HOW PILATES CAN HELP
YOUR CLIENTS REHAB
FROM INJURY
If you’ve never considered the role Pilates can play in rehabilitating clients with injuries, think again.
o the uninitiated, Pilates can sometimes be dismissed as a
gentle mind body workout that takes place behind closed
doors. Something a bit like yoga, perhaps. The fact is,
however, that this method of conditioning was born out of a need to
achieve functional strength necessitated by a weakened physical state.
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Origins of Pilates-based work in rehabilitation
As a child, German-born Joseph Pilates suffered from a multitude
of illnesses that resulted in muscular atrophy and weakness.
This inspired him to become physically stronger and, ultimately,
dedicate his life to the pursuit of functional strength. His pursuit of
physical and mental strength led him to study yoga, martial arts,
Zen Meditation, and Greek and Roman exercises. He worked with
medical professionals, physicians and his wife Clara, who was
a nurse. It was the integration of these various modalities that led
Pilates to develop his own unique method of physical and mental
conditioning, then termed ‘Contrology’.
Introducing his method of whole-body conditioning to the US in
1923, over the next couple of decades Pilates saw it embraced by
popular dance instructors and choreographers, including Martha
Graham, George Balanchine and Jerome Robbins.
As elite performers, dancers often suffered injuries that
demanded long recovery periods. Unique at the time, Pilates’
method encouraged movement early in the rehabilitation process.
He found that by introducing movement without impact early in the
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rehab process, the pace of healing increased and time off training
decreased.
It wasn’t long before the wider dance community caught on and
adopted Pilates’ methods for both conditioning and rehabilitation.
Seventy years later, his techniques began to permeate and gain
popularity in rehab circles. By the 1990’s, an ever-increasing
number of rehabilitation practitioners were using the Pilates Method
in multiple fields of rehabilitation, including general orthopaedic,
geriatric, chronic pain, neurologic rehabilitation, and more. Within
the rehabilitation setting, most Pilates exercises are performed
on several types of apparatus, the best known of these being the
spring-based Reformer.
The apparatus work evolved from Pilates’ original mat work (which
was difficult due to the effects of gravity on the body). On the apparatus,
springs reduce the effects of gravity and help control movements,
which aid a safe recovery. By altering the tension on the springs or
gradually increasing gravitational forces, someone recovering from
injury can be progressed towards full functional movement.
Today, more and more healthcare practitioners are using the
Pilates-based approach in rehabilitation.
Motor learning, core control and the Pilates-based
environment
Core control is the most common desired outcome for functional
movement. Research led by Richardson and Hodges in 1990’s
Australia looked at the importance of trunk control. Their research
focused on defining the activity of core musculature among healthy
adults experiencing chronic low back pain during upper extremity
movement. The results support the importance of core stiffening
in preparation for movement of the extremities: core stiffening is
not thought to restrict movement, rather to facilitate controlled