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Here’s a cute little recap of sorts I put together for a private session tailored to a 65-year-old male with noteworthy thoracic kyphosis and a mild loss of lower body strength with imbalance/asymmetries due to a past knee fracture on the left leg.

I’ve incorporated learnings from various resources e.g. courses and workshops I’ve attended, whether in person or online. Suffice to say, there are so many amazing resources available and it’s been a joy getting to apply these.

For this client, the primary goal was to address kyphotic posture gently and progressively through supported extension (well enabled by apparatus like the Barrel and Cadillac), while the secondary objective was to build functional leg strength to support balance and mobility in daily life, while working to reduce existing asymmetries.

Goal 1: Address kyphotic posture & build thoracic extension capacity

Top exercises if I had to choose:

1) Forward Push Thru on the Cadillac which

• Combines both flexion and extension to allow the client to more naturally unfold into extension.
• Option to add on rotation in a saw stretch variation which is great for thoracic mobility.

2) Arc Barrel for supported extension/rotation. In prone positions (tummy down on a flat mat), extension exercises can be really tough and uncomfortable for kyphotic clients. Lying prone on the barrel provides a more accessible entry point to these exercises, and allows a gradual progression in building up thoracic extension capacity. I also love Arm Circles on the small barrels for the chest opening due to the tightness of pectoral muscles in these kyphotic postures.

Of course, there are so many more exercises you can do, e.g. we could combine the use of the barrel with the springs on the Cadillac as a progression.

Apart from the exercises themselves, it would be important to build the client’s awareness of their scapula position. Ideally, the client can “sense their shoulder blades coming together”.

Goal 2: Lower Body Strength Asymmetries

Equipment like the Cadillac and Chair are actually amazing for working with asymmetries in lower body strength in bilateral movements. For instance, you can use a split pedal for bilateral footwork on the Chair. Meanwhile on the Cadillac, the leg springs offer independent resistance from a stable frame while on the reformer, the straps work with a moving carriage to create a connected system that can often hide unevenness. This means that the Cadillac’s separate springs demand more torso stabilisation and control. At the same time, strength demands e.g. on hip extensors to press the straps down in the sagittal plan also increase as the leg springs are heavier than those on the reformer.

A classic for knee strengthening would be the Forward Step Up on the Chair – sometimes referred to as the lunge on the chair. In a private session, the client can get the most out of this with tactile feedback to guide them through the natural bony rhythms of the knee (there is a spiral that takes place deep within the knee – femur spirals in, tibia spirals out as the client steps up onto the chair) and focus on knee alignment as the knee joint goes from flexion to extension.

I particularly like the Foot Press on Long Box – this would ideally be taught with client lightly relying on the chair handles first for balance and stability. Apart from training lower body strength (gluteus medius to stabilise, glute max to extend the hip, vasti of the quads to extend the knee, hamstrings to bend), there’s a lot of deep core work to stabilise in the coronal plane.

Goal 3: Breath & Ribcage Expansion

This involves lateral and posterior ribcage breathing, breath-to-movement integration, as well as an understanding of breath to support extension and mobility. For kyphotic postures, this is especially helpful.

The Breathing Side exercise on the Arc Barrel feels incredible for chest opening. I’ve included an image above to depict this, but do note that I had too much hip rotation here and my lateral flexion onto the barrel could have had much better detail. I love how using a curved accessory like the arc barrel provides feedback which allows for a fuller range of movement.