Clinical Pilates and Physiotherapy
What is Pilates?
Pilates refers to a unique body conditioning exercise method that is created for the purpose of re-balancing our body, to bring it into its correct neutral alignment as we target the deep postural muscles (such as the transverse abdominals and muscles of the pelvis).
Fundamentally, pilates challenges our core muscles and builds strength from inside to outside, helping us to reshape our body, adding more leanness and tone to our figure. One of its strength is that it marries perfectly strength and flexibility components, even as it takes out unnecessary stress and tension.
Pilates is definitely a growing trend in western countries amongst athletes and celebrities, as well as in the treatment and rehabilitation of orthopaedic, peripheral and musculoskeletal injuries.
What is Clinical Pilates?
So how Clinical Pilates was created is through the modification of pilates by physiotherapists by combining the original principles of Pilates with the latest rehabilitation research and education with emphasis on activating and strengthening our core muscles, to rehabilitate, prevent injuries as well as boosts fitness. In a nutshell, Clinical Pilates is the perfect complement to physiotherapy.
Pilates was first discovered and created in Germany in the early 20th century by a man called Joseph Pilates. He is very active and participates in a range of sports activities including diving, gymnastics and boxing.
However, you’ll be intrigued to find out that Joseph spent the most of his childhood days struggling and battling against asthma, rickets and rheumatic fever – it was all these that propelled his desire to overcome these problems and to become healthier. So he studied a number of different disciplines such as Yoga and Zen, which he then combined to create this new exercise method called Pilates today.
During the war he practices his exercise method, and became actively involved in the rehabilitation of war victims. Once the war ended, he then relocated to New York and went on to open the first Pilates studio ever, attracting and treating dancers, athletes, actors and all who benefited from his services.
Clinical Pilates vs Pilates
Clinical Pilates is used mainly to treat people with musculoskeletal, orthopaedic or sports in nature (think injuries to the bones, joints, muscles, ligaments etc), and is conducted by a physiotherapist who is certified with a Clinical Pilates certification.
If someone gets injured from a direct trauma or as a result from repetitive strain, they usually experience joint stiffness, muscle tightness, postural problems or abnormal movement patterns. That’s why it’s important to treat the complaints above before starting on pilates (that’s why physiotherapy and pilates complements each other so well).
Sometimes, certain pilates exercises may cause an aggravation of symptoms. An example is such as a person with low back strain and pain, which is caused by over-extension in the lower back. Such patients may have a more pronounced lordosis and extension pilates exercises is not advisable. This is something is will not be picked up if a person attends a standard routine pilates class, which combines both flexion and extension exercises.
So now it’s not only vital to select the right type of pilates exercise, it is also vital to ensure that the correct and appropriate level of pilates is prescribed. You see, standardised and routine pilates is likely too difficult for a person with an existing back pain – it will likely cause the client to compensate and use their stronger unaffected muscles as opposed to their core muscles, effectively distilling the benefits of pilates.
On top of that, the client may start to experience muscle spasm in the more-used unaffected muscles due to the increased exertion. What our physiotherapists will do is to first test your muscle strength and range of movement before you start any pilates to ensure that the exercises are appropriate and just-right the challenge that is helpful for recovery.
Another benefit of clinical pilates over the standard routine pilates is not only it is more tailored to individuals and their specific conditions, but it is also more functional. An example if the client is unable to participate in their favourite sport or activity such as playing soccer, dancing or even boxing, the physiotherapist can then modify the standard exercises prescribed to strengthen the core muscles as they execute the movement that aggravates the problem. This means that the core muscles of a football player is challenged as he kicks and dribbles the football, and not just in static postures.
When we treat and manage peripheral joints and/or muscular injuries such as wrist or ankle instabilities, the injured joint usually becomes the main focus of the treatment. Of course, this makes sense and is a good place to start for rehabilitation and gradually progressing to strengthening and stabilization.
However, clinical research is beginning to show that we should also take a big-picture view of the injury; that improving a client’s dynamic control of their movements will likely lead to less injuries in the mid to long term. There is a growing movement to rehabilitate athletes and clients with complementary pilates-based exercises to teach them how to move more efficiently. Pilates is commonly used to also treat injuries to the ankles, knees, hips, shoulder and elbows.
Spinal Injuries and Back / Neck Pain
One of more effect ways to treat back pain is to combine manual joint mobilizations, soft tissue release as well as pilates. Research proves that back pain often leads to a decrease function of multifidus, a deep muscle of your spine at the level of injury. The problem is that these muscles usually are not able to “switch” themselves on again once is starts to decrease in function - if left to itself, even if the pain has been resolved with superficial approaches, as the muscle continues to waste away from disuse, will cause future recurring back pain as our body tries to compensate for the muscle weakening by using other supporting muscles - this is why the multifidus requires specific physiotherapy and pilates-based training to be reactivated and strengthened, which will lead to increased stability of our spine.
Back injuries not only causes spine weakness, but also tends to recur over time, especially in bad postures which overloads the spine joints. Clinical pilates is a physiotherapy exercise that facilitates the strengthening of the deep spinal muscles as it educates a client where their neutral spine is. Over time, the client will definitely feel and know that their back is stronger, as they become more and more aware of what sitting or standing in good posture is.
In the long run, patients will also develop the muscular endurance to sustain the better posture for longer periods, as they consistently undergo clinical pilates for rehabilitation and fitness.
If a client is new to pilates, usually a one-to-one session with a physiotherapist or trying it in a very small class is strongly encouraged, so that he or she can learn the correct techniques as well as the five (5) concepts of proper pilates [(1) breathing; (2) neck position; (3) rib position; (4) pelvis position; and (5) stabilizing].
Pilates can get a little challenging and easily be done incorrectly, which is why it is vital for close supervision to prevent one from learning the wrong movement patterns.
Benefits of Clinical Pilates
Which clients would benefit from Clinical Pilates?
Clinical pilates is very specific to target:
Our therapists will be able to identify your posture, understand your injury cause(s), as well as understand the motivation why the person is aiming to return to (e.g. wanting to return to a specific sport or activity) and to implement exercises more functional and beneficial to the client for that activity.
That means that clinical pilates treats not only the cause of the injury but we are also able to pinpoint the exercises to strengthen the injured areas, on top of a “global” perspective of management for injury prevention in the long run.
If you know someone who has been suffering from recurrent back pain, neck pain or peripheral injuries such as pain in their shoulder, knees and ankles, they may just need clinical pilates with us =)