How should you modify Long Back Stretch on the Reformer for someone with Thoracic Outlet Syndrome?

When considering how to modify the Long Back Stretch on the Reformer for someone with Thoracic Outlet Syndrome, it's crucial to prioritize the individual's safety and comfort. Thoracic Outlet Syndrome can involve compression of the nerves or blood vessels between the collarbone and the first rib, leading to pain, numbness, or weakness. Given this condition, omitting the exercise altogether is the most appropriate choice in this context.

By avoiding the Long Back Stretch, you reduce the risk of exacerbating the symptoms associated with Thoracic Outlet Syndrome. This exercise often requires extended positions that might place additional stress on the shoulder area, which could potentially worsen the client's condition. Therefore, refraining from this specific movement allows for a safer and more beneficial approach to their Pilates practice, enabling a focus on alternative exercises that can better accommodate their needs without causing discomfort.

While other modifications could offer some adjustments to the exercise to make it more accessible, they may not fully mitigate the risks involved for someone suffering from this syndrome. Therefore, opting to omit the exercise is the most prudent strategy in this scenario.