By Kristen Reynolds From put me back together.com
For a number of reasons, a common challenge for entry level physical therapists is effectively implementing therapeutic exercise programs. Not all academic programs provide their graduates with a large, mental library of exercises. Athletic patients may be bored with the idea of hamstring curls or crunches, while others require modifications for such exercises because of other co-morbidities or injuries. Some patients have poor kinesthetic awareness and it is difficult to teach their bodies to feel the essence of an exercise. With Pilates being included with a rehab program makes the opportunity for therapists to progress clients back to their previous level of strength and function. Clearly, designing a safe, progressive rehab program that benefits patients with multiple impairments in a limited episode of care is no easy feat. That’s where Pilates came in.
When Pilates Mat exercises were introduced to me at Active Motion
Physical Therapy, my clinical instructor had a conversation after the patient’s treatment about her impairments, functional limitations, and goals of continuing a program on her own after discharge. To sum it all up, the CI looked at me and stated “it just makes sense.” This statement holds true to me more and more each day three years later.
Completing a comprehensive Pilates teacher training program and utilizing
the method in daily practice has sincerely improved my clinical skills in regards to breaking down movements and teaching them in part and whole tasks. Joseph Pilates developed more than 500 exercises on a handful of apparatus designed to correct alignment and balance muscle development of the entire body utilizing a variety of developmental and gravity-eliminated postures (which I recall learning specifically during PT school lab!) Impaired range of motion, muscle length, and muscle performance are all targeted through sequenced eccentric and concentric contraction. The spring-loaded equipment in particular, significantly enhances neuromuscular re-education and helps the patient actually “get it” when trying to cue lumbar or scapular stabilization. When they “get it” I take an exercise to the mat (and sometimes incorporate resistance bands) to morph the exercise into one for home.
There is always an opportunity for modification and progression to allow for patient success and challenge and most importantly, compliance. Now I split my practice and teach Pilates at OMBE, an integrative health center. A large number of my clients are those with injury or postural-induced pain that are attending acupuncture or chiropractic treatments and need a safe method to resume strengthening or those who have “graduated” from physical therapy because their short-term rehabilitation benefit has been fully utilized. Attending private sessions and small group classes under the direction of a comprehensively certified Pilates instructor is a smart solution for a lifelong fitness regimen when suffering from orthopedic or sports-related injuries.
About the Author: Kristen Reynolds is a Doctor of Physical Therapy, specializing in orthopedics and sports medicine, and a PMA® Certified Pilates Teacher.
Sean Gallagher P.T.
• I have had a Pilates studio in my physical therapy practice since I opened it in 1990. The article supports the fact that patients need a comprehensive exercise program that will not only allow them the health benefits of exercise, which the research supports on many different levels. Exercise machines that have been developed to work only single muscle or to sell exercise equipment do not meet the needs of function. Since the brain integrates movement in dynamic multi-segmental symbiotic relationships trying to develop strength and flexibility through an inter connected skeletal chain with single muscle work or even groups of muscles really doesn’t address these relationships.
What I noticed very early on in my PT career was that most of my patients (80%) would not have needed PT if they had been in a comprehensive exercise program. What other exercise system available today has over 60 years of clinical practice and research (Joe Pilates always talked about his experiments and research into his method) that has continued to provide clinical affirmation for the last 45 years? Pilates is being researched more and more today and most of it is finding that it works as stated and in many instances is as good or better that what it is being compared with.
I think that this is because no other system (unless it is based on Pilates) has provided a methodology that incorporates the developmental sequence, open and closed multi-segmental muscle chain movements, Dynamic balance between stability and mobility, full ROM of every joint in the body( thus allowing for the brain to better integrate a living posture that is balanced), all while being able to make it interesting, challenging for different levels of participants and makes clients feel good after doing it. All using only a few apparatus(since most pilates equipment allows 40-80 exercises on each one their design is in line with the method – functional and integrated) with the eventual goal of self maintenance doing the mat work at home.
So besides the insurance and cost dynamics of Pilates being in a PT clinic the real reason why Pilates should be integrated into physical therapy is that it will not only help your patients with their current injuries it will help them maintain a balanced neuromuscular system that should keep them from needing a return to PT and live a much more productive and healthy life.
Terry Walters • I totally agree with your philosophy and pilates should be offered as a healing process from physicians to their patients. There are so many individuals that do not even know what pilates is.
Samantha Reed • Pilates helps people learn how to move & make work more efficient.