By Dr. Suzanne Martin • Edited by Amanda Altman
Pilates Style: Tell us about the Zone of Apposition (ZOA) concept.
SM: I came across it while researching the causes of scoliosis for my upcoming book on spinal asymmetry and scoliosis. The ZOA describes a volumetric internal area between T8 and L3 (from the bottom of the scapula to the middle of the low back) that is essential for good breathing and posture, yet critical in the development of spinal asymmetry.
PS: Why is the ZOA relevant for Pilates teachers, in particular?
SM: As Pilates instructors, we emphasize posture and breathing; attention to these areas promotes emotional stability as well as a healthy spine. A natural rotary action occurs with every breath due to the (normal) unlevel height of the respiratory diaphragm. Consistently slumped, poor posture in the ZOA locks up the vertebra, begins a rib convexity, limits spinal flexion and rotation, diminishes oxygen consumption and promotes emotional instability due to dysfunctional breathing. Yikes!
PS: What can we do to help nurture the ZOA—and prevent spinal issues from arising?
SM: Fascial tension is an added dimension to expanding the potential of muscle tone and activation, since fascia connects the muscles into a system of slings. Imagery is known to create small internal muscle contractions and coordinations. Imagining a movement first is what happens naturally before we make a motion in the area of the brain called the Supplementary Motor Cortex. So using imagery as a tool to pre-activate certain areas of the body places tension on the fascial system, potentiating the muscle effects.
Adding rotational exercises—like the ones in the routine that follows—helps to unlock and balance spinal asymmetry. Another simple cue: smile! When you smile (see the Zoa Stance on page 58), we provide tension to the Deep Front Fascial Line while activating the deep trunk muscles, from the psoas and pelvic floor, all the way into the soles of the feet!
PS: Why did you choose to highlight the Reformer, in addition to matwork, in these exercises?
SM: While these mat exercises provide an open-chain plan for a good start, the Reformer is so versatile! Research shows that people develop external-space asymmetry along with physical asymmetries of the body. The Reformer excels for this issue. The Supine Thoraco-Lumbar Rotations (page 62) are a safe way for people—even those with profound spinal asymmetry—to breathe into the ZOA. It unlocks their asymmetrical thoraco-lumbar area via this “floating” resistance chain system (a concept I learned about from Dr. Chrissy Ruby) with the hands in a “rooster” position, the back on the carriage and the feet on the footbar.
The Reformer also serves as a concrete measure for accurate body position. The Z-Sit Spinal Spiral (page 61) with the pull of the hand loop also provides the floating chain effect. The landmark measurement of spinal-pelvic rotation in conjunction with floating resistance invites spinal and pelvic functional potential.
PS: Is this routine appropriate for all fitness levels? Are there any caveats?
SM: Anyone can do the posture stance, but clients with knee issues are better off seated on a pad or Sitting Box. Additionally, the rotations are not appropriate for those with osteoporosis.
PS: How often should these movements be performed?
SM: Add these mat and rotation exercises to your practice three times per week. Spaced repetition promotes adaptation and learning. Practice the ZOA Stance every day.
MAT: Finding the ZOA
• Aligns the internal trunk so the superior diaphragm assumes a dome shape—not a flat shape—that enlarges breath capacity
• Allows for proper coordination of vertebra-to-rib motion
• Begins with an image, coordinates that image to an understanding of the anatomy, and then brings the ability to feel the posture or motion
Setup: Stand with your feet parallel and sit bone–width apart.
1. Imagine an X from the sagittal plane, with one line from the inside of the lower end of your breastbone to the front edge of your sacral table, and the other line from the front of your 12th vertebra to the inside of your pubic symphysis. (In layman’s terms, connect deeply to the bottom of your internal rib cage with your middle pubic bones in front.)
2. Place the fingers of one hand at your xiphoid (below your sternum), and the other at your sacral promontory (lower back).
3. Using slight hand pressure, press your top hand backward and your bottom hand forward.
4. Imagine two lines coming together.
Teacher Tip: To cue my clients, I place one of my forearms vertically at the xiphoid, and the other vertically at the gluteal-fold area and gently press together. It’s a subtle movement.
Purpose: Smiling activates the tensional integrity of the Deep Frontal Fascial Line (DFFL), which runs from the soft palate down the back of the throat down the inside of the thoracic cavity behind the heart and lungs, moves past the respiratory diaphragm, down the psoas, through the pelvic floor to the hip adductors, hamstrings, calves, and finally to the soles of the feet.
Setup: Stand in an easy neutral with your feet parallel, sit bone–width apart, and your arms by your sides.
1. Smile strongly for 5 seconds.
2. Frown strongly for 5 seconds. Do 3 reps.
Teacher Tip: Avoid cueing the breath when doing this exercise with clients at the beginning, since most people drop when they exhale consciously.
Modification: Perform this exercise seated if necessary.
Advanced: Add smiling cues to your classes!
Breath of Fire
• Tones the respiratory diaphragm while expelling dead space in the lungs
• Focuses on the exhalation phase to promote vagal tone
• Supports emotional stability by enlarging expiratory capacity
Setup: Sit on a Sitting Box or chair, toward the front, with your feet hip-width apart (or on the mat with your legs crossed). Place your hands on the sides of your ribs.
1. Inhale for 4 counts, imagining, thinking about and feeling your ribs expand, like gills of a fish opening up; exhale while gently squeezing your rib cage. Do 4 reps.
2. Practice a percussive exhalation, keeping your lips gently closed and strongly exhaling through your nose. Attempt to compress your abdomen between the pubis and navel; feel like you’re wringing out a washcloth.
3. Repeat step 2 for 5–10 exhalations without stopping.
4. Inhale for 4 counts.
5. Exhale for 4 counts, gently squeezing your rib cage.
6. Take 1 percussive exhalation; hold the contraction for 4 counts.
7. Perform 20 percussive exhalations without stopping.
8. Do 3 sets of steps 1–2 in a row, and then cue to breathe normally. Assess whether the breathing is fuller or easier.
Tips: Sitting in front of a mirror helps to see if the thoracic outlet—the soft-tissue area around the neck above the clavicles—is puffing out. Avoid consciously attempting to inhale between the percussive exhalations. It will happen naturally.
Modification: This exercise is contraindicated for those with osteoporosis, high blood pressure, Ehlers-Danlos Syndrome, or during pregnancy.