Arthritis Self-Management

Pilates

by Carrie Cardinale, MPT

You have probably heard about the exercise method known as Pilates (Pi-LAH-teez). Nowadays it seems that Pilates is everywhere you look, and you may be wondering what all the hype is about. Is it a fad? A cult? Do you need to be able to touch the back of your head with your heels to be able to do it?

The answer to all these questions is no. Pilates is not a fad or a cult, and you do not need to be super-flexible, an athlete, or even a movie star to do it. Although Pilates has recently received the ringing endorsements of several celebrities, it is nothing new. Dancers have practiced it for more than 80 years. More recently, athletes have been using it to improve their strength and flexibility and prevent injuries. And more and more physical therapists are using it to help rehabilitate patients. In fact, there are many ways to modify Pilates so that it can be done by people who have various mobility restrictions, including people with arthritis.

What exactly is Pilates? Pilates is a nonimpact and nonaerobic form of strengthening and stretching exercise described by its creator as “the science and art of coordinated body-mind-spirit development through natural movements under strict control of the will.” Today you’re more likely to hear Pilates described as a strengthening of the “core” or “powerhouse” muscles (abdominals, back, and buttocks) through slow, mindful, and purposeful movements. You can do Pilates on a mat on the floor, up on a table, or on any of several specially designed apparatuses. To help you better understand this type of exercise and how it can benefit you, read the answers to the following common questions about Pilates.

Who came up with Pilates?

Pilates was developed by Joseph Pilates, who was born in Germany in 1880. As a child he was sickly, suffering from rheumatic fever, asthma, and rickets. Because he was so frail, he dedicated himself to building a strong body. He took up bodybuilding and became so physically fit that he was recruited to pose for anatomical charts. He was also a gymnast, a boxer, and a self-defense trainer. In 1912 he moved to England, and when World War I broke out in 1914, he was sent to an internment camp with other German citizens. In the camp he worked on his exercise routines and taught fitness exercises to other internees. As an orderly in a hospital at the end of the war, Pilates fashioned makeshift exercise devices that helped bedridden patients recover their strength faster. The routines and devices he developed during the war later became the basis for the Pilates Method. In 1926, he moved to New York and, along with his wife, opened a studio where many dancers rehabilitated and trained. Joseph Pilates himself trained daily and was physically fit until he died at the age of 87.

What makes Pilates unique?

The goal of Pilates is both a stronger and a more flexible body. Joseph Pilates had some training in yoga and was able to incorporate an emphasis on flexibility, deep breathing, and awareness of the body into his exercise method. Pilates is also unique in that every exercise strengthens muscles while elongating them. This approach differs from the common approach to strengthening, which builds muscle by loading the muscle as it shortens (as in weight training). In addition, the Pilates Method emphasizes quality over quantity. It energizes you without leaving you fatigued or with overworked and sore muscles.

Who can do Pilates?

Virtually anyone can use the Pilates Method. The young, the elderly, pre- and postnatal women, overweight people, and athletic people can all benefit from it. Furthermore, Pilates can be modified to help those with chronic pain, chronic conditions (including arthritis), low back pain, and even osteoporosis. It is an easily adaptable form of exercise, and there are many levels, from beginner to advanced. For people with arthritis in particular, Pilates can increase flexibility, strength, balance, and coordination without putting additional strain on the joints. Some people even find that Pilates reduces their arthritis pain. Remember, though, that Pilates is not aerobic; you will need to combine it with a type of aerobic exercise if your goal is to work your heart and lungs as well. And as with any exercise routine, you should always consult your doctor first.

Where can I take a Pilates class?

A good place to start is at a Pilates studio. You can find one in the phone book or online; there is usually at least one in every city. You should make sure that you work with a certified Pilates instructor who has a minimum of 100 hours of training. The instructor should also have experience teaching clients with arthritis or other mobility restrictions. I recommend that you have a few classes with the instructor by yourself or with a friend so the instructor can give you personal cues for your condition and body type. Then you can progress to a group class at the studio. Once you’ve got a good grounding in Pilates, you can try a Pilates DVD at home or join a class at your local gym that saves you money. But in general, small classes are better. A ratio of eight clients to one instructor allows the instructor to see you and give you verbal cues on how to correct your form. Large gym classes are not recommended if you are a beginner because you will need more cues than individuals usually get in such a class, to protect your body and perfect the exercises. (If and when you take a larger class, make sure you go up to the front so the instructor can watch you and help correct or cue you. This is not the time to be modest.)

Last Reviewed on January 25, 2012

Carrie Cardinale is a physical therapist who has been treating individuals with arthritis since 1996. She has been using the Pilates Method since 2006.

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