Your clients and athletes demand and deserve customized, adaptable solutions when injury or chronic pain impairs movement and performance. Known for its whole-body approach to fitness, Pilates is the perfect way to help your patients recover, rehabilitate, and reach their goals.
With Pilates for Rehabilitation, you will learn how to apply proven Pilates methods to address dysfunction and help your patients achieve optimal performance. Renowned instructor and physical therapist Samantha Wood provides detailed descriptions of the most effective exercises for rehabilitating and healing injuries, improving functional strength, promoting efficient movement, and managing pain.
In addition to step-by-step instructions for Pilates apparatus and mat work, you will learn the indications and contraindications of each exercise and the primary muscles involved so you can determine when the exercise is appropriate for each client. Modifications and progressions allow for adaptation of exercises based on the stage of rehabilitation or the severity of the injury or condition being treated. Suggested exercise protocols, organized by common orthopedic injuries in anatomical regions, offer the flexibility to tailor a program to the specific needs of each client.
Authoritative yet accessible, Pilates for Rehabilitation paves the road to recovery. Recommended by BASI Pilates and full of the latest research, proven exercises, and expert advice, this is the ultimate rehabilitation guide.
Earn continuing education credits/units! A continuing education course and exam that uses this book is also available. It may be purchased separately or as part of a package that includes all the course materials and exam.
Part I. The Case for Pilates
Chapter 1. The Science Behind Pilates for Rehabilitation
Chapter 2. Guiding Principles of Pilates
Chapter 3. Integrating Pilates With Rehabilitation
Chapter 4. Methodology and Apparatus Needed for an Effective Practice
Part II. Exercises
Chapter 5. Mat Exercises
Chapter 6. Reformer Exercises
Chapter 7. Cadillac Exercises
Chapter 8. Wunda Chair Exercises
Part III. Pilates for Common Injuries and Pathologies
Chapter 9. The Cervical and Thoracic Spine
Chapter 10. The Lumbar Spine
Chapter 11. The Shoulder
Chapter 12. The Hip Injuries
Chapter 13. The Knee
Chapter 14. The Foot and Ankle
Samantha Wood, MPT, MBA, PMA-CPT, RYT, is a licensed physical therapist, a Pilates Method Alliance–certified Pilates instructor, a Yoga Alliance–certified teacher, and an associate faculty member for BASI Pilates. She has been a member of the American Physical Therapy Association (APTA) since 1997 and of the Pilates Method Alliance (PMA) and Yoga Alliance since 2010. She is the owner of The Cypress Center in Pacific Palisades, California, where she and her staff integrate Pilates with physical therapy for people of all ages and abilities. Her clinical expertise includes Pilates-based rehabilitation, yoga therapy, orthopedics, sports therapy, and functional rehabilitation.
Wood received her bachelor’s degree in exercise science from USC in 1991, where she worked as a student athletic trainer with athletes from all sports, specializing in volleyball, football, and track. After graduation she worked as a fitness instructor for Golden Door Spa aboard Cunard cruise ships. Two years later she earned a master of physical therapy (MPT) degree from Western University of Health Sciences. She also holds an MBA from the University of Southern California (USC). She has worked with many celebrities and professional athletes; while at HealthSouth in Arizona, she was the physical therapist for the Phoenix Suns, Phoenix Coyotes, Phoenix Mercury, and Arizona Rattlers. In 2010, she was selected as the physical therapist for the EAS Unstoppable Tour, where her responsibilities included keeping elite athlete Sam Tickle in top physical condition as he completed his 30-sport, 30-city, 30-day journey.
Wood began her Pilates studies in 2001 with Rael Isacowitz and has attended many of Isacowitz’s advanced courses, including the prestigious mentor and master programs. She created and teaches two advanced education courses for BASI Pilates: Pilates for Injuries and Pathologies (for Pilates teachers) and Pilates: Integration Into Therapeutic Practice (for rehabilitation professionals). She has been presenting those courses, in addition to offering other workshops and lectures at Pilates conferences around the world, since 2010.
Wood has been featured in the Ask the Expert column in Pilates Style magazine and authored and modeled for an article entitled “Check In to (Injury) Rehab.” She also wrote an article about integration of Pilates into a physical therapy practice for Advance for Physical Therapists.
“This well-written book is comprehensive but concise, and is easy to read and understand. The descriptions, variations, and photographs of exercises are excellent…a great rehabilitation resource for clinicians and instructors.”
Doody's Review Service, 5-star review
"Samantha introduced me to Pilates, and at first it was such a challenge! But after practicing Pilates for many years now, it has helped to minimize my injury recovery time. Samantha can do the same for you with Pilates for Rehabilitation!"Sugar Ray Leonard
Former professional boxer
“The trinity of objectives in all of athletic medicine is prevention, optimization of performance, and injury care. Samantha Wood eloquently and cohesively demonstrates in her book Pilates for Rehabilitation the practical concepts and contemporary techniques for addressing today’s problems with tomorrow’s solutions.”
Bert Mandelbaum, MD
Team Physician for LA Galaxy, U.S. Soccer, and Pepperdine University
Co-Chair of Medical Affairs at Cedars-Sinai Kerlan-Jobe Institute
Santa Monica Orthopaedic and Sports Medicine Group and Sports Foundation
Chairman of the CONCACAF Medical Committee
Assistant Medical Director for Major League Soccer
“I have had the pleasure of knowing and working with Samantha Wood for more than 15 years. During that time she has always had a unique talent for tailoring rehabilitation programs for both my professional and casual athlete populations. Now, in Pilates for Rehabilitation, she provides an easy-to-read and, more importantly, easy-to-apply handbook for medical professionals and interested individuals. All of us are looking for that added edge to perform to our best while reducing the chances of injury. Samantha has now added to our arsenal. A must-have on your shelf and by your side.”
George Billauer, DC
Team Chiropractor for U.S. National Soccer Team, LA Galaxy, Los Angeles Football Club, and Mexican National Soccer Team
Previous Affiliations: Los Angeles Dodgers, Los Angeles Kings, Chivas USA
“As a Pilates professional I am always in search of fresh resources and material to inspire my teaching and practice. Pilates for Rehabilitation is just the book to fill the void in my understanding and application of the remedial approach of the Pilates method. Samantha Wood’s approach to rehabilitation is both scientific and practical, without losing the underlying principles of the Pilates method itself. Although the exercises are focused on rehabilitation, I found them to be just as effective for athletic performance. I plan to recommend this book to my clients, colleagues, and students, who I feel could all benefit from Samantha Wood’s wealth of knowledge.”
Ed Botha
Pilates Teacher
BASI Pilates Faculty Member
Pilates Anytime Teacher
“Samantha is a brilliant therapist and innovator and has been a pioneer in bringing Pilates to mainstream physio rehabilitation practice. Her experience as a physio, athletic trainer, and business woman will undoubtedly make this book worth the time and energy to read!”
Amy Gladin
Physical Therapist and Clinician Researcher at Kaiser Permanente San Francisco Medical Center
“For many years, Samantha has incorporated her sensible and easily applicable techniques in Pilates to rehabilitate and restore many of my injured patients back to good health. Pilates for Rehabilitation provides an excellent resource for other rehabilitation therapists to incorporate a restorative Pilates approach to not only heal and manage ongoing injuries but also prevent future injuries through core strengthening and improving functional strength and movement.”
Julie Ma, MD
Primary Care Physician for UCLA Health
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
What is the center?
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
In Pilates, centering yourself means more than finding your center of gravity; it means uniting body, mind, and spirit. (Isacowitz 2014, 9)
Physically speaking, finding one's center refers simply to the place in one's body that is one's center of gravity. This will be slightly different for each individual, based on his or her specific anatomy. But in Pilates, the word center means much more. The concept that all movement originates from the center or core is a common theme in Pilates. It is often termed the powerhouse in Pilates; it is described by Isacowitz as the internal support system; and it is sometimes referred to as the local muscle system in the rehabilitation realm (see figure 2.2). Whichever term you prefer, we are talking about the deep, intrinsic muscles of the trunk. These transversus abdominis, multifidi, diaphragm, and pelvic floor muscles attach directly to the spine and offer stabilization. Note that none of these muscles can be easily accessed, as they are deep lying and are not developed in the same way that other skeletal muscles are, such as the biceps or quadriceps. Perhaps this is why the mind - body approach of Pilates works so well in spinal stabilization; it allows us to get deeper and facilitates this neuromuscular connection.
Figure 2.2 The local muscle system or internal support system.
Why Pilates works in injury rehab and prevention
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury.
Pilates is a great tool to assist or even enhance a physiotherapy program when someone is recovering from an injury. By strengthening the deepest muscles of the core, optimizing alignment, and creating correct movement patterns, we can also help to prevent reaggravation of those injuries and the development of new ones. PTs are always searching for a system that can take patients from the early stages of rehabilitation to the long-term goal of a conditioned, efficiently functioning body. Pilates is that system! Other rehabilitation professionals often ask me, why do you think Pilates works so well in injury rehab and prevention? Here are what I see as the 10 fundamental reasons, both scientific and practical, that Pilates is so effective in injury rehab and prevention.
10 Fundamental Reasons Why Pilates is Effective in Injury Rehabilitation and Prevention
- Pilates focuses on the center or core muscles.
- Pilates exercises emphasize both stability and mobility.
- Pilates includes both closed-kinetic-chain and open-kinetic-chain exercises.
- Pilates exercises work muscles statically and dynamically - emphasizing both concentric and eccentric muscular contractions.
- Pilates exercises are functional.
- Pilates places an importance on breathing appropriately.
- Pilates is adaptable for many different patient populations.
- Pilates is a mind - body form of conditioning.
- Pilates equipment is safe and easy to use (with proper training).
- Pilates is a wise business choice to expand your wellness services.
2. Pilates Exercises Emphasize Both Stability and Mobility
A strong, optimally functioning body must be both stable and mobile. Adequate stabilization proximally enables us to attain optimal function distally. Take, for example, a tennis player: he must have proximal strength and stability of his shoulder girdle, yet tremendous mobility in the arm to be able to efficiently hit the ball. If the shoulder is weak or unstable it is likely that an injury will occur over time. The common tennis injury lateral epicondylitis, or tennis elbow, is often caused by late strokes and "wristy" impact due to a lack of scapular stability, which places too much stress on the elbow and wrist joints. One of the ways we treat this is to strengthen the muscles of the arm, shoulder, and upper back to help take stress off of the elbow. Can we do this with Pilates exercises? Absolutely! However, if the shoulder girdle is so stable that it doesn't move, it is not possible to raise the arm overhead into the proper position to deliver a powerful serve. Thus, exercises that mobilize the shoulder complex are also important, and there are many of these in the Pilates repertoire as well.
Being too loose (hypermobility) or too tight (hypomobility) can both lead to injuries and pathologies. Weight-lifting regimens often emphasize stability to the point where the person is so stable he or she cannot move. Certain types of yoga or stretching programs, on the other hand, focus so much on stretching that people end up with a weak core and hyperflexibility, which can lead to conditions of instability.
In Pilates, some of the exercises focus on stability (front support), some focus on mobility (kneeling arm circles) and many provide a perfect combination of both (diagonal pull). Thus, Pilates emphasizes both stability and mobility, allowing us to achieve optimal performance and helping to prevent injuries.
Stability + Mobility = Agility. (Brourman, 2010)
5. Pilates Exercises Are Functional
The three previous fundamentals establish that Pilates exercises enhance both stability and mobility; include both open- and closed-chain exercises; and work the muscles statically and dynamically (emphasizing both concentric and eccentric phases). All of this leads us to reason 5: Pilates is a very functional type of exercise.
When functional movements such as walking or running are performed, a single muscle does not work in isolation. Such movements often involve multiple muscles - some working concentrically, some eccentrically, and some isometrically - in a highly coordinated manner to achieve the desired action. Many Pilates exercises simulate everyday activities, which makes them perfect for injury rehab and prevention. Looking again at the example of a biceps curl machine at the gym, the client is seated on a chair with the trunk completely supported and the arms resting on a platform. The motion is to bend the elbow against resistance, resulting in isolation of the biceps muscle and emphasis only on the concentric phase of the movement. How often in life do we need this type of strength? Not often unless we are arm wrestlers! More frequently we need to be able to perform such tasks as lifting our carry-on bag and placing it in the overhead compartment on a moving airplane. This takes not only dynamic (concentric and eccentric) upper extremity strength, but also scapular stabilization and core stabilization. An exercise such as the kneeling biceps on the reformer simulates this type of action.
The concept of functionality in rehab also means we must look at what the client needs and make our exercises task specific. Is your client a ballet dancer needing flexibility, a rugby player needing strength, a desk jockey needing postural exercises to reverse the effects of sitting all day, or an elderly woman who needs to be able to get up from a seated position? The huge repertoire of Pilates exercises provides endless options to allow us to make the exercises appropriate for all types of clients. If the exercise does not exist in the repertoire, we can design an appropriate exercise, using the equipment to either provide support or create additional challenge.
Learn this exercise: pelvic curl
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement.
Primary Muscles Involved
Abdominals, hamstrings, and gluteus maximus
Objectives
Mobilization of the spine and pelvic region, spinal articulation, hamstring control, pelvic lumbar stabilization, and recruitment and cocontraction of the core muscles
Indications
This is usually one of the first exercises I teach to patients, as it is relatively simple yet emphasizes the correct recruitment of the core, articulation of the spine, mobilization of the pelvic region, and coordination of the breath pattern with movement. Though challenging to execute correctly, even an attempt is beneficial for patients learning the concepts of neutral spine position and core control. It is great for those with general stiffness or arthritis of the spine, a weak or inhibited core, or tightness of back extensors or hip flexors.
Precautions or Contraindications
Acute lumbar disk pathology and osteoporosis
Instructions
Lie supine with the knees bent, legs parallel approximately hip distance apart, arms relaxed at the sides with palms down, and the pelvis in a neutral position (see photo a). Inhale to prepare, exhale to set the core, and begin to curl the pelvis and spine off the mat, one vertebra at a time. Inhale and hold at the top; the pelvis should be at maximum posterior tilt and a stretch should be felt in the hip flexors (see photo b). Exhale as the spine is lowered, starting at the thoracic vertebra and rolling down one vertebra at a time until the tailbone touches the mat.
Variations
- For disk pathologies, omit the deep lumbar flexion and maintain the spine and pelvis in neutral as it is lifted.
- Place a ball between the knees to promote more adductor engagement and reach the arms overhead as the pelvis lifts to elicit more upper spine control (see photo c).
Progression
- Feet placed on a foam roll (see photo d)
- Bottom lift on reformer
- Pelvic curl with roll-up bar on Cadillac
- Pelvic curl on wunda chair
Technique Tips
- Keep the neck and shoulders relaxed.
- Maximize lumbar flexion as the spine lifts off the mat by pulling the pubic bone toward the chin (posteriorly tilting the pelvis).
- Visualize the lowering of the spine like a Slinky spring toy going down steps, deliberately placing one vertebra at a time. This will help to achieve maximum articulation and spinal mobility.
Related Books
