Pilates can be used for general fitness or to help with rehabilitation. Many clients are referred from Physiotherapists, Osteopaths or GPs to help them manage and recover from injuries.
Recovery from disc prolapse
Andrew came 3 months after a disc prolapse and initial physiotherapy treatment. He was still suffering pain. Although his lumbo-pelvic stability systems were not functioning that well the most noticeable thing was a structural fault. He was hiking up his right hip, not flexing the hip joint in gait, and the result was a high hip on that side. Releasing the fascia manually on that side brought pain relief for the first time. This allowed him to perform the exercises to regain core control and correct the gait.
Although Pilates works well at regaining muscle balance and control a deep structural pattern can inhibit that and manual release and realignment may be necessary.
Shoulder Pain
Eileen does a lot of running and gym work. One day she came with some shoulder pain and had a strain diagnosed in a posterior shoulder muscle. Assessing movement of that arm her pectorals were over active on shoulder flexion, pulling the humeral head forward. Some general upper shoulder fascial releases were performed and then the pectorals where a fascial knot under the armpit was found . Working on this to melt it away, “ I can feel that dissolving”, she said, aiding the arm into a more harmonious biomechanical action. The pain disappeared and further exercises were incorporated into the rest of her workout to help the muscle balance of the shoulder.
Although one muscle was strained the cause of her pain was a biomechanical fault due to a fascial tightening of an opposing muscle compromising the joint action. Release of the restriction restored joint alignment allowing proper movement without pain.
Hip Pain
Niamh, nearly eight months pregnant, came to her regular session complaining of severe pain in the front of the hip when walking.
On assessment I noted that on hip flexion her superficial flexors were over active resulting in an anterior positioning of the femoral head in the hip socket. After some fascial releases, resettling the femur in the hip socket and careful tactile and verbal cueing with specific movements she was able to walk without any of the previous pain.
She remarked “ I thought it was due to the pregnancy and positioning of the baby and would have to suffer it until the birth”.
Fitness
Frances had been doing Pilates elsewhere for 3 years, moved to the area and wanted to restore fitness after childbirth.
Although she was familiar with the exercises she was not working her body efficiently, overusing muscles inappropriate for the movement. After 5 sessions, cuing carefully getting her to think more about the movement and experience it she eventually got it and realised what she had been doing. “ Oh that’s where I’m working from, not there, I get it, that’s much harder. It's like starting again, I've wasted three years, can I come twice a week? ”.
Although Pilates works by encouraging good movement patterns it is easy to do the exercises and just reinforce faulty patterns. Careful observation and cueing is essential to retune the body to get the best benefit.