In the Fall of last year I received a phone call inquiring about private Pilates instruction. Virginia Hall had recently read an article about my company in a local newspaper and she explained, was looking for someone to work privately with her daughter who was mentally disabled. Having studied yoga for a number of years, Virginia was familiar with Pilates and how it can be used to focus on and correct particular muscular issues.  We arranged to meet the following week at my studio space in Frenchtown, New Jersey.

Tammy Hall is 44 years old and has Down Syndrome.  Born in 1963, at a time when pre-natal testing was unheard of, her parents waited months for a diagnosis.  Genetic counselling was in its very early stages and after finally finding a doctor who was willing and able to meet with them, Tammy had a series of blood tests that gave them a conclusive diagnosis of Downs.  With almost no resources available to the family, Tammy attended a special education school in West Orange, New Jersey.  Physical therapy was never offered, and although a series of x-rays on her hips, knees and pelvis showed no structural issues, Tammy’s gait was always clumsy and she had little sense of balance.  Both feet over-supinate, causing an inward rotation at the ankle, more pronounced on her left foot, which has led to an over-developed Achilles and in turn, an under-developed gastrocnemius. “We never could get her calf muscles to develop” her mother explained.  Slim and in good health throughout her childhood, her weight started to increase in her early 20’s, contributing to her uneasy walk.

After discussing with the family what the goals were for Tammy, and getting the go ahead from her  doctor, I started working with her privately three times week.  Uncertain of exactly how I could help, I researched Down Syndrome and found that manifestations include muscle hypotonia, joint laxity and atlantoaxial instability (symptomatic AAI occurs in only 1-2% of Down Syndrome patients).  It was here that I believed Pilates, with its controlled movements and smaller muscle recruitment would prove most valuable.

Bright, cheerful and extremely determined, Tammy learns best by watching me move. Focusing at first on her sense of balance and proprioception, we progressed slowly.  Using the Method fundamentals, we worked on connecting her breath, controlling her movements and staying engaged (sometimes a challenge!).  Able to fold herself in half during the Saw, or touch her palms to her toes during a warm-up, it was vital that Tammy learnt the ‘less is more’ rule of Pilates. 

Each of our mat sessions start with the Roll-Down, a fundamental exercise which focuses her on the importance of controlling her movements.  Stabilizing through the pelvic lumbar region using the pelvic curl has taken some time as the controlled movement patterns become established. Exercises such as Leg Circles and Corkscrew were also slow to assimilate as initially Tammy was unable to hold her legs in an upright position.  Now with stronger hamstrings and core stability, she executes perfect leg circles.  As her sense of balance improves, Kneeling Swimming has fast become a favorite, with various family members being privy to spontaneous mat demonstrations on the sitting room floor.  She is now able to hold a full plank position on the ball, something I find quite extraordinary. With the use of bands, the Swiss ball and her particular favorite, the MVe chair, Tammy has progressed enough to attend a weekly group class. She has almost the full repertoire of beginner exercises under her Pilates belt and watching the other class members, modifies when necessary. 

Four months into our program the results are plentiful.  Tammy’s gait has improved, her back and upper body are developing, her weight is coming down and she is much more aware of how she moves.  The calf muscles that remained underdeveloped are taking shape beautifully.  Equally important to the physical improvements are the sense of belonging and achievement she feels.  A regular at the studio, other students have built their own relationships with her, asking after her if she can’t make class, even baking her cookies and cakes at Christmas time.  Tammy’s family is thrilled by the improvements they see. As her mother says “If we had been given access to Pilates when she was a child, who knows where she might be now”.