Clinical Pilates – what’s behind clinical exercise?

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As Physiotherapists and Pilates Instructors, our evidence based practice is intermingled between manual and movement therapy. Firstly, we address the injured structure using evidence-based medicine, then improve it’s function by recovering muscle activation, joint stability then strength.

Pilates plays an important role in rehabilitation of most injuries by improving muscle activation and joint and trunk stability before moving to traditional strength and conditioning exercises.

It’s also a great balanced way to approach exercise: ensures that no muscle group is overworked; and teaches the body to operate as an efficient system in sport and daily activity. Efficient and resilient bodies can be less prone to injury.

The key to getting the most out of your Pilates is having a great instructor.

And the keys to being a great instructor are accuracy and specificity

1. Accuracy

Accuracy relates to how Pilates is taught: the type of exercises and the context.

The success of the system relies heavily on the careful education and monitoring of a client by a correctly trained teacher.

The question must be asked: does the advantage of teaching 30 clients in a class outweigh the disadvantages of 50 per cent to 90 per cent of those participants getting it wrong?

From experience, we know that it can take up to 30 minutes of one-to-one attention and direction from us before a patient learns to isolate and activate the correct muscles for even one new movement pattern. And then they have to practise it! One-to-one training is the best medium and must remain the basic initial learning tool to learn to use the “core muscles” correctly. Small groups of no more than 4 or 5 is the next step.

2. Specificity 

Specificity relates to what is being taught.

We’re talking about the critical word in exercise philosophy here: you get what you train for.

So, if you as a client are doing Pilates and strengthening the wrong abdominal muscle group, you will probably get good at tensing the wrong muscle, but never achieve correct stability. Or if you have not been shown correctly how to move especially after an injury your brain can learn incorrect movement pattern and your body may be setting itself up for further injury.

The greater the specificity, the greater chance of success with our goal to deliver an effective exercise program.


The power of Pilates lies in the detail. Physiotherapists are experts at observing and correcting movement. The specificity and accuracy of Clinical Pilates make it such a potent tool for anyone interested in maintaining peak physical conditioning as well as a great rehabilitation instrument.

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