Pilates Therapeutics: The Upper Core, Volume 1

I'm reviewing this workout after doing it once.

General workout breakdown: This approximately 75-min. Pilates DVD takes you through 25 Pilates and Pilates-derived exercises in an approximately 56.5-min. program designed to rehabilitate or prevent repetitive stress injuries in the upper body. Suzanne believes that core strength, flexibility, and proper posture as well as diaphragmatic breathing can help computer users and others whose jobs or lifestyles result in repetitive arm movements or positions.

After an overview of the program's purpose, the warm-up (just under 7 min.) begins standing, with spinal ripples, swings, side stretch / bend, and a partial roll down & up with hands clasped behind head; it finishes on the floor for rolling the legs side to side and forward bends over crossed legs. Breathing exercises (11.5 min.) begin lying sideways over a small arc, include feeling the ribcage while breathing, self-traction while holding one arm, slight rolling back and forth; the next segment is done seated and becomes a pattern of deep breathing with hands on ribcage and percussive breaths (similar to kapalabhati pranayama or breath of fire in yoga). The abdominal section (7 min.), done lying on the back, works up to levitating the head and arms off of the floor, working through the stages of alternating chest and abdomen breathing, arms overhead with ribs dimpling, hands levitating, pelvic area hollowing, and finally head lifting. To release you let the head rock side to side, then do nose circles. Upper Quadrant Exercises (6 min.), done on the back with knees bent, works through clasped hands reaching overhead & back down, arms alternately reaching overhead and down by side, angle arms pressing together when crossed over chest - pressing on floor when opened out, and making angel wings in the snow. Nerve Gliding (7.5 min.) begins seated with sweeps (dyamic forward bends w/ neck turned to one side and then the other) before switching to a crossed legged position w/ hands clasped behind back for more static forward bends w/ arms up & gentle rotation. You then lie supine for a combination of angel swings & taking off the imaginary shirt before finishing in a quadruped position (on hands & knees) w/ hands rotated in for big body rolls (I think she calls this shoulder gliding). Scapular Muscle Stability (8.5 min.), done prone, rests the forehead on one hand while the other arm moves deliberately overhead and by the side. Rib Mobilization (7 min.) is done in a seated position, with legs crossed and forearms or hands to the side, with rounding and arching the spine; you walk one arm out for stretch and repeat the spinal flexion and extension before lying on the side for a full stretch. Triangle Pose Push Up and Spinal Roll Up (just over 2.5 min.) finishes the practice. The triangle here is more of a downward-facing dog position, with hands rotating inwards; with the push-up the crown of the head lowers between the hands as the elbows go out to the side. After walking forward into a standing forward bend the session ends with a final roll up with the taking off the shirt move.

As Suzanne herself states, the pace is slow and controlled on purpose, with an emphasis on quality and focus over quantity and just doing it to do it. Exercises are only done a few times. Suzanne tries to do things evenly; while she allows you to spend extra time on one side if needed, she encourages you to try both sides as much as you can.

Level: I'd recommend this to exercisers with some previous experience with Pilates, other bodywork, and/or mind-body forms of fitness. This program is designed to be gentle and accessible, and all but the most absolute beginners and/or those in the most acute pain may find it useful. One can't really rate something like this as "beginner" or whatever because as a therapeutic program it's outside the realm of the normal Pilates progression.

I consider myself at the int. / adv. level of Pilates, comfortable with the all but the most advanced matwork exercises and somewhat limited in strength and/or flexibility in a few spots. I had no problems executing this program, but as explained below I have no upper body issues exept for the occasional tightness. As someone who is still relatively new to the world of therapeutic practices I found this useful and informative.

Class: Suzanne instructs live while Autumn demonstrates the exercises; Suzanne actually does many of them, too. Most of the time Suzanne mentions but does not show modifications, although once or twice she demonstrates an alternative version.

Music: bland instrumentals play during the title sequences, but there is no music during the workout.

Set: an unexciting dance studio, with a barre and images of dancers on the back wall and a floor that has seen many a dance shoe.

Production: clear picture and sound. The camera angles are helpful, with the close-ups actually useful in reinforcing Suzanne's points. This is not a big budget production, so don't expect any bells or whistles. The information and routine are the stars.

Equipment: Suzanne demonstrates the exercises with a mat, folding chair, block, and baby arc. Honestly, all you really need is access to something against which to lean for a few minutes (any chair, sofa, barre, table, countertop, windowsill, TV, or wall that allows you to form an approximately 90 degree angle when you bend over will do) and a few pillows, bolsters, blankets, and/or towels, plus a mat or equivalent if you need it. I used my Bosu in place of the arc, but it was a hair big, plus it was awkward lugging it out for just a few minutes of use.

Space Requirements: enough room to lie down with arms and legs extended and moving around.

DVD Notes: The main menu choices are Play Entire Program or Choose Individual Scenes (Overview, Introduction, The Upper Core, Upper Core Exercises, The Warm-up, Breathing, Abdominals, Upper Quadrant Exercises, Nerve Gliding, Scapular Muscle Stability, Rib Mobilization, Triangle Pose Push Up & Spinal Roll Up, and Closing).

Comments: As Suzanne mentions, if you have an injury or issue in your upper body it's best to clear this with your physical therapist or other medical advisor. She reminds you regularly to listen to your body and to modify, prop, or even skip if you have issues. Suzanne never mentions any specific conditions, although the cover refers to carpal tunnel syndrome as an example of repetitive stress injuries that could be treated and prevented by Suzanne's techniques.

If you're looking for a program that stresses proper shoulder and neck alignment in the usual Pilates matwork routines (a Pilates equivalent to Lauren Mones"Aligning the Upper Body), this is not it. (Perhaps that will be in the Vol. 2 Suzanne mentions?) If you're looking to feel the burn, get your sweat on, be motivated by an energetic instructor, or have a blast, this is not the workout for you. This is a gentle, therapeutic session designed to alleviate and prevent pain, injury, or chronic conditions.

Suzanne envisions you using this program in conjunction with proper walking (discussed briefly in the overview) and sleeping posture (demonstrated at the end of the workout) to live a pain-free life.

I don't have any chronic or serious upper body conditions (well, I have an elbow issue, but that's from a childhood broken bone), but I do spend more time than I should slumped over my computer and books. So right now I'm approaching this more from a preventative standpoint than using it as part of treatment. After doing this program for the first time my upper back felt more open, with kind of that warmth that comes from increased blood flow and freedom that comes from tension-free muscles, and several days later I still find myself more aware of my posture. I anticipate pulling this out during a recovery when I feel I need some extra attention in this area or if I ever have an issue in the upper back region (knock on wood this never happens…).

There are an increasing amount of good therapeutic programs out there, a number of which are on my shelf, so this may get lost in the shuffle, especially with its long running time. For something more athletic in nature, JB Berns"Freedom Restoration Series has two routines each for the shoulders and hands & elbows. Other more athletic rehab-based programs to consider are Debbie Sieber's Total Body Solution and Denise Beatty's Fitness Fix series.There are a number of good therapeutic yoga programs now available, too. Gary Kraftsow's Viniyoga Therapy for Upper Back, Neck and Shoulders immediately comes to mind, especially if you also have neck issues. [No one instructs how to release the neck like Ana Forrest, however; you can find her discussing this on Strength & Spirit and Power of Strength.] Gary has worked with the National Institute of Health on studies about yoga and back pain, so he brings a similar approach, fusing a mind-body connection and a focus on breath with western medicine and physical therapy. I highly recommend Jill Miller's material; she's designed her own brand of yoga and movement to create routines Tension Tune Down series, specifically Upper Back & Neck as well as Rotator Cuff; you'll see a few similar exercises, especially on the former, but Jill adds in a hard rubber ball to work into pressure points. Jill's Yoga Link: Shoulder Shape Up and other Yoga Tune Up materials would also make good complements, although they are not as gentle as Suzanne's or Gary's programs. Barbara Benagh's Yoga for Stress Relief's shoulder premixes and Desiree Rumbaugh's Yoga to the Rescue series may also prove useful.

I have not yet tried Classical Pilates Technique with Consideration of the Neck & Back, so I don't know how these two videos compare. My guess is that if you're disappointed to hear that Suzanne doesn't focus on the position of the upper back and neck in the usual Pilates moves you'd be happier with the Classical Pilates DVD. The Classical Pilates DVD might also be a good next step after Suzanne's: once you've rehabilitated your injury you could use the pre-Pilates routine and then progress through the others to get back up to speed with your normal Pilates routine or learn how to do Pilates.

There are several other titles in the Pilates Therapeutics series, and I'd be interested in seeing the Pelvic Core, a sort of bookend to this video, as well as any future variations on this theme that Suzanne films.