Hi all,

Sorry this is getting to you later than expected. I wanted to go ahead and post these scenarios on the forum so they were available for us to continue discuss. We will use these three situations as topics for tonight’s mentoring meeting.


Scenario One:

(This one is from our Reformer 2 module for those of you who attended)

65 year old woman
Walks 2-3 miles a day
Has recently been diagnosed with ostopenia
Has done some Pilates at her gym, but stopped after a few classes because it was bothering her neck (no neck injuries)
Two months ago she stepped off a curb abruptly and is still experiencing pain in the right side of her low back. Still able to accomplish her ADL (activities of daily living :)
She has some knee grinding, accompanied by mild pain when walking up hill or stairs (no history of knee injury).
Her GOAL: To prepare for a trekking trip to Peru in 6 months.

Design an overall program for this student including what key elements would you work on, work toward, what would you focus on as points of getting her closer to her goals while helping to reduce pain and increase mobility/stability.

You can also create the “ideal session” for her (this would be one that would be after you’ve established the baseline, fundamentals etc.)


Scenario Two:

(This and the next scenario are similar to the ones we did in Ref. 3, but not exactly. Please read through them carefully.)

  • 16-year-old female gymnast.
  • Actively competing at the state and national level.
  • Has been diagnosed with facet syndrom in her low back (L1/L2-T12).
  • Pain is low level and constant.
  • Pain increases primarily on the left side when she is doing a lot of extension, which typically means when she is practicing her across-the-floor program.
    •     This typically will make her have to rest for several days.
  • She is hoping to compete in a major qualifying competition in 2 months.
  • She typically practices 5 days a week 3-5 hours each day.
  • She has been advised to take at least 2 weeks off to rest and recover.
  • She is tight in the anterior hip and anterior shoulder, very strong.
  • She is hypermobile in the lumbar spine and mildly kyphotic in the thoracic with only mediocre flexibility in this area.


Scenario Three:

  • 48-year-old male cyclist.
  • Construction worker for the past 25 years. 
  • Tight in quads and anterior shoulders
  • Significant kyphosis and forward head
  • Has had multiple injuries over the years including:
    • Torn rotator cuff – surgery (15 years ago)
    • ACL surgery on the right knee (10 years ago)
    • Fell off a ladder 5 years ago, diagnosed with serious lumbar and thoracic strain – feels 80% recovered except…
  •  Suffers actively from sciatic pain that goes all the way to his left foot
    • Sciatic pain comes and goes, is residual from ladder fall
    • Pain is exacerbated by long rides
  • Is extremely strong due to is labor-based work although he does more foreman work now and less manual labor
  • Would like to ride around the Big Island of Hawaii this summer – 8 months to train

 Scenario Four:

(I couldn’t help myself…)

  • 36-year-old pregnant woman – early in her second trimester.
  • Hypermobile particularly in thoracic spine, shoulders and hips.
  • Practices yoga on and off, was a dancer and athlete, but less active in the past 5 years since having first child.
  • Has right upper trap tension due to stress that results in migraines once every 2 or 3 months. 
    • Also has some nerve pain through front of right shoulder, elbow and hand due to broken elbow 18 years ago.
  • Has a long history of low back discomfort without any diagnoses, does not interfere with ADL
  • Was recently in a car-accident so neck pain and pain around right scapula has increased making it difficult to sleep, flex her neck or rotate.
  • Has right SI joint disfunction that comes and goes but has been exacerbated by pregnancy and the car accident.
  • Preparing for 6 week trip to CO where she will be hiking, camping, swimming and generally be very active. 
    • At that point she will be entering her third trimester. 


  Case Studies Recording 

  Case Studies Analysis