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Clinical Pilates a useful tool for physiotherapists

Photo: Clinical Pilates a useful tool for physiotherapists
Pilates is a valuable rehabilitative tool for practitioners and can be instrumental in women’s health, according to Musculoskeletal Physiotherapist and Clinical Pilates Instructor Yvonne McKenny of Evoker.

A graduate of the University of Sydney, Ms McKenny gained qualifications in the musculoskeletal field of sports and spinal injury management. This education, coupled with her sporting background in netball, competitive swimming, cycling and running, led to a passion for Pilates.

“My interest in Pilates goes back to my teens as I found it to be a brilliant complement to my swimming training.

“I continued to participate in Pilates throughout university and grew a greater appreciation for its place in women’s health and its use in conjunction with physiotherapy as a rehabilitation option.”
As a result, Ms McKenny undertook further training and certification exams to become a clinical Pilates instructor.

“I continue to go to workshops and attend various classes myself to add to my repertoire, knowledge and critique of movement.”

Many women are introduced to Pilates through pregnancy, either antenatally or postnatally, as a suitable form of exercise due to its focus on strengthening the pelvic floor and deep abdominals, said Ms McKenny.

“This can involve returning to exercise after pregnancy, learning to re-engage the deep abdominals and pelvic floor or merely getting stronger and improving quality of movement dynamically and safely.”

One of the benefits of instructing Pilates classes is that clients open up about various women’s health and personal issues they are facing, said Ms McKenny.

“When I started teaching Pilates classes the interactions often led to discussions over their concerns for their bodies, their backs, their journeys through pregnancy or simply their difficulties with other women’s health-related issues like, pelvic pain, incontinence, prolapse or just feeling weak through their core, back and pelvis.”

Pilates is also beneficial in a rehabilitative function for the injured population, said Ms McKenny, and execution matters.

“It’s not good enough to copy the movement. Often there are learned compensations or areas of weakness that need to be challenged to see a change in their condition.

“As a physio, these considerations are ingrained in your knowledge of assessing the human body and your understanding of injury management and Pilates is a useful extension of this.”

Pilates instruction can also be a means of assessment in the quality of a client’s movement, identifying weaknesses or areas lacking mobility and as a measurement of a client’s progression, said Ms McKenny.

"I often incorporate Pilates as a means to assess my patients’ quality of movement, improve strength, body awareness and control.”

If clients are new to Pilates or are returning after injury or pregnancy, one-on-one time is critical to get the foundations of movement correct, explained Ms McKenny.

“It's important to get the right muscles engaged and have a strong awareness of body positioning throughout the exercises. It also involves getting to know what you should be feeling.

“It can be overwhelming in a class context when they’re trying to keep up with the moves, and someone is talking about breathing and unfamiliar terms and cues.”

Integrating reformer Pilates, a machine-based and more intense and dynamic form than a mat-based routine, is encouraged after initial assessment, said Ms McKenny.

“When we are confident that they are safe to do so, this can add an extra dimension of variety and challenge that can be enjoyable and rewarding.

“Like any exercise, consistency is key, so it's important to spend the time and effort to get results.”

In the management of a patient’s injury, the emphasis invariably shifts from a hands-on approach to a more active phase in physiotherapy, said Ms McKenny.

“Sometimes this is when patients feel like they are doing well, but are not 100 per cent.

“Their pain is down, but you’re wary that they haven’t ultimately addressed the underlying areas of weakness that led to their painful episode.

“With my ‘ pain-free’ physio hat on, Pilates takes patients out of the 100 per cent full weight bearing, gravity loaded, vertical positions to offer low load, horizontal, spring-loaded resistance training.

“So, if someone is experiencing pain in weight bearing, yet we need strength for recovery, Pilates is an awesome solution. We can get the strength requirements without the painful weight bearing.”

Pilates is also an ideal bridge to discharge, offering an exercise-based therapy to meet a client’s specific area of need, said Ms McKenny.

“Many clients are originally introduced to Pilates as a part of the management of an injury, but grow to love it and continue to attend regularly as a form of exercise”

All injury specific benefits aside, Pilates is ultimately a form of exercise, and for every exercise, there are endless modifications to cater for any number of conditions: post-surgical, weight-bearing restrictions, ante and postnatal, sports and spinal injuries, said Ms. McKenny.

“Pilates can be adapted, and the difficulty of exercises progressed to challenge even the most flexible, strong and fit clients.

“There are options for everyone, which makes it useful in the clinic when helping patients manage conditions that take them away from their exercise of choice

“The diverse repertoire can be stimulating both mentally and physically, not to mention incredibly enjoyable,” said Ms McKenny.

For physiotherapists interested in becoming Pilates certified, Ms McKenny recommends taking matwork classes first, then moving onto ‘reformer’ and ‘barre’ to widen their exposure to the discipline.

“Ideally at small studio class where there’s a closer instructor-student ratio so that you can get the attention you need.

“It’s important to be familiar with what it feels like to do Pilates. What messages you took from it. What you found challenging.

“Going to classes consistently will help you feel and appreciate the benefits, as well as affirming that this is an exercise therapy you believe in.

“It will also give you a greater understanding of the implications some of the movements may have, for different injuries, ages and fitness levels.”

When choosing a Pilates program, and there are many that are tailored to allied health professionals, it's important to find one that's a good fit, according to Ms McKenny.

“Make sure you do your research to find the course that will be most appropriate to your personal and clinical level of experience and suits the type of people you treat. 

“Wherever you choose, the principles remain the same: master the foundations of Pilates first.”

Mastering the foundations of Pilates is most important in a clinical setting. The advanced exercises and repertoire are not realistic for most of the injured population, said Ms McKenny.

“It’s the basics of body awareness, breathing, engaging different muscle groups and moving with control, that ultimately offers the most to our patients.

“It’s easy to get carried away, adding on too many challenging progressions, but it’s critical that your patients have displayed mastery in the basics first.

“Once you have these tools, you can go on to different courses, workshops and classes to add to your colourful and varied repertoire,” said Ms McKenny.

So, whether clients are pregnant, injured or simply want to improve their tennis game, Pilates might be an invaluable complement to a physiotherapy clinic.

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Haley Williams

Haley Williams has a Bachelor of Communication in Journalism and over a decade of experience in the media, marketing and communications industries.

She is a widely published journalist with a particular interest in writing magazine features on parenting, health, fitness, nutrition and education.

Before becoming a freelance journalist, Haley worked as a writer for NeoLife (a worldwide nutrition company), News Limited and APN News & Media.

Haley also has extensive experience as an SEO Content Writer and Digital Marketing Strategist.