Pilates and Physical Therapy
Pilates and physical therapy have many interesting connections, from development during World War I to the use of equipment to address muscle imbalances. Both systems address the mind-body connection and are accessible to people of all ages and abilities.
Pilates and physical therapy both developed during World War I.
Originally known as Contrology, Pilates is a system of exercises performed on either a mat or special equipment like a reformer. The method was created by Joseph Pilates, a German-born boxing coach, in the early 20th century. Joe was a sickly child who became interested in anatomy and movement to improve his health. While living in Great Britain at the start of World War I, he and other German-born citizens were sent to an internment camp at the Isle of Man. There he provided exercise for bedridden patients at the camp hospital.1
Across the pond in the US, the precursors to physical therapists known as “rehabilitation aides” began working with soldiers returning from war.2 It is so interesting that the need for physical rehabilitation became glaringly apparent in this turbulent time, and that so many people have since committed to meeting that need.
“Change happens through movement, and movement heals.” -Joseph Pilates
Pilates and PT both utilize props and equipment to re-educate the body.
Both Pilates and physical therapy focus on practicing new movement patterns to increase strength, mobility, and coordination. Using props and equipment provides feedback to the nervous system, making it easier to sense where the body is in space and to move efficiently. This sense of spatial awareness is called proprioception, which supports tasks like walking, picking up a book, or holding a phone.
In the physical therapy clinic you’ll likely see weights, thera-bands, physio balls, and the like. Some clinics also have Pilates equipment like the reformer. The reformer has a mobile carriage, a footbar, and springs that create resistance. By pressing against the footbar and feeling the springs lengthen, the equipment increases proprioception, or awareness of movement through space. Other examples of Pilates equipment are the Wunda chair, cadillac, ladder barrel, ped-o-pul, spine corrector, foot corrector, and toe corrector.
Pilates and physical therapy both address muscle imbalances.
One of the biggest challenges we see in the PT clinic is lack of deep core support, which is the culprit of many injuries. The deep core stabilizers are muscles that maintain a joint’s position against gravity and against movement of other parts of the body. The most well-known stabilizers are the “core” muscles located in the abdominal wall, low back, pelvic floor, and diaphragm. Sometimes these muscles are called the “core cylinder” or “core canister” because the muscles are oriented in this shape. These muscles are activated through the main principle of Pilates, which is breath.
“Above all, learn to breathe correctly.” 3 -Joseph Pilates
Interestingly, we also have deep stabilizers in the hips, shoulders, neck, and even the feet! The deep stabilizers of the shoulder are the rotator cuff muscles. When these muscles are unable to fire, a larger global muscle (the deltoid) frequently takes over to help out. Unfortunately, this results in poor movement patterning, which can lead to injury. For example, lifting a heavy object without support from the rotator cuff may lead to a rotator cuff tear. If the deeper stabilizing muscles aren’t activating, then the joint can’t function efficiently.
The beauty of Pilates is that its focus on breath helps activate deep core stabilizers to support efficient movement. It may be helpful to work directly with a physical therapist or Pilates instructor to practice these movement patterns.
The mind-body connection is a vital part of both Pilates and physical therapy.
Physical therapists witness each day how a client’s mind impacts their physical recovery. A big part of therapy is helping clients find a path forward after injury, being a cheerleader during the hard parts of rehabilitation, and helping them see the light at the end of the tunnel.
In his book, Return to Life Through Contrology, Joe says, “Contrology is complete coordination of body, mind, and spirit.” 3 In fact, one of the principles of Pilates is concentration. Every exercise is a full-body movement that requires concentration to get the full benefit, which involves focusing the mind. One of my Pilates clients once said, “I can’t think about anything else when I’m in a Pilates class, and I feel calmer!” Coordinating mind and body together with breath brings us into the present moment.
Pilates and PT serve a variety of populations.
The earliest adopters of Pilates were professional dancers in New York City. While Joe was a boxing instructor with no background in dance, his method helped dancers address their own movement challenges and stay healthy. Today, Pilates attracts not just the elite athlete, but people of all ages and abilities. Physical therapists are integrating Pilates into the therapeutic process because of the wonderful benefits of the work.
Pilates and physical therapy really do go hand-in-hand. There are so many benefits to doing Pilates - it is a great complement to strength and cardiovascular training and can become part of a regular workout routine. If you have questions about how Pilates can be incorporated into your physical therapy session, please reach out to us!
“Every moment of our life can be the beginning of great things.”3. -Joseph Pilates
References
1Alpers, A. and Segel, R. The Everything Pilates Book. 2002.
2Ruth B Purtilo, Early Markers of a 100-Year Journey Toward the American Physical Therapy Association Becoming an Ethically Grounded Societal Presence: An Ethicist’s Reflection, Physical Therapy, Volume 101, Issue 11, November 2021, pzab240, https://doi-org.ezproxy.baylor.edu/10.1093/ptj/pzab240
3Pilates, Joseph H. Return to Life Through Contrology. 1945. Reprinted by Pilates Method Alliance.
