Transcript Slide 1

Modified Pilates – an
introduction
Katy Baines
Learning outcomes
The student will:
• Be introduced to the history, method and
technique of pilates
• Be able to identify the 5 key elements used
in the modified pilates approach
• Explore the ‘neutral zone’
• Observe and practise some commonly used
pilates matwork exercises for use in the
clinical setting
• Consider the evidence base to modified
pilates
History
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Joseph Humbertus Pilates - born Germany 1880
Studied yoga, zen meditation and Roman exercise
in attempt to enhance his immune system
Applied his regimes in prisoner of war camps to
good effect during WW1
1960s moved to USA and introduced technique
into the world of ballet and opened the first pilates
studio in NY
Pilates died in 1967 leaving no will or line of
succession
Today various forms of pilates continue to evolve
- APPI modified pilates provides a functional,
dynamic treatment tool for physiotherapists
APPI method
• “A form of dynamic stabilisation retraining
that reconditions the body from the central
core to prevent reoccurrence of, and treat,
a range of postural, musculoskeletal and
neurological conditions “
» Withers and Stanko, 2001
Method
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Mind –body centering
Breathing control
Central core stability in lumbo-pelvic region
From core, intensity of exercise is adjusted
through use of levers (limb movts) and or
resistance (theraband, pilates equipment)
• Focuses on correcting body imbalances and
re-educating habitual patterns of movement
Technique
• Matwork exercise to promote core stability,
flexibility, endurance, postural and body awareness
to correct muscle imbalances
• Breathing control – for diaphragmatic and TrA
activation; exhalation with the movement of greatest
effort
• Concentration – workout for mind and body
• Control – movement control essential
• Centering – central ‘powerhouse’
• Precision – routine techniques that lead to greater
awareness and control
• Flow – even, continuous flowing motion to promote
re-learning
5 key elements
• Lateral breathing – lateral thoracic expansion not
abdominal breathing
• Centering – neutral spine position; midpoint
between lumbar flexion and extension; co-activation
of inner core TrA, multifidus and pelvic floor
• Ribcage placement – aligned with pelvis; neutral
thoracolumbar junction; dissociation arm and leg
movts
• Shoulder blade placement – lengthen between
clavicles; co-activation UFT, LFT and Ser A
• Head and neck placement – lengthen back of neck;
activation DNF
Neutral zone
•Active physiological motion comprises neutral and elastic
zones
•Neutral zone: small zone of motion around neutral joint
posture requiring minimal restraint by the passive sub-system
•Elastic zone: end of the neutral zone to the end of the
physiological motion where the passive sub-system provides
restraint to control end of range motion
•Need a bit of motion in the neutral zone but too much can
lead to clinical instability
•Clinically looking for stability not rigidity to allow flowing
motion
Clinical stability
•Global muscle systems – long levers, at risk of overloading
areas of weakness. Local muscle systems - short levers;
beneficial
•Transversus abdonimus (TrA) links abdomen with
thoracolumbar fascia (TLF), erector spinae and quadratus
lumborum (QL)
•Stable neutral – spinal stabilisation via lateral fascial tension
•Multifidus – facet joint stabilisation posteriorly
•Psoas – the ventral multifidus?
•Diaphragm – assists TrA by preventing displacement of
abdominal viscera, allowing TLF tension
•Pelvic Floor – activation with TrA
Transversus abdominus,
TLF
QL, Psoas, Multifudus
Muscular slings
• Primary sling – TrA, multifidus, PFM, diaphragm
(LMS)
• Posterior oblique sling – Latissimus Dorsi and
contra-lateral Gluteus Maximus
• Anterior oblique sling – External Oblique and
contra-lateral Adductors
• Deep longitudinal sling – Erector Spinae
TLF
Sacrotuberous and long dorsal ligt.
Biceps
femoris
• Lateral sling – Gluteus Medius and Minimus, TFL
and contra-lateral adductors
Posterior and anterior
oblique slings
Deep longitudinal and
lateral slings
Clinical application
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Identify the dysfunction
Re-train the LMS
Incorporate the relevant slings
Link to function
Example exercises
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Imprinting
One leg stretch
Shoulder Bridge
Clam
Breaststroke Preps
Roll up
Side leg lift, add kicking variation
Evidence base – to explore
further
•Hides et al,2001 – correction of muscle imbalances in
lumbar spine
•Hodges,1999 – benefits of local muscle system; TrA function
•O’Sullivan,2000 – lumbar segmental instability
•Panjabi, 2003 – neutral zone
•Pool-Goudzwaard et al, 1998 – lumbopelvic stability clinical,
anatomical and biomechanical approach
•Richardson et al, 2002 – TrA, SIJ and LBP
•Urquart et al, 2005 – abdominal muscle recruitment
•Vleeming et al, 1995 – thoracolumbar fascia function