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Physical Therapy And Pilates

Woman using pilates performer at physical therapy clinic

There is nothing more frustrating than getting an injury, especially for athletes in competition season or for those starting out on a new fitness goal. Not only are there a range of symptoms that can affect everyday life (such as pain, stiffness, or reduced mobility), but it can be incredibly demotivating. For some, it may feel like life will never be the same.

Physical therapists are experts in helping individuals recover from injuries and achieve their fitness goals through the use of various techniques, including exercise and Pilates. Pilates is a highly effective method that some physical therapists incorporate into rehabilitation programs to help patients recover from injuries and improve their overall fitness. Many physical therapy offices have pilates reformers or machines but aren't really qualified to teach or use them. At Ironhorse, several of our physical therapists are also Certified Pilates Teachers who utilize personalized one-on-one and group Pilates sessions to enhance recovery outcomes for our patients. A reputable certification program is typically 1 year long and requires a minimum of 500 hours of apprentice teaching. All of our physical therapists and pilates teachers are certified by reputable programs.

What Is Pilates?

Pilates is a specific form of exercise that was developed by Joseph Pilates at the start of the 20th century. The techniques and movements have advanced over time, but have always focused on improving control through movement. The emphasis is on breathing, core strength, and the mind-to-body connection, so technique is important throughout the exercises. The goal of Pilates is to use specific exercises to build strength, flexibility, and mobility.

Clinical Pilates is a type of Pilates that is supervised by a trained health professional, such as a physical therapist. The exercises are often used by physical therapists to help improve core stability, which is essential for proper posture and movement. Additionally, Pilates can be used to improve muscle imbalances, which is a common problem for patients recovering from injuries and other musculoskeletal conditions. This can lead to further pain and injury if left unaddressed.

Pilates Versus Other Types Of Exercises

Pilates is a unique type of exercise. Whilst other forms of exercise may focus on weight loss and building muscle bulk through the use of heavy weights, Pilates is primarily about muscle control and core strength. It teaches stability and control through movement in order to retrain the muscles into healthy states. Clinical Pilates also commonly incorporates a Reformer – a specialized moveable platform that uses strength and movement to challenge the user.

Pilates is a whole-body exercise and frequently only requires the use of body weight. It can also be modified and regressed to accommodate more irritable or extensive injuries. But it is quite versatile and can also be used to enhance sports performance by challenging one's core with increased resistance as well. Many professional athletes incorporate Pilates into thei training. 

The Benefits Of Pilates

Physical therapy and Pilates are often used together as they complement each other well and can lead to better outcomes for patients. Physical therapists can use Pilates to help their patients achieve their goals. As a result, Pilates is being increasingly used in physical therapy clinics, hospitals, and community settings.

Some of the benefits of Pilates include:

  • Can be used to build strength, flexibility, and mobility
  • Can help to rehabilitate injuries, such as hip or knee pain
  • Can be used for endurance, speed, or power, depending on the goals of the patient
  • Can be used to rehabilitate after surgery and rebuild strength
  • Can be beneficial for reconditioning, particularly for those with sedentary lifestyles
  • Can be helpful as a cross-training fitness tool for other sports, such as netball or football
  • Can help with correcting posture and creating better postural habits
  • Can be used as part of a maintenance program after physical therapy to help patients stay strong and healthy
  • Can be used for aging adults to maintain muscle strength and prevent falls
  • Can be used as part of a general exercise routine to increase muscle tone

Additionally, Pilates is a low-impact form of exercise. Therefore, it can be beneficial for patients that aren’t able to participate in higher-intensity activities like running. Pilates can be used across the health and fitness spectrum, from the early stages of an injury to the later stages of a fitness program.

When Is Pilates Used?

Pilates is a type of exercise that can be adapted or modified depending on the patient, their condition, and the severity of their symptoms. It can be used as part of a rehabilitation program or in a general fitness regime to build strength and endurance. Physical therapists design tailored Pilates programs depending on the patient’s goal, which means Pilates can be beneficial for people of all ages and backgrounds.

Physical therapists typically use Pilates for injuries and conditions such as:

  • Osteoarthritis
  • Back pain and sciatica
  • Hip and knee problems Neuromuscular conditions, such as Parkinson’s disease
  • Cardiovascular conditions
  • Rehab after orthopedic surgery
  • Women’s Health
  • Poor posture
  • General health and fitness

Pilates is a useful rehabilitative tool to ease symptoms like pain, stiffness, and reduced mobility. It can also be used to progress fitness levels and help improve performance in sports and sporting competitions. Here's a video of a couple of our clients with osteoporosis and arthritis doing pilates on the pilates chair with our head PT, Victoria Liu:

Is Pilates For Everyone?

Pilates is suitable for a wide range of people, including those with injuries, chronic conditions, and those looking to improve their overall fitness. Prior experience is not necessary as the physical therapist guides and supports each Pilates exercise.

However, as with any form of exercise, it is important to consult a healthcare professional before starting Pilates, especially if there are any concerns or underlying health conditions. Additionally, some people may need modifications to the exercises to make them suitable for their individual needs. A physical therapist can progress or regress the exercise program, depending on the needs and goals of the patient. In some cases, however, other forms of exercise or treatment may be more suitable.

Pilates At Ironhorse

At Ironhorse, our physical therapists use clinical Pilates to treat our patients. Our physical therapists have additional training in Pilates and rehabilitation, so are able to tailor the session to each patient’s needs. This helps improve health outcomes for our patients.

Before starting, our physical therapists assess each patient to determine the best course of care. This includes special tests for strength, range of motion, balance, posture, and alignment. Our assessment helps us determine the main issues and therefore where to focus the Pilates exercises and the selection and dosage of the exercise.

We can then incorporate Pilates into our physical therapy sessions as part of treatment for specific conditions or general health. We also run one-on-one and semi-private group Pilates classes (up to four people per class) as an adjunct therapy that complements our other physical therapy treatments, including massage, home exercise programs, and lifestyle education. In some cases, our physical therapists may prescribe some of the Pilates exercises for home and will guide and monitor this to ensure the best outcome.

Our Rehab Pilates Program

Pilates is a versatile form of exercise as it can be tailored to meet the specific needs and goals of the patient. For example, it can be used to rehabilitate from injuries by targeting areas of weakness or muscle imbalance. However, it can also be used to maintain strength and fitness after an injury to help prevent recurrence. This versatility makes Pilates a valuable tool for both injury prevention and recovery.

At our San Ramon clinic, we have many patients transitioning from physical therapy to our semi-private group Pilates sessions. Usually, this happens during the later stages of rehabilitation, when patients are feeling better and are looking to continue their journey to better health. We call it our “Rehab Pilates” program.

The program is mainly designed for people who want a regular form of exercise without getting hurt or aggravating an existing injury. They want accountability and/or a community of like-minded people to exercise with in a non-judgemental environment. The focus is often posture, core strength, and mobility. This is particularly useful for people who have recently had an injury or who are afraid of getting injured as they have “bad knees” or a “bad back”. We also often see a lot of patients with osteoporosis, arthritis or pre- and post-natal women. To help our patients on their health and fitness journey, our team has weekly meetings to tailor the program to meet the needs of our patients. Here's a video sample of our core and pelvic floor pilates semi -private group sessions:

Is Pilates Used For Prevention?

Yes, Pilates can also be used as an injury prevention tool. Physical therapists often recommend Pilates to patients with a prior history of injuries, particularly if they are still at risk of further injury. Pilates offers a great opportunity to target areas of weakness or muscle imbalance which can help prevent injury recurrence.

Physical therapists may also recommend Pilates to otherwise healthy adults. Pilates can be used as a conditioning tool, helping to build strength, mobility, and flexibility, which are core components for injury prevention. Additionally, Pilates may be recommended to older adults who are at risk of falls in order to promote strength, balance, and coordination. Here's an example of an exercise we use to prehab or prevent injuries in runners:


Combining Physical Therapy And Pilates For The Best Outcome

Pilates is a whole-body form of exercise that can be tailored to each patient, depending on their needs. As a result, many physical therapists use Pilates as a rehabilitative tool to improve the clinical outcomes for patients.

Whether recovering after an injury or building strength as part of a fitness routine, Pilates is beneficial for a wide range of people. It requires precision and control through movement, which can help improve strength, flexibility, and mobility. In combination, physical therapy and Pilates can have a positive impact on health and fitness.


Physiopedia. Pilates. Available from: https://www.physio-pedia.com/Pilates

Australian Physiotherapy Association. What Is Physio? Available from: https://choose.physio/what-is-physio