Practitioners in Recovery

Hi, I'm joy Puleo. And I am here with Tiffany DeMartin, Rebecca Philipo and Kristin Brighty. And this is the third of our series on working with breast cancer clients. Now, at this point your client is pretty much on their way to recovery. Chemotherapy is behind them, radiation is behind them as is the initial surgery, whatever it was that they had.

And so we're gonna start integrating some more, what you would see as traditional Pilates exercises into their routine. But you will notice that I have them all set up slightly differently, and I will explain that in a second why that is and how this can also be slowly graded in to your client's earlier experiences. One of the things that's important at this point to keep in mind is emotionally, your client now has been sort of graduated or let go from all of their treatments. And while there's cause for celebration there, I just want you to know that in your studios you might also be hearing some anxiety coming up from that. Because as much as the medical system was not a welcome a guest to the dinner table, it was the medical system that really helped to flush the cancer or rid the cancer from your client, so in essence the loss or the cleaving off of that medical establishment and all those appointments and all the purpose that was behind the medicine leads to some anxiety of what's next.

And can I trust my physical body to take the treatments it was given to do what I needed to do in the future. So that's really where the intentions are for these movements. So this is the first time you've seen us supine. I have Kristin here on a wedge. Most clients at this point will be fine lying supine, but still early on in the process, you may need to grade them toward the floor.

The wedge is really a lovely assist. It just lifts the thorax just a little bit against the floor. It relieves any strain in the neck or the shoulders if the shoulders are still having issues lying comfortably alongside the body. Tiffany, I have her on a little more advanced setting here. She's on a roller.

The roller has certainly a harder surface underneath her pelvis, but it gives her nice feedback. It also elevates the pelvis higher than the shoulders. This by the way is just a lovely opportunity to breathe and relax. Having the pelvis lifted, the diaphragm is a little freer, the scalings and the upper respiratory muscles can just sort of relax a little bit here. So this is just also a nice position, but do keep in mind, although we're gonna have Tiffany staying there for a while, it may not be where you want to keep your client for long periods of time.

And here with Rebecca, I have her on one of those toggle balls that has only about 25% air in it. And what that will do is that will just gently provide some instability underneath her. It's gonna help her tap into her core without gripping into it. Now, here's the deal, Rebecca is also a mountain biker, and I want her to get, I want her not to power through those hip flexors of hers, I want her not to power through her core, but then, I want her to find sort of those deeper connections. So having just that little bit of instability underneath her is gonna to have to make that come into play a little faster.

Okay, so we're gonna start with basic fundamentals. Now, I'd like to say these are Pilates fundamentals because they're in a lot of our Pilates traditions. But these fundamentals actually come from multiple traditions. And I have been a student of many, a disciple of none. So I've picked a lot of these off of the tree of gratitude to all of my prior teachers and I really I send this out to them.

We are gonna start with what we tend to think of as the pelvic clock, but I want to change your thinking on the initiation a little, and instead of thinking of "I'm moving my pelvis," we're gonna start with a sacral initiation. So you'll notice here on Rebecca, I have dots, and I must thank Madeline Black 'cause I think it was a Madeline Black workshop that I took was the first time I saw dots and it lit up my brain on that's how we can see into the body. So I have Rebecca dotted up here, and what I'm trying to do is get a front body view of where the sacrum might be in the body. I'm gonna ask Tiffany, and I'm gonna ask Kristin to put their dots on. And guys the fuchsia and the pink dot will be on what is the top of the sacrum.

And put the green dot on your pubic bone. And here's the deal if you're gonna ask your clients to dot up which they actually like it because it gives them some feedback and something to work with. That's great, but they should always put their own dot on their own pubic bone, okay. Okay. So we're just gonna start with a little rocking, which would be six o'clock and twelve o'clock in our Pilates repertoire.

But here I'd like you to think of this rocking as starting from the sacrum and the bottom of the sacrum, which is rounded it's like the bottom of a boat, right? And I want you to tip a little bit more towards your fuchsia and your yellow dot. And in that tipping, what do you get with the pelvis? The pelvis starts to spill posteriorly, yeah? Now, I want you to find that nice balance spot on your sacrum and then tip a little more toward the green dot, right?

So tip a little more toward the green dot. Nice. Now, come back and find your balance. Can you feel that balance please? Good.

Now, as you tip toward your fuchsia dot and toward your yellow dot and you get into that little posterior tilt by getting that little deeper or that, I shouldn't say deeper but that connection to the sacrum to generate the movement in the pelvis, to generate the openness of the lumbar spine, you should be feeling a little deeper core connection and integration into that movement. Now, you're gonna release that or instead of releasing think of stretching so that that green is lengthening away, you find your buoyant moment, and now you continue to lengthen it into that little bit, a little bit of an extension. This is how we talk about lengthening the front body and the back body. Here in this little bit of lengthening of the green dot away, the whole front body is opening. This is actually really nice for Kristin to work on that scar tissue.

She has a scar from her belly bottom down to her pubic bone from a surgery for ovarian cancer. It's also an excellent way for Rebecca to work on creating length across all the way up here in the chest, even though she's moving down here and lengthening through that green dot and the pubic bone. Rebecca has had a double mastectomy and it has scar tissue, which limits some of her motion in the chest. And for Tiffany, this just should feel good. (laughs) So we have that little rocking into flection and extension of the lower spine.

And you certainly can start to take this bigger, but the initiation should always come from that really, it's almost like if I can imagine a fourth dot right in between, that hovers between those three sacral dots and that's where the initiation starts from. Awesome. It also gives your client and understanding of where their sacrum is, and so when you start to talk about pelvic placement they have relevance for it. Excellent. And now we can also take this a little if you'd like, a little east and west or a little yellow dot to fuchsia dot.

And because I have Rebecca here on the ball, she's got this little instability underneath her, and you're just gonna go a little such a small side to side with your pelvic abs, yeah. And it gets a little, it's hard to find, isn't it guys? Can you see how one side you can, for me on my right side, if I were a rower, I'd go in a circle to the right. Your one side might feel very easy to feel that groundedness and on the other side you think, "oh, I can't move this, is the camera picking that up, I hope not." Right, okay, good. And if you'd like to now take this into a circle, you're more than welcome to.

And it's really small. And again, that initiation comes from, if you can imagine a space right in between, a shared space in between all three of these dots, and that's where this initiation is starting from. The sacrum moves, the pelvis follows as does the lower spine, and you may even get some reflection of movement in the legs, that's your choice. You can keep the legs completely stationary, or you can let them reply to the movement in the pelvis. Awesome.

Okay, how does that feel? Ready to move on? All right, we're gonna move on to something called Pistons. This is from the Kathy Grant Heritage Training. I love these, I think you've seen these in many many places, and that is literally moving the femur.

So you're gonna lift your leg up, and just hold it there for a second. The lower leg is very relaxed and now we get that femoral movement in the hip joint itself. The femur should feel heavy and weighted. And I really want you to feel that femur dropping down into the hip socket. Now, from that place right there, where the femur meets the acetabulum is where I want this movement to generate from.

Let's have you lower down and lift up, three times, one. And it's just easy, don't think about it, two, and three. That leg comes down. We're gonna go to the other side, same thing. Just lift it up, tap it down.

And this is not, "I'm working my hip flexors," this is not abdominal, this is truly letting the bone of the femur swing in the joint itself. Very light, very easy, very lubricating, as my mentor, Doris Paxton Lee Hall would say, "they're a yummy." Yeah, awesome. Okay, legs up, feet are down. Let your right leg open out into a bent knee fallout, and then bring that leg back. Now, you guys watch those dots on these, and let's do right leg three times.

Everybody come together. Right leg, three times, open, one, close, two, close. I can get caught in the talking and forget to queue. Let's do left leg open, close, open, close, open, close, and hold. I love these because there's now a rotary component at play.

You're gonna open your right leg, you guys watch their dots. And we want them to see that the opposite dots up here on the sacrum does not roll with the leg, but that it stays stationary against the weight and the pull of that leg out to the side. Bring your leg back, open the other leg out and bring it back. Now, what if we did allow for motion in the pelvis. Open the right leg out and allow the pelvis to roll.

Now, listen to my queuing 'cause I'm throwing this out to you spontaneously. Bring the pelvis back, bring the sacrum back, which will bring the leg back. Excellent. Go to the other side and allow for the natural roll. Careful Rebecca, not to fall off the ball.

Now, bring the pelvis back, right? We even wanna think of bringing the lumbar spine back, the pelvis back, and then the leg follows. Two very different experiences. They both have value. Awesome.

Let's take this into a regular knee fold into toe taps. So you're gonna bring your leg up. Now, we get those shin more active, so Tiffany push up against me. And by getting this shin more active, what happens? We're getting a little more along the lines of the whole front of the leg, into the hip flexor, into the core more active.

Rebecca has to balance against this. Watch her dots, see that she stays balanced. Kristin has a little bit of support so that she's not taking this into her upper body, her neck and her shoulders. And Tiffany has now this roller also has a tiny bit of a balance component not so much in this position, but it has a nice massaging effect and it lifts the pelvis up off of the mat. A little higher than the ball does.

Everyone tap your toes three times and exhale to lift one, exhale to lift two, exhale to lift three. Great. Bring that down, let's do the other side. Now, hold on one second, bring the leg up. Ride the breath, you tap and (exhales) Ride your breath.

Let the leg feel light. Ready? Tap down, exhale, tap down and up, tap down and up. Great. Okay, now bring both legs up.

Now, we're adding challenge. Rebecca suddenly went like this, right? Kristin is saying, "I'm so happy I'm on this wedge." We'll start with these toe taps. We'll do three times each side. Again, ride your breath as you lift the leg, ready, tap and lift for three, one, two, three, switch sides, tap and lift one, two, three.

Let's alternate. Tap your right and alternate. Nice. And they did exactly what I wanted them to do because now you're gonna do reciprocal, as one comes up the other goes down, and this is a progression. One gets a little more challenging feet is off of the other.

Great, super. And bring the legs up. Right knee comes into your chest. I'd like you to hold that leg, take your left foot down, lengthen it out and take the stretch. And here I've seen the stretch done a thousand times and everybody is always focused on pointing through that bottom foot.

I don't want you to do that, I want you to take a moment and focus on the knee that is coming toward you. And if you can bring it as close to your midline and with every exhalation, can you bring the thigh, can you bring the thigh closer to the chest? The thorax. Can you release it as you inhale, exhale, pull that and release, and good. Now, I'm gonna ask you to switch your legs. I wanna change the intention, same stretch, and it's gonna be a slightly different intention.

So here what I want you to focus on, sorry, I'm making, I'm trying to be coy and sit on the arc and it's not gonna work. I want you to focus on the leg that's down. The heel is down, right? So you're not trying to lift that leg, you not trying to hold it up. And now don't think of the stretches coming through the toes, but imagine from the very top of the thigh, as you exhale, as you pull this leg in there's an elongation through the femur and that translates down to the lower leg.

Do you guys feel that? So it's a very different and lovely feel. Of course, we're looking at those dots that they're not spilling out into an extension, but instead they're really opening and lengthening through the front of the hip. Now, Tiffany has a lot of flexibility. Most of your clients actually will probably need to be here in order to truly feel the elongation coming through those hip flexors, the relationship between the pelvis and the top of the femur.

Great, super. Bend your knees, bring your knees into your chest and just rock a little left and right. And what we'll do now is have you put your feet down and can we get rid of the ball, get rid of the roller, Kristin just stay right where you are. Okay, and for Tiffany and Rebecca in particular, when they lower their pelvis down to the mat, there should be this feeling of ease across the back of the body. Okay.

Awesome. Now, as much as I adore the dots and I'd like you to keep the dots on, I know what will end up happening is the fly all over the place, can you take your dots off. While they're doing that a quick story. We do a POT in Chicago every year and one year I did a workshop, I dotted everybody up. I came back the next year and don't you know, in the bathroom, in a corner on the wall, I found a dot.

(laughs) All right, so we're gonna take this now and let's move into doing a little ab curl and into our roll up. So I'm gonna ask everybody to use a band. We're gonna use a band because it's a nice opportunity to put some different feedback into the body and into these roll-ups and these ab curls. Kristin is gonna hold a band between her hands. I'm keeping her on the wedge, again for clients for whom it may be tough to lie down or who may have issues with either their cervical spine or their shoulders, the wedge is a lovely option.

Rebecca, I really want her to open up her back body, so we're putting her in that wrap we had where she takes it around her neck, crosses the band behind her and she holds the band in her hands. And for Tiffany, we're gonna put the band around her feet. Now, I just wanna point out I have Tiffany's band wrapped around her feet. We put the band on the bottoms of the soles and then wrapped her through the center, and she comes out through the pinky side of her foot. Okay.

That wrap is a really lovely wrap. It's gonna help us get her a little bit connected into these AB doctors. If I want to get her connected to her center, I would reverse that wrap and have her come through the big toe line, okay. And we could do either. That was arbitrarily what we decided for today, okay.

So can I have everybody lie down, Kristin you're perfect where you are. Rebecca is gonna bend her knees. Tiffany is gonna keep her legs straight. Tiffany I'd like you to pull up on the bands so that you create this elastic connection between your feet, your arms and your torso. And that's gonna be part of what's gonna help her in this ab curl.

And it's also gonna start to train her to be nice and long through her legs into that band. For Rebecca, we're gonna keep her knees bent and she's gonna focus on bowing and widening across the back body. And for Kristin, we've got that band, she's pulling out. She's getting a little bit into the outside of her shoulders, the AB doctors of her shoulders to assist her in this curl. And just a simple ab Curl ladies, everybody exhale, curl.

And then back down. Exhale curl. What this feedback does is it puts more emphasis on sort of these external or these elastic components that are gonna connect us to different mild fascial chains. Good. And last one, and just hold it there.

Now, when I start to prep for the hundred, I like to do something called the cradle, but we start with the ab curl first and let's have you come on down and rest, curl up one more time, sorry, curl up one more time. Good. This cradle, there's a relationship between here, the legs, the core and the upper body, and it's a very nurturing cradle position, yeah, and then come on down. Great. Good.

Rest your arms, Tiffany. Rebecca, we're gonna keep you where you are. I wanna change Kristin a little bit And I'm gonna ask her to use a ring between her thighs. and the reason for that with Kristin, I wanna start to stimulate, remember she's got the scar here, and I wanna start to stimulate some real midline connection for her without overdoing the abdominals. The feedback into her hands, so you're gonna use this ring between your hands, into her hands, gently pressing to the midline.

The feedback of the AB doctors is gonna help her activate through the pelvic floor into her lower core without just having those abdominals always pushing on that scar. Kristin your mobility is gonna be really small here, okay. All right, so let's have you come back up into that cradle position, and let's start to work with the legs. One leg at a time. Kristin's gonna move very small and you're gonna lift your right leg up and then bring your right leg down.

Let's do three. Let's do three on the right side, two, yep, and one. Great. Rest and go back down. What I want you to pay attention to is what's happening to the pelvis.

I kind of wish we still had those dots there. Arms are gonna come up again. You're gonna curl up. You guys all look at your pubic bone. Imagine that is right there and keep that pubic bone still as you raise and lower the leg for three, two, yeah, and one, and then come on down.

Super. Can you see how this starts so maybe lead us into the hundred? Now, we're gonna do this one more time, and this time both legs. So arms come back to position. You curl up, you lift.

Good. Whole, now, Rebecca, if you want it to put your hands behind your head you could. Bend your knees for me, Tiffany. And now lifting the legs and lowering the legs. Good.

And then back down. Super. Okay. All right, we're gonna ask Kristin to get rid of the one in between her legs. She's gonna hold that mini ring now between her hands.

I really do like the mini ring because it helps to find and track to the midline a little bit better. Everybody's legs are straight out. Rebecca, I am gonna ask you to put your hands behind your head. Tiffany arms are gonna go straight up and just give me that little bow, that upper body ab curl. Hold it, good.

Now, look down through your pubic bone all the way through to your legs. Lift your right leg six inches off the mat. Good. Lower that down for three, two, one, lift the left leg for three, two, one. You're ready, legs lift both legs.

Come on three, two, one, and hold. Now, you're ready, you're gonna go into the a hundred. Not here, Tiffany, you're gonna hold your hands here, right? The theoretical hundred. On your exhale, pop those legs up, exhale and up and then down.

Now, exhale up and hold, hold, hold, hold, hold, Kristin you can pulse, you can pull, you can press, you can pump, whatever you wanna do and down. Okay, so we kind of just surprised them with that, how do you guys feel? (laughs) And that's kinda the way I like to do progressions, I don't like to say to everybody, "Hey guys, you're gonna do a hundred starting with the legs down," because it sucks them out, but here they just naturally and easily worked up into that progression. And you all did really, really, really, really well. And what was nice in my mind is I had an eye on those dots the whole time.

And I'm sure you also had a sense of the feedback of where those dots were in relationship to how to manage the pelvis against the load of lifting your legs. So that was an example of how to get into the a hundred with the legs down, starting with the ab curl into a little cradle and certainly starting actually with our fundamentals into the and curl, into the cradle, and then with the legs extended, really well done. With that, I'm going to turn, I'm not gonna pay any attention to you as you roll up, come up as you please and as you like, don't make it perfect don't worry about it. Awesome. We will do a little rolling down and rolling up.

I do prefer to start from the seated position. Gravity wise, it just puts you in a really nice place with gravity from which to roll in and out. Now, we're gonna keep Rebecca here with her strap behind her back. Rebecca, your job is to really feel your back body in that Stripe. If you want to bend your knees slightly, you're more than welcome to.

Kristin has the ring so she's gonna feel her midline, and we're gonna keep Tiffany with a band. And that band is gonna, you're almost like a circle inside of your elastic band if you can imagine that. So arms come up a little bit. Tiffany, I know that's a lot of work on the upper arms. And we'll have everybody slowly roll down with your breath.

And it could be a couple of rounds of breath, that's fine. And then take the arms overhead. And now the most important part of the roll up is ride your breath like a wave. So it's an exhalation and as you exhale, chin to your chest, rolling through that and come up and over. Yeah, great.

Now, you're gonna rise up your spine. You know our typical saying one vertebra at a time, and then let's start with the sacrum, initiate from your sacrum rock back, yeah. And keep rocking the sacrum back, which is gonna move the pelvis, which will move the lumbar spine, which will take you to your lowest rib, which will take you to the thorax, and then the arms come up overhead. Inhale and on the exhale, chin to your chest, you're gonna reverse, and you're gonna peel yourself up through your thorax, through your lumbar spine. Use the elasticity that you have, whatever that is to help you and manage you up.

And sit up tall. We're gonna do one more of these and I'm gonna come over here, I'm gonna stand with Rebecca. And I'm gonna ask Rebecca to press out against me. I know her strength and we wanna get into some of her lateral strength to help her through that little blip in her roll-up. And you're gonna start to roll down.

Rebecca, keep pressing into me. You guys remember you're moving you're tipping the sacrum back, that's gonna take the pelvis back, great. And then arms come up, inhale, fullness of your breath here. And with your hands always feel like you're pressing and reaching forward, reach forward, reach forward, reach forward, reach forward, and then sit up tall. And when you sit up tall, if you could imagine that sacrum again, you're nice and balanced on that sacrum which gets you really up and on top of your sit bones.

Well done. Now, you're gonna hold here and take it forward, if you will for me. Bend your knees and pull your thighs into your chest. And Tiffany, you're gonna hold that band really low if at all by your feet. Rebecca has her band around her shins.

Kristin's gonna get rid of her band all together. Now, here, breathe. We're always so anxious to get to the rolling part. I would like for you to breathe. I would like for you to feel your back body here as you breathe, all that space that you create and that relationship of your femur to your ribs.

And the other part I'd like you to consider you as an instructor, is what's happening in terms of the crease of the hip and the way the femur is sitting in the pelvis. And with each breath that femur should sink a little bit more. Does that make sense? It makes sense to you guys ? Great.

Now, let's have you lift your feet and find your balance point. Keep that same relationship with the femur to the thighs, the femur, I'm sorry, to the chest wall. Inhale, go back, inhale. Exhale, roll and balance if you can. And if you can't, don't worry put your feet down.

Inhale, roll, massaging the back of the body. Exhale balance. Make this about the breath. Inhale, roll, exhale, balance. Inhale, roll.

Ready? uh, that made it better. Last one and, (exhales) Straighten out your legs, fall forward sit up nice and tall. Now, let's do your final roll down, ready? Rolling down.

Good. Arms overhead, ride your breath, and roll up. Reaching forward, reaching forward, reaching forward, reaching forward, and sit up tall. Great. Now, let me ask you guys an honest question.

I know there's a camera in the room, but an honest question, did the rolling like a ball help your final roll up? Okay. So opening the back body is really key to opening up and making that roll up, especially with straight legs available to people. Really nicely done. And you have three different spines here who have three different likes or dislikes for the rolling series, and y'all did great.

So with that, we're gonna get rid of those bands for now. Kristin, you're gonna get rid of the wedge. You're gonna take a ball and lie sideways on the ball. I'm gonna ask Tiffany and Rebecca to come and grab a Pilates arch. And let's start with the step facing the ocean out here to my left and the gentle slope facing toward the right.

Great. Okay. We're gonna do some side body openings. Now, Kristin has some issues in terms of she had a fall and on top of everything else, Kristin, right? You had a fall.

She had a fall and we think there may have been a slight fracture of a rib. Certainly there's some issues with her rib and definitely a bone bruise. So I'm gonna ask Kristen actually to use the toggle ball for some of the side body work. And what's really nice is that the toggle ball is excellent, an excellent tool for your women who are actually newly out of their surgery, comfortable enough to lie on their side. This is a way to activate and access the side body and some of that elasticity of the side body.

For both Rebecca and Tiffany, we're gonna use the Pilates arch. The slope of the arch is really optimal for a lot of this work. You can see that they're sitting in the well here and that there's this gentle slope toward the floor. And that's gonna help us really open up the thoracic in a side bend in a lovely and easy way. If your client has issues lying on their side on the arch, because it is not padded, please put their mat on top or you can get there's a little mini mat, or quite frankly, you can cut a regular mat into quarters and use that on your arc.

So let's have you all side lie and let's just find your placement, yeah. Now, in terms of the head and the neck and the hands, Tiffany is supporting her head with her hand, you can do that. If your client has the flexibility in their neck and they can actually take that side bend all the way through the cervical spine, they can put their head down. Another nice option, and I'll do this with Tiffany here, is to put the ball, Tiffany, let's put the ball, here under your head, like a little pillow. Okay.

For Kristin, Kristin, let's see if we like where this ball is placed. Let's put it up a little bit higher. So it's really bottom rib to top rib or under the armpit, there. Super. Bottom knee is bent and that top leg can be out nice and long.

Let's take the top arm over and breathe. Okay. Now, first thing that I like to look at as an instructor is when they go over, am I just seeing the stretch concentrated in the shoulder? Am I seeing the stretch coming all the way from the hip, through the side ribs all the way up through the fingertips? Just notice.

Now, can I ask you to take that top arm reach it to the ceiling, and then bring it down. Let's just move the arm only. Down and overhead. Bring it back down and overhead, and down and overhead. Last one and overhead.

Super. Now, let's bring that arm down. Your bottom hand can work as a little bit of support for you and let's have you just come into a little bit of a side bend. So you're coming up into a little bit of a side bend. For Kristin, this is gonna be a little bit harder, she does not have, arm down, yeah, you don't have a lot of movement.

Keep this hand down and just come up, and then go down. Okay, so let's do that together. Everybody let's go down to start and come up to your range. Ready? Come up, hold and go back down.

Rebecca, you don't even have to come up that high. You don't have to leave the arch at all. This is really a stimulation of the side body, it's not intended to be a Kit-Kat, a kick something oblique exercise. Okay, good. Last one.

And now take it down after you've done that and go back into your stretch and see if you can get a little deeper into your stretch. One of the mistakes we make is that we stretch first and we forget that the dynamic movement itself will elicit a response. Great. And now let's have you rotate a little bit toward the arch or toward the floor, so the upper body, the left half of the thorax is rotating toward the floor. And then come back to starting position, inhale.

Tiffany, you can put your hand behind your head. You can use your bottom hand to support your neck if you'd like, and rotate and open. Good. And now rotate and take that naturally into extension if you can. So as you come back open, look up into a little extension and that's beautiful.

And then fold again. For me, I like to think one half of the rib cage is folding over the other. This is not just a rotation, but it's a softening. So now as you do the next one everyone's soften your sternum as you come forward, and let the softening of the sternum help ease you into that mobility. And I don't know if you just saw it but Tiffany just went another three inches as did Rebecca.

Beautiful. Super. Now, here, you can take this and add some leg movements. I really like this leg to be nice and long and reaching if you can on a diagonal slightly behind you, top arm is reaching, and we're gonna go into our rotational diagonal. Okay.

Ready, now, listen to me, you're gonna bend your elbow come back to sideline and pull your knee to your chest. Open out, pull in, open out, pull in, open out, in, I'm gonna go faster, out in, out in, out in, out in, two, one, now we'll take it into the stretch and breathe. Good. Beautiful. Super.

Slowly come on out of that. Again I'm not sure what's, what's visible on camera, but that last stretch, I felt like you guys were all significantly longer. Awesome. We will do that and repeat that on the other side so you can catch that and for you guys to practice it. But before we go to the other side, lemme ask you all to have an arch and we'll flip the orientation of the arch so that it's this way.

In our earlier workouts, we did some cat work and we made cat also quite dynamic. We're gonna do the same here. Fore arms on the arch. Now, this is a lovely opportunity to start getting weight bearing, right? A client who has had chest surgery, thoracic wall surgery, trauma to the chest wall, it will be a long time before they're comfortable completely weight-bearing.

This is a lovely way to start working. We did chair work on all fours and now we're down lower, but we're not quite to the ground just yet. Let's start with just a simple cat. Now, I have Tiffany putting one hand behind her back, and I want you to think about this motion. This motion might be simple to you and I but after breast cancer surgery, this motion is very challenging motion and very needed in life in order to reach behind you for anything, to grab something, to just start getting that mobility of the arm internally rotating and spiraling behind you.

So this is a lovely place to work on that, it also adds a little extra challenge to your cat because you've only got one arm single arm is weight-bearing. So let's have you round your back, everybody, and then lengthen out. Now, we have a theme here and it was that sacrum. And I would put dots on their backs, on their sacrum here. It's a nice place again for them to sort of feel and understand, but I won't do it right now.

But if you have dots in your studio, it's fabulous because it gives clients a very good proprioceptive feedback about where their sacrum is. And for you guys as you do this, I want you to imagine the initiation of the cat starts from that set little sacral clock that we did that little, yup. And that moves the pelvis, which moves the lumbar spine. And then as you lengthen out the sit bones, imagine, remember your green dot, your green dot lengthening away. And your extension is a reply of the movement of the sacrum and the pelvis.

I am not intimating that the sacrum itself is moving, I'm saying you're initiating, it's in little tiny micro movements that you're initiating the movement deep through that sacrum, does that make sense? Okay. Good. So we have our cat into our cow, and don't ask me which one is the cat or the cow 'cause I can make an argument for both of them, but we're gonna take it into a dynamic movement. Now, Tiffany, can you change your hand and put it behind your head?

And again, think of brushing your hair, right? This is an important skill especially for a client with breast cancer. It's also an important and interesting challenge for her to do this as a single arm cat. Everyone, starting with that sacral movement round your back, send your sit bones back to your heels, right? We got this nice shoulder range that's happening here, straighten out your spine and come forward forward, forward, forward, forward, forward, forward, forward into extension, round your back and curl back, lengthen out, come forward, forward, forward, breastbone comes forward up and around and I create this lovely circle and dynamic movement, right?

So Kathy Grant is so known for her cats. I don't know if this is exactly one of her cats, but it's very much like a lot of her dynamic and moving cats and cat is a great place for us to start getting this system integrated and moving. I don't know whether I wanna look at what's happening at the level of the pelvis or if for my breast cancer clients I wanna look at what's happening in the shoulder here and how the rib cage rounds and extends through the shoulder or the humorous support that it has. Good. Excellent.

End, sit back. Great. You can keep your hands on top of the arch and just rock a little side to side. And now here as, I'm stumbling because there's such a nice opportunity to look at three different bodies and how they process the Child's pose position. So look at Tiffany, Tiffany has the flexibility.

Look at Rebecca, well, this is where we know that we have issues with flexibility due to what's happening across the chest wall. So she's really playing with that Child's pose. And Kristin is thinking, "I'm not entirely sure how I'm gonna get comfortable in this position." (laughs) Awesome. Great. Now, we're gonna take you up out of this.

Good. And we're gonna turn your arch around again. This time you're gonna be side facing out to the water. And that should relieve your cramping Kristin, on your foot. Okay.

Now, due to short-term memory issues, I'm gonna try to do it exactly the way we did it on the other side. (laughs) But you know, menopause, anything could happen. So we'll start. I'd like you to make sure your necks are as comfortable as they can be in this position. And just drape yourself, in your case, Kristin, over the ball.

You guys, Tiffany and Rebecca over the arch, good. Simple arm movements. Let's just bring the arm down and overhead. This is also a nice, lovely place to work with spirals of the arm. Can you play with just internal and external rotation of your arm?

Whatever is natural and whatever timing works for you, whether that arm comes directly overhead, you'll notice Rebecca's coming slightly in front as she starts to internally and externally rotate that arm. This is a more comfortable range of motion for her. Good. Another really lovely thing and I know we didn't do this on the first side is to take the arm straight up to the ceiling and let's just internally and externally rotate that arm. Good.

Take that arm forward and as you are internally and externally rotating, just bring it toward the window. Good. Now, open it up, back to where you started pointing up to the ceiling. Good. Now, let your rib cage just go back a little bit toward the room and keep internally and externally rotating as you go into a little extension across your chest.

Good. And then come on back and then come on over. Good. Now, we're gonna go into those not full oblique exercises but integration into a lateral side bend. So Kristin, you can bring your front hand in front.

Good. Tiffany I think you're fine where you are, Rebecca, the same, you're gonna go over with your arms. Inhale, on the exhale as the arm comes down in front of you guys on the arch, you're just gonna side bend up. Kristin is gonna side bend up as much as she feels comfortable. What I love about this ball, stay there, guys, what I love about this ball, Kristin, is you can feel your ribs actually pressing into the ball to facilitate the side bend on this side.

Excellent. Now, come back down over, inhale and exhale and with the breath, inhale over and exhale up. Good. Two more, inhale, over, exhale, up , last one, inhale, over and exhale, up. Great.

Now, let's take this into our diagonals. So you're gonna take your arms over, you're gonna reach on a diagonal, folding one half in this case for you guys, it's the right half of your rib cage over the left. Not yet with the leg, just a forward fold. Tiffany can't see anybody. She's wondering, "what's happening." And you're gonna forward fold, beautiful, and breathe.

Now, come back to your side and now open into a little extension, open and look up into a little extension. Good. And then curl forward, as you curl forward, can you soften your sternum? Oh, beautiful. And then open up to the side.

So what do I mean by softening your sternum? Exhale, breathe, I'm gonna put my hand right on your sternum, Rebecca, and fold over my hand if you can, and I'm looking at the back body and this openness of the back body through the elbow. Lovely, Beautiful. Now, we are going to add this with the leg. So, let's have you come to your side.

Let's bring the knee and the elbow together, let's start there. And then let's send everything out and then pull everything in. Remember, I am really fond of this concept of close the body to open the body, close the body, to open the body. Yup, three, two, and one. Beautiful.

Now, take it into that diagonal stretch and see if you don't get a little farther. So, come down onto your arch, rotate and fold into that. Lovely. Super. Let's have you slowly start to come in to come out of that.

Okay, they're all looking at me, but lemme see your eyes, how are you feeling? Good. All right. All three of you, so Kristin, let's get the arc, let's turn your arc the other way around. Let's have you seated facing into the room.

Okay. Let's just start stimulating your hands and your fingers. Can you start with your feet? Yup, yup, yup, yup, yup, yup, yup, go, go, go, go, go, go, go, go, go, go, go, go, go, open your stance, open, bring them together, open out and bring them together. Stimulating hands and feet, right?

Remember neuropathy is something of an issue, yeah. Good. You can hop scotch, you can do diagonals, right? You can totally, you can totally play here and rest for a second. Okay.

I hope you noticed something. Did you see the smiles on all of their faces? They had no idea that was coming and it's really important to actually that you allow for some playfulness in your classes, especially, listen, in all classes, but especially if you are dealing with something as heavy as the word cancer, the more you can add playfulness, suppleness, lusciousness joyousness into your workouts, really the lighter the spirits are when they walk out your door. Okay? So, but that was actually purposeful, stimulation of the hands and the feet, right?

Remember chemotherapy, neuropathy, radiation can also cause neuropathy. There can be all sorts of nerve issues on the affected side, and all these are wonderful. So let's now just end with some integration of arm movements with spinal movements. So let's have you take your arms straight out in front, push your palms to the wall, open out, bring your hands together and then pull them in to your heart. Okay?

So I'm gonna stand here, arms out, push out, open, hands together and to your heart. Great. Now, I wanna add some bowing, just like you did, Tiffany, bring your hands to your heart. Add a little bowing of the upper body. Really let the head hang.

As the arms go out I want you to rise up your spine, as the arms open, add a little lift through the sternum. Good. And then bring the arms together and your breath, but I do like the exhale as you come into your heart and the inhale generally to open out. And again, notice we're keeping this initially at or below 90 degrees, which is available to most of your women who have had breast cancer surgery. But we can now take this and we can now take this on a Y, bringing this up into a Y.

Yeah. And then close and fold. I love the breathing and this orientation, right? If you think all the way from the belly button up through the arm lines in the breath. Good.

Kristin is starting to take up one arm up one arm down, and she's also turning her head toward the top arm. You can turn your head toward the top arm. You can look toward the bottom arm. All of these options are beautiful and wonderful. Great.

Super. Let's have you interlace your fingertips, turn your palms, bring your hands up over your head. And you're gonna create almost like this little halo around you, bend your elbow slightly. Super. Now here, let's bring your hands forward of your forehead and bow forward.

So hands forward of your forehead and bow, take your hands overhead and behind you and extend. And lemme get out of Tiffany's way so you can see your, keep your halo so don't straighten your arms. Keep your arms a little bent and bow. Sit up nice and tall and lift, right? So now we've got that arm connection.

You're gonna get this arm line directly through what would be the scar line, and then you're gonna come forward, curl. And then up, if they've had a mastectomy, this is really a lovely way to start to get into some of that scar tissue. And now we're gonna take this into circles. So you're gonna bow go to one side, come over and around. Good.

Let's go to the same side. You know our rule for this three times, one. Good. And notice how the rib cage replies to their movement. Notice how the head is responding in the pelvis.

Go the other direction, take this as big or as small as works for you. And I think I just heard by the way, some crack cracks. Super. Great. Now take one hand behind your head, the other hand is gonna be behind your sacrum.

Feel your head gently pressing back into your hand, and that elbow is in your peripheral vision. The hand that is on the sacrum, feel that hand gently pressing into the sacrum, and can you in opposition draw, if you can imagine that little, what it was it, the green dot pulling in and lifting up ever so slightly. Keep that posture as you take the arms up, take the arms up, take the arms up, take the arms up, and then you're gonna take them around, pin wheel them around and switch. Make sure you get that little gentle pressure, yeah, into the head and the sacrum before you send the arms out. Pinwheel them around and switch.

Good. Out, pinwheel wheel around and switch. Can you give me that out, pinwheel around and switch, out pinwheel around and switch, out pinwheel around and switch one more time out, pinwheel around and switch. Now, with nice ease of movement, big inhale, switch, big inhale and switch. Last one, big inhale and switch.

Super okay. Two and we're gonna do our collecting of energy. I like you to start, remember, I love the folding your body to open your body. So you're gonna fold and then you're gonna send your arms all the way out, up and around and collect your hands together. Pull that down through the center, fold yourself forward.

Open out, collect around, hands together, pull all that energy down through your center, fold yourself forward. Last one, ready? Bring your hands together, really feel that energy connecting, bring it down through the center. So there you have it. Here's our attempt at taking the Pilates fundamentals into some more of the Pilates.

Would you recognize in your Pilates mat environment from here from all of these positions, supine, side lying, all fours, and from here, actually, I probably would take them standing from all of these positions, you can start to infuse everything you already know and that you use with your clients every single day. I cannot thank my trio enough. These last three workouts have been very special for me. Thank you to Rebecca, to Kristen, and to Tiffany. Most importantly, thanks to you for being interested in this work and for starting your journey on working with clients with breast cancer at various levels or in various places of their breast cancer experience.

So thank you all.