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Pilates for Post-RehabilitationDownload PDF

By Kerrie Lee Brown as published in OnSite Fitness, Oct 2010


Physical activity for older adults is on the rise. Mind-body exercise is leading the charge by being integrated into the rehab community – helping older adults do what they do best.

Often noted as a form of exercise for the highly skilled, rich or famous, Pilates is now being embraced by the medical and rehab communities who are applauding the wide-reaching virtues of this highly targeted approach.

The American Council on Exercise reports that there has been an increase in specialized fitness programming for older adults over the past few years. A well-balanced fitness program offers many benefits for seniors because it conditions muscles, tendons, ligaments and bones to help fight osteoarthritis and osteoporosis; keeps the body more limber; stabilizes joints; and lowers the risk of everyday injury. Moreover, physical activity helps enhance overall quality of life, increases life expectancy, and helps older adults stay independent.

The American College of Sports Medicine (ACSM) reported that increased fitness programming for older adults, functional fitness and Pilates in particular were among the hottest fitness trends for 2009. Pilates is a gentle restorative exercise regimen perfectly suited for most people as they recover and work to rebuild their bodies.

Pilates works on developing a balance between strength and mobility through individual and adjacent joints. It serves to increase core stability and peripheral mobility, ensuring proper muscle firing patterns are maintained. Pilates can increase neuromuscular awareness and improve balance and coordination. It allows focus to be placed on individual body parts as well as their integration into the body as a whole.

REACHING THE REHAB COMMUNITY
Pilates continues to be used to create positive movement experiences for those with any type of movement dysfunction. Leading Pilates authorities are assisting this currently by developing specialized programming for particular populations. Today there is a definite partnership between Pilates experts and rehabilitation specialists and by working 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 exercises are consistent with those of rehabilitation. Addressing the body as a whole, not just a collection of individual parts, allows for successful aging and the ability to function at the level an individual wishes. Mobility of joints, strength of the muscular system, integrity of our shoulders, hips, knees and spine… everything is interconnected and must all be addressed when managing or preventing aches, pains and degeneration.

The rehab and medical communities are embracing Pilates for many reasons based on this theory. 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.


PILATES PROGRAMMING AND EQUIPMENT
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, 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.

Pilates exercises modified to be done in chairs are becoming more common and are specifically designed for those who may not be able to lay down on a mat or other Pilates equipment. Regardless of the reason for someone’s mobility challenges, there are hundreds of exercises that can be advantageous from a seated position. In many cases, participants will notice changes right away in the way they move.

In chair-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.

The variety of exercises available 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. For example, the side arm work sitting on the Reformer using a very light spring tension can help access the deep stabilizing muscles of the shoulder girdle including the rotator cuff. Performing this series of exercises not only targets individual muscles, but takes into account the positioning and stabilization of the body as a whole and how this plays into creating healthy movement patterns right away.

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. Specially designed Pilates equipment can help facilitate these adaptations. Knees, hips, shoulders and particularly the spine can be rehabilitated effectively on the Reformer – the most popular apparatus – as well as other pieces of equipment and props.

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 and modification choices 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.

EXERCISE FOR A LIFETIME
In any form and at any level, even the most rudimentary, Pilates can be a starting point, an end point or a maintenance tool for the active aging. Virtually anyone can realize improvements to an array of movement dysfunctions including neurological disorders, cardiopulmonary restrictions, orthopedic complaints and a host of other physiological conditions.

As a result, more and more facilities are implementing high-quality equipment and training into their locations to fulfill their clients’ unique needs – and qualified Pilates instructors, more than ever, have access to the most up-to-date repertoire on the market to meet all of their clients’ needs.

No matter what age, ability or goal, those interested in enhancing their health, fitness and lifestyle in general, are enjoying what this method of exercise has to offer. The result is that they have found a newfound method to take back their quality of life and strengthen their core muscles for a pain-free lifestyle.