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Clinical Pilates Principles

June 4, 2014

Understanding the principles of Clinical Pilates will help you get the most out of your session rather than simply performing a series of exercises. A Physiotherapist trained in Clinical Pilates (accredited by the Australian Physiotherapy Association and claimable on most Private Health Funds) will design a specific program based on Physiotherapy research. Pilates is based on control, breathing, flowing movement, precision, centring, stability, and range of movement. Clinical Pilates adds to these principles the findings from an individual Physiotherapy assessment which could be a direction preference ( see attached research article), or specific anatomical structures that need to be treated such as nerves, muscles and tendons, joints and ligaments. Physiotherapy and Clinical Pilates is evidence based. Recent Neuroscience research into neuroplasticity also supports the principles of body awareness (for more details go to and read ‘The Brain That Changes Itself’ by Dr N. Doidge ).


The Pilates Method was developed by Joseph Pilates. He called it “Contrology” because it involves ‘controlling’ the body’s movement. This develops greater coordination and balance, which can be reduced after an injury or with chronic pain. By focusing your attention on the affected area and repeating the movement, patterns will be learned which can improve function and reduce pain.


Keeping movement flowing helps with control and precision, which is functional. Unlike Yoga, where end of range positions are held for a minute or two, Pilates continually moves. Some Pilates movements have the trunk of the body held still while the limbs move, which is functional. We don’t usually stretch our trunk and limbs at the same time to perform functional activities.


Relaxed constant breathing is essential to the flowing nature of Clinical Pilates. It is important to breathe in during the direction of greatest effort of movement and not to hold your breath, as this tenses the outer abdominal muscles and diaphragm and deactivates the deep abdominal stabilising muscles.


Precision of movement involves spatial awareness, i.e. knowing where your body is in space, and is also known as proprioception. It is essential for normal, functional movement.


Every joint in the body has 2 types of muscles : deep stabilising muscles, and more superficial power or strength muscles. The stabilising muscles are located closer to the axis of rotation of the joint to stabilise it , and the power muscles are further away from this axis and use pulley systems and power to move the joints ( A bit like a mechanical crane having a stable base and then a long arm or lever to lift things to a great height) . When an area of the body is injured the deeper stability muscles become weak and the power muscle go into spasm, and fatigue sooner. There is much evidence to support this. Pilates involves activating these deeper stability muscles initially and then progressively increasing strength.


Concentrating on activating the deep abdominal muscle ( Transversus Abdominus) by gently pulling the navel in towards the spine and pulling up the pelvic floor while breathing freely into the lower ribs, allowing them to expand and contract provides the stable base for the rest of the body to then be activated. Also concentrating on scapular (shoulder blade) stability by gently pulling the shoulders down towards the hips helps to centre the body. Lastly awareness of the posture of the spine ( being lengthened up tall) also helps.


Also known as ‘Flexibility’ is important for optimal functional movement. Pilates works on stability and strength of the body throughout the range of movement available. Flexibility will increase fairly quickly at the beginning.

Concentration and Repetition are the keys to success!