Pilates on the Line
By Christine Romani-Ruby, Scott Bruce, and Sarah Sander
Christine Romani-Ruby, MPT, ATC, is the Academic Clinical Coordinator of Education and an Assistant Professor at California University of Pennsylvania (CUP). She is also co-owner of PHI Pilates. Scott Bruce, MS, ATC, is the Head Athletic Trainer and an Assistant Professor at CUP. Sarah Sander, MS, ATC, PES, recently earned her master’s degree from CUP and now works for Susquehanna (Pa.) Health Systems Sports Medicine.
Training & Conditioning, 16.3, April 2006, http://www.momentummedia.comIn most athletic departments, having a great football team is a top priority. Athletic trainers and strength coaches usually spend more hours with these athletes than any others. Because of the physical demands of the game, a great deal of effort must be spent on the strength and conditioning program. And because of the high rates of injury, much time is spent on injury prevention, assessment, and rehab.
Here at California University of Pennsylvania, our 2004 football season ended on a sour note. We won only four games while losing seven, going 1-4 in the second half of the season while sustaining a lot of injuries. Our fourth-year football coach was doing a great job, but he was looking to do something more to make a winning team.
One of the things we noticed while rehabbing our players was that they tended to be deficient in core strength, which may have been a contributing factor in the injuries. In response, we suggested the introduction of a core strengthening Pilates program to see if it could reduce injury rates and increase performance. Several NFL players, including Ruben Brown of the Chicago Bears, Al Wallace of the Carolina Panthers, and many of the Oakland Raiders have adopted Pilates as part of their conditioning programs. We decided to see how it could help an NCAA Division II squad that was coming off a disappointing and injury-plagued year.
MIXING PILATES & FOOTBALL
Pilates is a method of exercise developed by Joseph and Clara Pilates in the early 1900s as a study of movement. It includes over 500 controlled movements that are multi-faceted and involve both the mind and body. An original student of Joe and Clara Pilates, Ron Fletcher states that his mentors stressed the importance of being more aware of and communicating with the body. Pilates has been a popular conditioning and rehabilitation method of dancers for a century, and its mystique is becoming attractive to competitive athletes with a desire to improve performance and prevent injury.
Because Pilates is based more on an Eastern philosophy than a Western way of thinking, its benefits to football players are difficult to list in the traditional manner. You can’t really label each Pilates exercise as one for flexibility or one for strengthening. Each movement is about synchronizing the entire body.
In addition, repetitions and load are not a measure of success. Exercises flow and build on one another with a focus on body alignment and control. Success is personal and the individual is compared only to their previous performance of the exercise.
Even though Pilates is very different than a traditional football strengthening program, we felt it could benefit our football players in unique ways. To start, we looked at injury trends in the sport. Among injuries that football players may suffer, hamstring and groin injuries are two of the most debilitating and problematic. Even the mildest strain can take players out of the game for weeks or even months. In addition, these injuries are recurrent in nature and tend to linger for long periods.
Pilates has the unique ability to create muscle balance about the pelvic-hip-lumbar complex. Traditional conditioning and rehabilitation programs often place the emphasis on one component of muscle balance at a time, such as hamstring flexibility or adductor strength. Pilates exercises are whole-body and functional in nature. They not only create flexibility, but increase strength and endurance in the opposing muscles at the same time. This allows the athlete to use their new range of motion immediately. This functional movement also encourages an active stretch very similar to the PNF stretching frequently used in conditioning.
Another area of concern in football athletes is the large number of lumbar and thoracic spine injuries. It is important for offensive and defensive linemen, especially, to have strong oblique muscles to withstand the force of impact. Traditional abdominal crunches can set the player up for injury by creating an imbalance of the abdominal musculature. During a traditional crunch, the internal oblique and rectus abdominus muscles become short and strong, while the external oblique elongates and the transverse abdominus contraction is inhibited by an overpowering rectus abdominus.
Engaging the external oblique with Pilates encourages a more balanced participation of the abdominal muscles for spinal stabilization. This starts with the most basic component of Pilates—breathing. To breathe Pilates style, athletes are directed to inhale by “expanding their ribcage laterally,” and on exhalation, “draw their navel to their spine and slide the ribs into the front pockets of the pants.” The Pilates method mimics a diaphragmatic breath, encouraging expansion of the rib cage on inhalation and contraction of the deep abdominal muscles on exhalation. Since exhalation is the only way to voluntarily contract the transverses abdominus, this is an efficient way to train the muscle to engage during certain activities.
Along with injury prevention, we felt Pilates could help increase agility in our athletes. Although Pilates exercises will not directly affect speed, they do place an emphasis on body control and posture, two important elements of agility. The proper posture and control attained through Pilates maximizes the athlete’s efficiency of movement by optimizing length tension relationships of opposing muscle groups. Emphasis on body control through core strength increases the stability of the spine, which also leads to more efficient and agile movements.
We brought the above ideas to the team’s strength and conditioning coach, who is also the offensive line coach. He agreed that the team lacked core strength and was interested in the program. Because we only had the resources to offer the workouts to 25-30 players, we decided to train just the offensive and defensive linemen, who seemed most in need of the benefits of Pilates.
We began the program during our off-season winter conditioning in January 2005. Athletes came in two or three mornings a week for one-hour workouts. The Pilates program was utilized as an adjunct to the regular weightroom and cardiovascular conditioning programs. During the summer, athletes were given a program to do on their own that included a significant amount of Pilates.
The first step was teaching the athletes how to do Pilates exercises. The correct form in Pilates is of utmost importance, so early on, we taught at a very slow pace. All of the exercises have levels, and we started at the lowest level and went to higher levels as the players showed progress. We also emphasized that the quality of the exercises is more important than the quantity of reps.
A few athletes in the first weeks had such poor core strength that they struggled mightily with some of the remedial exercises, but with time and coaching they were able to do them easily. Feedback from a talented instructor is crucial to gaining the benefits of the Pilates method, so two of us were continually giving the players pointers.
We also spent time teaching the Pilates breathing method. We started every class with a lesson on breathing and then incorporated it into each exercise using visual cues and proprioceptive techniques to help the players improve. One such technique is to instruct them to expand their ribs to the “east and west” (laterally) when inhaling through the nose and then exhale through the mouth. We also told them to make a “Ha” sound when exhaling—like a song note, and imagine their ribs sliding into the front pockets of their pants.
The actual program consisted of the following exercises. Athletes were given verbal feedback throughout the workout.
Standing Footwork: This exercise is used as a warmup. It strengthens the muscles of the legs and pelvis, increases hip flexibility, strengthens the core, and improves balance.
The athlete begins in the Pilates posture “V” stance. While maintaining the Pilates “V”, the athlete is instructed to rise up onto his toes as high as possible while still keeping his heels together. The athlete then lowers his back to the ground while maintaining a neutral spine during the entire movement. Maintaining proper Pilates posture, the athlete is instructed to perform a plié, bending at the hips and knees. A pole or wall can assist those athletes who need balance assistance, especially beginners. The exercise is repeated eight times.
Breathing instructions: Inhale when beginning the movement and exhale while performing the movement.
Progression: Combine these two movements and have the athlete do them in reverse order.
Hundred: This exercise is also used as a warmup. It strengthens abdominal muscles and increases spinal flexibility.
The athlete is instructed to lie on his back with arms at his sides and find a neutral pelvis position. The athlete then curls his head and shoulders off the floor to the point just before the neutral pelvis is lost. At the same time, he lifts his legs off the ground, tightening his abdominals. The arms are then to be moved up and down slowly, initiating movement from the shoulder joints.
Athletes complete 10 sets of 10 seconds, totaling 100 seconds.
Breathing instructions: The athlete inhales for a count of five and exhales for a count of five.
Progression: Lift the legs into a tabletop position (hips and knees bent to 90 degrees) prior to initiating the exercise. It can also be progressed by increasing the repetitions or combining it with other abdominal exercises.
Articulating Bridge: Another warmup exercise, the articulating bridge focuses on core strengthening and lumbar flexibility. It will increase spinal flexibility and strengthen abdominals, lower back muscles, gluteals, and hamstrings.
The athlete begins lying on the mat with feet flat on the floor and knees bent. Heels should be in line with the ischial tuberosities and arms relaxed at the sides of the body. The athlete is instructed to draw his navel to his spine and begin “peeling” the vertebrae from the floor one at a time, beginning with the tailbone. The movement will end when it reaches the shoulder blades. The athlete then returns to the starting position by returning one vertebra at a time to the floor. The exercise is repeated eight times.
Breathing instructions: The athlete inhales while preparing for the movement and exhales as he lifts his torso into the bridge position. He inhales again at the top of the position and exhales while lowering.
Progression: The athlete can extend one leg prior to starting to bridge, then continue the exercise as described above, maintaining a pelvis level with the leg extended throughout the movement.
Plank: This exercise focuses on core strengthening, stability, and lower-body flexibility. It increases stability and strength of the core, and increases flexibility in the hips.
The athlete starts by kneeling on the mat on all fours. Hands are aligned directly beneath the shoulders, and knees directly beneath the hips. While keeping the shoulders wide and flat, the athlete lifts into a push-up position by placing one leg at a time on the floor behind him. While maintaining body alignment, the athlete extends one leg at a time. Repeat eight times.
Reverse Plank: This exercise focuses on core and lower body strengthening and upper body flexibility and strengthening. It strengthens the abdominals, as well as the back and hip extensors.
The athlete begins by sitting on the mat with his arms behind him. Weight should be on the hands with fingers pointing at the heels. The athlete then lifts his torso and pelvis into a plank position. The athlete raises one leg at a time without losing proper body alignment. Athletes repeat five extensions with each leg three times.
Breathing instructions: The athlete inhales to prepare for the movement, exhales as he lifts the torso upward, inhales again at the top position, and exhales while lowering.
Rolling Like a Ball: This exercise focuses on core strengthening, stability, and spinal flexibility. It strengthens the abdominal muscles, improves balance, and increases spinal flexibility.
The athlete sits near the front of his mat with knees bent and feet flat on the mat. The athlete then grasps his legs behind each knee and brings his chin toward his chest. Shoulders should be down and elbows positioned up and away from the body. Keeping the same body position throughout the movement, the athlete rolls backwards to the shoulder blades. He then rolls back up and balances on the tailbone without letting his feet touch the floor. Repeat eight times.
Breathing instructions: The athlete inhales while rolling back and exhales when returning.
Progression: Grasp the ankles and pull into a tighter ball.
Side Plank: This exercise focuses on core and upper-body strengthening and stability. It strengthens the core, arm, and upper back muscles, increases strength specifically in the quadratus lumborum, gluteus medius, and rotator cuff, and increases shoulder stability.
The athlete sits on the side of his hip with the legs extended slightly in front. The athlete crosses the top leg over the bottom, resting on the ball of his foot. His hand is placed on the floor, aligned comfortably with the shoulder. The athlete then lifts his hips off of the floor and sweeps his top arm upward in one movement. The athlete then allows the body to rest on the lower hand and foot. Ribs should be directly above the pelvis and shoulders and hips square with the body. The athlete holds this position for a set, and then lowers to the floor while maintaining body alignment. This exercise is performed five times.
Breathing instructions: The athlete inhales as he prepares for the movement and exhales as he lifts into the plank position. He holds the position while inhaling and exhaling for three sets.
Progression: Place one foot on top of the other, requiring more balance. It can also be combined with other movements when an athlete progresses to this point.
It’s been a full year since we implemented the program and we are very pleased with the results. To gauge the Pilates’ effectiveness, we compared injury rates from 2004 to 2005 and tested players’ agility.
Our first positive results showed up right after the 2005 preseason football camp. During our 2004 preseason camp there were 79 injuries with 156 days lost because of these injuries. Of the 79 injuries, there were 28 muscle strains and five injuries to the lower back. During our 2005 preseason football camp there were 66 injuries of which there were 15 muscle strains and only two back injuries.
Additionally, only 86 days were lost to the injuries. Although this computes to only a 17 percent drop in injuries, there was a 46.5 percent decrease in the number of muscle strains and a 45 percent decrease in the number of days lost. Using the NCAA’s Injury Surveillance System formula, in 2004 we had 27.24 injuries per 1,000 athlete exposures, while in 2005 we saw an injury rate of 22.75 injuries per 1,000 athlete exposures.
To test the program’s effects on agility, we compared the offensive and defensive linemen who participated in the Pilates training against the position players who did not. The tests used were the Shark Skill Test (SST) and the Lower Extremity Functional Test (LEFT).
The players were first tested prior to the start of their Pilates training and again five weeks later. The times for the SST for the Pilates-trained linemen dropped from an average of 6.8 seconds to 5.9 seconds, while the non Pilates-trained position players’ times dropped from an average of 5.5 seconds to 4.9 seconds. The results of the LEFT showed a drop in time for the Pilates trained linemen from an average of 23.4 seconds to 21.1 seconds. The time for the non-Pilates trained position players dropped from an average of 19.8 seconds to 19.7 seconds.
The results showed in the team’s on-field performance. The football squad went 8-2 for the season, and 5-1 in the Western Division of the Pennsylvania State Athletic Conference, earning a share of the league title. It was Cal’s first football championship since 1984, and its best winning percentage since 1960. The squad also showed endurance, winning its final five contests.
Overall, we felt the Pilates program provided an additional platform to assist football players in preventing injuries and increasing agility. These exercises are time efficient and require no additional equipment. Pilates exercises are a very simple way for teams to gain the edge they desire.