When new clients come to my Pilates classes, I always ask about their goals. The most common ones tend to be to increase core strength and improve flexibility, with close runners up being to tone up, improve posture, reduce back pain, or improve the pelvic floor. Pilates can help with all of these things.
The surprise benefit - and that which is reported to me most often after people have been coming for a while - is how well you feel for doing Pilates. People leave with a sense of ease in the body, and have an enduring sense of wellbeing. The emotional benefits of setting aside an hour in a busy schedule are valued by Pilates devotees, and it becomes a priority in their lives. While there is no overtly spiritual dimension to Pilates, it involves mindful movement, like a physical meditation. A state of psychological flow is often reached, where you become fully immersed in a feeling of energized focus and enjoyment as you concentrate on the precise movements. Spending time in the zone can help you to progress more effectively in what you are learning, and also feel greater happiness and emotional wellbeing.
Distractions can prevent you from fully connecting your mind and body, so here are my tips for getting the most out the mind-body connection in Pilates:
Do you remember the Olympic Legacy first touted in Singapore, when London was awarded the games in 2005, and which continued to be promoted into 2012, when London hosted the Greatest Show on Earth? If you live in the UK, you could hardly have failed to notice the promise that hosting the Olympic games would leave a fitter, leaner nation more engaged in sports. As we approach the opening ceremony in Rio for this year's Olympic games, I thought it would be interesting to look into how much participation in sports has changed in the past recent years. Sadly, there's not much that will hit the headlines.
Data on sports participation for England have been collected throughout this time period by the Active People Survey. Since the survey started, the number of adults (age 16+) who participate in sport has remained fairly stagnant, hovering around about the 35 to 36 percent level. There were modest increases around the times when London was awarded the games, and around the games themselves, but nothing sustained. The most recent data (to 2016) revealed that fifty-seven percent of adults do not play sports. It's worth noting that non-competitive activities, such as aerobics and zumba, are included in the data, but other physical activities, such as walking, gardening and Pilates are not. A more general measure of physical activity has only been included in the survey since the 2012-2013 period. This showed an increase in people classed as active (≥ 150 minutes/ week of moderate or vigorous physical activity) from 54.9 percent in the survey ending in 2013, to 57 percent in the survey ending 2015.
Source: Active People Interactive. URL: http://activepeople.sportengland.org/ accessed 01/08/2016
It's hard to tell what would have happened in the absence of the games, and whether it as a minimum prevented a decline in sports participation that could have justified the nearly £9 billion cost of the games (somewhat offset by economic benefits), but at the least, I find the Olympic games to be an entertaining diversion, and am looking forward to seeing records broken, medals won and the inclusivity of the paralympics in the coming month.
Today is my fortieth birthday, and my thoughts have been very much preoccupied with this milestone. I am pretty positive about it - it's a privilege denied to too many. It was also a great excuse for a party! However, I'm aware that in fitness circles, this puts me in the category of 'older adult', and according to 70 percent of Brits, I'm apparently no longer fit to wear a bikini. Fortunately, I belong to the remaining 30 percent, so won't let that stop me!
But what does being an older adult mean in terms of exercise? Not all that much, actually, if you're fit and well. There are no contraindications to exercise at any age - it's medical conditions and injuries that define what you should and shouldn't do, and if anything, exercise becomes increasingly important as we age. However, as I enter my prime I am aware that there are certain things I (and all of us) can be doing to help stave off conditions associated with ageing. The biggest skeletal changes which start to become noticeable after forty are loss of muscle mass and bone density:
Muscle mass declines by 3-5% per decade after 30 years of age in physically inactive people. This can lead to weakness, loss of stamina, and difficulties with weight management. The good news is that weight bearing exercise can help to maintain and even increase muscle mass at any age. A sufficient intake of protein - in conjunction with strength training - is needed to sustain muscle mass. However, don't go overboard, as you use calcium to help digest protein, so too much may increase osteoporosis risk (see below).
From your mid-thirties onwards, bone density drop can drop by about one-percent per year, potentially leading to osteopenia or osteoporosis. In the early years following the menopause there can be a rapid decline of 20 percent, with an associated risk of bone fractures. Strength training and impact exercises will help to minimise the loss of bone density, as will ensuring an adequate supply of calcium and vitamin-D. Daily short bursts of sunshine in the summer - not enough to burn - will provide all the vitamin D you need in the spring and summer. Public Health England also recommends taking a daily 10 microgram vitamin-D supplement in the autumn and winter. Calcium can come not just from milk - other great sources include leafy greens and baked beans. Also, there is emerging evidence that Vitamin K is necessary for bone health - present in meat, eggs, dairy and natto (fermented soy).
With a good lifestyle, age shouldn't hold you back at all. Some of my oldest clients are also some of my most capable. I'm reaching half the age of body builder Ernestine Shepherd (pictured - unfortunately not one my clients), so I reckon I'm just getting started.
My Dad ran his first marathon when I was a small child. His training took him away from home so much, that my Mum threatened to leave him if he ever ran another. He went on to run another five marathons. One or other of them never took the hint, and they are still married. During his last marathon, my Dad injured his hip, around 18 miles in. Given that he was 'nearly there', he carried on, in agony for the final eight miles. That's right, he ran EIGHT MILES in agony. Fortunately, he recovered fully and didn't suffer a recurring injury as a result. As a child, I didn't see the grief; I saw the heroism of his running and thought that running a marathon was the ultimate proof of being superfit and determined. From a personal challenge point of view, I think all runners dream of the marathon, but in terms of fitness, the 5k race is a superb distance to run. Not only is it a metric distance - what era are we in, the 1950s? - it is also offers benefits for your health, wealth and sanity.
Here are my five favourite reasons for loving 5k:
Dedication and superhuman fitness are seen in the 5 km race too. Mo Farah set a British 5,000 m record of just 12:53:11. Mind you, even Mo had to give a marathon a try, so perhaps the call of the marathon is just too strong to resist.
If this is the answer, what is the question: 100 billion. Any guesses? One answer is the number of stars in the Milky Way. It is also the number of neurons (brain cells) belonging to your average adult human. The brain typically shrinks with increasing age, at least in part due to death of neurons, leading to a decline in our mental abilities. However, we now know that new neurons, as well as new connections between them, can be generated throughout life. Exercise seems to slow or reverse the brain’s physical decay, much as it can with muscles. However, while exercise promotes the production of new neurons, learning a new skill helps to join them to the existing network of cells in the brain, without which the new brain cells would not survive.
Dancing combines the benefits of exercise with those of learning a new skill - dancers are constantly learning. This may be why a major study of the susceptibility of senior citizens to Alzheimer's disease found that dancing was the best method of reducing dementia risk. While a reduced risk of Alzheimer's disease was associated mental tasks such as reading (35%) and doing crossword puzzles (47%), frequent dancing was found to reduce the risk by a whopping 76 per cent. Other physical activities included in the study, such as cycling, swimming and golf were not found to have any beneficial effect on Alzheimer's risk. Dancing has also been found to be beneficial for people living with Parkinson's disease.
Psychologist Jean Piaget defined intelligence as "what you use when you don't know what to do". What better way to keep your mental acuity in top form by challenging yourself with new skills? In a dance environment, you are using several brain functions at once - kinesthetic, rational, musical, and emotional. You have to make rapid decisions about which way to turn, what speed to go, and which limbs to move. In a class environment, you are continually learning new and changing choreography. You are forced to use - and build - your intelligence as your teacher gives you new challenges. In partner-based dance you are constantly adapting to your partner's movements - you don't know what to do, you use your intelligence to respond accordingly.
While moving at a slower pace, and less involved in rapid decision making, Pilates also involves continual learning of new movements and choreography, combined with the benefits of mindfulness and correct breathing, which help to ease stress and calm the mind.
Not that this is ultimately why you should dance. I would love you to dance for joy. The more the better - so dance, dance like noone is watching!
A challenge in any group exercise class is to pitch the exercises at the right level. Even in settings where I have divided the classes according to level, within each class there will be a range of abilities. I always offer different options, and I see my job as providing you with a challenge to make progress. Equally, each person needs to be honest with themselves about their own capabilities. It is unlikely that there will be one person who is 'the best at everything' and I encourage you to focus on your own journey rather than competing with the others.
How hard you work is strongly dependent on your personality and motivation. Some people are happy to tick over maintaining their current level of fitness, whereas others love 'feeling the burn' and will push themselves as hard as they can. So, how hard should you work?
One of my favourite sayings in this world of fad exercises is, "The best form of exercise is the one that you actually do." There is little point in exercising harder than you can maintain long term. For cardiovascular effort, there is a scale of perceived exertion (Borg Scale) which runs from 6 (no effort, eg. watching TV) to 20 (maximum exertion that you can only maintain for a short period, eg. sprinting to finish a race) and applies to adults under 65 years of age:
For muscular effort, you will get the quickest results by working to muscle failure. In doing so you risk suffering from sore muscles the next day - and stretching before or after your workout won't prevent it. It is important to recognise when your muscles have reached failure. Beyond this point, it is only possible to continue by executing the exercise with poor technique - using other muscles, poor alignment or momentum to do the work. This is where problem start, and the risk of injury increases.
Joseph Pilates is quoted as saying, "A few well-designed movements, properly performed in a balanced sequence, are worth hours of doing sloppy calisthenics or forced contortion." In Pilates, I don't encourage you to work to muscle failure. An important part of Pilates is practising healthy movement patterns, so that they become instinctive. If you reach muscle failure, your technique is likely to be starting to suffer, and you will start to reinforce poor alignment.
Should you feel pain during exercise? It depends what you mean by pain. You should feel that your muscles are hot and working hard and this may reach the point of feeling painful, even. This is not a problem, and can be part of a good workout, as long as it doesn't spoil your enjoyment of the activity as a whole. Your muscles will strengthen and it will be more comfortable next time. Any pain in the joints, however, is an indication that you should stop and rest, and choose an easier version next time. If your joints get aggravated and inflamed it will serve no purpose in strengthening you, and will make your next workout feel harder, rather than easier. And here is where you risk long term injury. If your muscles hurt so much that you can no longer continue with good technique, then this is also an indication that you should stop, or choose an easier option that you can continue safely with.
If you arrive in class with an injury or pain, let your instructor know - it may be wise to avoid even starting some exercises. Always let your instructor know if an exercise is causing you to feel pain and remember to keep each exercise within your own safe working level.
I love my sleep. Throughout my life I have instinctively held it to be the cure-all for everything - colds, headache, heartbreak. You name it, I'll try to sleep it off. Sleep has been in the news this week, with a global study of sleeping habits revealing that the 'winners' in the Netherlands sleep on average nearly an hour longer each night than in sleep-deprived Singapore and Japan. In the UK, we average just under eight hours, which is somewhere between the two. The conclusion was that we are experiencing a 'global sleep crisis', and we have recently been warned that ignoring the need to sleep is supremely arrogant. Poor sleep patterns have been linked to cancer, heart disease, type-2 diabetes, infections and obesity.
An interesting finding that was new to me was that waking time has little effect on sleep duration, but time going to bed plays a big role. So, if you want to improve your sleep duration, don't have a lie in, get yourself to bed earlier! If you're not tired in the early night time, then consider the following:
Thanks to recent publicity, courtesy of the delightful Angela Rippon and Dr. Chris Van Tulleken, the sit to rise test has caused quite a stir in my classes. The idea behind the test is to use how easily you can sit on the floor and return to a standing position as a predictor of mortality risk.
The scoring is based on five points for sitting and five for rising. Sitting without using the aid of support (such as a hand or knee), and without losing balance scores five points, and five points is scored for returning to standing without needing support. One point is lost for each point of support used, and 0.5 points are deducted for a loss of balance. The sitting and rising scores are added together to give a score out of ten (the “SRT score”). Crossing legs is permitted, but it isn’t required. The test can be repeated and an assessor can give advice on how to improve the score. The final score is independent of the number of attempts and the best sitting score is combined with the best rising score to give a score out of ten.
As a theory, it’s easy to see how this could measure the characteristics associated with good health. To score a perfect ten requires a combination of power, balance, flexibility, coordination and leg and core strength. Excessive obesity would also make this a harder task. But what does the science say?
The test was originally proposed in the late 1990s as an evaluation method in sports and exercise medicine (Araújo, 1999). More recently, a study to assess its effectiveness as a predictor of mortality was conducted, using over 2000 volunteers aged between 51 and 80 years (Brito et al., 2012). The subjects were followed up later, by which time there had been 159 deaths in the group. The results showed that lower SRT scores were strongly associated with higher mortality1. Each increase of one point in the SRT score was associated with a 21 percent improvement in survival. The findings held even when controlling for gender, age and body mass index (BMI). Those with a score of one had a 5-6 times higher risk of death than those with a score of eight to ten. This difference suggests that the sitting score is good predictor of all-cause mortality.
There are some limitations to the research, which the authors note. These include the possibility that some subjects had sub-clinical injuries or degenerative injuries that affected their score. They also did not control for physical activity patterns, which would likely have influenced the score, but not necessarily in a way that invalidates the conclusions. Excluded from the study were those a) regularly competing in sports events; (b) presenting any relevant musculoskeletal limitations that could affect SRT; and (c) refusing to perform the SRT. This would naturally exclude the high performing outliers and also those who were too nervous to try the test - perhaps they are at high risk of falls, or have osteoporosis? The ‘musculoskeletal limitations’ were not specified, but I would hazard a guess that it would include problematic knees and hips, including replacements. Indeed, I would not recommend that this test is done by people with joint problems or osteoporosis, or if you have any concerns about falling, except under the advice and supervision of a suitably qualified professional.
The sample was mainly of Caucasian individuals of high socio-economic status in Brazil, so it is unclear how applicable the study is globally. I note that in many countries, the flat footed squat is a common resting position - so I would be interested to see the test repeated across continents. Additionally, the subjects were aged between 51 and 80 years old at the start of the study. It doesn’t necessarily follow that the test will give the same results for people outside this age range. The follow up time was on average (median) 6.3 years later, but with a range of 0.1-13.9 years! It was not explained why this range was so high, but is presumably a consequence of administering a large study of volunteers.
The authors noted:
“We considered participants who achieved [SRT scores of 8–10] to have preserved functional independence regardless of age. The ability to achieve a high SRT score could reflect the capacity to successfully perform a wide range of activities of daily living, such as bending over to pick up a newspaper or a pair of glasses lying under the bed or table. Moreover, a high SRT score likely indicates a reduced risk of falls. It is also noteworthy that during the application of SRT in our centre over a 14-year period, there have been no adverse events, reflecting a high level of safety associated with this simple assessment tool.”
If you can do the sit to rise test with a score of eight to ten, then this is a positive indicator for your wellbeing. If you struggle to get up and down, then work on your general fitness and revisit the test later. There are some minor issues with the methodology of the test, but nothing that makes it invalid for the general older population.
Watch me demonstrating high and low scores for the test below.
1 P<0.001 Mathematicians refer to this as ‘highly statistically significant’, which means that the probability that the results are a fluke are less than one in one thousand.
Araújo, C. G. S. (1999). Teste de sentar-levantar: apresentação de um procedimento para avaliação em Medicina do Exercício e do Esporte. Revista Brasileira De Medicina Do Esporte 5(5), 179-182. URL: http://www.clinimex.com.br/artigoscientificos/rbme_set-out99_teste%20sentar-levantar_procedimento%20para%20avalia%C3%A7%C3%A3o%20em%20med%20exerc%C3%ADcio.pdf
Brito, L.B.B., Ricardo, D.R., de Araújo, D.S.M.S., Ramos, P.S., Myers, J. and de Araújo, C.G.S., 2012. Ability to sit and rise from the floor as a predictor of all-cause mortality. European journal of preventive cardiology 21(7):892-898. URL: http://geriatrictoolkit.missouri.edu/srff/deBrito-Floor-Rise-Mortality-2012..pdf
Advocating a balanced diet can seem old hat. An idea for a "new" diet plan is to eat what you like, but cook it yourself. More honestly, this is a very old diet. It'll never make much money, so there isn't much scope for sponsorship or celebrity endorsement, but it has a lot of merit.
Endless debates rage in fitness industry about carbs, fats, dairy, grains etc. But what happens when you stop eating an arbitrary food group, say foods containing the letter 'P'? The first thing is that whole swathes of food are off the menu. You have to cook more homemade food, and turn down unexpected treats offered to you. Your health improves, your weight is easier to manage. Word gets around, so more people try it, and find that they too, are better off without those pesky Ps. Then the food industry catches on to the trend and spots the gap in the market. P-less people are so much healthier, right? Suddenly 'letter P' alternatives are produced P-less snacks, drinks and ready meals are available. Now P-free converts enjoy the freedom to eat out at restaurants, and the shop in all aisles of the supermarket again, and their generous colleagues thoughtfully cook P-free cakes, so they don't miss out when it's birthday time. Hurray! But then, P-free people start eating a diet virtually indistinguishable from their full alphabet friends, save the possibility that they are lacking a few nutrients that they would otherwise have got from pork, peas and potatoes. They have come full circle, and are eating junk food again. The letter P never was the problem. Instead, it was the easy access to and reliance on cheap, bountiful, ready-made foods.
Michael Pollan illustrates it succinctly in the video below. Homemade foods will almost certainly be healthier for you, and those that aren't are too much hassle to cook regularly. Nobody is seriously suggesting that you start milling your own flour, but there is some wisdom in the idea that time spent preparing food means that you will approach eating less mindlessly - or more mindfully, if you like - but that's a topic for another day.
Like a bit of glamour? Clean freak? This is a simple method to make a cover for a 2 cm thick pilates head cushion. The final dimensions are 24x34 cm, so there is a generous seam and hem allowance, but it doesn't need to be precise. I'm a bit gung-ho when it comes to sewing, so I apologise to anyone who sews meticulously! Also, my beloved vintage sewing machine has broken - this is sewn on my young daughter's machine, which handles the light material used surprisingly well!
It would make a nice hand-made gift for the Pilates-lover in your life.
Fitness and Pilates instructor with a passion for science.