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Pilates for Injury Recovery

Pilates for Injury Recovery

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Participation in Pilates has grown exponentially around the world over the past five years. Experts say Pilates is effective in injury rehabilitation settings as it can provide athletes with a challenging workout without impact or excessive weight bearing.

Traditional athletic training methods will help develop the muscles required in a specific sport, but may not address the stabilizing muscles around the joints or the torso. Often, one muscle is identified, and exercises are designed to isolate that muscle, usually in a single plane of motion.

However, Pilates exercises can be more complex than traditional moves and will therefore recruit more efficient neuromuscular firing patterns. These patterns will in turn strengthen muscles from many angles and in a variety of different ranges of motion.

Pilates Primer

Pilates is ideal for anyone wanting to expand their exercise regimens to include stabilizing and strengthening moves that also work the musculoskeletal and fascial systems. Pilates is functional and works all levels of muscles and therefore fascial systems-a perfect complement to anyone’s sport conditioning or strength training.

Unlike other strength training regimens traditionally designed for athletes, Pilates focuses on recruiting the deep stabilizing systems of the body, thereby improving biomechanical efficiency and muscular balance along with increasing proprioceptive awareness. 

Active recovery is the period of muscle regeneration after a strenuous phase of competition or activity. Pilates is an excellent training modality during active recovery during pre-competition and post-strenuous activity. It can help during this period by gently working through movement patterns that allow the muscles and joint structures to achieve their ideal functional positions and sport-specific skills.

One of the focuses of the basis of Pilates is ideal alignment of the skeleton to promote optimal movement, core strength, and stability and mobility of the periphery, and this is most easily found in a supported position. Exercise progressions develop from there. Mindful movement and proper diaphragmatic breathing provide kinesthetic awareness and a stable base from which to move. The idea of focusing the mind on what the body is doing can afford profound benefits.

Recovery from Injury

Pilates focuses on rehabilitating in an effective way with low-level skill development and progressive loading through the affected area. Rehabilitative programs will begin with a focus on strengthening the deep supporting structures of the body, and then progress to more complex movements that integrate the injured area into full functional and sport-specific movement patterns.

Throughout the progression, biomechanical compensations are identified and specific corrections or modifications are given to improve the quality of the movement patterns and to strengthen the mind-body connection.

Pilates offers clients a variety of options and movement experiences, which is integral to their motivation, interest and recovery.

“Pilates promotes postural alignment and muscle activation throughout a movement, ensuring there is appropriate stability proximal or distal to the movement,” said Carole Chebaro, H.B.Kin, B.Ed, MSc, a physiotherapist and co-founder of Neurocore Physiotherapy Centre in Richmond Hill, Ontario. “It can vary from specific isolated movements to more dynamic ones as necessary for the stage of rehab. Many of my clients have acquired brain injuries, MS, [and] spinal cord injuries, and present with quite variable mobility levels-but adapting exercises to their individual programs has provided these clients with a sense of accomplishment and achievement as they are able to participate in mainstream exercises appropriately.”

The biggest concern physical therapists have about implementing Pilates into their practices is that the instructors are not trained, qualified individuals with the knowledge in special conditions and injuries, said Chebaro. Another concern is that the assessment of what the client needs may be lacking in depth without the appropriate educational background and training. “The key is quality education,” Chebaro said.

Pilates for Rehabilitation

According to Laureen DuBeau, master instructor trainer for STOTT PILATES®, there are other areas of sport training in which Pilates can be useful. During rehabilitation, Pilates can provide an interim step between non weight-bearing, to open-chain, to explosive movements.

“The focus on mobility, flexibility and strength through a full range of motion can help restore the injured area to a healthy state before sport-specific training begins,” said DuBeau. “In rehab, Pilates can be used at all stages from the most acute phase to advanced functional re-education.”

These concepts are being embraced by sports trainers. This training progresses from general to specific, and from simple to more complex. The lighter resistance and multi-angular training makes Pilates perfect for athletic development as well as anatomical adaptation focusing on developing muscle memory and patterning, according to DuBeau.

Core strengthening is an integral component of any injury prevention, rehabilitation or sports performance program. A strong core provides a dynamic link between the upper and lower body, alleviating excess stress on the peripheral joints.

This in turn leads to enhanced athletic performance by providing a solid foundation from which the upper and lower extremities can generate force for running, throwing, rowing or jumping.

The STOTT PILATES® methodology is based on The Five Basic Principles, which is a way of initiating proper and corrective movements. The principles focus on breathing, pelvic placement, rib cage placement, scapular stabilization and mobilization, and head and cervical spine placement.

This programming promotes both stability of the core and mobility of the joints using eccentric contractions, controlled ballistic movements and low-load mindful movements. All three training theories are used in sport and provide optimal firing muscle patterns. Pilates focuses on active lengthening of muscles and mobility of the joints, rather than traditional prolonged static stretching.

Pilates exercises can be easily incorporated into regular sport-conditioning regimens. For instance, on a light weight day, a recovery workout day, or prior to skill acquisition days, a Pilates workout is a great way to work on neuromuscular coordination and efficient muscle-firing patterns. Another option is to add Pilates exercises to a warm-up for muscle activation.

When all neuromuscular and fascial systems work in a timely and coordinated fashion, athletes can achieve large gains in strength, skill, coordination, and biomechanical efficiency. Pilates focuses on improving stabilization of the lumbo-pelvic region, and therefore improved core stability improvement will carry over to the sporting realm, reducing the risk of injury and improving performance.

Although core training may be a bit of a catchphrase 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, according to Lindsay G. Merrithew, president and CEO of Merrithew Health & Fitness.™

“The attention to the core, proper alignment and efficient movement patterns that Pilates offers through its numerous variations of exercises and modifications, with or without specialized equipment, is a natural carryover for the athlete,” said Merrithew. “Our team has developed equipment and accessories that allow this method of exercise to reach a wider audience no matter what their goals or fitness levels.”

Wayne Seeto is a lead instructor trainer for STOTT PILATES® in Toronto, Canada. He received his bachelor’s of occupational therapy degree from the University of Queensland, Australia, and his master’s of science (physiotherapy) at McMaster University in Canada. 

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