What is Pilates? Is it good for me if I’ve had an injury or a problem that’s just not getting better? What is the difference between Traditional Pilates and Clinical Pilates?
Traditional Pilates is most suitable for people without injuries to maintain flexibility, tone muscles & improve posture.
Clinical Pilates is when specifically trained physiotherapists use Pilates exercises for treatment of chronic, long term problems. These sessions are 1:1 and are specific to each patients needs. This extends to surgery prehab to determine if surgery is needed or if conservative management is better.
Pilates has been around for decades now, but many people wonder whether this popular form of exercise is right for them. More and more people are talking about Clinical Pilates, how it differs from Traditional Pilates and the role it plays in injury management, chronic pain management, neurological patients and many other conditions.
Pilates is a form of exercise developed by Josef Pilates in the 1920’s. Traditionally, the exercises focus on breathing, body placement and activation of deep muscles to improve posture and build strength and flexibility. Traditional Pilates exercises are done either as floorwork or on equipment that uses springs and pulley systems to provide resistance. Traditional Pilates classes are held in gyms or studios and are run in small or large groups, led by a Pilates instructor. Generally, everyone in the class is doing the same exercises together at the same time. The purpose of these classes is usually fitness, strength and flexibility.
Clinical Pilates is a research-based interpretation of traditional Pilates, developed and used by Physiotherapists to build individualized exercise programs, specific to each person and his or her unique set of injuries or problems. Clinical Pilates is more than just exercise. Practitioners of Clinical Pilates are predominantly Physiotherapists. (Note- there are some Osteopaths and Chiropractors who are also trained in the method). This means that the practitioners who use Clinical Pilates are medically trained professionals, who have a sound understanding of anatomy, disease, pathology and injury. They are trained to conduct a careful and thorough assessment to diagnose the cause of a problem for an individual.
Using the Clinical Pilates assessment process, a practitioner will work out what is causing the problem and how to treat it. Analysing directions of movement is an important part of this assessment process. Physiotherapists who are trained in the use of Clinical PiIates will only select the exercises that can treat your problem, based on that clinical assessment of movement and direction. Clinical Pilates treatment programmes will often be “biased” towards the left or right side of the body to address asymmetries that are picked up on assessment. The bias is often rooted in the direction of an old trauma such as whiplash, or repeated postures like bending or twisting. It sometimes feels a bit weird for people to work one side of the body more than the other. But it’s a bit like doing a filling on one tooth and then doing one to the same tooth on the other side so they are the same! The treatment needs to be specific to the problem.
Clinical Pilates is especially suitable for people requiring specific, individualized, therapeutic, exercise-based treatment, not simply a generic exercise class.
Chronic back pain is one such condition. There has been much research done on the subject of exercise for chronic back pain and how strong muscles support the spine to relieve it. Generic exercise classes strengthen muscles, but when injury or pain is present, exercise selection needs to be careful and specific, so as not to aggravate the problem. Clinical Pilates treatment programmes are designed to achieve this outcome by facilitating correct activation of the correct muscles in the correct direction, which helps manage pain.
Many other chronic conditions also fit into this category. For example, many people with chronic hip, knee or shoulder pain are told to build up the muscle strength around the painful joint. By looking at the relationship between the spine and the nerves communicating with the muscles around the painful joint, Physiotherapists trained in Clinical Pilates can tailor an exercise-based treatment program for that chronic joint pain.
In some cases of chronic joint pain, people may be told that they will need joint replacement surgery at some stage down the track. A successful Clinical Pilates exercise program in the “pre-hab” phase of this process may actually be successful in abolishing pain and improving a person’s mobility and surgery is in fact avoided all together!
Other conditions that Clinical Pilates works really well for are those chronic recurrent overuse type injuries from sports or work-related activities. The specificity of the Clinical Pilates assessment and treatment programming addresses the asymmetries that are often behind the biomechanical imbalances of chronic recurrent sprains and strains. Aches and pains associated with Fibromyalgia, Benign Joint Hypermobility, Dysautonomia, Arthritis and Pregnancy are all well treated too, with the Clinical Pilates approach.
While there are many Pilates training courses around, DMA Clinical Pilates and Physiotherapy are the pioneers and world leaders in Clinical Pilates for Physiotherapists (and other allied health). DMA Clinical Pilates and Physiotherapy have been conducting training courses in Clinical Pilates for over 25 years, both within Australia and worldwide. There is a DMA Clinical Pilates certification program supported by ongoing research and course updates to ensure best practice and evidence based treatment for better outcomes. DMA Clinical Pilates and Physiotherapy have a clinic in South Yarra (VIC), and a growing network of DMA trained Clinical Pilates experts in the field, practicing in Australia and internationally.
Article compiled by Physiotherapist Ilana Raitman, with input from Maya Panisset, Treena Lord and Andrew Brand, Physiotherapists at DMA Clinical Pilates and Physiotherapy, South Yarra VIC Find a Clinical Pilates Clinic here.
DMA Clinical Pilates
09 Mar 2018