Hi everyone, my name is Madison. I’m a kinesiology student from the U of A, and I’ve had the pleasure of completing my practicum at Pivotal’s High Performance Centre. If you’ve seen some of Pivotal’s recent Instagram posts, or been to the HPC location and saw a fancy new piece of equipment in the corner, you may have noticed that a few of our physiotherapists are now offering Clinical Pilates! When trying to decide if you should book an appointment you may have a few questions. Here’s an overview of what clinical Pilates is, who it’s for, and what to expect from your first appointment.
What is Clinical Pilates?
Pilates is an alignment-focused exercise that targets strength, core stability, flexibility, muscle control, and posture. It was developed by Joseph H Pilates, who was inspired by exercise practices such as yoga and ballet. There is a heavy emphasis on body alignment during pilates and each movement is carried out in rhythm with the breath. The exercises can be performed on a mat or using equipment such as a Reformer, Wunda chair, etc. Clinical Pilates is led by Pilates-trained physiotherapists who are knowledgeable in injuries and exercise prescription. It is taught one-on-one with the goal of improving functional movement control and reducing the risk of injury by addressing compensatory movement patterns and enhancing core strength and stability.
Why you should try Clinical Pilates (even if you aren’t injured)
While Pilates can be a great tool for rehabbing injuries, it is also an effective cross-training tool for a variety of athletes such as golfers, basketball players, football players, and more!
My Take
During my time as a competitive figure skater, I did group mat Pilates classes. I enjoyed them as it wasn’t as intense as other off-ice workouts, but allowed me to strengthen my core and improve my body awareness and muscle control. If I had the chance to try clinical Pilates while I was still competing, I think it would have enhanced my experience. After doing clinical Pilates with Robyn, I received specific feedback on how I was moving. She was able to cue and correct my body alignment during each exercise, which would have potentially gone unnoticed in a group class setting. Now, as just an average gym-goer, I found clinical Pilates to be a great way to change up my exercise routine and help me improve my low back pain.
Dancers
Dancers often use Pilates as a form of cross-training. A study done in 2018 found that Pilates helped dancers improve their posture, strength, and flexibility when added to their training.
Runners
Another study done on recreational runners found that clinical Pilates helped improve their functional movement control thereby reducing the risk of running-related injuries. Due to the repetitive stress of running, it can make runners more susceptible to overuse injuries. The Clinical Pilates study targeted the compensatory movement patterns that were putting the runners at risk of injury. By focusing on core stability and lower limb alignment during their sessions, the runners were able to improve their dynamic knee valgus (the knee collapsing inwards while running) and improve their scores on a functional movement screen.
What is Clinical Pilates beneficial for?
Low Back Pain
Low back pain is a common complaint among people and occurs in around 85% of patients who seek physiotherapy. It is characterized by pain and increased muscle tension or stiffness that is between the bottom of the rib cage to the glutes. Clinical Pilates can help by improving body awareness, postural control, increasing mobility and strength in the lumbar region to help reduce pain. There are a variety of causes for chronic low back pain, so opting to work with a physiotherapist trained in clinical Pilates one-on-one allows the session to be tailored to your specific needs rather than going to a group class.
Multiple Sclerosis (MS)
MS is an autoimmune disorder that attacks the myelinated axons in the central nervous system and causes neurological deterioration. There are several different types of MS but they all have a similar set of symptoms which include: fatigue, sensory loss, muscle weakness, spasticity, and more. It has often been thought that exercise can exacerbate symptoms and cause relapses in MS. However, current research indicates that physical activity can help manage the symptoms and improve overall quality of life. Pilates has been shown to have few adverse effects for those with MS and it can help improve balance, gait, physical-functional capacities, and cognitive functions. Therefore, due to the benefits of Pilates and its gentle nature, it may be a good option to consider for those with MS.
ACL injury rehab
The ACL, otherwise known as the anterior cruciate ligament, is a ligament inside the knee joint that helps increase knee stability by preventing the tibia from moving too far forward in relation to the femur and from rotating inwardly too much. Injury to this ligament can cause instability in the knee, so it is important to strengthen the muscles surrounding the knee. Pilates can be used to help treat partial tears in the ACL and ACL repairs by strengthening the core, quadriceps, and hamstring muscles.
Other Injuries
Clinical Pilates can also be helpful for people with osteoarthritis, recurring injuries, patients with multi-site injuries, and Motor Vehicle Accident (MVA) patients in addition to their physio treatments and more! This is because Pilates focuses on full body strength, control, core stability, movement integration, etc.
What to expect from your clinical Pilates assessment at Pivotal?
For your first visit, you will have to book a one-hour long clinical Pilates assessment with one of the physiotherapists who offer the service at Pivotal’s High Performance Centre. During the assessment, the physiotherapist will discuss your medical history, inquire about any concerns you want addressed or any goals you have, and then take you through a physical assessment on the Pilates equipment.
The physical assessment includes:
- Spinal flexion and sequencing
- Spinal extension
- Pelvic positioning/ ability to reference neutral
- Hip/LSp differentiation
- AAROM of spine in flexion and extension, SF
- GHJ AROM: flex, extension, abduction
- Scap stability
- Spinal sequencing of flex/SF in standing
- HIP AAROM/AROM flex, ext,add, ER
- Motor control of the above movement and proprioception
- One leg stability
- Endurance of spinal flexors (hundred)
- AROM CSp flex (hundred)
- TSp flex/ext
- Functional patterns: deep squat, rolling up of out bed, putting on a sock(taking on and off leg springs)
- Ankle AROM, strength in PF
- Movement strategies ( splaying chest, PPT, over gripping glutes)
- Bed mobility, willingness to move, pain triggers
- Retraining the brain
After the assessment, the physiotherapist will work with you to develop a treatment plan. From there, you can book either 30-minute or 60-minute follow-up sessions.
Special thanks to Robyn Carignan for providing some information, guiding me through and filming some pilates. You can book your own Clinical Pilates session with Robyn, Kim Gibas, or Abbey Oke.
References
Ahearn, E. L., Greene, A., & Lasner, A. (2018). Some effects of supplemental pilates training on the posture, strength, and flexibility of dancers 17 to 22 years of age. Journal of Dance Medicine & Science, 22(4), 192–202. https://doi.org/10.12678/1089-313x.22.4.192
Cuddy, P., & Gaskell, L. (2020). “how do pilates trained physiotherapists utilize and Value Pilates exercise for MSK conditions? A qualitative study.” Musculoskeletal Care, 18(3), 315–329. https://doi.org/10.1002/msc.1463
Eliks, M., Zgorzalewicz-Stachowiak, M., & Zeńczak-Praga, K. (2019). Application of pilates-based exercises in the treatment of chronic non-specific low back pain: State of the art. Postgraduate Medical Journal, 95(1119), 41–45. https://doi.org/10.1136/postgradmedj-2018-135920
Laws, A., Williams, S., & Wilson, C. (2017). The effect of clinical pilates on functional movement in recreational runners. International Journal of Sports Medicine, 38(10), 776–780. https://doi.org/10.1055/s-0043-111893
Maan, Dr. J., & Mehta, Dr. S. (2023). Effectiveness of pilates in rehabilitation for reconstructed anterior cruciate ligament. International Journal of Physical Education, Sports and Health, 10(5), 212–216. https://doi.org/10.22271/kheljournal.2023.v10.i5d.3096
Rodríguez-Fuentes, G., Silveira-Pereira, L., Ferradáns-Rodríguez, P., & Campo-Prieto, P. (2022). Therapeutic effects of the pilates method in patients with multiple sclerosis: A systematic review. Journal of Clinical Medicine, 11(3), 683. https://doi.org/10.3390/jcm11030683Çelik, D., & Turkel, N. (2015). The effectiveness of pilates for partial Anterior Cruciate Ligament Injury. Knee Surgery, Sports Traumatology, Arthroscopy, 25(8), 2357–2364. https://doi.org/10.1007/s00167-015-3718-1