Pilates Provides Effective Rehabilitation for Both Body & Mind
August 2005
Pilates Provides Effective Rehabilitation for Both Body and Mind
By Daniel Wilson
Across the country, a rapidly grow-ing number of physical therapists and their clients have discovered that Pilates, a popular form of body-mind exercise, is tremendously effective for rehabilitating injuries.
The success of Pilates as a fitness program is well chronicled—the Sporting Good Manufacturers As-sociation reports that the number of North Americans participating in a Pilates class has grown more than 500 percent in just the past four years. Now, many physical therapists are turning to Pilates as a primary method of rehabilitation with outstanding results.
It’s the Principles – Not the Repertoire
Pilates develops core strength, inte-grating the trunk, pelvis and shoulder girdle. By emphasizing proper breath-ing, correct spinal and pelvic align-ment, and complete concentration on smooth, flowing movement, clients become acutely aware of how their body feels, where it is in space, and how to control its movement. Quality of movement is valued over quantity of repetitions, and proper breathing is essential as it helps execute movements with maximum efficiency.
Pilates for rehab, however, can dif-fer from Pilates the exercise. “I think it is important to clarify Pilates for rehabilitation as not ‘just Pilates,’” says Brent Anderson, PT, OCS, president of Polestar Education, a Pilates-based
rehabilitation, fitness and training in-stitute headquartered is in Miami, FL.“When you’re talking about Pilates for rehab, you’re talking about modify-ing the exercises and working in the Pilates body-mind environment to be able to facilitate a positive movement experience for your client.”
“That’s the crux of why Pilates is so powerful in the field of rehab,”Anderson said, “If you use it correctly and are able to provide that positive movement experience, your client’s outcome physically and emotionally is going to be much greater. It is more about the principles of the exercise than the actual repertoire.”
Rob Kopitzke is a PT and co-owner of Body Concepts, Inc., a physical therapy and personal training center in El Dorado Hills, CA. Body Con-cepts has both a Pilates studio and a traditional therapy gymnasium. “Cli-ent-wise I would say that 80 percent of the time I choose the Pilates studio over the gym,” says Kopitzke.
“It’s a more dynamic environment. It allows for an earlier progression. As the patient gets stronger physically and mentally, he or she can increase the amount of resistance or difficulty for each exercise. They can basically go from a non-weight bearing status to a full-blown effort. From that stand-point it provides a nice progression that other traditional or conventional forms of therapy can’t duplicate.”
Anderson agreed and explained that with Pilates a PT can create a positive movement experience with an exercise that a patient may even perceive as beyond their capacity. “They might look at the equipment and say ‘There’s no way I can do this’,and then they do it, and without pain. It totally changes the paradigm of the belief model that the movement causes pain. This shift in attitude is much more powerful than any strength or flexibility measurement”
As an example, he points to a recent patient who had tremendous low-back pain for three years. The patient had been an avid runner and equestrian but was no longer able to do either. He had also undergone various conven-tional rehabilitation programs without success. After four visits using Pilates he was 80-percent pain free. Anderson put him in a lower-back care program and after only a month, the patient was riding again.
“He was to the point where he didn’t really care about riding or run-ning anymore—he just wanted the pain gone,” Anderson said. “Through Pilates, however, he’s changed his perception and is active again. Pilates can be implemented so gently yet so successfully by a skilled practitioner, that it can completely change people’s lives in the way they view their capa-bilities.”
Versatility a Factor
Another reason many therapists are turning to Pilates is the tremendous versatility of the equipment, which can benefit them both clinically and financially. “Compared to most rehab gym or studio set ups, physical therapists find they can do much more on a single piece of Pilates equipment than on multiple exercise machines designed to do one thing,” said Ken Endel-man, CEO and founder of Balanced Body.
According to Anderson there are almost a thousand exercises a PT can use on a single piece of equipment or trapeze table. “If you have four differ-ent types of Pilates equipment, you literally have 4,000 different exercises you can choose from”, said Anderson.“But if you have a leg press machine, all you can do are leg presses. That can be mundane for both client and thera-pist. Pilates is limitless and allows us to be very creative in our programs.”
Kopitzke said his clients get more out of a one-hour workout on a reformer then taking them through potentially 10 different pieces of other exercise equipment. Just as important, he adds is how a reformer’s versatility helps with the bottom line. “If you have limited space, you need to get equipment that gets you the most bang for the buck. That makes a re-former a very smart investment.”
Why Isn’t Everyone Doing This?
So why aren’t all PTs offering Pi-lates? One contributing factor could be that shrinking insurance reim-bursements are forcing many PTs to see multiple patients during an hour, to make up for declining revenue. This creates an atmosphere not conducive to a Pilates intervention.
Another limitation may be a lack of education. Many PTs were not exposed to Pilates training while in school. Now they realize they need to get certified while still working and running their practice. That’s a drawback to some.
However, from a pure business standpoint neither reason has merit in the long run. “It is important for all PT’s to know that if you are able to add Pilates to your practice, even as just an adjunct, you can bill [for it]. It becomes a nice supplement and you’re not totally dependent on insurance or Medicare payments,” said Anderson. It can also be tremendously prof-itable—Polestar sees approximately 140 people go through the center on a daily basis—and all of them pay out-of-pocket.
The Future of Rehab
What’s on the horizon for Pilates as a rehabilitation tool? Some see it expanding into the area of neurologi-cal rehab for patients with multiple sclerosis, Parkinson’s Disease and stroke. For these patients, the amount of movement awareness input they get combined with the frequency of that input facilitates a better recovery.
Therapists know, however, that while these patients need a lot of repetitions, they must avoid becom-ing fatigued or overheated. Because Pilates allows for a larger number of movement patterns without as much cardiovascular stress, patients can undertake these exercises without adverse effects.
Overall, the future looks bright for PT’s and Pilates. Endelman said therapists and rehabilitation centers are one are of the fastest growing markets at his company. “I think many are finding that it simply is a kinder, gentler way to rehab, yet still incredibly effective both physi-cally and emotionally. When I talk to PTs and ask them what’s the best thing Pilates has done for their practice, some of the answers are surprising. Many say it’s not necessarily the improvements they’ve seen in their patients’ strength and flexibility, but how it affects their clients’ positive mental perception of their own well-being. That’s powerful stuff.”
Daniel Wilson is a freelance writer out of Rocklin, CA.