Santa Monica Area Health, Beauty and Fitness | Pilates: A Healing Practice

(A Healing Practice -- written for Pilates Style Mag '05 by Barbara Stamis & Leigh Ann Caldwell.)

Frank Vitale, a 53-year-old publishing executive in New York City, woke up one morning four years ago and could not get out of bed.  "I was in terrible pain, more pain than I had ever been in," he says.  Vitale was soon diagnosed with two herniated discs in his lower back.  His doctor recommended surgery, but Vitale decided against it and was prescribed two cortisone shots and physical therapy, common treatment approaches to back pain.

After six months of physical therapy, Vitale felt his recovery process had reached a plateau.  His therapist explained that there was not much else he could do for him.  "Don't twist, don't bend, don't put compression on the legs," says Vitale of the instructions given by his therapist.  "All I could do was walk in a straight line."

Still searching for a way to deal with his back pain, Vitale read an article about Pilates and was intrigued.  "Intuitively, it sounded like it might be what I needed," he says.  Vitale began his Pilates sessions nearly four years ago and has been pain-free for two and a half years.  "Overall, Pilates has been amazing for me," he says.

Like Vitale, more people are turning away from traditional medicine for illness and injury recovery and instead seeking alternative forms of care.  Pilates is one of those methods, in addition to chiropractic, massage therapy, acupuncture and yoga, that is growing in popularity as natural, nonsurgical ways to help people gain a deeper understanding of their bodies and heal themselves.

PILATES FOR HEALING

In 2000, there were 1.7 million people practicing Pilates; today that number exceeds 9 million.  Many of these people are turning to the method for its therapeutic benefits, not just for fitness.  The reason for this increase is simple, according to Madeline Black, owner and founder of Studio M, a Pilates, Gyrotonic and Integrated Manual Therapy studio in Sonoma, California.  People are seeking out Pilates, she says, "because it helps them; they are getting results, better results."  Whether they're dealing with back pain, torn ligaments, carpal tunnel syndrome, joint problems, scoliosis, multiple sclerosis or cancer recovery, there are many people who have been helped by Pilates.

Margie Featherstone, 43, was diagnosed with multiple sclerosis two years ago, and now swears by the Pilates method.  The disease affects balance, increases muscle fatigue and tightness, and often interferes with bladder control.  Pilates addresses many of her symptoms.  "Pilates develops a different kind of strength.  You strengthen from the inside out," says Featherstone.  "It keeps my body sound."

When practiced according to the traditional protocol developed by Joseph Pilates, the method can help improve how the body functions by strengthening core muscles and restoring balance.  Many instructors who stay true to this method attest to the fact that this strict regimen of exercises, executed in Joe's prescribed order, can help heal many clients.

But the kind of Pilates that Vitale practices is different.  His teacher, Michelle Cohen, an instructor at the Kane School of Core Integration in New York City, and other instructors across the country, rehabilitate injuries by tailoring workouts to individual clients' needs—integrating traditional Pilates principles (core stabilization, breath, flow and precision) with human anatomy, biomechanics, physical therapy principles and other movement-based theories.  By blending modalities, instructors create a dynamic, individualized and integrated experience for each student.

This individualized approach appeals to those who have become frustrated with the one-size-fits-all treatments they have received in the past.  "Pilates attracts people who are injured who haven't been successful dealing with their injury through other traditional means," says Kelly Kane, owner and founder of the Kane School, which provides exercise and rehabilitation as well as a teacher training program.  "We empower people ideally to understand themselves and their bodies.  We show them how to heal themselves," she says.

Pilates instructors reinforce good posture and alignment by teaching people to strengthen areas in the body with exercises that relate to functions performed in daily life.  Clients can then apply this knowledge to everyday activities, such as walking, doing the laundry or lifting heavy items, and thus learn to move in healthier ways.

PROGRESSING THE METHOD

Rehabilitative Pilates instructors are taught that an injury, such as a shoulder impingement or a torn knee ligament, is often caused by a misalignment somewhere in the body.  Indeed, in researching injuries and the muscular-skeletal system, physiotherapists Mark Comerford and Sarah Mottram theorized that the body must be retrained in proper alignment to strengthen and heal injured areas (Manual Therapy, 2001).  Black agrees with this theory.  "You must look at the whole being…the whole body, rather than just the injury," she says.

Vitale's herniated disks, for example, were actually triggered by a misalignment in his legs.  His instructor assessed his postural habits and body alignment in detail.  "His weight didn't go evenly through his pelvis," says Cohen.  "And he absorbed the weight in his back and knees."  She says the additional weight in his back and knees caused his back pain and eventually contributed to his disc herniations.  Cohen designed sessions for Vitale and worked to stabilize his pelvis, mobilize and lengthen his spine and strengthen his legs independently of his pelvis.  Together, these exercises focus on his body as one working system and have helped him overcome his back pain.

This more progressive approach to Pilates started in the early 1980s, when Jean Claude West, a former dancer with a background in dance medicine and a master's degree in motor learning, began to integrate physical therapy and dance medicine ideas into Pilates.  "I ventured deep into the understanding of dance injury and developed a reputation as a troubleshooter," says West, who continues to teach in Mill Valley, California.  His first clients were dancers who began seeing West to deal with pain and recover from injuries.

Simultaneously, James Garrick, MD, founder and director of the Center for Sports Medicine in San Francisco, became attracted to the therapeutic approach to Pilates.  He was the first to integrate Pilates into a physical therapy program, at his outpatient clinic at Saint Francis Memorial Hospital in San Francisco.  Two decades later, an estimated 2,000 of the nation's 100,000 physical therapists use Pilates techniques in their physical therapy practices.

MINDFUL MOVEMENT

Even though Pilates is starting to expand into the rehabilitation arena, few scientific studies have been done about the method.  One of the first, which was conducted by Colleen Grafa, a physical therapist in Sherman, Texas, was released in March by the American Physical Therapy Association.  Grafa studied the benefits of the Roll Up, a basic Pilates exercise in which a client must focus on the various parts of the abdominal section to alleviate pressure on the back.  She found that the focus required to perform the exercise correctly strengthens the connection between the body and mind, and teaches people how to heal their bodies.  According to Grafa, this mind-body connection makes Pilates more attractive than traditional exercises prescribed by most physical therapists.

Indeed, many instructors attribute the success they have with injured clients to the connection between mind and body that Pilates fosters.  Brent Anderson, PT, owner and co-founder of Miami-based Polestar Education, posits in his doctoral thesis that Pilates changes a person's perception about his injury, which increases the chances for recovery.  He has found that clients are encouraged by the improvements they see as they gain awareness of their bodies.  This shift of mindset seems also to encourage the healing process.  "Pilates' use of body, mind and spirit creates the possibilities of more experiences without pain," he says.

Jeffrey Lackner, MD, assistant professor at the Department of Medicine and director of the Behavioral Medicine Clinic at the University at Buffalo, says that there is a strong relationship between a person's perception of pain and his physical state.  "A minority of chronic low back pain is due to a physical cause.  The more people can understand the complexities of their problem, the more they can take steps to gain control.  That's what pain is all about," he says.

Despite a lack of research on Pilates, the number of practitioners continues to grow.  People like Frank Vitale are responding to the empowering feeling they get when they gain knowledge of their bodies and heal in a comfortable environment.

Vitale now knows how to manage his body in order to stay out of pain and avoid reinjury.  "It's about my alignment and body dynamics, balancing my body's imbalances," says Vitale.  "I know it works.  I don't have any real fear that one day I won't be able to get out of bed again."

Leigh Ann Caldwell is a freelance radio and print journalist in Brooklyn, New York.  Barbara Stamis is a Pilates instructor specializing in chronic pain and those with specific needs.  For more information on Pilates classes for healing and Barbara's teaching, go to Pilates Healing Classes.

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