Forum / Let's Discuss! / Bertolotti's syndrome

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On: April 08, 2014 14:09 PM
I have a client that is about 7 months post natal. I have been working with her the past 3 months. She has just recently been diagnosed with Bertolotti's syndrome. We had been working together with opening up and connecting with her post-natal body and doing very gentle strengthening work. She is wanting to return to Pilates and I would love any knowledge about how best to work with her new diagnoses. Thanks, Alli
On: April 11, 2014 05:06 AM
Hi Alli, I have not worked with a client with this syndrome. Here is my advice but take lightly b/c your eyes and hands may see/feel a lot of other places you have to go to and pay attention to. In this syndrome L5 can be fused to the sacrum and/or ilium on one side. This creates a situation that basically has your client swinging that leg through from their L4 with every step. This can create all sorts of havoc and compensations in the body. The symptoms ( pain and dysfunction) usually don't spring up until after 30. With or without this type of syndrome people have all sorts of strategies that they employ because of bad body mechanics to injury /trauma and while they are young they usually do ok but as the body ages all of this will show up. My suggestion is to definitely go back to basics and Core Train. I would also combine this with Gait training so she has some strategies to employ throughout her day to keep her tuned. During the work outs start with subtle body movements, small range of motion. Stay away from one leg standing balance postures at first. She needs to know how to support herself on one leg for Gait but you want to move gingerly to that b/c too much too soon could throw her into a tailspin.The reformer is a great way to start to balance the legs with lots of support. She needs to explore all the natural ranges of the spine and pelvis but in a very small range of motion. And there will be different cues for her depending on what side she is rotating, side bending, scissoring the pelvis etc. Be very detailed oriented with her. She probably also has some tight global muscles ( I'm thinking piriformis, hamstrings and I'm sure her feet and ankles are pretty tight). When one part of our body is not doing it's job everything up and down the chain tries to multi task and do too much. This leads to rigidity and immobility. Release work is probably going to be pretty high on your list for her. Casey just released a Release Workshop on the site. You should check it out. Please keep us updated and maybe send us a video of what you are doing with her. It would be interesting to follow her progress. Love Jen
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