First Stretch class - the disasters & where to from here!

[BodylineHealth]

Hi there fellow ST's!

As a newbie to stretch therapy, I wondered whether I could call on the ST community to share their experiences so far of ST and offer any advice.

I had my first ST class of 6 participants on Thursday and have been very excited about it! As a remedial therapist, my class has come entirely from my database, so they are at least familiar with the benefits of stretching. However, despite regularly prescribing stretches and exercises, I found myself like a fish out of water in the class - and I've known my participants (the majority) for years. I was so nervous the night before, I even dreamed about it where I had over 40 people turn up for the class (in a space only big for 10 people)!

A big thank you to Merryn for posting her class plans. They're fabulous and very useful.

So, I'm curious about several things.

I could only fit in an 8 week term this year and wondered if others had done similar and what to focus on. I started with the foot sequence (including Cherie's plantar fascia release on the ball - thanks Cherie!). [side note: Despite the fact everyone loved the tennis ball release, the last minute extra tennis balls I grabbed weren't up to scratch and as soon as weight bared down on them, most either squashed flat or burst!! Thankfully, most had a good sense of humour and we moved on!]

Next was introducing the pelvic movements and daily 5. We completed the 'Elvis/ J. Lo' (again, awesome cue Merryn!), did the angry cat/ happy dog, looked around at our tail and finished with the side bend (kneeling).

Everyone did really well.

As any class, I'm sure, there were varying degrees of ability and flexibility. One lady in her 60's had a double mastectomy approx. 12 months ago, and found the side bend a little uncomfortable. I imagine there would be a considerable amount of scar tissue from the operations, including over her lats. She felt more comfortable as the shoulder rolled forward. I imagine a lot of the restriction in that area for her now would be due scar tissue - should I be suggesting this is an area for her to continue working on? Should I continue with that exercise or should I be suggesting another/ modification initially?

I also have a lady in her mid 50's who is used to doing yoga. There are 2 points here:

1 - although I explained to her this is not yoga, I feel there is a sense that given the initial class, she feels as if it's 'easy' or 'not enough'. I wondered what experiences other ST's have had where there is a more 'advanced' student in the class and how you have handled such students.

2 - During side bend, she feels 'bunched up' on the side she is bending towards, on the L & R. From her 'experience' she stated 'and I don't think its very good' - i.e. its causing her discomfort therefore it should be avoided.

Knowing her through treating her for many years, the area she mentions is what we've been working on more recently in the clinic, so when she made the comment, instinctively, I believe this to be an area she needs to stretch. Even so, I felt quite intimidated by her 'matter of fact-ness' and reminded me of how green to ST I really am!

So, in summary, I'd like to hear about your experiences and how you handled situations such as the ones stated above as well as suggestions for class plans moving forward into week 2.

Thanks guys,

Holly

[Kit_L]

Holly wrote:

As any class, I'm sure, there were varying degrees of ability and flexibility. One lady in her 60's had a double mastectomy approx. 12 months ago, and found the side bend a little uncomfortable. I imagine there would be a considerable amount of scar tissue from the operations, including over her lats. She felt more comfortable as the shoulder rolled forward. I imagine a lot of the restriction in that area for her now would be due scar tissue - should I be suggesting this is an area for her to continue working on? Should I continue with that exercise or should I be suggesting another/ modification initially?

I also have a lady in her mid 50's who is used to doing yoga. There are 2 points here:

1 - although I explained to her this is not yoga, I feel there is a sense that given the initial class, she feels as if it's 'easy' or 'not enough'. I wondered what experiences other ST's have had where there is a more 'advanced' student in the class and how you have handled such students.

2 - During side bend, she feels 'bunched up' on the side she is bending towards, on the L & R. From her 'experience' she stated 'and I don't think its very good' - i.e. its causing her discomfort therefore it should be avoided.

Knowing her through treating her for many years, the area she mentions is what we've been working on more recently in the clinic, so when she made the comment, instinctively, I believe this to be an area she needs to stretch. Even so, I felt quite intimidated by her 'matter of fact-ness' and reminded me of how green to ST I really am!

May I comment on the above, part by part. Sorry to take so long to reply; I had hoped that one of the other teachers would weigh in.

I recommend that you introduce the partner stick stretch in the next class, and you personally work very gently with the double mastectomy women: this stretch, applied at a suitable level of intensity, has helped a number of other patients with the same history. Be very gentle, and repeat at least twice.

The yogini: remind her it's the first class in a Beginner's series: it will get harder. And you can always give her stronger versions of any of the basic poses, too.

As for the "bunching up": instruct her to breathe in deeply and lift her ribs before bending to the side (in any pose requiring lateral flexion). The response described is usually the obliques cramping, and often happens with short-waisted people. It is not any kind of problem. Tell her, too, that if this persists, immediately stretch in the other direction. This will 'de-cramp' that spot immediately.

Otherwise, please report back from week two (or it might be three by now). kl

[oliviaa]

Hi Holly

Congratulations on your first class!

Re. the discomfort in the side bend, many people feel this, particularly in the standing and kneeling versions where the support arm is close to the body. Try the standing one with the support arm reached out to something stable (a table-top, a rail, a chair back as long as the chair won't move), or the kneeling one with a low stool or block or chair seat to lean on. This will free up space on the inside the curve on the side being bent towards, but still allow the person to support themselves.

For the lady who has had a mastectomy, I recommend passive backward bending where the arms are slowly moved from next to the hips through to just above shoulder 'height' (think crucifix); this allows a gentle pull across the chest, completely controlled by the student, and is passive (think 'drape', rather than stretch). As well, if there's a left/right difference across the chest, the student can adjust each side to suit, or even move one arm at a time to reduce the overall stretch.

For the Yogini who 'thinks' it's too easy early on, suggest you introduce the lunge as a hip flexor and then a hamstring stretch; everyone else in the group needs to get going on the hip flexor work, and the Yogini will also likely be very tight in that part. You could do the partner assist with hand behind the glute of the back leg, but then work with her specifically and sit on her hip so she gets the idea quick smart!

A general teaching point ... try not to engage with the energy behind a student's question, rather just the content.

Cheers

Olivia

[BodylineHealth]

Hi Kit & Olivia,

Thank you both for your responses. Both very insightful & helpful.

Tomorrow night is week 2. I have taken into account both your recommendations for the class plan, begining with the daily 5, then adding the stick stretch, passive backbend (NB: Liv, just to clarify, do you mean the supine over rolled up mat/ support #27?) and possibly introducing hip flexor/ hamstring. I'm thinking of starting with the passive backward bend before the stick stretch (???) as I'm finding people are extremely stiff through their UTx/Tx/Sh's and I'm having difficulty performing this stretch effectively with this population. Please feel free to comment/ suggest.

I like the idea of the stool/ chair in front for the side bend too, thanks Olivia. Kit, the bunching up explanation was very helpful, thank you.

The general teaching comment is also very helpful, thanks Liv. Having been a practitioner from 16, I've been used to having to come up with all the answers and trying to figure it out for myself. I'm not used to letting people figure it out for themselves, so this is a big learning curve for me!!

On a real plus, I have some very exciting news about the lady who's had the mastectomy that I thought you may find interesting; since she's had chemotherapy, she (let's call her 'Maude') has had no feeling in her feet (over 3 years). Apparently this is common for chemotherapy patients. Maude came in for her usual remedial massage treatment today and was 'bursting at the seams' to tell me her exciting news - she has a sore foot! In the first class, we focused on the foot sequence and started with the plantar fascia release. Ever since then, her feet have felt warm and a whole different bunch of sensations (including soreness from the session!). She was so excited to tell me about her sore foot as the specialists have told her she'd never have feeling in her feet again. I've never seen someone so excited to feel soreness! She's absolutely chuffed with the class and can't wait until tomorrow night! We're going to continue doing some foot work, particularly the PF release and I'm interested to hear of other exercises that may also be useful.

I will keep you posted on the progression of the classes and students. I look forward to your comments and suggestions.

Holly

[oliviaa]

Hi Holly

Re. passive backward bending, yes to #27. Make sure you do some version of the lunge before you introduce this; good practice to pre-stretch the hip flexors ahead of any back bending.

Great news on the foot soreness, too!

Cheers

Olivia

[Kit_L]

There comes a time in all relationships where the pupil moves beyond the teacher; example:

Olivia wrote:

Try not to engage with the energy behind a student's question, rather just the content.

Perfection, right there.

Thank you, kl

[BodylineHealth]

Thanks very much for all your support and insight.

Latest updates: Week 5 (this week)

I'm finding I'm not getting through many exercises in a session (no complaints from anyone, it's just time flying while we have so much fun!) so I haven't bottom to the stick stretch or backward bending just yet. This week I'm focusing on shoulders, so I'm aiming to include stick stretch and possibly introduce backward bending. The last session was supposed to be warming up to introduce back bending but by the time we'd reviewed and worked through various 'warm up exercises', we'd already gone over time!

'Maude' unfortunately has to put her classes on hold until next term as she's injured her back (lifting and twisting a week after the first class) so there are no other developments with her, other than her feet both feeling sensation ever since the first class.

The 'yogi' isn't as much of an issue now - we've discovered many new areas she needs work on, so she's being challenged well and truly! An interesting development is discovering one of the students is an ex gymnast and is thoroughly enjoying and getting a lot out of the classes. My challenge with her will be providing enough advanced stretches for her to keep her challenged. Her main objective is not just maintaining her flexibility but building strength, especially around her leg/ pelvic area. I've suggested we include more C-R through greater range than just EROM. I'm open to your suggestions and comments on this.

The others are just really enjoying the class (and time away from the kids!).

I welcome comments and suggestions from you all.

Thanks again, Holly

[oliviaa]

Hi Holly

Re. the ex-gymnast, one of the things I found at the end of my years doing gymnastics was that I had distinct patterns of flexibility around my body; that is, some parts very loose, others very tight. Specifically: loose in legs-apart movements, very tight outer hamstrings; super-tight calves and ankles; tight hip flexors; marked differences around the shoulder joint --- loose in flexion (including being very flexible in thoracic extension, indeed spinal extension generally) but relatively tight in the back of the shoulder joint; tight in thoracic rotation.

Not knowing your student, I'd recommend you have her focus on how she can even out flexibility around all joints. I feel very fortunate that I got involved with ST in my early 20s and have worked on precisely this in the past 15+ years (as well as on maintaining strength) and now --- entering middle age --- I have no problems in my body, which is not true of many of those I did gymnastics with.

Cheers

Olivia

[BodylineHealth]

Hi Olivia,

Thanks heaps for the feedback and suggestions.

The classes went really well. The ex-gymnast is so stoked she's looking into studying massage and ST

We have 4 x classes/ wk scheduled for this term; fingers crossed we get the same response this time around.

Speak to you again very soon!! x