An overview of clinical Pilates

In a nutshell, Pilates is a form of exercise that teaches you how to use your stabilising (core) muscles to control movement efficiently and effectively during functional activity.

Being able to move more easily during functional activity improves overall health and wellbeing.

The history of Pilates

Pilates was developed in the early 20th century by Mr Joseph Pilates.

His intention was to improve rehabilitation programs during the first world war and to assist soldiers in regaining their health through stretching, strengthening, and stabilising their muscles.

Pilates has been recognised and utilised more by physiotherapists worldwide over the last 35 years.

What is the difference between clinical Pilates and traditional Pilates?

Clinical Pilates is an adaptation of traditional Pilates.

It is completed under the supervision of a physiotherapist. The aim is to learn how to activate specific muscles and promote a better quality of movement to achieve long term recovery following injury and/or surgery.

Clinical Pilates is also a safe and effective form of exercise for people with chronic lower back pain and/or other long-term injuries.

Exercises are tailored and progressed specifically to an individuals needs based on a thorough assessment of ability and musculoskeletal condition.

The role of the physiotherapist is to help educate about any ongoing pain, help alleviate any fear associated with movement, correct poor movement habits and postures, and promote recovery.

The science behind clinical Pilates

Joint stability is achieved by the collaborative working of three subsystems.

Passive system (osseoligamentous structures), active system (muscles) and the neural (nervous) system.

Instability occurs when either of these components are disturbed by things like tissue damage, weakness, poor posture, or poor motor control.

In Pilates, you learn to engage the deepest abdominal muscles, which form the foundation for optimal movement, joint stability and correction of poor biomechanics that underlie injuries.

The benefits of clinical Pilates – who should have a go?

Clinical Pilates is suitable for everybody, especially those who live with musculoskeletal pain, injury or are recovering from surgery. It is particularly good for those experiencing recurrent or chronic pain.

Pre-natal and post-natal women find clinical Pilates increases pelvic floor strength and control for prevention and relief of lower back and pelvic pain.

People with postural problems find clinical Pilates helpful as it allows them to develop awareness of their body, as well as increasing strength and flexibility.

Posture correction and improvement is key in Pilates as working the core muscle isn't possible without good posture and position.

Clinical Pilates will keep you active and improve not only physical fitness, but also mental and emotional health.

A woman doing Pilates

The full body benefits of Pilates

  • Building strength – Pilates is well known for building core strength. However, Pilates is also a whole-body workout, activating muscles that control movement
  • Improving flexibility – Pilates focuses on very specific mobilisation exercises, stretches and strengthening, that combined, improve the flexibility in the joints and muscles.
  • Concentration – Pilates is a workout for the mind and body. It takes an awful lot of concentration to ensure you are in the right position, activating the right areas and moving in a certain way. It allows you to really focus on how your body is moving and more importantly, how movement patterns have become dysfunctional.
  • Relaxation – Concentrating on your body and how it moves allows you to become very much present in the moment – just like mindfulness.
  • Breathing – Breathing techniques are used to encourage the best activation of the core muscles, as we exhale our deep abdominal and pelvic floor muscles contract, which helps with improving the strength and function of the muscles.
  • Balance and stability – Balance work improves joint proprioception which weakens with pain and injury. By working in balanced postures, we also challenge our stabilising muscles in functional positions.
  • Posture – Learning good posture can help to prevent injuries and reduce chronic pain. Pilates improves the alignment of the body to teach you how to use the right muscles at the right time.
  • Injury prevention – Additional to recovery, Clinical Pilates is great for preventing injury. By strengthening muscles, improving flexibility, correcting posture, and dealing with imbalances, it helps your body become more resistant to future injuries.

Is specialised equipment required to participate in Clinical Pilates?

No – to get started you just need a floor with a mat or towel. However, Mr Pilates did design machines such as Reformers and Cadillac Tables which can provide other challenges and progressions.

Clinical Pilates can be performed individually with a physiotherapist or in a class environment.

Why not have a go?

For beginners, performing a Pilates exercise involves engaging the 'core' muscle in a posture neutral position, then challenging your control by moving the limbs.

Various muscles will then work together to control your spinal position.

Eventually, you will work in different positions to challenge different areas.

How to contract the deep core muscle in neutral

  • Lying on your back with knees bent comfortably. Feet on floor in line with hips and knees
  • To find neutral – flatten your spine against the mat, then arch the spine upwards. Repeat 3-times then find halfway between the 2 points. This is neutral.
  • To engage the core muscle – trace a straight line from one hip bone to the other. Draw the stomach behind that line without squeezing the glutes or tilting the pelvis... it is a bit like stopping a wee or zipping up those skinny jeans!
  • While engaging the core, try and breath normally without holding your breath – in through the nose and out through the mouth.

To consider whether Clinical Pilates is for you, or you have concerns about your posture, book an appointment with an APM Physiotherapist in your local area by calling 0800 967 522.

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