Clinical Pilates and the “core”
Clinical Pilates is the use of the Pilates method by a health professional such as a physiotherapist to address various musculoskeletal issues and movement dysfunctions, and is based on current scientific knowledge about the spine, biomechanics and core stability. Pilates is a tool to re-educate the body’s movement pattern making it more efficient and therefore, reducing pain. The human body was designed to move and to move in a variety of ways and requires core stability to do so safely and effectively.
What is the core?
It is made up of both an ‘inner’ and ‘outer’ unit of muscles. The ‘outer unit’ consists of the superficial muscles of the abdomen that control the movements of your trunk; this includes the rectus abdominus and obliques (internal and external). The ‘inner unit’ consists of muscles deep to the ‘outer unit’ that are meant to stabilize your trunk, pelvis and spine; this includes the transversus abdominus, pelvic floor muscles, multifidus and the diaphragm.
Why is the core important?
In order to have a properly functioning and healthy body, both sets of core muscles have to do their jobs well to allow for safe dynamic movement and provide load transfer between the upper and lower body. The ‘inner unit’ is especially important to provide a stable foundation in which the ‘outer unit’ can work off. The ‘inner unit’ consists of muscles that are anticipatory in nature and that fire at low intensity allowing for them to be on for long periods of time. Unfortunately, pain and injury inhibits these muscles from doing their job either by failing to turn them on or delaying their response; leading to an eventual loss of strength and endurance. This continued dysfunction causes general instability throughout the spine/pelvis and can lead to further or recurrent injuries.
How do I know if I’m using the right muscles?
I hear this from clients in my practice all the time, and it’s difficult to know just by touch if you are isolating the ‘inner unit’ properly. For example, I have found that the majority of times clients think that they are recruiting their transversus abdominus when in fact they are using their oblique muscles. We are fortunate to have a Real Time Ultrasound (RTUS) machine at our clinic that allows us to visualize the ‘inner unit’ muscles mentioned above to ensure our clients are recruiting them correctly ( link here to RTUS article from last year on the blog please ) Once the proper recruitment pattern has been developed, clients can then use our Clinical Pilates program to continue progressing and really achieve results : less or no back pain, increasing spine stamina , strength, confidence which leads to overall enhanced love of life and fitness.
This is only a brief overview, and just one component of a Physiotherapy treatment plan that can be developed for you at Trimetrics based on your personal history and goals.
Jessi Thompson, Physiotherapist
Clinical Pilates, Acupuncture, Kinetacore IMS