Pre-Pilates Exercises for Patients

Neutral Spine and Imprint
Using the breath, drop one vertebra at a time down towards the ground (as if into wet sand to form an impression). Begin at the base of the skull and travel down through the length of the spine through the tailbone. Think of dropping across the width of the shoulders, the base of the rib cage, and the pelvis/sacrum. This exercise establishes the "netural spine" from which the other exercises are based. 

Naval to Spine Breathing
Maintain the "neutral spine." Specifically, imprint the lower ribs and the tailbone. Prepare with an inhalation, exhaling, draw the abdominals towards the spine and back of the pelvis. Maintain the "braced" pelvis as you inhale before beginning again. This exercise engage the deep abdominals to stabilize the neutral spine position. 

Pelvic Clock
Imagine your pelvis as a clock with the numbers facing forward. Your navel is 12 o'clock, your pubic bone is 6 o'clock, your left hip bone is 3 o'clock, and your right hip bone is 9 o'clock. Using the idea of imprinting, exhale each number of the clock towards the ground. Be sure to connect the numbers together, like a plate rolling on the floor. Do now allow any other parts of the body to respond or tense up (particularly the quads, gluts, and spinal erectors). Reverse directions after 2 or 3 times. This exercise engages the deep abdominals to move the pelvis. 

Coccyx Curl
Beginning in neutral spine, prepare with an inhalation. Exhaling, hollow out the abdominals and drop 12 o'clock to the ground, thus allowing the tailbone to curl up towards the back of the knees. The pelvis is very scooped and hollowed in this exercise created a stretch in the lumbar spine. 

Bridge
Begin by lying flat on your back, knees bent, arms straight alongside the body and palms flat on the ground. Raise your tailbone, curling up one vertebra at a time. Reach the tailbone towards the back of the knees and reach the knees towards the toes. Maintain navel to spine support and keep the imprinting across the back of the shoulder blades. Do not allow the ribs to push forward, maintain a connection between the front of the ribs and frontal hip bones. 

Hamstring Stretch (Supta Padangusthasana) 
Lie with your back on the floor, legs extended. Insert one foot into a strap or belt. Extend both legs fully. Maintain the imprinted spine with navel to spine breathing. Keep a focus on a stabilized pelvis, drop the extended thigh bone down into the open hip socket. Draw the leg towards your chest maintaining the "dropped" feeling in the hip socket. 

Psoas (Bent Knee Raises)
Lying on your back, stabilize the pelvis by using navel to spine breathing. Maintain the "tripod" support of the imprinted lower ribs and tailbone. Take a few breaths. On the next exhalation, engage the Psoas and drag the knee towards the chest (keep it a small movement). Keep the full spine imprinted, use the pelvic clock image as needed to stabilize the pelvis completely. This exercise strengthens the Psoas muscle to ease lower back pain. 


Variation: Alternating knee raises - raise right knee, then left knee, lower right then left. Alternate. Maintain hollowed abs throughout. 

Neck Pull/Roll Up
Place interlocked hands behind head. Maintain neutral spine and exhale navel to spine. Stabilize the shoulder blades by drawing them down the sides of the rib cage. Curl up one vertebra at a time through the seven cervicals, keeping the weight of the head in the hands. Think of "dropping" each vertebra with the breath. This exercise establishes length and gives stretch to the neck.