Pilates PT is THE way to rehab, prehab and help prevent chronic pain. There, I said it. Ok yes, obviously I’m biased, but honestly I’ve seen it with my own eyes over and over again. As a Certified Pilates Instructor, a Licensed Physical Therapist, studio owner and most recently a Certified Health Coach, and I’ve been practicing Pilates-based rehabilitation, in one form or another, for the past 13 years. Over the years I’ve figured out a secret principle to get anyone moving better. This secret is so simple that it will make rehabilitation specialists cringe if I tell you. All the years of schooling and testing and internships, and it all boils down to basically two things. Are you ready? Here it is... “If it doesn’t move, get it moving” and “If it moves too much, stabilize it”. I’ll make it even more simple, if you are stiff (hypomobile) or limited in your range of motion, you need to get that area moving. And, if you are over flexibile (hypermobile) you need to strengthen around that area. Yep, there it is, but shhhh don’t tell anyone, we can keep it our little secret!
Now that the secrets out, I will say here is where the skill of a Physical Therapist comes in. HOW do we get an area moving and or stabilized? Well, as a graduate of a primarily manual therapy Physical Therapy program, my original training was to do hands on manual therapy. There is absolutely nothing wrong with doing manual therapy from time to time, and yes I even still use some of my manual skills. But as a Pilates PT, we have all these cool apparatus, equipment and props at our fingertips to both assist (AKA, mobilize) and resist (AKA, stabilize) movement, so the possibilities are endless!
As a self-admitted Pilates PT nerd, I could spend hours talking about the benefits and breaking it down to specific joints and diagnoses, but you don’t want to read all that. So let’s talk about one specific aspect that all Pilates instructors teach daily to help improve mobility and function: Dynamic Stretching.
In a nut shell, there are 3 types of stretching: Ballistic (bouncing), Static (holding), and Dynamic (moving through a range of motion). If you’re reading this, hopefully you know that we don’t teach bouncing stretches anymore, as the potential for injury is high. Static stretching, where you hold a muscle or joint at its endrange for 30-60 seconds, has a place in rehab, especially for the neurologic population or someone with contractures, or even post-workout. However if the goal is get your joints and muscles moving through their range of motion, which is generally the whole point, then Dynamic Stretching is THE way to go.
So What is Dynamic Stretching?
Dynamic stretching is simply moving the body through its available range of motion. These “stretches” increase blood flow, warm up your muscles, and utilize concentric and eccentric muscle activation. (I could write a whole other blog about Pilates and eccentric muscle control). Taking the muscles and joints through their available range, but not exceeding it, allows the muscles to learn to work appropriately for both normal daily activities and sport specific movements. Also by moving the muscles and joints to endrange, we are mobilizing the nervous system and fascial tissue. Many times we forget that not only do muscles or joints get tight, but also our nerves and fascial tissue can be become tight or adhered. As a final thought, many of the Pilates exercises that focus on dynamic stretching also have a reciprocal inhibition aspect, in that you are contracting one muscle, while stretching the opposite.
Lets look at two specific Pilates exercises that embody dynamic stretching, neural mobilization, strength and flexibility.
Climb a Tree
This exercise can be done on a mat, a ladder barrel or as seen here on the reformer. The “spirit of the exercise” is to dynamically stretch the muscles and improve posterior neural chain mobility on one side (think lumbar flexion, gluts, hamstrings, gastrocs, soleus, sciatic nerve, etc…), while improving hip flexor mobility and abdominal strength on the opposite side. As an added bonus you get ankle dorsiflexion strength, and generalized coordination and control are required, making this one of my favorite exercises.
Single Leg Monkey
The Monkey exercise can be done facing different directions or as a single or double leg exercise. When thinking about dynamic stretching and neural mobilization for different body types, I like to break it down to the single leg version facing the tower. The “spirit of the exercise” is to again dynamically stretch the posterior chain; however I specifically like this exercise for the client who has poor lumbar flexion. Think about the client who maybe has tight hip flexors and tends to hip hinge, or has hard time doing a roll down on the mat and who can’t articulate through their bridge. As they are bringing the bar “around the corner” this exercise requires a lot of lumbar flexion and deep abdominal strength to not “get stuck”. In other words you can’t fake it; you have to dig in to the deep core muscles. This exercise is a great example of lumbar mobilization into flexion, while getting posterior lower extremity mobility and deep core strength.
As you can see, Pilates exercises multifaceted and it takes the skill of a therapist to pick and choose the appropriate exercise for the specific client. Exercises can be focused on improving stability, mobility, or a combination of both. They are focused on neural mobilization, fascial release, joint mobility and concentric/eccentric muscle strength.
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Having difficulty finding the right position during exercises? Don’t understand a recent medical diagnosis? Want to know how to target a problem area? Interested in being the next PilatesPT of the Month? You have questions, WE have answers! Don’t hesitate to email askpilatespt@gmail.com!
With Love, Scrubs, and Sidekicks,
