During the latter part of the War, Joseph Pilates worked with injured soldiers who were unable to walk. He attached springs to the hospital beds to help support the patients' limbs, leading to the development of his famous pieces of equipment. Today, due to the focus on correct alignment of the joints and the emphasis placed upon correct movement and muscle recruitment, the Pilates Method is the perfect tool for rehabilitation from a wide range of injuries and pathologies.

The Pilates studio equipment and mat-work exercises, offer the opportunity to exercise all body parts at any stage of rehabilitation, from the start. It is also the breakthrough solution for many who suffer from chronic pain conditions. This is due to the ability of adapting support systems progressively, in open and closed kinetic chains, as well as the variable level of resistance available from the springs and pulleys.  

With a main focus on lower back pain, research has proven ‘core stability’ exercises to be beneficial in improving functional ability, quality of life and pain levels. Core stability is at the heart of the Pilates method, as the exercises are all designed to work on the deep abdominals as well as the lower back and pelvic stabilisers, in conjunction with other muscle groups. When adapted effectively, it is one of the safest and most effective movement therapy techniques, as it not only treats the presenting problem, but the person as a whole functioning unit. This, holistic approach, is significant, especially for individuals with complex or multiple conditions.

Below are a few examples of common pathologies and how Clinical Pilates sessions may help:

• Lower back pain and/or nerve impingement (disc or facet joint related spinal stenosis) are commonly experienced by the majority of our population at some point in their lives. Research has established that chronic suffering from these problem causes deterioration of the supportive musculature surrounding the spine, pelvis and hips, causing a vicious circle in the management of chronic pain. Pilates works to stimulate the activity of these muscles, regaining their function in supporting the problem area, during activities of daily living, work and sport, resulting in improved quality of life and preventing further deterioration.  

• Osteoarthritis of the spine and peripheral joints causes stiffness of the joints joints affected by osteophytes and wearing of the cartilage. Atrophy and weakness of the muscles surrounding these joints is common. This causes increased instability in the arthritic areas, leading to further inflammation and pain. Pilates can slow down the process of deterioration, preserving and improving the support and function of joints, leading to less frequent flare ups and preventing disability.

• Rheumatoid or autoimmune conditions can be aggressive affecting more than one area of the body. By practicing Pilates the erosive changes may be managed, without the risk of increased fatigue and flare ups. Pilates can also give the immune system a boost, as increased circulation, improved cell breathing, a more regulated heart rate and detoxifying effects are all part of the benefits.

• Joint replacements may be necessary following trauma, deformity or arthritic changes. Surgery involving the process of a new joint, often leads to weakness and lack of sensory ability in the area, often resulting in reduced function. Pilates can offer the appropriate sensory and motor stimulus in regaining maximum function, not only for the replaced joint, such as the knee or hip, but for the entire limb, while considering its relationship to the rest of the body.

• Post-operative cases in general, beyond those of musculoskeletal nature, can benefit from the method. It can be effective not only in returning the surrounding musculoskeletal structures to optimal function but also in reducing scar tissue and speeding up the healing process by restoring homeostasis. In particular, abdominal surgery and gynecological procedures are helped, due to the focus on re-educating the deep abdominal and pelvic muscles.

• Pre-operative conditioning is necessary in many cases, in order to prepare the tissues for the procedure they are about to undergo, i.e. Anterior Cruciate Ligament repairs. Pilates can be very beneficial, for this pre-operative period, as the area will be vulnerable and will require a safe approach for conditioning prior to surgery.

• Ligament, tendon and muscle injuries, including sprains, strains and tears all require exercise therapy to restore their integrity, strength and extensibility. This can be achieved gradually through Pilates sessions, promoting lay-down of collagen fibres in an organised fashion, due to the appropriate amount of stress and tension, applied to the tissue, while encouraging correct alignment and movement patterns.

• Tendonitis, often presenting in shoulders, the achilles tendon and patella (knee), it requires efficient strengthening and stretching regimes to restore the tendon affected, reducing inflammation. Pilates can achieve this, while retraining the area to function correctly, preventing the problem from returning in the future.

• Tension headaches, neck and shoulder pain are common, due to many hours spent working at desks and behind computer screens. Postural re-education and promotion of spinal and shoulder strength during Pilates sessions, create a stable base of support for the head and neck, allowing the superficial muscles to relax, thus, promoting sufficient blood flow to the brain and alleviating symptoms.  

• Spinal deformities such as scoliosis, lordosis and kyphosis, can cause pain and discomfort due to muscular imbalances and visceral misplacement. Some of these deformities can only be improved with surgery, while others are correctable by changing muscle tone and flexibility. A Pilates exercise programme, specifically, tailored to the situation, can alleviate many of the uncomfortable symptoms and eliminate progression, by preserving and increasing available strength, visceral positioning, lung capacity and functional movement.

• Osteoporosis is a common risk factor for fractures, as it is characterised by a lack in bone density, affecting areas such as the hips, the upper and lower spine. Preserving bone density and encouraging lay-down of new bone can only be achieved by weight bearing activity. This is particularly important in cases of osteopaenia, where bone density is at risk but still sufficient. Too much load during exercise can lead to fractures, therefore Pilates can be the perfect technique in finding the right balance for every individual case.

• Neurological conditions such as Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy and Strokes may feature deficits in sensory and motor function, spasticity and contractures in muscles, as well as lack of balance and coordination. Pilates exercises can help, by strengthening the core muscles, using full body movement and developing proprioception, which is a sensory ability of the nervous system. Pilates creates new neurological pathways, through hands-on guidance, props and resistance. Spasticity can also be reduced with the specific movement patterns and weakness can be eliminated, with the possibility of improving or regaining fine and gross motor skills.

• Cardiovascular and respiratory conditions may benefit from Pilates exercises due to their ability to increase lung capacity and circulation. The breathing techniques encourage maximum oxygenation safely and strengthen the primary and accessory respiratory muscles. This may lead to regulation of blood pressure, improved chest clearance and reduced incidents of chest infections.

Conditions are best treated with Pilates exercises by an experienced professional, preferably qualified in a health care discipline.