Modified Pilates APPI
At Grange Physiotherapy we offer individual tuition in Pilates taught by Chartered Physiotherapists. What is the difference between different types of Pilates?
Pilates is experiencing a boom in the health and fitness world with a proliferation of traditional pilates training courses offered for the general public, fitness instructors and professional health care workers (as designed by Joseph Pilates between 1914-1950’s). However, through years of studying and practicing pilates as physiotherapists the APPI (Australian Pilates Physiotherapy Institute) found that traditional pilates lacked the specificity and research base for use as a clinical tool in the professional health care setting with certain of the exercises being potentially hazardous to rehabilitation.
Therefore, the original 34 pilates matwork exercises have been modified to incorporate the recent research on lumbar instability, muscle imbalance and adverse neural tension. APPI success relies on this research based approach to pilates training. As physiotherapists, we recognise the demand for more specific pilates training which targets the higher theoretical and practical experience of higher degree therapists, presents the most current research relevant to pilates and teaches a realistic framework of exercises to apply in the clinical setting.
What is Pilates?
Pilates is a mind body conditioning exercise programme that targets the deep postural muscles of the abdomen and spine to improve overall central core stability and posture. The mind and body are brought together to achieve these aims through the following eight sound principles:
- Concentration
- centering
- breathing
- isolation
- routine
- precision
- control
- flowing movement
As part of your rehabilitation Pilates offer excellent exercise progressions aiding return to into sport and normal activity.
How does it aid rehabilitation after injury?
In order to prevent a recurrence of back pain, it is essential to retrain the deep abdominal and spinal muscles. Hodges (1999) developed a model of spinal stability by drawing on all the research presented previously. Hodges proposes that TrA, multifidus, the diaphragm and the pelvic floor muscles are co-activated to form an enclosed abdominal ring, termed a ‘cylinder of stability’. This closed cylinder of stability allows the contraction of TrA to generate an increased IAP to increase lumbar stability (1999). Activation of TrA, multifidus, the diaphragm and pelvic floor is required to increase the pressure in the abdominal cavity and increase tension in TLF to increase spinal stability.
This cylinder of stability hypothesized in the literature is what is termed as the ‘central core’ in pilates. As stated previously, pilates focuses on building an efficient ‘central core‘. In pilates, ‘central core’ refers to the TrA, multifidus, pelvic floor and diaphragm. In pilates, abdominal hollowing techniques are utilized to activate this central core. The ‘Modified pilates rehabilitation program’©’ also focuses on contraction of the pelvic floor to facilitate the TrA and multifidus muscles to contract, thus activating this central core. Pilates then challenges this central core by introducing graduated arm and leg movements and stretches.
In conclusion, there is substantial evidence on the importance of TrA and multifidus in the role of lumbar stability. Abdominal hollowing techniques have been advocated to reduce the recurrence of low back pain and lumbar instability. The pelvic floor has been shown to activate in close association with TrA and the diaphragm in a feed forward mechanism to increase spinal stability. Therefore, pilates offers an excellent adjunctive tool to Physiotherapists and provides patients with a method of exercise that focuses on correct movement quality not quantity, core stabilisation and postural correction.
Who is appropriate for Pilates?
Pilates suits all ages and fitness levels and is particularly beneficially for those with:
- Back pain
- Poor postures
- Neurological conditions
- Mental health conditions
- Sports injuries
- Arthritis
- Stress related illness
- Before and after pregnancy