At Elements we have a monthly two hour “continuing education” teacher meeting. This last meeting was particularly inspiring. We discussed how Gyrotonic exercise addresses Lumbar and Pelvic stability.
Recently more and more people have walked through Elements Center’s door with a diagnosis of “hypermobility syndrome.” Some symptoms included back pain, torn capsules in hips and/or shoulders, achiness and fatigue similar to fibromyalgia. Hypermobile joints can be due to three primary reasons 1) a disease such as Ehlers-Danlos syndrome 2) Ligament laxity with certain body types often seen in dancers and gymnasts, you may be familiar with the “Gumby” type person 3) or compensatory hypermobility due to hypomobility elsewhere in the musculoskeletal system, for example if someone has a fused joint in the spine due to arthritis or surgery often the joints above and below the fusion are hypermobile to make up for the loss of range in the fused joints. In general hypermobile people present with excessive or extreme range of movement.
Of course we discussed the Gyrotonic principle of “Narrowing the Pelvis.” “Narrowing” consists of and isometric contraction of the core stabilizers such as the transversus abdominis, pelvic floor and multifidi to elongate the spine while supporting the pelvis. However, this very important and effective maneuver can take quite a long time to perfect before introducing movement safely to the hypermobile crowd. In a non-injured healthy body narrowing occurs naturally before movement. After an injury or altered mechanics narrowing needs to be re-learned. For more information on narrowing, please read my previous blog on the Transversus abdominis.
Above is a baby standing with a nice round belly and then below he naturally narrows, drawing in his abdominal stabilizers flat, as he prepares to go up on his toes.
Discussed next was the Gyrotonic concept of “stability through contrast.” Another wonderful principle in which one reaches through the spine or limbs in opposite directions to create stability just like a tightrope is stable in the middle because the two ends are pulled tight. This too is an effective way of creating stability so that movement can still occur. However, creating the sensation of internal traction for hypermobile people without hyperextending the knee or overstretching a capsule can be difficult for the beginner student to differentiate. In the beginning Gyrotonic students learn “leg pumps” by sliding the heel into the resistance of the weight while sitting on the floor. When done well the force goes right through the center of the bones through the heel, no pressure goes into the ligaments in the back of the knee.
Lastly and what we spent the most time on was “wrapping the sacrum” which goes along with “burying the sacrum.” In physical therapy we teach creating stability in the sacroiliac joints through form closure and force closer of the sacrum. In form closure the bones of the sacrum fit into the bones of the ilium to create stability and in force closure the muscles, fascia and ligaments that connect to and over the ilium and sacrum create force on the sacrum into the pelvis. We all agreed many of the Gyrotonic exercises that involve wrapping the sacrum could be introduced to a beginner student or safely taught in a group class with a hypermobile student as long as the anterior labrum or psoas is not compromised/injured. The “wrapping muscles”, deep external rotator muscles, also help stabilize the lumbar spine in closed chain movements such as standing phase of walking. Several people with instability of the lumbar spine present with weak gluteal muscles as well as weak deep abdominal muscles, if the ligaments are physiologically over stretched and the muscles are weak there is very little support for the pelvis, SI joints and lumbar spine.
Combining the narrowing with the wrapping of the sacrum allows for the anterior sheath connecting to the pubic bone (via external oblique, internal oblique and Transverse abdominus), the posterior diagonal sheath (gluteus maximus and biceps femoris), and the longitudinal sheath (multifidus, deep layer of thoracolumbar fascia and long head of biceps femoris in to the sacrotuberous ligament) to all support the low back and pelvis.
Some of the final ideas we drew from our meeting were:
-Limit the range until the concepts of narrowing, stability through contrast and wrapping the sacrum are practiced.
-Teach arch and curl series on the handle unit much later for the hypermobile clients. It was debatable if the benefits of moving the fascia, viscera and muscles through the arch and curl series seated on the handle unit out weight the risk of increasing range in the spine is even warranted in this population. Begin with spinal motions on the stool maintaining a narrowed pelvis or even cat back series from Gyrokinesis until the student understands the range they can tolerate without loosing the strength to narrow and maintain an elongated spine through out the movement. Perhaps introduce arch and curl series facing the tower with resistance to help activate tone in the muscles or standing so the ligaments can stay elongated and the legs active to help maintain stability with movement, which is the ultimate goal.
– Use resistance to help create traction thorough hypermobile joints and strength through the muscles such as in traction series which consists of using heavier weights in a smaller range.
– Teach Psoas abdominals over simple curl ups to allow for less mobility and work to stabilize the spine against the pull of the psoas again if the hip labrum is not injured.
-Often at Elements we return to the homework series created by Paul Horvath for the scoliosis workshop. It requires stabilizing the pelvis with all of the above Gyrotonic stabilizing principles with emphasis on a slow three second exhale allowing the stabilizers including the diaphragm to coordinate and initiate prior to movement.
These ideas have worked in our practice but we only have antidotal evidence. I have heard many times that Gyrotonic exercise is too “stretchy” for my body, or Gyrotonic exercise doesn’t work for me I need more strength not more range. We at elements disagree, people with hypermobility are drawn to the Gyrotonic method because it feels good and works through out ones range. Hypermobile people can learn to stabilize with movement from an experienced instructor using the Gyrotonic method.
The staff’s conversation and practice went well beyond the 2 hours and continued via email. What we all agree on is that the body is an amazing creation with biodynamic, energetic and anatomical interrelationships that science has only begin to discover not to mention that 2 hours and a few emails just touch the surface of the benefits of the Gyrotonic method for people with hypermobility.
Lengthen, Strengthen, Move,