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Clinical Pilates
Doing more for low back pains than ‘core stability'

Pilates has been used by many to prescribe  “core stability" for low back pain.  Specifically, this approach promotes core muscle contraction and maintain it while lmovements are performed. Recently, there is a growing mass of research showing that this approach is not beneficial.

Clinically, encouraging these heightened contractions and rigid postures can reinforce unhealthy beliefs around movement, and perpetuate pain.  (Nijs et al., 2013).

Over the years, with new emerging evidence on back pain,  Physiotherapy and Clinical Pilates has evolved to move beyond this stability approach.

In particular, Clinical Pilates explores movement rather than promote rigidity.  Instead of focusing on isolated contractions, it concentrates on factors (evidenced based) contributing to pain.

Below listed are a few areas in which Clinical Pilates can be helpful to people with low back pain.

Body Awareness

Altered body schema has been observed in people with low back pain (Mosely, 2008) such as lack of awareness of body position with movement.

Performing movements with tools such as mirrors for visual feedback can help reconnect body with movement and improve co-ordination.

De-threateningc Movement

Evidence has shown that one's pain experience can be linked to tissues perceiving danger during movement (Mosely & Flor, 2012). Meaning, if you subconsciously fear movement will hurt, it can amplify pain, whether there is any damage occurring or not.

Therefore clinical pilates can be used to explore safe movements initially before progressing movements back towards the perceived "harmful" direction (De-threatening).

Tissue loading

Tissue loading with exercise can have an several positive effects. Firstly, loading muscles, tendons and joints around a painful area can initiate a neurophysiological response to reduce pain similiar to manual therapy.

Secondly, loading can initiate  tissue repair,  strength and conditioning in muscle, tendon, cartilage and bone. This is done through a process called mechanotransduction (Khan & Scott, 2009), where unhealthy weaker cells are replaced with healthy stronger cells.

In summary, discouraging rigidity and being liberal with movement is good for low backs.  As always, chatting to your Physiotherapist about the benefits of an exercise programe for your problem is the best place to start.

References

Khan K. M., & Scott A. (2009). Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. British Journal of Sports Medicine, 43, 247-251.

Mosely G. L. (2008). I can’t find it! Distorted body image and tactile dysfunction in patients with chronic back pain. Pain, 140, 239-243.

Mosely G. L., & Flor H. (2012). Targeting cortical representation in the treatment of chronic pain: a review. Neurorehabilitation & Neural Repair, 26(6), 646-652.

Nijs J., Roussel N., Paul van Wilgen C., Koke A., & Smeets R. (2013). Thinking beyond muscles and joints: therapists’ and patients’ attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Manual Therapy, 18, 96-102.

Smith B. E., Littlewood C., & May S. (2014). An update for stabilisation exercises for low back pain: a systematic review with meta-analysis. BMC Musculoskeletal Disorders, 15, 416-437

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Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.

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Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to

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3. increase the function of their hand following injuries or post-operations

Commonly treated hand pain injuries includes

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REFORMER CLINICAL PILATES & WELLNESS PILATES

Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.

It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.

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Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired, tight and tense muscles to accelerate recovery and  shorten downtime / recovery period required.

It also prevents muscles from scar tissue micro-tears (and potential ruptures), and increases muscle performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.

Read the benefits of regular deep tissue release therapy here.

ALTERNATIVE THERAPIES

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At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

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