Breast cancer

The first symptom, or subjective sign, of breast cancer is typically a lump that feels different from the surrounding breast tissue. According to the The Merck Manual, more than 80% of breast cancer cases are discovered when the woman feels a lump. According to the American Cancer Society, the first medical sign, or objective indication of breast cancer as detected by a physician, is discovered by mammogram. Lumps found in lymph nodes located in the armpits[8] can also indicate breast cancer.
Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain ("mastodynia") is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast health issues.
When breast cancer cells invade the dermal lymphatics—small lymph vessels in the skin of the breast—its presentation can resemble skin inflammation and thus is known as inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer include pain, swelling, warmth and redness throughout the breast, as well as an orange-peel texture to the skin referred to as peau d'orange.
Another reported symptom complex of breast cancer is Paget's disease of the breast. This syndrome presents as eczematoid skin changes such as redness and mild flaking of the nipple skin. As Paget's advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharge from the nipple. Approximately half of women diagnosed with Paget's also have a lump in the breast.
Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Metastatic breast cancer will cause symptoms that depend on the location of metastasis. Common sites of metastasis include bone, liver, lung and brain. Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are "non-specific", meaning they can also be manifestations of many other illnesses.
Most symptoms of breast disorder do not turn out to represent underlying breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorder symptoms. The appearance of a new symptom should be taken seriously by both patients and their doctors, because of the possibility of an underlying breast cancer at almost any age.

Causes

The primary risk factors that have been identified are sex, age, childbearing, hormones, a high-fat diet, alcohol intake, obesity, and environmental factors such as tobacco use, radiation and shiftwork.
No etiology is known for 95% of breast cancer cases, while approximately 5% of new breast cancers are attributable to hereditary syndromes. In particular, carriers of the breast cancer susceptibility genes, BRCA1 and BRCA2, are at a 30-40% increased risk for breast and ovarian cancer, depending on in which portion of the protein the mutation occurs.
Personal history of breast cancer: A woman who had breast cancer in one breast has an increased risk of getting cancer in her other breast.
Family history: A woman's risk of breast cancer is higher if her mother, sister, or daughter had breast cancer. The risk is higher if her family member got breast cancer before age 40. Having other relatives with breast cancer (in either her mother's or father's family) may also increase a woman's risk.
Certain breast changes: Some women have cells in the breast that look abnormal under a microscope. Having certain types of abnormal cells (atypical hyperplasia and lobular carcinoma in situ [LCIS]) increases the risk of breast cancer.
Race: Breast cancer is diagnosed more often in Caucasian women than Latina, Asian, or African American women.
No physical activity: Women who are physically inactive throughout life may have an increased risk of breast cancer. Being active may help decrease risk by preventing weight gain and obesity.
Antiperspirant use: British scientists found that aluminum, a common ingredient added to antiperspirants to stop the skin from sweating, may be linked to breast cancer. Deposits of aluminum in high concentration near the underarm have been found in outer breast tissue in patients who used antiperspirants. Researchers believe the aluminum is being absorbed from antiperspirant sprays and roll-ons since aluminum is not normally found in the human body.
Pork consumption: People who eat an average of just over one ounce of pork daily have a significantly higher risk for cancer.
Processed meat consumption: The sodium, nitrates and nitrites in processed meats may irritate cells and initiate DNA changes that can lead to cancer. The risk is even higher when these foods are cooked at high temperatures for extended periods. High-heat grilling and pan-frying generates heterocyclic amines (HCAs), which are known carcinogens.
Tamoxifen may interact unfavorably with certain antidepressants when used for prevention of breast cancer recurrence.

Inteligent Exercise Part2

Although there are pilates-style studios and classes springing up across the country, Moira cautions people to research before they begin a program. "Because the method of exercise is very much knowledge-based, requiring a deep understanding of body mechanics and technique, I recommend that people begin one-on-one or in small group sessions with a certified instructor."

Moira and partner-husband Lindsay Merrithew are so committed to preserving and promoting the integrity of the exercise system that they've developed a resource centre of sorts. In addition to their two studios, where you can participate in private and group sessions, they also offer comprehensive training and certification. And if you're having difficulty finding a certified instructor, they encourage you to contact them for assistance.

In the meantime, to help you get started in the comfort of your own home, STOTT PILATES has produced several instructional videos, ranging in level of difficulty and described as "a godsend for all those keen to try exercise based on the teachings of Joseph Pilates but unable to find or afford an instructor in their area." And, if you're really serious, STOTT PILATES can provide you with the related resistance equipment, which they manufacture and sell to fitness enthusiasts and professionals all over the world.

"When I think about how I used to do sit-ups. I used to throw myself down on a mat, do 75 sit-ups and I'd be working my hip flexors instead of my abdominals, thank you very much," recalls John. "This is much different. You actually spend time learning how to exercise effectively."

And if you're still not convinced, take it from renowned ballet dancer Karen Kain, one of Stott's first clients: "Within the first week I could see a difference, not only in my strength and flexibility, but in how much better my back felt."

The First Lady of Pilates Part2

CBI: What do you define as your company's mission?

MS: STOTT is both an educational organization and an equipment manufacturer. We started the company 12 years ago before pilates had become a household word, and our goal has always been to provide high-quality exercise training equipment and support for people who want to get involved. People frequently don't know where to start, and we believe it's important to educate them not only about Pilates, in general, but also about how it's evolved – today, there are a variety of different approaches. That's why we refer to our program as STOTT PILATES, because, while it's based on pilates, we've done a great deal of research to refine our system of exercise.

CBI: What groups are currently certifying Pilates instructors? And are instructors still hard to find?

MS: There are a large number of people, groups, and associations that certify pilates instructors, but the educational level and quality varies dramatically. Some certification programs involve as little as 15 hours of training and don't require a practical examination; they make use of a written test to gauge the competency of instructors. We're finding that many of these people come to us later when they realize they need to know more. We have a training and certification center in Toronto, licensed training facilities in the U.S., and also offer instruction in other parts of North America and Europe. To give you a sense of what we do: our mat class instructor training is a 30-hour program; our reformer curriculum is a 60-hour (or six-weekend) program; and our advanced course, in which people learn about the use of other equipment, such as the Cadillac, chair, and barrels, is a 72-hour program. Only after a person successfully completes all of them can they become a fully certified Stott instructor. We also offer a 24-hour program for instructors who will be working with injured or special population clients. There's currently a huge demand for pilates instructors, but, unfortunately, there still aren't a large number of good, highly qualified instructors.

CBI: Do you still do any teaching yourself? Do you number many of pilates' celebrity practitioners among your clients?

MS: I've held onto a few clients, but, as our company's program director, do very little teaching today. I'm much more involved in teaching instructors and instructor-trainers; I do presentations at industry events and for fitness industry organizations; and I've also been very much involved in the production of the 21 videos that we've completed – 14 of which were for instructors. In terms of celebrities: The Cleveland Indians baseball franchise are big buyers of our equipment, and the Princess of Brunei recently purchased some of our units for her palace. Other clients include Lucy Lawless, better known as 'Zena, The Warrior Princess,' British actor/ comedian John Cleese, rock star Rod Stewart, Cirque du Soleil and a number of professional dancers.

– BAM

Inteligent Exercise Part1

Out of the Dance World... and Into the Mainstream
Don't let the lithe bodies, deep breathing and soft music lull you into thinking exercise based on the teachings of late fitness guru Joseph Pilates (Puh-lah-teez) is just for dancers. It's not. The fact is people from all walks of life, all around the world, are committing themselves to what some are calling a "deeper," more "intelligent" approach to fitness. "I don't come from a dance background, I'm an aging white guy," says John Ford, who suffered muscle tension and joint pain before embarking on a program at the STOTT PILATES Studio in Toronto. "My shoulders used to be hunched up around my ears. Now they're where they should be," says the 48-year-old union representative, adding, "I don't have the knee problems I had before, my posture is better and I'm looking forward to running and roller blading again." Although the method of conditioning has been around since the 1920s, until fairly recently it was a well-kept secret by dancers who used it to help rehabilitate from injury and enhance performance. As people like John discover its benefits, however, it is becoming more widely known and appreciated. "People are developing a more measured, holistic approach to fitness," says Moira Merrithew, a former professional dancer and program director of the STOTT PILATES Studio. "They still want to look fit and toned, but they also want to enjoy the process and to feel more vital and aware of their bodies." In the mid '80s, after hanging up her pointe shoes to nurse an injured foot, Moira discovered the neuro-muscular technique through the Dancer in Transition Resource Centre which offered her a grant to study at Joseph Pilates' studio in New York City. "Learning the intricacies of the method not only helped me to rehabilitate and achieve an optimal level of fitness personally, it inspired me to share the technique with others," says the soft-spoken 38-year-old.	Just as Yoga has evolved over the years to reflect the knowledge and styles of certain experts or gurus – Iyengar and Kudalini being examples – so has exercise based on Joseph Pilates' method. "By taking the teachings of Joseph Pilates and updating them to include what we now know about the body, we can offer a highly effective and safe exercise regime," says Moira. Moira's contemporary approach, known as STOTT PILATES, preserves the essence of Joseph Pilates' original "mind-body" teachings but enhances them with modern biomechanical knowledge and input from such health professionals as physical therapists and chiropractors. Unlike the original method, it incorporates the modern concepts of core stability and neutral postural alignment – restoring the natural curves of the spine – as integral to developing total fitness. As certified instructor Syl Klotz will attest, STOTT PILATES is a mindful yet dynamic workout that can be customized easily to suit the needs and objectives of each participant. Its repertoire of more than 500 challenging moves are based on the principal that by systematically and methodically developing a strong and flexible torso, the whole body can be balanced, aligned and conditioned for optimal performance. "It's the perfect complement to cardiovascular exercise such as power walking, aerobics or cycling," adds Syl. Done regularly – either on a mat or using specially-designed resistance equipment – the posture-improving regime promises muscular strength, flexibility and endurance, without the bulk. And unlike traditional weight training or aerobics programs, an emphasis on movement quality versus quantity makes STOTT PILATES more "work-in" than work-out, leaving participants feeling refreshed, not exhausted. "After only my first session, I felt a combination of strength and peace," says Lydia Stone, who first heard about the method of exercise through a dancer friend. "It makes you feel strong, stretched and invigorated," says the 39-year-old magazine editor and mother of two. "I can't wait to go back."

The First Lady of Pilates Part1

Moira Merrithew has mastered the moves as published in Club Business International magazine
STOTT PILATES, based in Toronto, was founded in 1987 by the husband/wife team of Lindsay Merrithew and Moira Merrithew, and produces a wide range of equipment, manuals, videos, etc., all predicated on the principals of Joseph H. Pilates. Merrithew serves as the president of STOTT PILATES, while Merrithew is the program director of the STOTT PILATES Studio and International Certification Center, which has certified more than 1,000 instructors in the STOTT PILATES techniques. For the many other thousands who have participated in STOTT classes or made use of her educational videos, Moira Merrithew is one of the most visible embodiments of the pilates method. Recently, she spoke with CBI about pilates, her company, and a number of other topics. CBI: How did Joseph Pilates come to develop his theories of exercise? Moira Merrithew: Pilates had asthma as a child, which is thought to be one of the reasons for his strong emphasis on breathing. His approach was to incorporate Eastern and Western traditions – i.e., the Eastern emphasis on controlled breathing, controlled movements, and a highly focused attention, and the more Westernized approach, which tends to rely heavily on resistance. In Pilates' day, a lot of people were developing exercise techniques, and it's likely they all influenced each other. Interestingly, there's a patent dating back to the late 1880s that details an apparatus very similar to the reformer. CBI: Has there been any solid scientific research that documents the purported benefits of pilates? MS: There's been one small controlled study, which compared exercises performed on a reformer with ones utilizing weights and pulleys – that study concluded that the reformer delivered better benefits. There have also been some positive studies, not on pilates, specifically, but on the effects of torso stabilization, restoring the natural curves of the spine, and maintaining the pelvis in a neutral position, all of which are components of pilates-based exercise. But if you're looking for a major piece of scientific research about pilates specifically – it doesn't yet exist. CBI: Pilates is often referred to as a mind/body form of exercise. What does it offer from a psychological perspective? MS: Pilates helps the individual to look inward, primarily by emphasizing their breathing, which helps the mind to focus on what the body is doing. People who practice Pilates-based exercises report that their workouts leave them feeling more serene, invigorated, and self-aware.	CBI: Like so many other forms of exercise, pilates can obviously be practiced at home. Are there any advantages to pursuing it in a studio or club? MS: It's great if people have the discipline to work out at home, but the ideal is to have the instructor with you. There's no question that pilates is best practiced in a personal-training type of environment, and that students with enjoy the best results when they have access to all of the equipment. It's important to understand that, while people tend to rave about the reformer, and while it's crucial to a pilates-based workout, it's only one part of the program. The work that's done on the mat and other equipment is also very beneficial and important. Actually, the ideal training scenario would be to complement your club workout by also working out at home. CBI: How can pilates best be applied in a club setting? MS: A lot of the clubs that have been successful with pilates-based programs began with a good, solid, personal training program and worked their way into pilates-based exercise. Many of them have retrofitted a squash court or some other preexisting space to create a pilates center. The beauty of this approach is that it attracts people of every age and fitness level, and, as a result, can open up markets that, previously, may not have been well-served. We also think that pilates can become an important profit center. If you look back at personal training, you realize that, for many years it wasn't taken all that seriously, but then club owners began to realize that there was a lot of money to be made with it. It's the same with pilates-style programming. Currently, about 50% of all pilates-based instruction is done in a one-on-one environment. We strongly believe that, as with personal training, the success of any pilates-based program ultimately rests with instructors – they're the people who drive this trend. CBI: If you were to give a beginning pilates student some advice, what would it be? MS: Students should understand that pilates is a process, with the main goal being postural correction and enhancement of athletic performance; muscle toning is a byproduct. Students should also be aware of the fact that pilates-based training never has to stop – their bodies will continue to change, and they'll never hit a limit. A good instructor will always be able to take them a little bit further. CBI: Are there any grievances or dangers that can legitimately be laid at the foot of pilates? MS: Because pilates is so instructor driven it's really important that prospective instructors be carefully screened. The quality of instructors can vary dramatically. Another thing that's important is to match the member's special circumstances, if any, with an instructor who's experienced in that particular area.

Why PILATES ??

Since 1998, the top growth activities in the fitness arena have been: Pilates training, elliptical motion trainers, recumbent cycling and yoga. The exercisers have been predominantly women, between the ages of 25 and 60, who are seeking less strenuous and more user-friendly methods for staying in shape. With this demographic, kinder, gentler fitness trends continue to displace traditional exercise. Because of the gentle strengthening and stretching in Pilates, these participants are reporting that Pilates programs best suit their fitness needs. Although centers are adding Pilates to meet these needs, many fitness centers do not have enough trained instructors. Pilates training is involved and time-consuming, so one of the greatest challenges to a Pilates program is finding enough competent teachers to staff the program.

With a growth of over 500% since 1998, interest in Pilates is still strong. The International Dance Exercise Association (IDEA) 2006 Fitness and Programs Equipment Survey reinforced this continued growth by naming Pilates not once, but three times in their top ten list. (Pilates personal training was number one, Pilates and traditional strength fusion was number four and Pilates, in general, was number six.) Pilates was identified as the top area of equipment growth by two-thirds of the 20,000 fitness professional respondents in 80 countries. And, Pilates participants are not only women. Men are starting to take an interest - with famous athletes such as Jason Kidd, Rich Beem, and Tiger Woods singing the praises of Pilates.

When Pilates was first introduced in the United States by Joseph Pilates in the early 1920s, the method was presented as a pathway to total well-being. "This will be the exercise that people will want and need in the new millennium," wrote Pilates in his book, Your Health, published in 1934. He continually alluded to the public's misunderstanding of physical training as it relates to health, and the unnecessary causes of human suffering that would shorten lives. He offered his vision as a method to lead mankind to universal health. He implored the public to employ a method of exercise based on correcting causes rather than merely treating symptoms that would "coordinate the body, the mind and the spirit, allowing them to perform their work with minimum effort and maximum pleasure."

A pugilist, gymnast and bodybuilder, Joseph Pilates created a fantastic method of exercise - vigorous enough for athletes such as dancers and boxers, yet gentle enough for older adults. This seemingly ordinary man designed: 12 pieces of exercise equipment, over 500 exercises, and an instructional method that is sweeping the nation 50 years after his death. Pilates had a very sickly childhood, suffering from rickets and asthma, and his own personal health and achievements as an athlete were a testament to the success of his method. He wrote that the physical education teachers of his time did not even practice what they taught and their health was in a deplorable state. He encouraged them to "walk the talk" and not be mere preachers of what normal health should be. He appealed to the human race that it was their duty not only to attain health, but to maintain it. He was genuinely interested in the good of mankind and wanted most to empower people to take control of their own well-being. Joseph Pilates truly created his method for everybody - he even wanted for children in schools to benefit from it.

To me, this all sounds familiar. It sounds like what we, as fitness professionals, want today. We want fitness to be done as a method of prevention. It should be done to prevent things like obesity, heart disease, and high blood pressure. It should be taught to children in the schools and practiced by young and old. It should be a necessary part of everyday life that can be completed gently, with ease. The mind should be involved, the spirit should be lifted. Joseph Pilates' vision is one that we need to push to the consumer today. "It is your duty not only to attain health, but to maintain it," said Pilates.

One in three American adults, aged 20 to 74, is overweight. One in every five children, aged six to 17, is overweight. And, 39% of American adults report that they engage in no physical activity. I believe the fitness professional of today is singing the same song that Joseph Pilates was in 1920 - only we are singing more desperately. With this in mind, it is no surprise that interest in Pilates is growing. This gentle form of exercise answers the needs of today's exercisers. Young, old, overweight, all can participate at their own level, competing only with themselves.

So, no need to stop what you are already doing, just add Pilates. This method of exercise mixes well with strength training, cycling, aerobic dance, kickboxing, or yoga and movements can be assisted with the use of the equipment for those who are overweight, weak, or coming back from an injury. Truly a method for everybody, it is a place to start, or a place to which one can progress. It is a method of exercise to with which to live. Pilates time has come.

PILATES A-Z

Our Supply Side Feature offers expert advice from suppliers to help give you an insider edge with your upcoming facility purchases and expenditures. In each issue, OSF editors will provide an industry expert to give you the insight on how to ask the "right questions" for product and service purchases for your facility. This won't make you an expert, but will give you the knowledge to ask those right questions when you are in the purchase mode. Send your specific topic requests and questions to us at editor@onsite-fitness.com, and we’ll get you an expert answer. ONSITE FITNESS: There’s a lot to take into account when introducing a Pilates program to your facility. What would you tell a facility manager to consider when is contemplating introducing Pilates into their organization? PILATES EQUIPMENT SUPPLIERS: There are a number of questions that you need to ask yourself, and these questions need to be answered in an initial investigation phase, well before you begin to set up the program. At the outset, you’ll need to figure out whether there is an interest among your membership for starting a Pilates Program at your facility. It’s a good idea to explain what you envision and poll your members to see whether the program is something they would participate in. If there is indeed interest expressed, then you may want to put together a brief business plan that answers a lot of fundamental questions, such as: How much floor space will we need to devote to Pilates? You’ll have to examine where you have floor space that can be available to commit to Pilates and, since it is a “mind-body” exercise, that area needs to be in a place where members can dedicate their focus solely to their movements without distraction. You also need to determine whether you’ll conduct classes with mats or whether you can add equipment. A typical Reformer, for instance, requires 60 square feet of floor space, so if you do not have a dedicated Pilates equipment room, you’ll need to have an area to store the machines between classes. What type of programming will we offer? Many facilities start with free mat classes and then may later transition into fee-based Reformer classes. But remember that just because mat work is used as an introductory class, it is not an introductory form of exercise. In fact, mat work is actually harder than Reformer work, as there is less assisted resistance. It could be that you’ll decide that your facility will continue with mat classes only and it’s best to get a feel from participants as to whether you need to progress to classes where more equipment is utilized. Where will I get my instructors? Much like other types of group exercise, Pilates must have a certified instructor present during the class and an enthusiastic and a knowledgeable instructor can make the difference in the success of the program. You’ll need to decide whether you want to obtain training for some people that you have on your existing staff or whether you want to hire outside instructors who have already been trained. There are pros and cons to both, but you’ll want to find someone who has good fitness knowledge, enthusiasm for the program and continued involvement with it. The quality of the Pilates trainers can have a great affect on the participation levels in the program so the importance of the selection of these individuals cannot be overstated. What kind of equipment will I need? If you’ve determined that you have enough space to utilize equipment, then you’ll need to decide which types are best for your classes, assuming that you don’t want to go the route of simply utilizing Pilates for personal training, which is an option as well. Remember, unlike most group exercise, Pilates equipment classes are taught in small group sessions with typically only 4-6 participants per class. Therefore you don’t need a large number of any single type of equipment. At that point, it simply becomes a matter of how much you are willing or able to invest. Keep in mind that the major Pilates equipment manufacturers do have leasing plans available as well, which will minimize your initial investment in the program. OSF: What are the basic types of equipment for Pilates? PILATES ES: Mat classes are typically performed in groups of 10-12 and are similar to yoga, with the difference being that the body is virtually in constant motion in Pilates, rather than the assumption of various held poses as in yoga. Mat classes may be done using only the body’s natural resistance against the floor or a wall, or some small equipment can be added to enhance the movements. A myriad of equipment can be included are such devices as the Magic Circle, foam rollers, stability balls, balance boards and foam cushions, all of which enhance mat routines. Equipment classes utilize equipment that is available in a number of different adaptations, but these are the basic pieces: The Reformer – the cornerstone of Pilates equipment, it provides a resistance workout to a participant who lies, sits, kneels, or even stands on a free sliding carriage; The Trapeze Table - or as it is often referred to, the Cadillac. This device can allow for up to 200 individual exercises, as simple as assisted motions, or as advanced as acrobatics by hanging from its upper bars. The Barrel - allows you to do core stretching and flexibility moves, and the Ladder Barrel enhances this by allowing you to adjust your footing to create a more challenging angle. The Chair – it’s built with resistance pedals that you press down on while performing series of demanding stretching exercises that build strength in the legs and the shoulders. OSF: You mention certified instructors. Where can I get my instructors certified and trained? PILATES ES: The Pilates Method Alliance (PMA) is a non-profit organization that provides the only nationally recognized certification exam for Pilates and has been doing so since 2005. While not all instructors that you have on site need to be certified, the PMA recommends that at least one certified instructor be on staff and present while Pilates programs are being taught. All of the major manufacturers of Pilates equipment offer instructor training, either through licensed training facilities or through host facilities that sponsor a visit from a certified master trainer in Pilates. There are also a number of companies in the market who will train Pilates instructors in specific methodologies, either as a form of continuing education, or to prepare instructors for certification. These trainers instruct on anything from the classical “contrology” originally taught by Joseph Pilates in his studio in the first half of the last century, to methods based on his teachings, but adding more contemporary updates that takes into account modern scientific research on biomechanics that was simply unavailable in his day.

OSF: Pilates is still a foreign concept to many people who go to our facilities. Since most are not that familiar with the activities, how best do you present the concept to them and then encourage them to regularly attend classes? PILATES ES: Pilates can be introduced in a number of ways, but it’s important to have a champion of the program within your organization. Whether that’s someone that you’ve hired from outside to lead classes or a newly trained personal trainer is unimportant, as long as it’s someone with a vested interest in the program, is charged with making the program run smoothly, can creatively adapt programs to individual needs, and has strong organizational and leadership skills. One excellent way to bring in new participants is to tailor programming to the unique demographics that already exist in your facility. Pilates exercises are very versatile and can be modified to meet a variety of these demographics. For instance, programs can be easily customized to meet the needs of expectant mothers, the aging populations or any number other groups that exist within your membership. It can also be introduced to members who are interested in sports-specific training, with programming that can be part of an overall conditioning program for golf, tennis, cycling or any number of other activities. Survey your members about what they are interested in and then figure out ways to create Pilates programs to complement those interests. PILATES EDUCATION & CERTIFICATION: There are currently two predominant philosophies when it comes to Pilates education. One is the classical approach based on the original teachings and equipment designed by Joseph Pilates. The other is a contemporary approach that takes into consideration modern scientific research to supplement the classical approach. Other programs meld the two philosophies together. BALANCED BODY University (BBU), the training division of Balanced Body Inc., has created a curriculum where both approaches are featured as well as blended together based on a current understanding of human biomechanics. The result is an educational offering where instructors can customize programs easily and effectively for all types of clients and members- from the post-rehab client, to the serious fitness buffs and athletes. The instructor training classes are modular in format with easy-to-manage segments. Instructors can begin teaching what they learned as soon as the weekend is over. This allows your program to get started quickly and grow at the pace that best suits a center’s needs. BBU offers Quarterly Updates on CD-ROM providing relevant and topical programming information to keep their classes fresh and interesting. PEAK PILATES educational workshops and certification programs are grounded in the classical Pilates method and emphasize an integrated and systematic approach for a balanced workout. Their certification programs focus on professional development with a proprietary coaching/training model. Continuing education workshops are open to Pilates and fitness professionals, as well as enthusiasts. All certification programs are offered through a modular educational pathway, allowing individuals to progress at their own pace and all programs are supported with comprehensive manuals and DVD’s. STOTT PILATES is a contemporary approach to the original exercise method pioneered by the late Joseph Pilates. Developed in collaboration with physical therapists and sports medicine professionals, the repertoire consists of more than 500 systematic, mind-body exercises that can be performed on a mat or specialized equipment pieces. Their Education Department continues to develop and refine the method to ensure that it is practical, relevant and in line with the latest exercise science research. STOTT PILATES training and certification programs are available at numerous locations worldwide offering more than 12 programs depending on background or area of interest. PILATES EQUIPMENT: BALANCED BODY With over 30 years in business and 17 U.S. patents, Balanced Body equipment accommodates a wide range of body types, is easy to use, ergonomic, quiet, durable and offers some of the finest wood products available. The Pilates Allegro® Reformer was specifically designed particularly those who may be short on floor space. The Allegro is a full featured Pilates Reformer that is light enough for one person to move, and can be easily stored by stacking one on top of another or by standing them on end. The Tower of Power™ can be easily added to an Allegro, expanding programming versatility by giving you the capability of a Reformer, a half-trapeze and a mat - all in the same compact footprint. The Allegro Sport™ Reformer is a simpler version of our Allegro System. The Sport is also a full-featured Reformer with a minimal storage footprint. Balanced Body provides consultations on Pilates business planning, programming strategies, education, facility layout, marketing, return on investment models and more. PEAK PILATES Reformer Frame is constructed of solid premium white Oak, with flawless mortise & tenon joinery. Carriage is constructed from a multi-core, 13-ply Baltic Birch with reinforced cross bracing for rigid stability. Foam Padding is an Olympic grade athletic foam. This material will last 3 times as long as other foam padding, minimizing costly re-upholstery. 4-Gear Position System (incorporates our proprietary "Negative Gear"), along with our 3-Way Adjustable Foot Bar (optional) effectively expands your range of work to accommodate all heights, body types and ranges of hip and knee flexion. STOTT PILATES STOTT PILATES equipment offers unique features including: Exclusive whisper-smooth, patented rolling mechanism on all reformers Our reformers have a 6-carriage-stop versus 4-carriage stop Higher carriage heights make it easier to mount and dismount reformers All STOTT PILATES reformers can be ordered with an additional six inches of length to the supporting rails and carriage to accommodate people taller than 6'4" Limited lifetime warranty on all large equipment including reformers and the Cadillac The Group SPX™ Reformer, developed for clubs with limited or multi-purpose space, is lightweight and portable without compromising quality and strength.

Exercise of the week

Saw targets internal & external obliques for spinal rotation; rectus abdominis and obliques to initiate flexion of spine; erector spinae to initiate roll-up STARTING POSITION Begin seated upright, with pelvis and spine in neutral. Keep your legs long and abducted slightly wider than shoulder-distance apart. Reach arms out to the side with your palms forward. EXERCISE 1. INHALE rotate your spine around a vertical axis, ensuring that your pelvis is still and arms are reaching out to the corners of your Mat. EXHALE articulate your spine into flexion beginning with your head. Reach front arm towards your baby toe as your back arm medially rotates reaching towards the back corner of the Mat. Remember to keep eyes down and your pelvis vertical. INHALE slowly roll-up through the spine and sequentially articulate out of flexion from your tailbone in order to reestablish a vertical position again. Complete the movement by reaching your back arm behind and stabilizing scapulae. EXHALE rotate your spine to face forward. Rotate your back arm laterally with palms facing forward on the return to starting position. Repeat on other side. Complete 3-5 repetitions each way. MODIFICATION For those with tightness in lower back, hamstrings and/or hip flexors try this exercise while seated on a foam cushion or platform extender. This exercise is excerpted from the Comprehensive Matwork Manual. Find more exercises in the STOTT PILATES teaching manual library comprised of 10 titles that document the entire STOTT PILATES exercise repertoire. Three titles are also available in Japanese, French and Spanish.

CAUTION: Please note the following important cautions before attempting STOTT PILATES exercises. Consult with your doctor before beginning this or any other exercise program, as not all exercises are suitable for everyone. This or any other exercise program may result in injury. If you experience pain or discomfort during exercise, stop immediately and consult your doctor. To reduce risk of injury, never force or strain during exercise. STOTT PILATES videos and manuals are sold without warranties or guarantees of any kind so the creators, producers, performers, participants and distributors cannot guarantee their suitability and safety for each individual. Any liability, loss or damage in conjunction with any use of this program, including but not limited to any liability, loss or damage resulting from the performance of the exercises demonstrated, or the advice and information given here is expressly disclaimed.

STOTT Equipment

About STOTT PILATES Equipment

Q.	What is a Reformer?
A.	The Reformer is the main piece of equipment used in Pilates exercise. The Reformer glides forward & backward on rollers and uses springs for resistance, along with other attachments, for a wide variety of exercises and positions (i.e. lying down, seated and standing.)
Q.	Is STOTT PILATES equipment like the equipment I've seen for sale on TV?
A.	STOTT PILATES equipment is far more versatile and durable than that sold on TV. STOTT PILATES designs and produces top-of-the-line equipment primarily used in clubs, personal training and rehab facilities. The STOTT PILATES At Home and Group SPX™ Reformers are designed for people who want quality equipment for home use or for use in clubs or personal training facilities, respectively.
Q.	What are the benefits of this type of exercise equipment?
A.	STOTT PILATES exercise equipment is highly versatile. It facilitates hundreds of exercise variations, is no-impact (and therefore easy on the joints), allows for modifications for those with injuries or conditions, allows for three-dimensional movement and conditioning, and is suitable for a wide variety of clients (from rehab to pro athlete). It also facilitates balanced strength and flexibility, provides eccentric and concentric muscle contraction (resistance on the in and out moves), total musculo-skeletal conditioning (muscles and postural alignment), and facilitates core conditioning and peripheral mobility.
Q.	Why are springs used for resistance instead of weights?
A.	By using springs for resistance, STOTT PILATES equipment provides gradual resistance as your muscles contract, which ensures the muscles are being worked properly. There is greater resistance at the muscle's strongest point of contraction and less resistance on the initiation and completion of the contraction so there is less stress on tendons and ligaments.
Q.	How much resistance (in weight) do the springs supply?
A.	Initial tension is 5 lbs for the first inch of tension (for full strength springs), and then increases by approximately 1 lb per inch. Multiply the number of springs and distance traveled to get approximate tension in pounds. On a STOTT PILATES Reformer, four springs are full tension & one is half. (Most people will simply note the number of springs used per exercise).
Q.	Is this equipment good for flexibility?
A.	Yes, STOTT PILATES equipment is excellent for improving flexibility. Flexibility is a key component of total fitness that has been largely ignored by other conditioning methods.

About the STOTT PILATES Method

Q.

What is the STOTT PILATES® Method?

A.

STOTT PILATES is a contemporary approach to the original exercise method pioneered by the late Joseph Pilates. Co-founders Moira and Lindsay G. Merrithew, along with a team of physical therapists, sports medicine and fitness professionals, have spent over two decades refining the STOTT PILATES method of exercise and equipment. This resulted in the inclusion of modern principles of exercise science and spinal rehabilitation, making it one of the safest and effective methods available. This clear and detailed approach forms the basis for STOTT PILATES training and certification programs. It’s used by rehab and prenatal clients, athletes, celebrities and everyone in between.

Q.

Why are you touted as the “Professional’s Choice”?

A.

Since its inception over 20 years ago, STOTT PILATES has grown from a small studio into the world’s most respected Pilates brand. While much has changed since we first opened our doors in 1988, our mission of promoting the ongoing benefits of mind-body fitness worldwide remains a constant. Our full-service company provides all the training, equipment and ongoing support you need to build a strong and successful Pilates business. Whether your goal is to establish Pilates group exercise programs, take your personal training to the next level, set up a fully equipped studio, or train to become a certified instructor – we go the distance to help you succeed. STOTT PILATES’ mission is to fulfill the needs of Pilates enthusiasts everywhere and that’s why we’re the number one source for everything Pilates – spanning equipment, education and media.

Q.

What is the difference between the STOTT PILATES Method and other Pilates techniques?

A.

STOTT PILATES incorporates modern exercise principles, including contemporary thinking about spinal rehabilitation and athletic performance enhancement. For example, some approaches may promote a flat back, whereas STOTT PILATES exercises are designed to restore the natural curves of the spine and rebalance the muscles around the joints, placing more emphasis on scapular stabilization. As well, there are more preparatory exercises and modifications to cater to many different body types and abilities, making it applicable to everyday life.

Q.	What are the benefits of STOTT PILATES?
A.	longer, leaner muscles (less bulk, more freedom of movement) improves postural problems increases core strength, stability and peripheral mobility helps prevent injury enhances functional fitness, ease of movement balances strength & flexibility heightens body awareness no-impact, easy on the joints can be customized to suit everyone from rehab patients to elite athletes complements other methods of exercise improves performance in sports (golf, skiing, skating etc.) improves balance, coordination & circulation
Q.	What are the principles behind the STOTT PILATES Method?
A.	STOTT PILATES exercise improves core strength and balances the muscles around the joints, improving the way your body functions, looks and feels. The Five Basic Principles focus on: Breathing Pelvic placement Rib cage placement Scapular movement Head & cervical spine placement

Q.

Is STOTT PILATES exercise like Yoga?

A.

In some respects Pilates is like Yoga. Both are considered mind-body type methods of movement; both emphasize deep breathing and smooth, long movements that encourage the mind-body connection. The difference is that while Yoga requires moving from one static posture to the next, Pilates flows through a series of movements that are more dynamic, systematic and anatomically-based incorporating resistance equipment. The goal with STOTT PILATES exercise is to strengthen the postural muscles while achieving optimal functional fitness.

Q.	Will I grow by doing STOTT PILATES?
A.	Much of Pilates exercise requires you to look within, focus on your breathing, and feel the subtle differences within your body. Many people come to a very meditative state while doing Pilates, and therefore will grow mentally and spiritually over time through this type of exercise. By strengthening the postural muscles people have learned to maintain good posture thereby appearing taller.

Q.	What kind of results can I expect from doing STOTT PILATES?
A.	You can expect an increase in strength, flexibility, mobility, balance, and body awareness, as well as a decrease in back pain or other general pains.

Q.

How long will I have to do the workout before I see results?

A.

The average active person doing 2-3 classes per week should see some results within 10-12 classes. This will vary depending on each individual and other factors such as the number of classes a person takes each week, whether they are private or group classes, whether they participate in other physical activities, and whether they have any existing injuries. It is also important to work with a well trained Certified Instructor.

Q.

I have a bad back. Will I be able to do Pilates?

A.

Although you should always consult your physician before starting any fitness routine, a Pilates workout is gentle and controlled with no sudden jarring actions. It is therefore more important that you work with a qualified instructor to ensure that you are doing the movements correctly. An experienced instructor will be able to modify the exercises to accommodate your limitations, continually challenge you within your range and monitor your improvements. If you commit yourself to a consistent workout schedule you will certainly feel results.

Q.	Will I get the same results with a mat workout as with a Reformer or equipment workout?
A.	Mat-based workouts are very convenient and can be done anywhere. Adding light equipment and the larger resistance equipment will place more emphasis on your outer limbs and add variety and intensity to your program.

Q.	If I'm doing Pilates, should I still do my regular workout?
A.	STOTT PILATES exercise is a musculo-skeletal conditioning program. It’s ideal in combination with some kind of cardiovascular exercise (walking, running, aerobics, aqua fitness etc.), and a great complement to your weight training program.

Q.

How can STOTT PILATES be different than weight training or other resistance exercise?

A.

Pilates is three-dimensional (i.e. exercises can be performed using all movement planes) spring resistance more closely resembles muscular contraction emphasis on concentric/eccentric contraction for injury prevention STOTT PILATES exercise is customizable for special needs in Pilates exercise, emphasis is placed on rebalancing muscles around the joints Pilates corrects over-training and muscle imbalance that leads to injury Pilates emphasizes balancing strength with flexibility (for injury prevention and more efficient movement) STOTT PILATES exercise leads to an improvement in posture and body awareness Weight training and STOTT PILATES can be combined in your fitness program and are a great compliment to each other.