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Why Practice Pilates
By Kerrie Lee Brown as published in OnSite Fitness, 2009

More and more healthcare professionals are turning to Pilates as an effective and lucrative adjunct to their business – helping thousands of people along the way. Here's why physical therapists are doing the same.

With over 10 million people participating in Pilates in North America, it's no wonder this popular form of exercise is being embraced by the medical and rehab communities. Healthcare professionals are applauding the wide-reaching virtues of this highly targeted approach and reaping the benefits of an enhanced business.

There are numerous reasons why professionals would choose to incorporate Pilates into their practice. Pilates puts major emphasis on balancing the muscular structure which in turn allows more focus on joint stability and mobility, and freedom of movement. It also improves postural problems, increases core strength, helps prevent injuries, enhances functional fitness as a whole, improves balance, coordination and circulation, heightens body awareness, and is low-impact on the joints.

In his time, Joseph Pilates was considered by many to be a master of rehabilitation. His approach focused on core strength, precision and control of movement. Combine that with current exercise science and you’ve got a recipe for success.

The emphasis on breathing also allows exercisers to focus their minds on what their bodies are doing. Pilates is all about using breath more effectively so we can increase awareness and focus in our every day lives. So the ultimate mind-body connection is truly effective – benefiting most people who participate at any age or life stage.


Contemporary approaches to the method today are paving the way for PTs because they consist of programming that accommodates all stages of recovery and rehabilitation. This has resulted in the inclusion of modern principles of exercise science and spinal rehabilitation. The rehab community has opened their arms to the notion of incorporating the principles of Pilates into rehab for older adults. Together, we can bridge the gap between rehab and fitness and be able to reach an immense number of individuals who otherwise would not realize their movement potential.

The basic principles of Pilates are consistent with the basic principles of Rehabilitation, working on the premise that Pilates and rehabilitation need to address the body as a whole, not just a collection of individual parts. Successful aging is the ability to function at the level an individual wishes – and requires mobility of joints as well as strength of the muscular system to propel us. The integrity of our shoulders, hips, knees and spine are all interconnected and must all be addressed when managing or preventing aches, pains and degeneration.

Pilates is gentle on the joints, focuses on suppleness and strength and can be used to address and rehabilitate specific issues with the active aging. Pilates can also be practiced for preventative measures and to stay in shape after physical therapy. It can be adapted to meet the needs and goals of individuals, and thus can be a very safe way to exercise and move the body. Pilates is both a mental and physical challenge and can be done for a lifetime.


Mind-body connection is the perfect starting point for any type of movement strategy. The concepts of breathing, pelvic and lumbar spine alignment, rib cage placement, shoulder mobility and stability, and head and neck alignment, can be applied to any movement for any diagnosis. Bringing awareness to posture may be the first step in improving fitness levels. Putting the body in a position where it moves and reacts more efficiently will take away much unwanted stress and strain. Developing proper movement patterns will also allow the body to heal in a way that reduces the likelihood of compensatory injuries.

Although 'core training' may be a bit of a catch phrase in the fitness industry, the true definition of the term is widely acknowledged in medical and rehabilitation communities as the basis for reconditioning the support musculature of the body. Pilates as a method of exercise focuses on working the muscles from the inside out rather than the outside in. In this way, the deepest layers of muscles in the torso (local stabilizers), transversus abdominis, lumbar multifidi and pelvic floor to name a few, are trained to protect the lower back while allowing the body to perform movements with more ease and fluidity. This is achieved by performing controlled movements, and by paying special attention to the mind-body connection.


The dynamic and sometimes large equipment in Pilates programming can be simplified to just an arm chair, with exercises designed for those who may not be able to lie down on a mat. For the most part newcomers to Pilates instruction start with basic mat and light equipment programming so there are no huge costs involved or overwhelming training with apparatus of the unknown.

In armchair-based Pilates, movements are performed on their own or with the assistance of resistance bands or small weights. Small props can help participants and instructors simulate many of the exercises normally done on traditional Pilates equipment with springs. The idea is to encourage ideal posture that works the all-important core muscles, and then work towards strengthening and lengthening the rest of the body as necessary.

With over 500 exercises to choose from, clients can challenge their deep stabilizers to maintain proper positioning while strengthening the core and periphery, using Matwork- and equipment-based exercises. They can then progress to more co-coordinated and powerful movements with the PT if trained to do so.


The variety of exercises available through Pilates as well as the ability to modify these movement patterns allows professionals to target a specific muscle or muscle group. By changing the angle or strength of resistance, injuries can be precisely addressed.

Specifically designed, Pilates equipment lends itself well to the rehabilitation process because of its ability to support body weight, its adjustability, and ability to help guide movements in the initial stages of recovery. Knees, hips, shoulders and particularly the spine can be rehabilitated effectively on many popular Pilates apparatus.

While Pilates equipment is outstanding in its ability to aid in the rehabilitation process, the machines on their own cannot achieve this goal. It is necessary to complement the equipment with sound principles of stabilization, intelligent exercise choices and modifications and an understanding of how all of these can be accessed using the unique features of the apparatus. None of these are possible without a thorough understanding of the Pilates principles and their implementation in a rehabilitative setting.


Pilates is also a perfect modality for rehabilitation from a sports-related or other injury. Not only is the focus on strengtheningthe deep supporting muscles of the area, but complex movements that integrate the injured body part into full-body functional and sport-specific movement patterns are incorporated. Muscular compensations are identified and then specific movement patterns are designed to strengthen the mind-body connection. The integration of the whole body has been shown to be much more effective than isolating the injury site. When a Pilates practitioner trains a client with a knee injury, the body is seen as a whole and the movement patterns are designed to strengthen the support structures throughout.

Active recovery is the period of muscle regeneration after a strenuous workout or game. Pilates can help during this period by gently working through movements that allow the muscles and joint structures to achieve their ideal functional positions. Also, during rehabilitation, Pilates can provide an interim step between non weight-bearing to open-chain exercises, through to explosive movements. The focus on mobility, flexibility and strength through a full range of motion help restore the injured tissues to a healthy state before sport-specific training begins. In rehab, Pilates can be used at all stages from the most acute phase to advanced functional re-education. Pilates is particularly effective in injury re-habilitation settings as it provides athletes with a challenging workout without impact or excessive weight bearing.

Kerrie Lee Brown is Vice President of Communications for STOTT PILATES®,