2024 Stretch to Win Case Study
My fitness and bodywork career started 14 years ago at a Sports Chiro clinic in Houston that specialized in sports injuries.
Every client who came to see me for Pilates or FST was either actively injured, recovering from an injury, or trying to prevent another injury. In addition to being in physical pain, these folks were frequently also in emotional pain and mental despair. Their pain and injuries took vibrant, healthy people and turned them into people who were desperate, angry, frustrated, and depressed.
My first truly deep understanding of just how injuries impacted our mental and emotional health came when I received an email from one of my client’s wives. This client had been an absolute bear to work with. He was an endurance cyclist who had herniated multiple disks. He was extremely cranky, short with his answers and shot daggers across the room with his glares. The first three sessions were typically grunts, as he barely spoke to me during our hour together. With each passing week, as his symptoms resolved, he became a little less cranky. He talked a little bit more. He started smiling, then laughing and it turned out he was an excellent conversationalist. I started looking forward to our sessions. When his prescribed number of Pilates and FST sessions were completed, he gave me a hug, thanked me, and walked out the door.
A week later, the email from his wife arrived. In one of the most heartfelt thank yous I have ever received, she explained that the injury had completely changed her husband’s personality. The incredibly happy go lucky man she’d married had turned into an asshole. He was always angry, always in pain. Their marriage was on the rocks, they’d been seriously considering divorce and had already met with a lawyer. When he started Pilates and FST, he was a little less grumpy at the end of the day. A little bit sweeter, a little bit more like himself. She’d waited, watching week by week as his symptoms unraveled the stranglehold they’d had on his mental and emotional health. As his symptoms resolved, his personality returned. They were able to work on their marriage and started to resolve the issues his behavior had created. Her email was a sincere thankyou for saving their marriage.
With that email, I knew I’d found my life’s calling; helping injured athletes heal their bodies by also supporting their mental and emotional health.
When Mr. Hill walked into my studio two years ago, he reminded me a lot of that client years ago. He was a strong, fit, healthy man in the prime of his life. He was also in debilitating pain that left him afraid to sit, to reach, to do any motion that would take his horrible-but-manageable-pain and turn into the excruciating-not-manageable type of pain.
A lifelong outdoor enthusiast, Mr. Hill was a rock climber, mountain biker, snowboarder, and hiker. The kind who went higher, harder, faster, further. The kind who jumped things, flew through the air and took fear as a personal challenge.
While previous neck and shoulder injuries had checked his activities before, a back injury brought all those adventures to a screeching halt.
The man in front of me hadn’t been on a bike or a board in months and was hiking desperately on his good days to get as much movement as he could before the pain took over. His days consisted of a constant mental chess game, calculating which moves were safe, which could be slightly altered to feel ok right now-with pain management planned for later, which activities were removed completely from the board, which activities would be traded for the others he really wanted to do. The mental and emotional exhaustion was palpable, as each session often started with a deep resounding sigh in response to “how’s it going?”
While Mr. Hill was doing his best to avoid surgery, we both knew it was on the table. In addition to seeing me for Pilates and FST, Mr. Hill was also treating his back pain with chiropractic, acupuncture, massage, PT, meditation, and therapy.
When working with Mr. Hill, I knew we had to work on mental and emotional safety around movement before tackling the traditional fitness concerns of stability, strength, and flexibility. Without safety, progress would be impossible.
We started with a functional core strength and range of motion test, with Mr. Hill moving his own body into various ranges of motion. I noted which positions caused anxiety, fear, or were avoided completely. Next, I used an FST session to assess his passive range of motion, this time noting any guarding and whether the available range matched the guarding or fear response in the ranges previously noted.
After seeing where Mr. Hill was able to move and how he reacted to certain positions, I created an FST and Pilates plan that kept him well within the areas where he felt comfortable, but focused on creating stability, strength, and mobility around the area of injury.
By stabilizing and strengthening around the injury, while also gently increasing mobility, we were able to create some relief in the pain points, while also building confidence and security in those ranges. Each week, we used FST to find and assess where those edges and boundaries were, downregulate the nervous system, improve range of motion and mobility, and teach the body new patterns.
Throughout our sessions together, there were excellent days where pain was minimal, strength and mobility were maximal. There were also days when pain was maximal, and our focus was really on managing the flare and moving in ways that felt good and provided relief.
While Pilates and FST weren’t the magic bullet we’d been hoping for, they did provide some relief as well as a strong pre-surgery foundation. After a series of disappointing nerve ablations, Mr. Hill opted for L5-S1 fusion, which was successful.
After surgery, Mr. Hill had much more available range of motion and we were able to focus even more in depth on recovering strength, mobility and range of motion that had been lost due to the original injury, as well as post-surgery recovery. We also continue to work on what Mr. Hill calls “corrective experiences”, a term borrowed from the book “The Way Out” by Alan Gordon. Corrective experiences are successfully performing activities or movements, pain-free, that we typically avoid because we’re afraid they’ll cause pain.
By using Pilates and FST in an intentional way, we were able to create entire sessions of “corrective experiences” for Mr. Hill, teaching the mind and body that the various movements and patterns are safe and do not cause pain or pain flares. FST allowed us to find his boundaries and work right up to them in a way that didn’t cause pain or flares.
I am extremely humbled by Mr. Hill’s trust and have greatly appreciated his willingness to experiment together as we “do weird shit in the name of science”.
Working with him has allowed me to really refine my skills as a practitioner and I have been able to apply the same principles of using Pilates and FST to develop corrective experiences for all my clients. Whether they come in with labral tears, frozen shoulders, herniated disks or sciatica, the results have been absolutely astounding.
Applying FST to my Pilates sessions has given me a deeper understanding of and connection to my clients. I can assess them tactilely in a way that is safe and helpful to their nervous systems. FST also gives me the ability to teach their body new patterns in a way that is gentle and beneficial to their joint and muscular health.
As a long time Pilates Instructor, I’m very excited about the results and the pace we’re achieving them with the intentional pairing of Pilates and Stretch Therapy when dealing with chronic pain.
What I’ve found is that my clients aren’t just getting relief. They’re getting their lives back. From spending a day snowboarding confidently, joining a dance class they’d never even attempt before, learning how to do handstands, or even just lifting something into a grocery cart or loading a dishwasher without pain, the results have spoken for themselves. “Corrective Experiences” are where it’s at.
A giant heartfelt thanks goes out to each of my clients who have joined me in experimenting, playing and “doing weird shit in the name of science”.
Have a great day,
-Rubecca
p.s. As always, I LOVE to hear your thoughts on these posts. Feel free to reply to email or bring up this topic in your next session. 🙂