Clinical Pilates – Could it Save Your Back
Pilates is an increasingly popular form of exercise originally developed by Joseph Pilates in the 1920’s. It is a total mind-body conditioning program designed to target the deep muscles of the abdomen and spine to improve overall central core stability, posture and balance.
Clinical Pilates combines the early principles of Joseph Pilates with current research in movement dysfunction, local and global stability and biomechanics to create a safe, clinically effective program for rehabilitation. In contrast to fitness Pilates, it is delivered by an experienced Physiotherapist with extensive background knowledge of anatomy and physiology, and specialist skills in movement and postural analysis. They will combine this with the concepts and fundamental principles of Pilates to create a rehabilitation program that is as individual as you, addressing both injury and any underlying dysfunction.
The benefits of Clinical Pilates are becoming increasingly evident and it is beginning to gain recognition for its effectiveness in not only the treatment of musculoskeletal injuries, but also injury prevention and performance enhancement. So why is it so great?
Improved Postural Alignment
Poor posture appears to be the consequence of an ever-increasing sedentary lifestyle, expanding waistlines and the occupational hazards associated with sitting at a desk for up to 8 hours per day. Pilates encourages good posture and alignment during all exercises paying particular attention to the shoulder girdle, the pelvic girdle and spine. Not only does this reduce abnormal loading forces through the spine and minimize stress and strain through the tissues of the body, it also results in an instantaneous ‘apparent’ loss of weight and increase in confidence.
“Weakness permits a position of deformity but shortness creates a position of deformity” (Kendall, 1983). Pilates aims to re-establish length through shortened muscles in order to restore mobility and normal movement patterns. Exercises primarily focus on incorporating dynamic stretches into movement whilst maintaining good alignment and control. A particular focus is placed on restoring normal mobility and mechanics through the spine and pelvis in order to ensure effective stabilisation through this central core area.
Pilates exercises focus around the concept of the powerhouse, formed by the muscles of the lower back and pelvis that are often viewed as those responsible for providing ‘core stability’. The powerhouse is worked in all Pilates exercises in order to create a stable base from which the limbs are able to effectively work. A number of exercises also work to build strength and stability around the shoulder girdle, which in turn provides an additional stable base from which the upper limbs can work.
The use of stability and control exercises as an intervention for people with spinal pain has long been supported by research. Stabilisation exercises which focus on building control and stability around the core and pelvic area are recommended in a number of clinical guidelines for the management of low back pain, and a recent systematic review concluded that such exercise interventions can be effective in reducing pain and disability (Brumitt J, et al. 2013). Effectiveness as a rehabilitation tool is not just limited to spinal pain and Pilates exercises are often included in the rehab of upper and lower limb injuries in order to ensure optimum alignment throughout the entire biomechanical chain and relieve stress on soft tissues and joints within the extremities that may be subject to overload.
A direct consequence of improving postural alignment is the even distribution of load throughout the body, minimizing stress through joints and the soft tissues. In addition, joints throughout the body are sufficiently supported by effective muscular activity, which prevents excessive shearing forces and as such predisposition to degenerative changes. Optimising the efficiency of movement also limits overload through tissues and as such reduces the risk of athletes developing overuse injuries with high intensity training.
Enhanced Sporting Performance
Building correct motor patterns with precision and control during low level activity will lead to improved efficiency of movement and facilitate the generation of greater strength, speed, power and flexibility. Pilates also places a strong emphasis on the mind-body connection resulting in improved body awareness; a skill that becomes extremely useful when training the technical element of your sport or activity. Reducing the risk of injury is also key here; if you are injured, you can’t train effectively…simple!
Just like your body the programme developed for you is unique and tailored to your specific requirements. As a movement specialist a Physiotherapist is in a great position to be able to identify specific areas of tightness and weakness, which may result in dysfunctional movement patterns. Pilates exercises prescribed within your programme will be adapted and tailored to focus on these particular dysfunctions.
So there you have it…now what are you waiting for?
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