“Hey, do you know of any places where my daughter can do Pilates after she is finished with PT?”
“Should my 6 year old do Pilates classes?”
“She has a stress fracture in her back and the doctor said she needs to strengthen her core. I heard Pilates is good for that so I bought her a DVD. Is that ok?”
“I need to do Pilates as conditioning for dance. What should I do?”
I get these questions all the time from parents and young patients. My answer to them has often been “Well it depends.” That is, until recently!
One month ago I had the absolute joy of attending the Pilates Method Alliance® Pilates 4 Youth teacher training in Berkeley, California. What a fabulous 2-day course in the most beautiful setting with the most interesting and brilliantly creative minds!!! It was perhaps one of the most inspiring courses I have taken in my entire PT and Pilates career thus far. It helped that we had a nice view of the San Francisco Bay, San Francisco, the fog, and the Golden Gate Bridge the whole time. I called it my #nerdcation.
Claremont Hotel & Spa in Berkeley.
I’m not sure if I spent more time learning or more time gazing out the window from my seat
The course was full of 60 or so instructors from all over the USA and the world who work with children and adolescents in all different settings: schools, clubs and camps, inner city wellness initiatives, health care/PT clinics and private practices, girl scout troops, and private Pilates studios.
The course was led by Celeste Zopich, Brett Howard, and Dawn-Marie Ickes, who co-authored the course manual and textbook Pilates for Children and Adolescents. These three brilliantly creative master teachers spearheaded the Pilates in the Schools movement, an initiative begun in the early 2000’s in the wake of decreased physical education time in public and private schools. You can read more about Pilates in the Schools and the research project they did with the kids here.
Watch a video about Pilates 4 Youth & Pilates in the Schools here:
I can’t say enough good things about the instructors. Celeste has a wealth of experience teaching in a parochial school. Brett teaches classes for children of all ages and brought a wealth of research and creative cueing and activity design perspective to the group. Dawn-Marie, the PT & Pilates teacher of the book, seems to be leading a life rather parallel to mine on the west coast. She works not only with young clients and incorporates Pilates into PT with them, but also has a special interest in women’s health and is a Redcord Neurac teacher trainer. I can’t wait to continue following these three as the Pilates 4 Youth initiative continues to take off.
See interviews from the book’s authors & course instructors here:
Too often children (especially girls) drop out of sports by age 13 due to burn out from early specialization, self esteem and body image issues, lack of success and fear of failure, or lack of funding from parents or other guardians. Or—on the other hand, children do not become active in the first place for so many cultural and societal reasons (that I don’t have time to discuss in this blog post) and we have even bigger problems of childhood obesity, low self esteem and body awareness, and low exercise interest or confidence.
Perhaps most interestingly, the course taught us about the “magic window” age of 9-13. This is when kids and teens are at the most vulnerable for both physical and psychological injury. The mind-body approach of Pilates targets these problems in a very kid & teen-friendly way. This is the best stage to intervene from an injury prevention standpoint in PT, too.
Favorite video quote from videos above (from a 13ish year old):
“Well I’m a swimmer and doing regular Pilates has helped me a lot with having regular breathing and opening up my shoulders and using my back muscles to move my arms.”
If that quote doesn’t sum up my personal and professional vision for helping my most beloved target clientele, I don’t know what does.
In the course, we learned how to design classes or private sessions for children of all ages and ability levels, from 5-6 year old girl scouts to 18 year old elite Olympians,. We had a great segment taught by Dawn-Marie on program design for children with special needs, or “special opportunities” as she liked to call it. She reminded us that all children and teens have challenges that vary on a long, diverse scale, regardless of the diagnosis or “category” in which they are placed. For youth of all ages and ability levels, it is our duty to determine how best to tap into each of their movement systems, regardless of the challenges and opportunities they face each day.
Superhero themed Pilates! It’s not hard work when you’re having fun while learning! I bet I know a few adults who would probably want to come to a class like this one…
The Pilates 4 Youth initiative is in a pretty grassroots stage now. So far the course has been put on twice to a total of about 150 people thanks to a grant from a generous donor. Hopefully it will continue to grow in popularity so that we can improve access for children of all ages to Pilates in a non-competitive environment. But we’re not exclusive to Pilates. And we are all over social media!
#hashtags are everywhere Follow the PMA on twitter at @PMATWEETER
Stay tuned! I’ve already been incorporating Pilates into my clinical practice for several years, but I’m anxious to start incorporating many of the new concepts I learned into practice and hopefully into group classes in the community soon. I’m excited to exercise my creative juices and have already invested in some fun tools to help me do so:
That’s a scooter board
Fabulous imagery and kid-friendly Pilates terms
To learn more about the Pilates 4 Youth initiative, check out the information on facebook.
Just ran across this great whiteboard video from an NPR post about low back pain. It’s a video by a Canadian primary care physician. It’s the best patient-friendly explanation I’ve seen of low back pain, what to know, and what to do about it.
While low back pain in the young athlete is not always the same as in adults and there are other kid- and teen-specific diagnoses AND PT treatments to consider, I still find this video very helpful for all ages. Though there are some very rare reasons they may have it, kids and teens almost never have problems like neurogenic claudication due to spinal column narrowing mentioned in the video. Discogenic pain is also more rare in kids and teens..
Given that low back pain is one of my favorite conditions to treat, particularly in the young athlete, I’d say this video hit the nail on the head for the most part. I love the physiotherapy, manual therapy, and Pilates shout-outs in the video. It’s important before beginning something like Pilates or yoga that you start slowly and ensure that your instructor is familiar with how to help people with injuries. In addition, if you are a kid or a teen, it’s important that the instructor is skilled in working with children and adolescents as there are special precautions that must be made in Pilates and yoga due to differences present in the growing spine vs. the adult spine. Typically what I do, as a Pilates instructor and PT, is teach kids the right movements they would need to know for Pilates, then find them the right Pilates instructor or class.
You can skip the ad at the beginning, but I also love the Neurac and WebPT advertisements at the start of the video. Between Pilates, Neurac, and WebPT, I use all of these things in my daily practice (in full disclosure: nobody paid me to say that).
The best 3 lines:
“Motion is lotion”
“A physiotherapist can probably help you with all of these things”
Last week I saw this Always ad defining #likeagirl. It went pretty viral among my facebook and twitter circles. If you didn’t get a chance to see it, see the link below. If you did, it’s worth another watch.
Upon watching this, I found myself wanting to cry, scream, smile, laugh, and fist pump. My personal and professional worlds were colliding. I love kids. I love psychological development (it was my major). I have studied peer relationships of children and teens. I love young athletes (it’s the title of this blog). I love a good youtube video and I love social media. I love advocacy for women’s health issues across the lifespan.
Like in the video, I wondered who is defining #likeagirl and why it is viewed by so many as an insult, especially when it comes to young athletes. Where did all of this come from–is this a thought women have of other women? Or a thought men have of women? How did girls’ own views of the phrase #likeagirl spin 180 degrees from positive to negative in a just few years across the young female lifespan?
Like any deep thinking blogger, I of course thought “this would make a great blog post.” I began to reflect on some striking #likeagirl challenges in my own upbringing as a female and how it affects my thoughts and views on this idea.
#Likeagirl defined during the “growing up” years
In 4th grade, I was one of only 3-4 girls in my class. I was teased, bullied, and outcasted for being the only member of the class in the gifted program. Anything anyone could try and take from me, they would. Lunch, pencils, erasers, paper, sanity, innocence…you name it. We tried to get the teacher and school to intervene but nothing really changed. So, fight #likeagirl I (well, my parents and I) did, and I moved on to a different school.
In 7th grade, the most “popular” girls sat next to me in science class. I specifically remember my “friend” asking me if she could cheat off of me during tests. I said no. There went that friendship. Apparently the way to popularity and being accepted #likeagirl was compromising morals.
As we walked down the staircase toward our 9th grade geometry class, my friend said “You know if you keep it up at this rate, none of the boys are going to like you.” It was me making straight A’s, swimming 5 hours a day, and setting nearly every school swimming record.
My friend then followed with “they’ll think you’re intimidating. Boys don’t like intimidating girls.”
At the time I remember thinking “wow, that sucks, boys won’t like me” for about 2.5 seconds. Then I was mad at her for thinking that saying that to me was going to change who I was and make me “give in” to the female norm (whatever that was) just so that boys would like me.
As if my friend were a fortune teller, I didn’t have a boyfriend for 3 years after that. That’s eons as far as high school goes. I had my moments of insecurity about it, but had plenty of other things going for me to distract me. I wasn’t worried about finding Mr. Right at 14, 15, 16, or 17. Ironically, I found him at 18. Mr. Right will tell you that he wasn’t intimidated by me, but looked up to and was inspired my successes. We started dating a month before high school ended. We’ve been together since then and now we’re married.
Daniel & I at our wedding in 2009. Duluth High School Class of 2002 representing!
Take that, Mean Girls.
Growing up, I was too busy swimming to get bogged down in the details and drama of teenage life. Being surrounded by a team that fostered friendship, acceptance, self discipline, self-confidence and the ability to rise from failure is an immeasurable benefit of youth sports teams. Unlike “throw #likeagirl” and “run #likeagirl,” there was no concept of “swim #likeagirl.” We trained in the same lanes as the boys, often pushing each other during practice to help each other improve.
That’s not to say I wasn’t an emotional, annoying teenager (sorry Mom and Dad) and that I didn’t have my moments of being challenged by the #likeagirl norm. I’m also not saying that every girl has to be a competitive athlete to have these values instilled in them. In fact, I believe just the opposite. There are countless other non-athletic outlets and avenues for girls to be successful and gain self confidence and self respect. We, as a society, need to embrace and encourage that.
Defining #likeagirl in the most educated circles
Along with sports, not every female needs academic success to define her, either. You may be surprised to know that even in the most educated circles of women, there are still struggles to define what #likeagirl means.
In college I was surrounded by new ways of defining female success. I’m not sure that I could have picked a better place to foster the #likeagirl mentality. But even Duke harbored its own challenges for women.
I remember walking around East Campus my freshman year thinking “why do these girls all carry purses with a big F or C’s on them? Who is Lilly Pulitzer? And who actually gets dressed in all of that stuff for an 8 AM Chem Lab when you have to wear a lab coat and goggles anyway?” I was completely flabbergasted with the materialistic side of all of the women around me. I had never been around so much privilege and entitlement. Feeling the “sink or swim” pressure, I accepted that I didn’t have to be just like them, even though I did gain an appreciation for things like Tory Burch shoes.
Let’s be honest, materialism is everywhere, not just at Duke. What I found more overwhelming than that was the fact that every female sitting in class with me was somehow like me. Everyone graduated in the top 1% of their class, made ridiculous SAT scores, was an incredible athlete, was devoted to community service and had already published books about it, was going to be the next Maya Angelou or rocket scientist…you get my drift. It was intimidating, impressive, and inspiring.
Here I was, surrounded by successful, accomplished women. I’d yearned for that given I’d run into problems with the definition of #likeagirl success in elementary, middle, and high school. I’m thinking “yes! finally people who are like me who will accept me!.” But something was still missing. I was a nerdy female athlete who liked to wear dresses and pearls one day, do crossword puzzles and hike the next day. This challenge to fitting in to the #likeagirl norm became abundantly obvious to me during sorority recruitment. Like in middle school, these women went to great lengths to be accepted into the most “popular” groups. Sometimes at the sacrifice of their own strengths and morals. That just wasn’t who I was. Also like in middle school, I did not sacrifice my standards to be popular. This was a blessing in disguise. I ended up being president of the sorority I joined, which was a phenomenal leadership and networking opportunity. In my group, women went on to become accomplished and successful lawyers, physicians, published authors, Teach for America leaders, CEOs, Miss America pageant contestants, Peace Corps and military officers, and stay-at-home moms. In our group, #Likeagirl took on many definitions of “awesome”, and that was ok.
In a men’s basketball-dominated school, the leaders of Duke Panhellenic sororities got together to support Duke Women’s Basketball. Our shirts said “Duke Women’s Basketball: the greatest thing since sliced bread.” We even got a notable men’s basketball player to join in our efforts.
#likeagirl challenged by Duke Women’s Initiative
While I was at Duke, these #likeagirl challenges played out before me on a daily basis like a great soap opera drama. It wasn’t just obvious to sorority women. Some smart Duke researchers caught wind of this, too.
The Duke Women’s Initiative was rolled out by woman President Nannerl Keohane in 2002-2003. It was a research initiative raising awareness to issues faced by women at Duke-women you’d think would have no problem defining or championing their successes. It highlighted the juxtaposition that the same women who were some of the most talented in the world in their fields would also find themselves downplaying their success by submitting to disillusioned social norms. They often gave into social pressures to build and mend their developing and broken female egos, respectively. In a sense, there was a real problem among Duke women to define what #likeagirl meant. Being around during this initiative is exactly why I chose to major in developmental psychology with a special focus on development of peer relations, particularly passive aggressiveness among females. I was so curious to know why we as girls act the funny ways we do.
The initiative coined the phrase “effortless perfection.” This describes the amount of effort many of these talented women put in to appear as if they’d put no effort into being successful. Why were they ashamed of people knowing they worked hard or were total nerds? Women confided that they didn’t want to make it look like they’d worked hard to achieve their successes, because hard work and determination connote “male”-like qualities they thought would be intimidating. And really–what it came down to–they wanted to appear this way because they were worried about acceptance and relationships with males and females on campus.
Whoa whoa whoa. That’s kind of like when my 9th grade friend told me boys wouldn’t like me for being successful, because that was intimidating. Or my 7th grade “friends” not liking me because I would not let them cheat. Or being bullied in 4th grade for being the smart girl.
#Likeagirl challenges extended to body image and social success too. Duke women would go to great efforts to mask eating and psychological disorders behind guises of normal-appearing, almost reckless or “laid back” behavior. You’d have the summa cum laude chemistry major who partied every night with her friends, but never studied with her friends because she didn’t want people to know she spent 10 hours/day in the library to get a 4.0. She only wanted them to see that she was a “cool party girl.” She probably didn’t like to talk about her grades or successes.
Like her, many women didn’t want men or other women to be intimidated by their efforts at appearing perfect, so they often hid those efforts or behaved in polar opposite, sometimes reckless ways. They didn’t eat or exercise with others for fear people would see how hard they worked to remain thin. They didn’t want to appear aggressive and dominating or weak and vulnerable for fear that they would not find friendship or intimacy because of those things. So we didn’t want to appear aggressive or intimidating, but we didn’t want to appear vulnerable either. Whew. Make up your mind, ladies!
On the swim team, there was no hiding how hard we worked or how much we ate. We all trained together, ate together, and often studied together, supporting each other through all of our efforts to be successful. This is my friend Julia. Julia was a Rhodes scholar finalist who went on to Harvard law school. Now she’s a rock star lawyer in Chicago.
As much as we did not or do not want to admit it, all Duke women likely had a piece of this mentality in us. After all, I’ll bet several of those women were 9th graders who were told it was not “cool” to be smart or successful. Why else would we, as a cohort, mask our successes in “effortless perfection” to try and fit in?
It wasn’t as bad as it sounds, though. There were great things about being around so many smart, successful women. I was fortunate to live with a different woman each year. Each woman had her own unique background and definition of #likeagirl. One was a varsity athlete, another was a biomedical engineer. One was a former pageant contestant, Duke cheerleader, brilliant double major, international public servant and future rock star pediatric NICU specialist. One was a champion of all things liberal arts, challenging abstract and socially responsible thinking on a daily basis.
Duke psychology majors. The blonde at the far right of the photo is my freshman roommate, Katie. Katie is now a lawyer. The girl on the left side of the picture is my sorority sister, Claire. Claire did Teach for America and now works as a science teacher.
These girls all had one thing in common: like me, they all had their struggles with defining what #likeagirl means. But they also didn’t let their athletic, nerdy, or “intimidating” pursuits get in the way of their relationships with significant others or friends. They didn’t compromise their personal standards so that “boys or friends would like them.” And they didn’t hide their efforts in being successful. We didn’t compete, but challenged each other. We were ALL far from perfect and accepted each others’ effortful imperfections. We were proud of being successful women without feeling shame for it. Maybe that’s what #likeagirl meant to us and should mean to everyone else.
The girl in the boot is my junior roommate, Kaitlyn. My sorority sister and good friend Becca is at right. Dr. Kaitlyn just completed pediatric residency. Dr. Becca now has a PhD in clinical psychology.
Defining #likeagirl in the professional world
In physical therapy school, I continued to raise the bar for myself. I didn’t make straight A’s and get uber-involved because I cared about the 4.0 or what involvement would look like on my resume. I did these things because, after all, this is the profession I chose to do and was paying a lot of money for. People were going to be trusting me with their injuries and their lives…and paying money for that! I wanted to soak it all in, then continually grow and learn more.
That’s pretty much what I’ve done–and I’ve done so following in the footsteps of some other PTs who totally rock it #likeagirl. Read this keynote address for incoming PT students last year given by one of my PT mentors who also happens to have founded the practice where I currently work. She has a great message of fighting #likeagirl to overcome adversity, embrace change, challenge the “norms” and become successful. She mentions the idea of surrounding yourself with people who are better than you are, surrounding yourself with people who challenge you, and taking in as many professional development opportunities as you can. Never does she mention compromising your values because “it’s not cool to be successful.”
I love what I do and I love learning more. I keep finding new things to learn about and courses to take. And now-I love teaching about it too. I have the privilege to teach students in the clinic and teach in the same PT program from which I graduated. I’m surrounded by fascinating female (and yes, some awesome male!) colleagues to keep me driven.
Nerdy PTs, mentors, and mentees have fun together. Here is part of the #pelvicmafia, a grassroots group of rock star women PT leaders advocating for awareness of women’s health needs all over the globe.
Recently, along with some awesome PTs, I was invited to share my nerddom with other PTs by teaching at next year’s national convention. It’s completely intimidating, but in an inspiring way. But, to be honest, I don’t need a convention to share my excitement for what I do. In my own life, I’m retweeting, sharing, pinning, instagramming or posting every article or inspirational item I can find. To all of you who follow me—sorry I’m not sorry for bombing your newsfeeds and timelines with this stuff.
Nerdy PT posts dominate my twitter and facebook feeds often accompanied with #nerdclub
#Likeagirl, I’ve turned from the girl being bullied or shamed for being nerdy and successful to someone who is proud to own it. It helps that I have a few supporters who are proud to “own it” with me.
Nerds can be princesses or Wonder Women, too. Here I am with the #nerdclub president.
#likeagirl, Dr. Julie style
And now I find myself colliding all of my passions, specializing in and working with young athletes. Working with young girls from age 6 and up, I have the joy of seeing girls go from “cute” and running #likeagirl in elementary school turkey trots, “sassy” and competing #likeagirl to make the middle school cheerleading squad, to “sophisticated” and swimming #likeagirl in high school to set records. I’m just happy to help them explore and stay strong in their passions and dreams. Unfortunately, along the way I’ve seen my fair share of girls who have fallen prey to peer pressure and given up on the dreams they’d once devised for themselves at that cute, turkey-trotting age.
My favorite 6 year old: being a rock star cheerleader
The most common age for sports dropout is 13. It’s that “magic window” age when girls are in that 7th-8th grade world of “to give in or not to give in.” Unfortunately in our world, there aren’t other great activities that are always “acceptable” for girls to put their hearts and minds into. Though I imagine there are exceptions to this, girls who hang out with the geeky boys, are in engineering club, beta club, national honor society, robotics club, and the 4H club—but don’t play sports or do “girly” things– likely won’t get elected to be prom queen.
And that makes me sad. I’m not saying the traditional “girly” or “sporty” things are bad. Be a pageant queen! Be a princess! Be a star athlete! Go you! I’m also not saying that the 4H club president needs to be famous. But girls need credit and encouragement for more than the traditional #likeagirl roles they have been given. They shouldn’t have to become “effortlessly perfect” for fear that someone will think they’re intimidating, nerdy, or not feminine for being successful.
She may not know it yet, but my favorite 6 year old is also the president of the junior #nerdclub
See this fabulous video from GoldieBlox, a company and campaign devised to inspire girls AND our culture to balance, nuture, applaud, and respect girls’ interests, regardless of what they may be. When I saw that video, it took me back to more of my college observations about defining women’s success by more than just a gender role.
In my experience as a youth sports PT, I find in that “magic window” age of 10-14, too many girls show up on my caseload riddled with pressures placed on them for being too athletic or not athletic enough, too nerdy or not nerdy enough. Some have injuries that just won’t go away without a medical explanation for them. It’s no secret to many of the professionals with whom I work that the girls are often subconsciously using their injuries as an “out” from the pressure of sports. As long as they are injured, they don’t have to compete. Plus they get a lot of love and attention by way of parents, friends, and healthcare professionals worrying after them and making them feel special. It becomes an endless, often sad, cycle, that can end in being socially outcasted, or in medical complications including anxiety, depression, and general decreased conditioning because they are no longer exercising. I think we can all agree that overall these situations probably aren’t the most productive or positive ways to make the girl feel special and valued.
It’s my wish in working with young female athletes or non-athletes, that they never feel pressured to stay involved in a sport or activity that doesn’t make them happy. Likewise, she should be accepted for doing the things that do make her happy. If a girl does or doesn’t love an activity, she should live in a world where she feels ok saying so. She shouldn’t be shamed for being successful because “that’s intimidating.” That can backfire, too. She’ll give up on her dreams and eventually get herself into trouble in some way. Even the young athlete who loves her sport should be encouraged to find balance in her interests, to find success in more than just her sport, academics or her appearance.
It’s important we as a society (and medical profession) encourage success and self confidence in any interest a girl has. We need to encourage that #likeagirl means something awesome, not awful. Maybe that 8 year old princess-loving girl will become a beauty model or Hollywood actress. Awesome! Good for her! Or maybe she will be the CEO of a Fortune 500 company. Or perhaps she will design the next vehicle that takes humans into space. See this GoldieBlox video about women becoming engineers.
Developing girls are vulnerable. What we as adults say to them makes a lasting effect. What their peers say to them makes a lasting effect. Just notice how vividly I remember 16 years later when my friend (who is still a good friend) said to me how unpopular or undesirable I was going to be for being a successful female.
So please—no matter what inspires her—help your daughter, sister, niece, friend’s daughter, friend, student or patient have the confidence to be proud to be #likeagirl, no matter what she does to succeed. Help her be proud to humbly share with others how much effort she put into doing so.
Model positive behaviors. Service, encouragement of other women, making friends with boys without making them boyfriends.
Encourage healthy competition on things that should be competitive (which is almost nothing we do). Encourage teamwork, compassion and support on everything else (which is almost everything we do).
Help her learn the difference between “humility” and “weakness”.
Help her learn the difference between “aggressive/intimidating” and “assertive and motivated”
Define success and confidence in something other than trophies, first places, makeup, number of boyfriends or girlfriends, or the size of her bra or her pants.
Help her learn that she does not have to strive for perfection in anyone’s eyes, not even her own. Flaws and differences are good, too. If she is that successful girl (which she will be if you follow all this blogworthy advice), let her know it’s ok to show and be proud of how much effort she put in to that success.
It’s ok to be different. Help her embrace the things that inspire her and make her unique, even if you don’t necessarily find yourself inspired by those things.
Encourage her to fight #likeagirl in whatever area inspires her and not let her gender define her in any way.
Step it up ladies! You don’t have to be a muscle bound, Rosie the Riveter type to be #likeagirl. It’s ok to be a pageant superstar, a cheerleader, or a princess. But it’s also ok to be an aerospace engineer, high powered CEO, blacksmith, NFL football coach, farmer, or construction worker. Be proud of who you are and model a positive female outlook for all those girls who are looking up to you. If you think someone looks “weak” just say so. If they look strong or successful, just say so. It doesn’t have to be tied to gender roles. Let’s make #likeagirl mean #likeawesome and not #likeawful.
Physical therapists have a vast toolbox of skills to help improve someone’s ability to move. Within that toolbox may be exercise techniques, Pilates, Redcord Neurac, dry needling, other manual therapy techniques, taping, tapping, yelling, cheerleading, lecturing, parenting, inspiring, and mentoring. The truth is, despite what any studies say or any expert will tell you, there is probably not ONE best treatment for any young athlete. I will say no more because Adam (@thesportsphysio) who I follow on twitter really just summed it up best. I’ll let him do the rest of the talking…
Young athletes deserve the highest quality of care. They may be young, active, and often have fewer complicated impairments as their adult counterparts. However, this does not mean that they deserve to be seen at the same time as more than one patient or by any provider other than a PT. Kids and teens have special needs that differentiate them from adults–their cognitive processing and ability to understand movement and exercise concepts often requires more attention than the average adult. Read this great post from my colleague, friend and boss about the ever changing waters and defnitions of what is “quality” physical therapy.