Niamh Wynne – Physiotherapist
I recently attended a clinical pilates course run by Dance Medicine Australia. The course provided me with an insight into the history of pilates and the huge difference that exists between clinical and traditional pilates. We were taught how to use clinical pilates in the assessment and treatment of all injuries/disabilities in order to improve muscle function and neural drive to the affected side of the body.
Clinical Pilates was developed from the work of Joseph Pilates in the early 1900’s. Joseph pilates worked with patients in the UK during the war, using resistive devices to allow bed ridden patients to exercise and improve muscle atrophy. This is what first lead onto the development of the reformer and trapeze table used today in clinical pilates.
The Dance Medicine Australia (DMA) Clinical Pilates teachings were developed by Craig Phillips. Craig first started doing pilates in the 1970’s as a student of the Australia Ballet School. Craig then studied physiotherapy and over the next 10 years researched pilates in relation to spinal stability. He has formulated and developed the Clinical Pilates programme for physiotherapists, accredited by the Australian Physiotherapy Association and The New Zealand College of Physiotherapy.
Clinical Pilates has developed and changed the traditional pilates approach in accordance with current knowledge and research. In physiotherapy, clinical pilates is used as both a diagnostic tool and treatment technique. Exercises are not based around improving strength and power, but more aimed at improving motor control and movement efficiency. That is, it is a way of training muscles to work smoothly and efficiently, therefore limiting wasted muscle activity.
Unlike traditional pilates, where you are instructed to breathe out on exertion, clinical pilates does not rely on expiration for stability. Patients are advised to breath as normal using the normal patterns of inspiration/expiration. Exercises are all taught in a dynamic rather than static position. This allows both local (deep muscles) to integrate with global muscles (larger moving muscles), allowing more efficient, normal function. Clinical pilates moves away from traditional teaching of trying to activate ‘the core’ in isolation, as in reality, this is something that never happens with normal movement.
Clinical Pilates can be used to assess patients by using both the patients history and a number of core pilates exercises. It is often noted that patients have a directional preference i.e. when performing the exercise to the right/left they find it easier or execute the exercise more efficiently. This generally correlates with the side of their body they have sustained most injuries on. An example would be post knee injury or more specifically, knee surgery in a patient who was in pain for 6 months or more. This patient has been in pain for so long, that often their muscles on the affected side have started to behave differently, leading to further pain and dysfunction. Based on assessment findings, the physio can find specific exercises that the patient can perform most efficiently and with the least amount of discomfort. This in turn improves muscle function and muscle firing on the affected side, limiting stress and load on the knee structures.
Clinical pilates can be used to treat a wide variety of injuries, not just low back pain. Book an appointment today to see how simple and effective this treatment technique can be!