Home Sweet Home:Pilates for Aging in Place

When I moved my Pilates teaching practice to St Louis from Chicago in 2012, my Grandpa Ned had recently passed away at age 106. Many of my new St Louis clients were in their 60s and moving their older parents out of their homes and into assisted living– a logistically and emotionally challenging process. Most of those clients still work with me, and many are now facing decisions about their own aging and care as they approach their mid-70s and beyond.  They feel younger and fitter than their parents, and they’re reluctant to leave their homes or saddle their own adult children with their care.

My clients aren’t alone in this struggle. By 2050, more than 90 million Americans will be 65  years or older. And according to the AARP, nearly 90% of adults over 65 want to live in their own homes as they get older. Continuing to live in one’s own home– or aging in place– can enable older adults to maintain dignity and manage daily life in a familiar place beyond retirement.

My Grandpa Ned had an atypical experience with regard to aging in place: he spent all but the last two years of his life in his own home. He enjoyed the comfort of the house he and wife bought as newlyweds– playing his banjo, walking up and down the steep hill between home and his favorite watering hole, and indulging in Irish whiskey or Moose Tracks ice cream.

Although no studies suggest whiskey and ice cream are the keys to longevity, some of the indicators for successful aging in place are linked to physical fitness. Ned may have fared well because he used fine motor skills on his banjo (mimicking the skills required for everyday tasks like holding a pen or turning a key in a lock), and took daily walks up and down a hill (helping him maintain his gait and also keeping his posterior chain strong). He had extraordinary genetics. Nevertheless, his daily activities resemble a few of the primary skills for successful aging in place: grip strength, gait, and squatting ability.

These skills appear throughout the Pilates work, and they are useful in programming for our older clientele. Many of our aging clients do less repertoire, fewer advancements, and more modifications. We may work to maintain fitness rather than progressing. Rather than slowing down our older clients’ lessons, we can include more of what they need.

Hands

Hands that work and move well are essential for fine and gross motor skills. For stiff or arthritic hands, alternately holding a gentle fist and then spreading the fingers can increase range of motion and relieve discomfort. Squeezing and releasing a soft ball several times or twisting a towel as if wringing it out can both improve grip strength. There are also several possibilities for hand strength within the classical Pilates repertoire: wrist curls from the weight series, the sandbag device, and the castanets series. 

More subtle integration of hand mobility and strength into a lesson includes: ● Having a client alternate gently squeezing their fists and spreading their fingers during  Reformer footwork

● Incorporating the wrist curling motion of the sandbag device when the client holds a  weighted bar or pole (such as Short Box or Roll Up)

● If your studio uses cloth towels, asking the client to practice wringing out the towel  before they clean their apparatus

● Empowering clients to change their own springs– however tempting it may be to do it for  them! 

Simple homework exercises for hands include:

● Opening and closing hair clips, hole punchers, or clamps with control

● Squeezing stress balls

● Stretching their fingers with a thick rubber band or toe corrector 

Gait

We’ve likely known an older person who seemed strong until they fell… and fell again. Balance isn’t just staying upright; it’s also moving through space deftly and confidently. Balance and gait are closely linked, so unilateral work has tremendous value for aging clients. Several of my clients have a love/hate relationship with Standing Pumping on the Wunda Chair, but for many it’s a big ask. Here are some ways to get there:

● Side-lying work provides feedback for side body alignment. This could be as simple as one-lung breathing or as rich as a side kick series.

● Swimming on the Small Barrel or Spine Corrector. If balancing on top of the barrel isn’t available, slow it down, lifting one arm and leg while actively resting the opposite arm and leg on the mat.

● Single-leg springs on the Cadillac or Tower

● Standing and shifting weight from foot to foot while holding a Magic Circle between the ankles. 

Homework assignments for balance and gait can include:

● placing an object on the floor and intentionally stepping over it

● practicing balancing on one leg, then balancing with eyes closed. 

Seat

The ability to sit down and get up again can mean the difference between an active older person and someone who (literally) just sits around. Squatting and getting up are required to garden,  work at a desk, eat at a table, and even use the toilet. We see the pattern for getting up and down nearly everywhere in the Pilates studio: the classical mount for both the Reformer and  Mat, Seated Pumping on the Wunda and High Chairs, and every Frog variant.

Delicate or replaced knees and hips in older populations can mean that some of these exercises need modification. Some possibilities for older clients who need to squat but can’t perform the  full exercise include:

- In Reformer footwork, asking a client to open the springs halfway, hold until the glutes  activate, and then straighten the legs. 

- Incorporating seated Magic Circle and Magic Circle pliés into the workout. - Pelvic Lift on the Reformer– potentially with lighter springs for capable clients

- Shoulder Bridge variations on the Mat, Small Barrel, or Spine Corrector. 

- The Wall Chair

Homework for squat strength can include the Wall Chair and Shoulder Bridges.

By emphasizing the role of simple and functional strength, Pilates instructors may be able to help our clients live richer, fuller retirements– both in the studio and at home. While living to 106  isn’t guaranteed, Pilates is certainly a practice for longevity.

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Kristen Davis co-owns The Pilates Lab in St Louis, Missouri, a host studio for Alycea Ungaro’s Real Pilates Teacher Training. In her 17 years of teaching Pilates, she has studied extensively under the lineages of Eve Gentry, Romana Kryzanowska, and Kathy Grant.