Pilates as Therapy

by Dana Mitchell B.Sc.P.T.

You have decided to make some changes to your health and lifestyle this year.  Maybe, your medical professional has suggested Pilates exercise or Yoga as part of your therapeutic return to better health.  You've done some homework, heard about many health benefits, become enlightened about medical conditions which may respond favourably from Pilates or yoga, and are aware the method of exercise is enjoyed by a broad age range.  Everything seems to check out, yet you are leery!  Is mind - body exercise really appropriate for anyone still overcoming an injury or with a chronic condition?

Pilates and/or yoga can be therapeutic for many, and greater therapeutic success can be achieved if these suggestions are taken into consideration.

• Pilates and Yoga should NEVER feel painful or straining on your body while are exercising or in the immediate thereafter.  The exercises move the body in the way it was designed to move, which means if it hurts, it wasn't meant to move like that!  Feeling pain means you need some immediate correction, or modification.  If your exercising environment does not allow for instructor feedback and correction when you need it, you are in the wrong setting.

• Individuals move in their own way and range which  is influenced by flexibility, anthropometry, and personal history such as injuries and medical conditions.  In other words, you shouldn't look like the person beside you, so don't try!  Concern yourself with how things feel rather than how they look.

• Injury & pain often lead to the body discovering compensation strategies, or ways to try to get the job done even though everything is not working properly.  Body compensations, over time, make the body less efficient by developing muscle imbalances, overworking some muscles & causing disuse atrophy in others. Body compensations may even perpetuate the pain / injury cycle.  You will get much more out of your Pilates/Yoga program if you pursue a personal initial assessment by a certified instructor whom will educate you on the compensations your body makes, & bring attention to personally re-balancing and correcting.   Depending on the degree of correction you require, you may decide that further private sessions are most beneficial, or move towards a group session.  Remember that group exercise means less personal correction and attention, the larger the group, the less attention you will receive. 

• If you have a high level of pain, fluctuating levels of pain, a flare up of your medical condition, pins & needles or numbness in arms or legs, or your injury is in an acute stage, it is best you seek medical attention and get appropriate treatment as advised by your medical professional.   Do not try to substitute Pilates or yoga for treatment as it is not the appropriate course of action in these scenarios.  Your Doctor &/or therapist will be able to advise you of when it is suitable to pursue Pilates or yoga.  Sometimes it is appropriate to have ongoing therapies in addition to private Pilates /yoga.  The private sessions are necessary to give the greatest specificity to your rehabilitation needs and you should inquire if your certified Pilates /Yoga instructor has specific training/ certification for rehabilitation clients.  You may also wish to inquire if the instructor feels comfortable with your particular injury, condition, or diagnosis to assist you in your therapy.  It is helpful if there is communication between the referring medical professional and the certified Pilates/yoga instructor.

• The frequency of a Pilates or yoga exercise program will influence how quickly a person experiences results, therapeutic or otherwise.  Practice and repetition at least 2 – 3 times per week is a necessary frequency to integrate and re-train motor pathways within the body.  That motor learning correction and balancing is what results in rehabilitation. 

• Videos, DVD’s and self teaching from books are NOT the way to go if you are just learning Pilates or if you are wishing to learn Pilates/ yoga for therapeutic gains.  There is zero feedback, zero correction, zero modifications, consequently body compensations go uncorrected, mistakes are learned, and imbalances and  injuries are perpetuated.   Watching a TV screen while exercising is likely to position the head and neck  improperly.   DVD’s, video’s & books eventually make a nice complement to instructed programs and allow a person to exercise at their convenience.  These forms of instruction are NOT a good way to first learn the mind body exercises.

If the program in which you are participating is appropriate, has qualified instruction, corrections & modifications throughout, the result should be a feeling of invigoration following the exercise session.  Improvements should be apparent from week to week and most importantly, you should be enjoying the process of discovering what better feels like!