Pilates

for Kyphosis
A BASI Pilates program designed to help correct thoracic kyphosis



























Lucy Penrose
19/01/2014
Wimbledon UK, April 2013

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Abstract

Kyphosis refers to an exaggerated curve in the thoracic region of the spine. A kyphotic posture can

give someone a hunched over and round shouldered look, and is fairly common among adults who

spend the majority of their time sitting at desks. This paper gives details of a case study that

explores the effects of the BASI Pilates method on a kyphotic posture. It will conclude that with

regular Pilates sessions, the muscular imbalances that cause Kyphosis can be addressed, and the

posture improved.

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Table of contents

Title page 1

Abstract 2

Table of contents 3

Anatomy 4

Introduction 7

Case study 7

Conditioning programme 8

Conclusion 12

Bibliography 13

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Anatomy


The spine is made up of seven cervical vertebrae, twelve thoracic vertebrae, five lumbar

vertebrae, the sacrum, (consisting of five fused vertebrae), and the coccyx, (a triangular bone

consisting of three to five fused vertebrae).

A healthy spine has several distinct curves when viewed from the side. The lumbar and cervical

regions are concave to the back, while the sacrum and the thoracic region are concave to the

front.

1
Clippinger and Isacowitz, Pilates Anatomy (Human Kinetics, 2011), p. 11
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The term Kyphosis refers to an exaggerated curvature in the thoracic region of the spine.

The muscles that extend the spine can be divided into three groups: the erector spinae,

semispinalis and deep posterior group. In a kyphotic posture the muscles that extend the thoracic

region of the spine, in particular the semispinalis, are weak.

2
Clippinger and Isacowitz, p. 22
3
Clippinger and Isacowitz, p. 15
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The pectoral muscles that protract the shoulder girdle are shortened and tight,











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while the trapezius and rhomboid muscles that retract the shoulder girdle are lengthened and

weak.

4
Clippinger and Isacowitz, p. 38
5
Clippinger and Isacowitz, p.38
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Introduction


Thoracic Kyphosis is a fairly common problem in society today. Characterised by a hunched over

look, it is often accompanied by rounded shoulders and a forward head. The cause can be either

structural or postural. In most cases, Kyphosis is a postural deviation resulting from increasingly

sedentary and desk bound lifestyles. Many adults spend the majority of their day sitting hunched

forward for prolonged periods of time, causing the thoracic extensors to become weak and the

pectoral muscles to become tight and inflexible. This can lead to pain and tension in the upper

back and shoulder region. A Pilates conditioning programme can be used to teach correct

alignment and correct muscular imbalance, improving posture and alleviating painful symptoms.

Below is a case study carried out in order to look more closely at the effects of Pilates on postural

Kyphosis.

Case Study

Name: Anna

Age: 25

Sex: Female

Lifestyle: Anna is a writer and an illustrator and spends the majority of her working day hunched

forward at her desk. She has fairly high cardiovascular fitness as she cycles every day and plays

football twice a week. She has practiced Pilates infrequently for the past two years. She complains

of shoulder and neck pain and tension and has occasional massages to relieve symptoms.

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Limitations and goals:

- Anna has a kyphotic curve in her thoracic spine so she needs to be re taught correct

alignment. Her spinal extensors are weak and lengthened so she needs to work to

strengthen them.

- Conversely, her pectoral muscles of the chest are short and tight as are her intercostal

muscles, so she needs to stretch them and to increase thoracic flexibility.

- Her shoulders tend to round forward so she needs to strengthen her scapular stabilizers,

(mid and lower trapezius, rhomboids, and serratus anterior).

- Anna complains of tension in her upper back and shoulders so needs to lengthen and

stretch her overactive upper trapezius and levator scapulae.

- She has tight and overactive hip flexors so she needs to stretch them and strengthen her

abdominals.

- Stronger abdominals will also help bring her pelvis into neutral as she is slightly lordotic in

the lumbar region of her spine.

Conditioning program
Anna has an intermediate knowledge of Pilates but practices infrequently. She agreed to attend

two one hour sessions of Pilates a week for a period of five weeks. Below is the plan of her first

session. Although the main focus for Anna is correcting her Kyphosis and muscular imbalances, her

conditioning programme has been designed utilizing the BASI Block system. This means that the

concept of the whole will not be compromised and each session will provide Anna with a

balanced work out. In addition, Anna has agreed to carry the Pilates principals in to her everyday

life and will make an effort to take regular breaks from sitting, and attempt to sit up tall instead of

slouching at her desk.

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WARM UP

Mat
Roll down Chest lift
Pelvic curl Chest lift with rotation
Spine twist supine Leg lifts/leg changes

We start with the roll down to focus mind and body, to coordinate breath and movement, and for
Anna to particularly focus on correct alignment of her spine. Engaging lateral breathing will stretch
the intercostals and encourage thoracic mobility.

FOOTWORK

Reformer
Parallel Heels Calf raises
Parallel Toes Prances
V position toes Prehensile
Open V Heels Single leg heels
Open V Toes Single leg toes

Lying supine will support Annas spine and align head and neck. I will cue to maintain a neutral
pelvis throughout.

ABDOMINALS

Step Barrel
Reach
Overhead Stretch

While the muscle focus here is abdominals, these exercises have the added benefit for Anna of
shoulder and thoracic stretch.

Reformer
Round back
Flat back
Tilt
Twist

This series strengthens the abdominals and engages the back extensors while avoiding excessive
flexion.

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HIP WORK

Cadillac
Frog
Circles down
Circles up
Walking
Bicycles

This series will strengthen Annas adductors and hamstrings with a strong focus on pelvic stability.

SPINAL ARTICULATION

Reformer
Bottom lift
Bottom lift with extensions

These exercises will strengthen Annas abdominals and hamstrings and introduce spinal
articulation without excessive forward flexion.

STRETCHES

Reformer
Kneeling lunge

This will give Anna both the hip flexor and hamstring stretch that she needs. I will cue her to keep
her back extensors engaged when straightening her front leg and lowering her trunk.

The Pole
Shoulder stretch
Overhead stretch

These exercises will provide Anna with the shoulder and chest stretch that she needs, while
improving scapular stabilization with a particular focus on the trapezius.

FULL BODY INTEGRATION

Reformer
Up stretch 1
Down stretch

Up stretch 1 will encourage back extensor and abdominal strength, both so important for Anna. It
will also give her a hamstring and shoulder stretch, while allowing her to practice shoulder
stabilization. Down stretch necessitates contraction of back, hip and shoulder extensors
throughout.

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ARM WORK

Reformer
Extension
Adduction
Up Circles
Down Circles
Triceps

The arms supine series will enable Anna to strengthen and increase the mobility of the shoulders
with a supported spine.

LEG WORK

Wunda chair
Leg press standing

The muscle focus is hamstrings, encouraging a balance between Annas overactive quadriceps and
hamstrings. She will have to engage her back extensors and abdominals in order to stand up tall,
and stay balanced.

Reformer
Single leg skating

With a strong focus on pelvic lumbar stabilization, this exercise will strengthen the gluteus medius.

LATERAL FLEXION/ROTATION

Ladder barrel
Side overs

This exercise will engage Annas back extensors, and strengthen her abdominals with a heavy focus
on the obliques.

Reformer
Mermaid

The mermaid will develop Annas spinal mobility, elongation of the spine and scapular stabilization.

BACK EXTENSION

Step Barrel

Swan prep

Swan prep will enable Anna to focus entirely on learning to engage and use her back extensors.
Progressing to Swan when ready will develop abdominal and hip extensor strength too.

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Conclusion

After ten regular sessions Anna has already felt the benefits of the BASI Pilates method. She no

longer has to be cued as much for spinal and pelvic placement as she has become aware of correct

alignment. She has gained a little more flexibility across the chest and her shoulders are becoming

more mobile. Annas back extensors are getting stronger and she has become aware of using them

while sitting at her desk. She has gained and a little more flexibility in the thoracic region of her

spine. Through the use of the Pilates conditioning program based on the BASI block system, Anna

has started to address the muscular imbalances of her body. Her posture has improved, and she

feels less tension in her neck and shoulders. Anna is now fully committed to correcting her

posture, and plans to continue on her path towards a balanced body using the Pilates method.

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Bibliography

BASI Pilates. Study Guide & Movement Analysis Workbooks, (Body Arts and Science International,

2000-2013).

Calais-Germain, B. Anatomy of Movement, (Eastland Press, 2007).

Clippinger, B. & Isacowitz, R. Pilates Anatomy, (Human Kinetics, 2011).

Keane, S. Pilates for Core Strength, (Greenwich Editions, 2005).

Lawrence, D. Pilates Method, (A&C Black Publishers, 2008).

Peterson, J. Teaching Pilates for Postural faults, Illness and Injury, (Elsevier Ltd, 2009).

Pilates, J. Return to Life through Contrology, (J.J. Augustin, 1945).

http://www.pilatesinteractive.com/

http://www.physiotherapy-treatment.com/kyphosis-treatment.html

http://thepilateshundred.blogspot.co.uk/2011/04/posture-201-kyphosis.html

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