Pilates mat training is now a widely used training method in the world of fitness and gymnastics studios. More and more physiotherapists are also discovering the added value of the Pilates method in therapy. Studies show a positive effect of Pilates-based interventions in terms of reducing pain and improving functional abilities, both in everyday life and in sport.
Pilates in snow sports: prevention of winter sports injuries
Summer is over and the next winter will soon be upon us. Alpine snow sports are not only a popular leisure activity, they also lead to accidents and injuries time and time again. In 2011, around 50,520 skiing accidents among the Swiss resident population resulted in costs of 441 million Swiss francs (Lit.1)! The body regions most affected are: Knee (30%), head (14%), shoulder (11%), thumb (8%)(Lit.2). Griffin et al. describe 4 categories of risk factors (equipment, anatomical conditions, hormonal and biomechanical factors) for an injury. In the field of biomechanics, these are primarily the level of strength and neuromuscular control, which is described as the unconscious activation of the stabilizing structures of the joints in response to sensory stimuli (= proprioception). Only the interaction of these two factors leads to good functional joint stability (Ref.3). In the statement of the "Hunt Valley Consensus Conference of Noncontact ACL Injuries", the improvement of body control was named as one of the main factors for preventing injuries. In addition, the importance of an intervention that includes the entire kinetic chain was emphasized. Pilates training specifically promotes awareness and increases the strength of the local stabilizers. Supplemented with proprioceptive strengthening exercises for the lower extremities, this training represents optimal prevention and preparation for safe winter sports!
1) bfu basics: Skiing and snowboarding accidents in Switzerland (2015)
2) Koehle, Michael S., Rob Lloyd-Smith, and Jack E. Taunton. "Alpine ski injuries and their prevention." Sports Medicine 32.12 (2002): 785-793.
3) Griffin, Letha Y., et al. "Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies." Journal of the American Academy of Orthopaedic Surgeons 8.3 (2000): 141-150.
Michael Brunner, sports teacher and head of training at Polestarpilates Switzerland
"You are only as young as your spine is flexible" (J. Pilates)
The ability to move our spine as harmoniously and controlled as possible in all planes of movement has a strong influence on our well-being and health. Jospeh Pilates once said: "If your spine is stiff at 30, you are old. If it is very flexible at 60, you are young." Various studies show that spinal mobility has an influence on the occurrence of pain, particularly in the lumbar region(Ref.1) and the loss of confidence in everyday life in older people. In sport, improved spinal mobility, combined with good trunk control, not only reduces injuries but also improves performance. Pilates training improves the mobility of the spine and the perception of one's own body. As a result, movements of the spine are optimally coordinated and posture is improved (Ref.2) and complaints in the area of the spine are reduced (especially in people with a pre-existing condition (Ref.3)). Training on the Pilates equipment enables therapists to support patients in mobilizing the spine in different ways. From guided and supported movements in closed kinetic chains to complex movement sequences in open chains, all options are open. The multidimensional, complex movement sequences that are possible in Pilates training mobilize and train fascial structures. In addition to the positive effects on the musculoskeletal system, this also has a positive influence on other structures in the body (Ref.4/5).
1) Andersson, Gunnar BJ. "Epidemiologic aspects on low-back pain in industry. "Spine 6.1 (1981): 53-60.
2) Kuo, Yi-Liang, Elizabeth A. Tully, and Mary P. Galea. "Sagittal spinal posture after Pilates-based exercise in healthy older adults." Spine 34.10 (2009): 1046-1051.
3) Brown, Kathleen C., et al. "Cost-effectiveness of a back school intervention for municipal employees." Spine 17.10 (1992): 1224-1228.
4) Langevin, H.M. et al.: Relationship of Acupuncture points and meridians to connective tissue points. The Anatomical Record (New Anat.) 269; Wiley-Liss, Hoboken, New Jersey, USA, 2002
5) Schleip, Robert. "The importance of fascia in manual therapy." DO-German Journal of Osteopathy 2.01 (2004): 10-16.
Michael Brunner, sports teacher and head of training Polestarpilates Switzerland
Pilates reformer training in the rehabilitation of the upper extremities
As in the rehabilitation of the lower extremities, the Pilates method and the reformer developed by J. Pilates are also used successfully in the rehabilitation of the upper extremities. Various studies show a connection between the occurrence of shoulder problems and poor posture. In particular, an increased kyphosis of the thoracic spine, a forward-positioned head and protracted shoulder blades are mentioned.(Ref.1,2,3) With the movement principles of breathing, axial length/torso control, articulation of the spine and organization of the head, neck and shoulders, Pilates has a positive influence on posture and thus lays the foundation for good mechanics in the shoulder joint. Movement integration, another principle of the method, leads to functional reeducation of the active structures involved through improved perception and control. In shoulder rehabilitation, the targeted use of breathing supports the mobilization of the thoracic spine into extension and thus leads to a more upright posture (Stomach Massage with the Arc). Assisted resistance in combination with activated trunk control improves proprioceptive control of the movement and promotes congruence of the joint partners (arm series). Dynamic stabilization of the entire shoulder girdle (Quadruped) prepares the patient for more complex everyday and sport-specific movements (Side Arm Series).
1) Kebaetse, Maikutlo, Philip McClure, and Neal A. Pratt. "Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics." Archives of physical medicine and rehabilitation 80.8 (1999): 945-950.
2) Greenfield, Bruce, et al. "Posture in patients with shoulder overuse injuries and healthy individuals." Journal of Orthopaedic & Sports Physical Therapy 21.5 (1995): 287-295.
3) Lewis, Jeremy S., Ann Green, and Christine Wright. "Subacromial impingement syndrome: the role of posture and muscle imbalance." Journal of Shoulder and Elbow surgery 14.4 (2005): 385-392.
Michael Brunner, sports teacher and head of training for Polestarpilates Switzerland
Pilates reformer training in the rehabilitation of the lower extremities
The reformer developed by J. Pilates and the Pilates method are already being used successfully in the rehabilitation of the lower extremities. In recent years, Pilates has become increasingly widespread in rehabilitation and is now supported by a growing number of studies (Ref.1,2). The Reformer enables a very finely adjustable load design and training in different starting positions of the body. In this way, the focal points assigned to the various REHA phases (according to Porterfield and de Rosa) can be ideally implemented (Ref.3). Acute phase: In addition to passive measures in the injured area, awareness exercises and stabilization exercises of the trunk, as well as movements distal to the injured area, prepare for active therapy in the subacute phase (relieving the right leg). Subacute phase: Functional educational stimuli are provided through assistive and selective movements in the affected area (weight-bearing on the right leg in a closed chain). Active rehabilitation: active stabilization of the affected areas and the trunk, approximation to typical everyday body positions (weight-bearing on the right leg in a sitting position). Post-rehabilitation: active and complex movement sequences with increased strength and stabilization requirements are selected according to everyday or sport-specific requirements (dynamic stabilization of the supporting leg on the right).
1) Levine, Brett, Beth Kaplanek, and William L. Jaffe. "Pilates training for use in rehabilitation after total hip and knee arthroplasty: a preliminary report." Clinical Orthopaedics and Related Research® 467.6 (2009): 1468-1475.
2) Beitzel, Knut, et al. "Knee: Rehabilitation." Rehabilitation in orthopaedic surgery. Springer Berlin Heidelberg, 2015. 147-182.
3) Geweniger, Verena, and Alexander Bohlander. "Therapeutic Pilates: Clinical Conditions/Patient Examples." Pilates- A Teachers' Manual. Springer Berlin Heidelberg, 2014. 265-271.
Michael Brunner, sports teacher and head of training Polestarpilates Switzerland
Training with the Pilates Arc™
The Pilates Arc™ is a further development of the classic Spine Corrector/Small Barrels and is ideal for group work. In contrast to the Spine Corrector with its narrow radius, the Arc also allows people with limited spinal mobility to train in a supportive extension.
The low weight and the removable support allow the Arc to be easily moved into a wide variety of positions. This opens up countless possibilities for training strength, coordination and balance in an exercise-friendly manner in addition to mobilizing the spine. If the Arc is turned upside down, it can also be used as an unstable base, providing additional challenges with its asymmetrical arc!
Michael Brunner, sports instructor and training manager for Polestarpilates Switzerland
From the acute phase to everyday exercise
Pilates equipment (trapeze table, reformer, chair, etc.) offers a wide range of possibilities in the rehabilitation of patients, from relieved mobilization to functional training in open chains. According to Porterfield and De Rosa, rehabilitation is structured in 4 phases (pain control, start of non-damaging movements, training within a safe framework and setting limits to the load).
In phase 1, the affected regions are relieved and the pain is controlled by therapeutic measures. Non-stressful movements within the possible range of motion should lead to freedom from pain. Using closed chains and with the support of equipment, phase 2 is dedicated to restoring mobility. In phase 3, the focus is on dynamic stabilization and functional re-education. Slowly increasing the load and adapting the coordinative requirements is achieved by reducing the support and changing the kinetic chains. Phase 4 marks the end of rehabilitation. The aim is to load the patient in everyday movements and define load limits.
Further reading:
Geweniger/Bohlander: The Pilates textbook, Springer Verlag
Michael Brunner, sports teacher and head of training at Polestarpilates Switzerland
Pilates training in physiotherapy
Pilates mat training is now a widely used training method in the world of fitness and gymnastics studios. More and more physiotherapists are also discovering the added value of the Pilates method in therapy. Studies show a positive effect of Pilates-based interventions in terms of reducing pain and improving functional abilities, both in everyday life and in sport (Ref. 1,2).
In particular, training on the Pilates equipment enables precise work with the inclusion of closed and open kinetic chains. This enables the patient to target and strengthen the deep-lying and stabilizing muscles with improved perception.
Building on the principles of movement - breathing, axial length and trunk control, articulation of the spine, organization of the shoulder-neck region, alignment of the extremities and movement integration - complex, three-dimensional movement patterns are created that are close to everyday life. By working in this way, patients not only strengthen their stabilizing muscles, but also benefit from a newfound awareness of their own body in everyday life.
1) Rydeard R. et al: Pilates-Based Therapeutic Exercise: Effect on Subjects With Nonspecific Chronic Low Back Pain and Functional Disability: A Randomized Controlled Trial J. Orthop Sports Phys Ther Volume 36 Number 7 July 2006
2) Gladwell v. et al : Does a Program of Pilates Improve Chronic Nonspecific Low Back Pain?. J Sport Rehabil. 2006,15, 338-350
Michael Brunner, sports teacher and training manager Polestarpilates Switzerland
