Parkinsons
by Miranda Lindgard
Like most people I thought Parkinsons was an old person’s disease. The only young person I had ever heard of having it was the actor Michael J Fox who developed the disease at just 29 years old. He seemed to be a very rare exception…
….but not as rare as I thought, or would have liked. For I have a student, and we can call her S, with the very same diagnosis – let me explain.
S started Pilates in 2016 following episodes of back pain. She started with matwork progressing quickly to intermediate level. She was strong, always thoughtful in her practice and keen to progress. We moved to Reformer small group classes where again she quickly learnt the intermediate classical system.
Over time I noticed in mat classes a tremor in her right leg that was more noticeable when her leg was in the air for example during Side Kick Series. If she had her foot anchored on the floor for bridges it was hardly noticeable. In her reformer practice it became visible in footwork Toes but not on Arches or Heels so we modified it if she felt uncomfortable. Over time the tremors increased even with feet in straps which became worrying and any exercises requiring balancing for example Front Splits became dangerous.
We talked about it and I suggested she ask her doctor as I could see it was becoming awkward for her during class. After several months of misdiagnosis she received the devastating news that she had Parkinsons at only 40 years old. We hugged, we cried together and then we made a plan: to do whatever it would take for her to be able to continue her practice without shame or embarrassment – one session at a time.
For S Pilates had become part of her daily life. It was not an option for that to change.
I have two other students with Parkinsons, male and female (Nadine in the photo) but are both in more advanced stages and are over 60. So I was used to teaching with the tremors and saw how closed chain exercises on the machines helped them control their limbs as opposed to Mat work they were less able to find the support needed in order to be stable.
With S it was different. She was young, fit and improving her Pilates practice every year. After the initial shock, she told me she wanted to continue in group sessions and didn’t want to be “singled out” if she couldn’t do an exercise. I was very careful not to draw attention to her all the while making sure she was safe. The group setting helped her feel “normal” and gave her the autonomy to control her movements all the while having me watch over her. She had researched Parkinsons and doing sport and was particularly advised to keep doing weight bearing exercises.
She had the advantage of being very fit and having a super strong core before the diagnosis. That hasn’t changed. What has however is her capacity to control her body, especially the right side. What started initially in her right lower leg has progressed to her right arm and as a piano teacher this is mentally and physically challenging for her.
So how has the progression of the illness affected her practice?
The illness has progressively reduced her capacity to do certain movements especially using her right leg. The tremors create instability especially when pressing on the right forefoot (Pumping on the Wunda Chair) or pressing back with her right leg (Eve’s Lunge-Reformer). Anything requiring a high heel position is virtually impossible (Arabesque 1, even Stomach Massage requires her to remain on her forefoot and not on the toes). All one legged exercises require a huge amount of concentration as she cant feel her right foot anchored correctly. This in turn weakens her confidence in her ability to execute the exercises. It’s stressful for her. We have learned that more resistance is helpful as it informs her muscles how to engage her core to maintain her balance.
She tells me that the most frustrating side effect is not being able to execute an exercise fluidly because her coordination has been affected. Swimming for example is a huge challenge. It’s not that her proprioception has been reduced, it’s just that her body does not respond. What she used to be able to do almost unconsciously now requires far more concentration. She basically has to learn how to reconnect her mind to a different body !
After the initial diagnosis, in order to “reconnect”, we went back to doing a few privates and slowed things down. She needed to feel and understand which parts of her body she couldn’t control as well as before. She realised she was not truly working from her deep abdominals. For example, before her diagnosis, in the Knee Stretch Series on the Reformer, we had worked up to Knees Off and she was able to really push and pull a full 20 reps at a fast pace. Due to the foot position as explained earlier, the exercise became frustratingly hard for her. Slowing it down gave her time to think about using her heels to engage her hamstrings. She could no longer cheat with her quads because they didn’t respond as well as they used to. Kind of a good thing!
The private sessions helped us find the right modifications and gave her back the confidence to rejoin the group sessions. Today S is still practising pilates at the same level (mat and machine) she was doing before the diagnosis. It is still not easy for her to find the balance between improving her strength, control and flexibility and fighting against the physical decline that inevitably comes with Parksinons.
After initially hesitating, because she doubted her capabilités, S took part in a weekend workshop with Brett in April 2023. We all know Pilates is about slow controlled movements so imagine how hard it is to demonstrate exercises in front of others when you have a physical handicap. I was moved by S s determination, courage and stamina. Her positive outlook is remarkable. S tells me that social interaction at the studio and the support from teachers and other students play an essential role in her wellbeing.
Put simply, she cannot imagine living without pilates. Parkinsons challenges all the pilates principles but I think S mainly gets through her sessions with a new one which I will call Determination!
Miranda is the owner of Pur Pilates in Lyon France
Initially trained as a UK solicitor, I spent all my free time in gyms or outdoors running. I discovered pilates in Paris between jobs as a lawyer after having tried pilates classes in gyms where i just didn’t get it.. Not one for spending hours sitting on a chair in the office, I jumped at the opportunity to help manage a renowned Pilates studio in Paris and went on to complete the Peak Pilates Comprehensive Classical training in 2005.
I opened my studio in 2006 in Lyon and have never regretted changing careers. I teach everywhere I go, to friends on holiday. I live, eat and breathe Pilates.
As an ex-gymnast Pilates has saved my back and even my basketball crazy kids enjoy stretching on my home reformer after practice.
NOTE FROM BRETT: She is also a really nice and fun person who inspires all her students to be dedicated Pilates students, and they adore her, too!