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5 Pilates Exercises to Improve Respiratory Function

/26 October 2023/ All MFN blog/

Pilates is a total body exercise method that is highly effective for strengthening and lengthening the entire body. While Pilates is mostly known to improve core strength (the “Powerhouse”), posture, and range of motion, this exercise method can be used to improve respiratory function in those suffering from respiratory diseases. Respiratory diseases include asthma, COPD, chronic bronchitis, emphysema, lung cancer, cystic fibrosis, pneumonia, and now COVID-19.  These diseases affect the way one breathes and lowers oxygen saturation that the body needs to function properly. One of the main principles in Pilates is breathing, thus the need to take a closer look at the effects of Pilates on respiratory function.

Benefits of Pilates Related to Respiratory Disease

  • Improves postural cavity to breathe properly.
  • Expands breathing capacity with diaphragmatic breathing.
  • Increases pulmonary ventilation which is needed for better respiratory function.
  • Improves lung volume.
  • Develops intercostal muscles (respiratory muscles) to better “squeeze” out impure air.
  • Improves exhaling all impure air out of the body while inhaling pure air.
  • Improves thoracoabdominal mobility.
  • Improves circulation to deliver oxygenated blood more efficiently.
  • Increased SpO2 (blood oxygen saturation).
    • >95% indicates healthy respiratory function.
    • <95% indicates taxed respiratory function.

The Pilates Breathing Method

Joseph Pilates, the creator of Contrology, stated in his book Return to Life Through Contrology: “Lazy breathing converts the lungs, literally and figuratively speaking, into a cemetery for the deposition of diseased, dying and dead germs as well as supplying an ideal haven for the multiplication of other harmful germs.”1

  • Lateral Breathing: The main goal for Pilates breathing is to breathe deeply expanding the ribcage without raising the abdominal muscles training them to jet out. Therefore, deep lateral breathing through the ribcage is the hub of the breathing technique. Proper breathing is inhaling through the nose and exhaling forcefully through the mouth. When one inhales, the ribcage expands out to the sides using the intercostal muscles, and then when exhaling the ribcage knits together like one is being sinched in a corset. According to Joseph Pilates, one should exhale forcefully getting all impure air out of the lungs like wringing out every drop of water out of a wet cloth.
  • Set Breathing Pattern: When performing the Pilates exercises, one should inhale to prep for the movement and exhale as one performs the movement.
  • Rhythmic Breathing Pattern: In some exercises, one breathes in rhythm to the exercise. This breathing consciously activates respiratory muscles to enable the lungs to expand and transport oxygen.

5 Effective Pilates Exercises to Improve Respiratory Function

The Hundred (Rhythmic Breathing)

  • Begin a tabletop position with the shoulder blades and head lifted off the mat looking forward.
  • Pump the arms up and down 100 times vigorously so the abdominals respond to and control the movement.
  • Inhale through the nose 5 times to the rhythm of the arms pumping, then exhale 5 times to the rhythm of the arms pumping.
  • Keep the lower back imprinted to the mat at all times.

Single Leg Stretch (Rhythmic Breathing)

  • In a supine position, lift the shoulder blades and head off the mat looking forward.
  • Bend the right knee towards the chest as the left leg extends straight out hovering over the mat.
  • Inhale through the nose as you switch the legs 2 times, then exhale as you switch the legs 2 times.
  • Inhale, inhale, exhale, exhale as you switch, switch, switch, switch.
  • Keep the lower back imprinted to the mat at all times.
  • Perform 8 sets.

Dying Bug (Set Breathing Pattern)

  • In a supine position, position the legs in table-top and arms extend straight up towards the ceiling.
  • Press the right hand firmly on the right thigh and press the right thigh to the right hand in opposition.
  • Inhale through the nose as you extend the left arm back overhead and the left leg extends straight out hovering over the mat.
  • Exhale through the mouth and draw the arm in and the leg back to tabletop. Repeat on same side and switch.
  • Keep the lower back imprinted to the mat at all times.
  • Perform 8 reps on each side.

Toe Taps (Set Breathing Pattern)

  • In a supine position, lift the legs into tabletop keeping the upper body and head down on the mat.
  • Anker the arms next to the body pulling the shoulders back and down on the mat.
  • Inhale through the nose as you lower both feet and legs together towards the mat. Keep the knees at 90º and the feet away from the glutes.
  • Exhale as you pull the legs back up to tabletop.
  • Keep the lower back imprinted to the mat at all times.
  • Perform 10 reps.

Thread the Needle (Set Breathing Pattern)

  • Start in a side kneeling position with the hips lifted off the mat and one forearm down on the mat with the other arm straight up to the ceiling.
  • Inhale through the nose as you lean the body back an inch to expand the ribcage.
  • Exhale through the mouth as you rotate forward and thread the arm under the armpit towards the back. Crunch the obliques and transverse abs.
  • Inhale through the nose as you un-rotate and return to the start position with the arm lifted towards the ceiling.
  • Perform 8 reps on each side.

Pilates, respiratory function and research

The literature is scarce and sometimes conflicting about the benefits of Pilates breathing related to the respiratory system. However, there are some existing studies that look at the increase in lung volumes, respiratory motion, SpO2, and the reduction in respiratory rate using Pilates breathing exercises. More research needs to be conducted. Refer to suggested reading at bottom of article.

Education for Fit Pros

Fitness Professionals & Personal Trainers: Become a Respiratory Disease Fitness Specialist!

Some of your clients may suffer from a respiratory disease and you may be an important source of relief. The Respiratory Disease Fitness Specialist online course will equip you with the knowledge to safely and effectively work with these clients to help improve their quality of life.

CarolAnn, M.S. Exercise Science and Health Promotion, is a 30+ year veteran in the fitness industry educating other health/fitness professionals to increase their expertise and brand influence.  She is on the MedFit Education Advisory Board and the head health/fitness educator for FiTOUR.  She is currently the Head Instructor at Club Pilates in Athens, GA.

Suggested Reading

  1. Cancelliero-Gaiad, K. M., Ike, D., Pantoni, C. B., Borghi-Silva, A., & Costa, D. (2014). Respiratory pattern of diaphragmatic breathing and pilates breathing in COPD subjects. Brazilian journal of physical therapy, 18(4), 291– https://doi.org/10.1590/bjpt-rbf.2014.0042
  2. de Jesus, L.T., Baltieri, L., de Oliveira, L.G., Angeli, L.R., Antonio, S.P., Pazzianotto-Fort, E.M. (2015) Effects of the Pilates method on lung function, thoracoabdominal mobility and respiratory muscle strength: non-randomized placebo-controlled clinical trial. Pesqui. vol.22 no.3. http://www.scielo.br/scielo.php?pid=S1809-29502015000300213&script=sci_arttext&tlng=en
  3. Hagag, A.A., Salem, E.Y. (2019) Pilates Exercises Improve Postural Stability, Ventilatory Functions and Functional Capacity in Patients with Chronic Obstructive Pulmonary Disease. IOSR Journal of Nursing and Health Science (IOSR-JNHS), vol. 8, Issue 4 Ser. VI., PP 86-91 http://iosrjournals.org/iosr-jnhs/papers/vol8-issue4/Series-6/M0804068691.pdf
  4. Baglan Yentur S, Saraç DC, Sarİ F, et al. (2020). Fri0613-hpr the effects of pilates training on respiratory muscle strenght in patients with ankylosing spondylitis. Annals of the Rheumatic Diseases;79:912. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2129

References

  1. Pilates, J., William, J. M., Gallagher, S., Kryzanowska, R. (2000). The Complete Writings of Joseph H. Pilates: Return to Life Through Contrology and Your Health. BainBridge Books, Philadelphia, PA. (Originally written 1945)
Gym woman pilates stretching sport in reformer bed

The Role of the Pilates Professional in Cancer Treatment and Rehabilitation

/10 October 2022/ All MFN blog/

I am a 15 year breast cancer survivor, and experienced what cancer patients go through, not just from theory, but from living it. I’m going to talk about the role that Pilates had in my rehab and why I consider essential for cancer patients and survivors.

After surgery and treatment, most cancer patients are left with lack of flexibility and range of motion, and poor posture because of the scar tissue. Most experience fatigue from chemo and radiation or just stress of the circumstances. Many go through hormonal treatment which reduces the muscle mass, increases the risk of osteoporosis and bone fracture, bone pain, fatigue, mood swings and lack of stamina and stress.

Breathing is an essential part of Pilates. It helps with stress and stamina, reduces fatigue, opens the lungs and helps with mood swings. When we are paying attention to our breathing, we clear thoughts and allow the oxygen and energy flow through our bodies.

Awareness is a principle that helps us increase the consciousness of our body and the parts that are in disharmony and need to be repaired, isolating them from other parts to progressively make them stronger and healthier. Mind –Body connection

Control is another principle helps coordinate the body parts and move them with the correct alignment, avoiding jerky movements used in general workouts (especially using the Core which we call the powerhouse) and increasing BALANCE that is so affected in cancer patients.

Flexibility and range of motion are key in the rehabilitation for mobility and functionality of the limbs or part of the body affected so we start testing the patient range of motion without any resistance at first.

Pilates machines have springs that allow switching among different resistance according to the patient’s condition avoiding injuries and pain,

Allowing the patient to get FLEXIBLE then STRONGER and then MANAGE THEIR OWN BODY improving posture, Functionality, mobility, self-image and self-confidence.

Exercise Samples

Graciela Perez is a National Academy of Sports Medicine (NASM) Personal Trainer, Aerobics and Fitness Association of America (AFAA) Aquatic Specialist, and a Cancer Exercise Training Institute Cancer Exercise Specialist. She’s been helping people reaching their health and fitness goals since 2003. 

pilates-breast-cancer

What is the Difference Between Pilates and Yoga breathing?

/17 March 2016/ All MFN blog, Conditions/

As an Occupational Therapist, many patients come to me who are in pain and are suffering from a variety of issues including breast cancer, repetitive stress injuries, musculoskeletal problems, and back pain. I use both Yoga and Pilates in my practice Integrated Mind and Body in Boston for relaxation, and to help prepare patients physically and psychologically for the treatments that I offer.

Aerobics Pilates personal trainer helping women group

Pilates for Breast Cancer Survivors

/8 February 2016/ All MFN blog, Conditions/

Pilates training can be an excellent way to achieve the postural re-education and muscle-balancing necessary to recover from the side effects of breast cancer treatment. Pilates can help alleviate pain from breast cancer operative procedures, restore joint mobility and tissue integrity, and help regain lost strength. Most importantly, Pilates can be a gateway for a true “Return to Life” for many women, as the title of Joseph Pilates’ popular book states. However, Pilates instructors should be on the lookout for some often coincident injuries that will require additional special knowledge about the shoulder complex in order to work safely and effectively with the growing population of breast cancer survivors.

pilates woman stability ball gym fitness yoga

Pilates Exercises for Healing: Shoulder Stretches and Bridging

/16 November 2014/ All MFN blog/

There are three phases of Pilates for breast cancer survivors. The goal of Phase 1, the Protective Phase, is to ensure tissue healing without sacrificing range of motion and flexibility of the chest and arm. In these exercises, only move your arms to shoulder height or 90° and during this phase try to use your affected arm normally to perform daily living tasks such as brushing your teeth, putting on deodorant on, or wiping up your kitchen table.

Below are two examples of Pilates exercises for breast cancer survivors that fall under the Protective Phase. Protective Phase exercises should have three to five repetitions each. This phase will last approximately 2 weeks, or until you feel comfortable progressing to more difficult exercises. The exercises should feel easier and there should be less and less discomfort as you progress.

Exercise 1: Scapula Protraction and Retraction

The scapula is another name for your shoulder blade. The purpose of this exercise (shown in the image below) is to warm up the shoulders in preparation for movement, as well as strengthen the scapular muscles, which are necessary for proper shoulder movement.

Contraindications: None

Equipment: Pad, small pillow, towel, or block under head if needed. Optional medium-sized ball (squeezing the ball between your knees will help to activate the pelvic floor and transverse abdominis muscles and prevent your knees from collapsing in).

Start:

  • Lie on your back with both knees bent and feet on the ground, hip distance apart.
  • Pelvis is level with the floor or slightly tilted toward your nose if you have back problems.
  • Arms and fingertips are reaching toward the ceiling only to shoulder height.
  • Optional: Squeeze ball between your knees.

Exercise:

  • Inhale, and reach fingers tips toward the ceiling (shoulder blades will lift off the mat). This is protraction.
  • Exhale, and bring your shoulder blades together (not too hard) as you imagine you are gently cracking a walnut between your shoulder blades. This is retraction.

Modification for an Added Challenge: Stretch a resistance band between your hands. If you are undergoing a breast implant expander program, TRAM, or DIEP flap reconstruction, do not use a resistance band until medically cleared.

Exercise 2: Bridging

The goal of bridging is to warm up the spine as well as your hamstrings and gluteal muscles. This exercise will help make it easier to put on your underwear and pants and reposition yourself in bed.

Contraindications: Check with your physician to make sure that this exercise is safe for you to do when recovering with drains in place.

Equipment: Pad, small pillow, towel, or block under head if needed. Optional medium-sized ball (squeezing the ball between your knees will help to activate the pelvic floor and transverse abdominis muscles and prevent your knees from collapsing in).

Start:

  • Lie on your back with both knees bent and feet on the ground, hip distance apart.
  • Pelvis is level with the floor or slightly tilted toward your nose if you have back problems.
  • Arms are long at your sides.
  • Optional: Squeeze ball between your knees.

Exercise:

  • Inhale to start, and then exhale as you tilt your pelvis toward your nose to imprint your spine.
  • Then push off through your heels, and lift your spine off the mat one vertebrae at a time. You will start moving the lower back, middle back, and then upper back off the mat.
  • Inhale as you hold this position at the point where you can remain still, without any movement of your pelvis. Both the upper part of your shoulder blades should remain on the mat.
  • Exhale as you return to the start position by gradually bringing the upper back, middle back, and lower back gently down to the mat, vertebrae by vertebrae to your neutral or imprinted pelvis. Think of rolling the spine slowly down to the floor.

NOTE: Be sure to… Keep both shoulder blades on the mat. Do not let the pelvis rock forward/back or side to side.

Modification for an Added Challenge: Hold a Magic Circle between your inner thighs for resistance as you lift your hips. Hold a Magic Circle between your palms with hands facing each other and fingertips toward the ceiling. Squeeze it when the hips are lifted.

Written by Naomi Aaronson and Ann Marie Turo. Reprinted with permission from Naomi Aaronson, MA, OTR/L, CHT; Also published on demosHEALTH; Images via demosHealth article.

Naomi Aaronson, MA, OTR/L, CHT can be reached at www.recovercisesforwellness.com.

Aerobic Pilates personal trainer instructor women

Pilates for Breast Cancer Survivors: Research and Findings

/11 November 2014/ All MFN blog/

Pilates was first developed by Joseph Pilates to strengthen muscles, increase flexibility, and improve overall health. In the 1950s, Pilates started using his method to rehabilitate dancers, including one of his first protégés, Eve Gentry. She was rehabilitated by Joseph Pilates after a radical mastectomy for breast cancer. After studying Pilates, she was able to regain full use of her arm and torso, a remarkable feat because all of her lymph nodes and chest muscles, as well as breast tissue, were removed with this procedure. Doctors could not believe the success that she had obtained with the Joseph Pilates method; he was a man ahead of the times.

Recent research and studies have helped supported Pilates’ work and demonstrate its benefits for recovering from breast cancer surgery.

Recent Research and Findings

Aerobics Pilates personal trainer helping women groupThe first study on the benefits of Pilates for breast cancer survivors was completed by physical therapists in 2008 [1]. It was a pilot study with only four participants, so the conclusions we can draw from this study are limited. However, they found that Pilates increased the flexibility of the affected arm after a twelve-week program, with participants exercising three times a week.

Another study done in 2010 [2] examined the effects of Pilates exercises on functional capacity, flexibility, fatigue, depression, and quality of life in female breast cancer patients. Pilates was performed three times a week for eight weeks. After participation in the Pilates exercises, improvements were noted in the participants’ levels of fatigue, flexibility, quality of life, and performance on a six minute walk test. This study helped demonstrate that Pilates was safe and effective for breast cancer survivors.

The most recent study published in 2012 [3] found that after twelve weeks of Pilates, thirteen participants improved their shoulder and neck flexibility. Improvements were noted in quality of life, body image, and mood. Although volume increased on the affected arm (a sign of lymphedema), one must note that this program did not modify the exercises for the class and that the sessions increased in frequency over the twelve-week period.

It is important to note that traditional Pilates mat exercises were used for the studies listed above, and minimal modifications were used which may have affected the results. However, all of these documented results help confirm that Pilates is a gentle but effective way to regain strength and recover from breast cancer.

Footnotes:
Keays, K, Harris, S, et al. “Effects of Pilates Exercises on Shoulder Range of Motion, Pain, Mood and Upper Extremity Function in Women Living with Breast Cancer: A Pilot Study.” Physical Therapy 88(4) (2008): 494–510.

Eyigor, S, Karapolat, H, et al. “Effects of Pilates Exercises on Functional Capacity, Flexibility, Fatigue, Depression and Quality of Life in Female Breast Cancer Patients: A Randomized Study.” European Journal of Physical Medicine 46(4) (2010): 481–87.

Stan, DL, Rausch, SM, et al. “Pilates for Breast Cancer Survivors: Impact on Physical Parameters and Quality of Life After Mastectomy.” Clinical Journal of Oncology Nursing 16(2) (2012): 131–41.

Written by Naomi Aaronson and Ann Marie Turo. Reprinted with permission from Naomi Aaronson, MA, OTR/L, CHT; Also published on demosHEALTH.

Naomi Aaronson, MA, OTR/L, CHT can be reached at www.recovercisesforwellness.com.