Integrating pilates into physical therapy is essential since it is a common challenge for entry level physical therapists to effectively implement therapeutic exercise programs. Not all academic programs provide their graduates with a large, mental library of exercises. Highly 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. Unfortunately, the increasingly declining number of visits associated with co-payments, deductibles, and authorized visits limits the opportunity for the therapist to progress a patient back to their previous level of strength. Clearly, designing a safe, progressive rehab program that benefits patients with multiple impairments in a limited episode of care is no easy feat.
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 physical therapy 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 physical therapy sessions and small group classes under the direction of a comprehensively certified Pilates physical therapist 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. She divides her professional time between private practice and an integrative health center in the Greater Boston area and enjoys teaching her signature barre fitness classes..
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