Working to overcome faulty compensatory
movement patterns is a fundamental goal in the
Pilates-evolved method.
movement. This phenomenon is at the root
of all Pilates-based work.
Joseph Pilates believed that core
control is the essence of controlling human
movement. Richardson and Hodges also
identified the transversus abdominus
muscle as being a primary postural
control muscle. It is hypothesised that
the transversus abdominus is activated
to provide core stability during dynamic
movement. This approach to core control
supports the theory of movement advocated
by Pilates-evolved practitioners, more so
than traditional methods.
The Pilates-based environment is great for
designing task-oriented interventions. Within
this environment, a faulty movement can
be broken down into components by using
the spring-based apparatus, and changing
the body’s orientation to gravity. When you
evaluate a client’s needs and the desired
movement outcome (e.g. jumping, sitting,
reaching, rotating, or walking) you can design
a similar movement with the appropriate level
of load to support it while it heals.
The 30-second article
• Joseph Pilates developed his
method of physical and mental
conditioning in the 1920’s as a way
to achieve functional strength
necessitated by a weakened
physical state
• Pilates found that introducing
movement without impact early in
the rehab process increased the
pace of healing
• Pilates believed that core control is
the essence of controlling human
movement
• Pilates-evolved exercises can allow
clients to minimise unwanted
muscle activity that can be
responsible for inefficient
movement patterns, early fatigue,
and injury.
The goal of achieving efficient movement
and returning to functional movement and
enhanced performance is the foundation
of Pilates-evolved work. Pilates-evolved
exercises can facilitate such movement
behaviour by allowing your client to be in a
position that minimises unwanted muscle
activity, often responsible for inefficient
movement patterns and early fatigue, which
can lead to injury.
When a desired movement is challenged
by a decrease in proprioception, individuals
often over-recruit muscles in an attempt to
stabilise. Although it has not been proved,
it remains plausible that over-stabilisation
or faulty stabilisation inhibits efficiency and
acts as a hindrance to efficient movement.
For example, your client may be able
to demonstrate a 90-degree straight leg
passively, but when asked to lay on his or
her side, with a decreased base of support,
the available range of motion on the hip
drastically decreases. When you challenge
the base of support, and therefore balance,
the degree of efficiency and range of a
movement often suffer.
The Pilates environment allows you to
decrease the proprioceptive challenge by
increasing the base of support and providing
adequate assistance and feedback for
optimal motor learning. You can progress
the movement sequence by decreasing the
amount of support, ensuring that the quality
of the movement does not suffer. You could
continue the progression toward a more
functional task and familiar orientation with
gravity. Additional motor learning theory
would teach that a cognitive level of learning
take place first with internal and external
feedback. Once association takes place
and your client continues the practice, the
new movement sequence may become
automatic. It is this automatic execution of
new movements that reduces the risk of re-
injury and increases efficiency.
Another important factor for attaining
automatic functional movement is neurologic
feedback from the deep muscles of the trunk,
or the multifidus. The multifidi muscles have
six times more muscle spindles than any
other muscle in the trunk. This great source
of kinetic feedback plays a large role in trunk
awareness (Richardson et al).
Theoretically, if the multifidi and other
deep paraspinal muscles are inhibited
secondary to pain and pain inhibition, we
can hypothesise that the same process
would inhibit the proprioceptive feedback
mechanism of that muscle (i.e. muscle spindle
fibre). The loss of proprioceptive feedback
leads to a decrease in trunk awareness and
control. Inhibition of core proprioception
may be responsible for faulty compensatory
patterns that can result in destructive forces
that prolong the healing process. Working to
overcome faulty compensatory movement
patterns is a fundamental goal in the Pilates-
evolved method.
When your client has shown successful
movement without pain, you can progress
the exercise by decreasing the assistance
and challenging the base of support. The
ability to challenge proprioception through
a movement phase in the Pilates-evolved
environment is endless. The three variables;
base of support, length of levers, and
degree of assistance, can be manipulated
independent of each other.
In
comprehending
current
motor
learning theories, biomechanical principles,
neuro-musculoskeletal physiology, and
anthropometry, Pilates-evolved work can be
a viable and effective method of movement
re-education.
Adapted from the research paper, Introduction
to Pilates-Based Rehabilitation by Dr Brent D.
Anderson, PT, OCS and Aaron Spector, MSPT
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NETWORK SUMMER 2017 | 31