Yesterday I was fortunate to have a private Pilates lesson from Arielle Bernard. She is an accomplished and fantastic instructor at the Pilates Institute in Saratoga Springs. I had never taken a Pilates class or done a video before, only having knowledge about this type of activity through reading or word of mouth. So, like most people I was a little nervous for the unknown that I was about to face.
The majority of my session was spent working on the “basics”. I spent most of the lesson on two well known pieces of Pilates equipment: the “Reformer” and the “Cadillac”. Both are frequently used in Pilates and help to assist with movement and provide resistance. The fact that these were basic exercises made me laugh a little when I realized that my core strength needs some improvement! The personal touch from Arielle and the one-on-one instruction showed to be a necessity for me. I did require constant cuing about my position and to be sure I was using the right muscles and keeping the correct form. By no means was it easy, but the exercise focused on areas that I needed help with and improvements in my body!
As Arielle and I talked through the session it was clear that we share similar styles and concepts when it comes to approaching body correction and strengthening.. First, the “core” (defined as the muscles from your buttock to your shoulders, in both the front and back) is where we like to focus and get people to gain control first. We both focus on form, and regardless of your knowledge or ability level, it is always better to have somebody watch you perform the task to ensure proper understanding.. With all the training and knowledge I have, I still needed her to constantly remind me to hold my belly tight, relax my shoulders, tighten my buttock – cues I give to my patients regularly. Also we felt that the more we understood each other’sprofession, the more we can help people over come injury or pain, get fit and live a healthy lifestyle. Many times she sees clients that may have injuries and feels they could benefit from PT prior to or in conjunction with Pilates. Also many times as PTs we are asked about Pilates programs or suggestions of what to do once PT has been completed. This is where we can greatly work together to better serve our community!
There have been multiple studies in a wide variety of journals regards the use of Pilates to assist with low back pain. This continues to be a “hot topic” in research. One research article compared the use of Pilates compared to no treatment to assist with reducing low back pain.1 The participants went through a six week program and improvements were seen in pain levels, general heath and sports functioning. 1 There were some limitations in this study, but what I infer and believe is that a program such as Pilates that focuses on core stability is an essential part of recovery from low back pain.
Most recently, in May 2012 a study was published in the Journal of Orthopedic and Sports Physical Therapy, a well respected PT journal. It attempted to help predict people with low back pain that would respond from a Pilates based treatment plan. 2 Another recent article cited in the first article (Lim et al) reviewed multiple articles and found that Pilates is not superior to other forms of exercise when treating low back pain. 1 Therefore this most recent article tried to identify factors that may lean more towards a Pilates based program. The results from this study found 5 factors that may predict good results in improving low back pain from a Pilates based intervention. They were: 1) no leg symptoms in the last week, 2) body mass index >25 kg/m2; 3) total trunk flexion <70 degrees, 4) left or right hip average rotation >25 degrees, 5) duration of symptoms less than 6 months. The participants that had 3 or more of these findings increased their likelihood to respond to a Pilates based program by 10-20x.2
The interventions were performed by physical therapist that had at least 2 years of training in Pilates.2 This is the start of great research to help us understand who will benefit the best from Pilates and may help us guide patients as well to a more fitting program once their PT is complete. Although some PTs do continuing education in Pilates, I think it is great in our community to get to know the professions and work together to best improve our patients and clients!
Thanks so much to Arielle (http://ariellepilates.com) for reaching out to me and inviting me to try Pilates! It was an enlightening experience! Check out Sports PTs Facebook page soon to see pictures of us in action!
Gladwell V, Head S, Haggar M, Beneke. Does a Program of Pilates Improve Chronic Non-Specific Low Back Pain? J Sport Rehabilitation 2006. 15; 338-350.
Stolze LR, Allison SC, Childs JD. Derivation of a Preliminary Clinical Prediction Rule for Indentifying a Subgroup of Patients with Low Back Pain Likely to Benefit from Pilates-Based Exercise. Journal of Orthopaedic and Sports Physical Therapy. 2012: 42(5) 425-436.