Clinical Pilates: Does it Actually Work?

Clinical Pilates is a form of physical exercise that is focused particularly on an individual’s balance, posture, proximal stability, strength, flexibility and breath control. It is becoming more commonly employed by Physiotherapists in the management of injuries, chronic conditions and post-operative rehabilitation. Most commonly, Clinical Pilates involves exercises on the mat, the ball, the use of the Trapeze table or the Reformer.

Clinical Pilates targets the strengthening of your deep spinals muscles, hip and pelvic musculature including the deep layer of abdominal muscles and pelvic floor muscles.  It helps the body to restore normal movement patterns and normal timing of muscle activation.  This improves the control and efficiency of the body.

Clinical Pilates (differing from generic Pilates and Pilates classes) is a tailored exercise program according to the needs and goals of each individual client. Your Physiotherapist identifies this key issue by applying carefully selected exercises to patients with specific injuries based on a complete Physiotherapy treatment. This ensures that clients achieve outcomes and long-term health goals.

Some of the key benefits of Clinical Pilates have been identified in the literature as;

  • Improved posture
  • Improved core stability
  • Improved tone of the abdominal muscles and pelvic floor
  • Improved balance, flexibility and strength
  • Increased muscle coordination
  • Prevention of lower back and neck pain

There are varying levels of research available to support the use of Clinical Pilates to achieve the key benefits outlined above. I have included just a few of the studies to give you an idea of what is being repeatedly identified and supported in the literature.

There are a number of studies that have found in the presence of back pain and neck pain, there is associated muscular weakness and dysfunction of the core muscles and stabilising muscles. Pilates has been found to retrain these stabilization muscles for the lower back and neck, thereby reducing the compressive loads of the pain sensitive structures, and normalising muscle control around these structures thereby reducing pain in the lower back, neck, reducing the frequency of headaches and improving posture (Gladwell et.al 2006, Horvath 2005, Moffett & McLean, 2006, Segal et. al., 2004).

Balance, proprioception and flexibility are key areas that have also been shown to improve with the engagement of Pilates. Each of these key areas may be inhibited in the presence of pain, leading to increased healing time and the development of compensatory movement patterns. In a number of studies, these key areas of balance, proprioception and flexibility were found to be improved in participants who undertook Pilates in comparison to those who participated in other forms of rehabilitation, or received no intervention (Segal et. al., 2004, Bryan & Hawson, 2003).

It is widely acknowledged that there are large number of key research based benefits of Clinical Pilates relevant to any age and every physical ability. Clinical Pilates is an excellent form of rehabilitation for many conditions of the spine and limbs and should be something you can consider when seeing your Physiotherapist.

For more information, please speak with your treating Physiotherapist today.

 

Sophie Halsall-McLennan

Physiotherapist

Fresh Start Physiotherapy

 

REFERENCES

Bryan, M & Hawson, S (2003). The benefits of Pilates exercise in orthopaedic rehabilitation. Techniques in Orthopaedics, 18(1), 126-129. Gladwell, V., Head, S., Haggar, M., &

Gladwell, V., Head, S., Haggar, M., & Beneke, R. (2006). Does a program of Pilates improve chronic non-specific low back pain? Journal of Sport Rehabilitation, 15, 338-350.

Moffett, J., & McLean, S. (2006). The role of physiotherapy in the management of nonspecific back pain and neck pain. Rheumatology, 45, 371-378.

Segal, N.A., Hein, J., & Basford, J.R. (2004). The effects of Pilates training on flexibility and body composition: An observational study. Archives of Physical Medical Rehabilitation, 85, 1977-1981.

About The Author

Sophie Halsall-McLennan is the owner of Fresh Start Physiotherapy and has a special interest in Hand Therapy and Shoulder Rehabilitation.  She has a Bachelor of Physiotherapy from Charles Sturt University, over 13 years of clinical experience as a Physiotherapist and is registered with AHPRA. She is also a lecturer at Deakin University.

Sports Injuries: A guide to Recovery

When you have sustained an injury, it can be a daunting time. You may be wondering what you have done and how you can best manage it to get back on your feet as quickly as possible and return to normal function. This is where Physiotherapy can help you.

We are qualified and highly experienced at the assessment of any musculoskeletal condition, the management for and the expertise to get you back to the highest level of function in a timely fashion.

During any acute injury, at the level of your tissues, there will be a level of disruption. Some of the tissues in the area, whether ligaments, tendons or muscles may have sustained a degree of tearing or compression. As a result, we experience pain and swelling local to the area of concern.

The best management for your acute injury at this stage is to cease participation immediately and to follow the following steps:

  1. Apply ice to the area. This may take form of an ice pack, a bag full of ice and water or melting an ice cube directly over the skin (but not over a wound). Apply the ice until the area feels very cold, but not painful;
  2. Apply some form of compression. If you have sustained an injury to your foot, it may be best to leave your shoe on to support the foot and to minimise the swelling. If you have a leg injury, then donning a pair of compression tights will assist you in relation to swelling;
  3. Keep the area elevated. If you have an injury to the hand, wrist, ankle or knee, elevating the limb above the level of the heart will help to reduce the swelling and fluid around the injured area; 1
  4. Avoid applying heat to the area. This will promote bleeding to the area, which in turn will increase the swelling and pain of the injury;
  5. Avoid running or excessive movement to the area. This will increase the blood flow to the area and increase the bleeding, pain and swelling;
  6. Do not consume alcohol. This will expand the blood vessels and lead to increased bleeding, that will slow down the injury process

It is important to follow these steps as soon as you have sustained your injury. The sooner you act, the higher the chance of enabling your body to move on to the next stage of healing. If you have great concerns about your injury, it is integral that you liaise with your Physiotherapist or Doctor as soon as possible.  If you require the fitting of crutches or a sling, general guidance and/or reassurance, it is crucial to make that phone call straight away.

If you have a deep skin tear, a gross deformity at the area of the injury, excessive and uncontrolled pain, it is critical to seek the medical attention at the Emergency Department of your nearest hospital.  You will be able to receive adequate pain relief, attention to any wounds and imaging, if required.

Once you have survived of the first 24 to 48 hours, it is important to meeting with your Physiotherapist. They will be able to assess you, determine the type and severity of the injury and devise an appropriate rehabilitation plan.

From this point, your Physiotherapist will seek to minimise the pain, swelling and inflammation of the area and commence work to restore normal movement. These factors will involve a combination of many treatment modalities including hands on treatment, taking you through certain movements and exercises, taping techniques or bandaging, fitting of a brace or walking aides, etc. You will also receive a program that you will be advised how often to partake in, to actively assist in the recovery process.

Any soft tissue injury can take a minimum (with minimal tissue disruption) of three weeks to recover and upwards of six weeks.  This will typically be the case if you have a very complex injury, or it involves structures that have a poor blood supply or under a great load in the body (such as the intra-vertebral discs or a nerve) 3. It is important to be aware of things that you can do to reduce the risk of delays or setbacks. During each of your consultations, your Physiotherapist will continue to progress your program, to put gradually increasing stress on the scar tissue that is healing, to help lengthen it and strengthen it.

When your body is ready, you will be given progressive exercises to help strengthen the area and the surrounding structures, to ensure your body is not compensating for the original injury. These compensatory strategies are an easy habit in which to fall, and can be very difficult to break.  Your body may have other mechanisms that require attention during your rehabilitation, such as your balance, or components of your balance.  You should be regularly taken through mini-assessments of each component that has been affected by the injury, to ensure there is reasonable progress and an adjustment of your exercises and home program to match accordingly.

During the recovery progress, your Physiotherapist will continually liaise with you, as to your goals for returning to particular levels of function, aspirations with your sporting, social and working environments.  They will also make recommendations for the steps you can take to reduce the chance of injuring yourself again.

If you would like more information, or have a question about your recovery, be sure to speak with your treating Physiotherapist today.

Written By Sophie Halsall-McLennan, Fresh Start Physiotherapy

  1. Website: https://www.ausport.gov.au/__data/assets/pdf_file/0005/380426/SP_32434_Incident_Management.pdf
  2. website: sma.org.au/resources-advice/injury-fact-sheets/soft-tissue-injuries
  3. website: highered.mheducation.com/sites/dl/free/0078022649/…/Prentice15e_Chap10.pdf

 

About The Author

Sophie Halsall-McLennan is the owner of Fresh Start Physiotherapy and has a special interest in Hand Therapy and Shoulder Rehabilitation.  She has a Bachelor of Physiotherapy from Charles Sturt University, over 13 years of clinical experience as a Physiotherapist and is registered with AHPRA. She is also a lecturer at Deakin University.

A Physiotherapists Guide To Tennis Elbow

INTRODUCTION

The following is a guide to understanding Tennis Elbow, its symptoms, who is vulnerable, how it is diagnosed and the recommended treatment.

TENNIS ELBOW

“Tennis Elbow” is a broad term often used to describe pain or discomfort on the outside of the elbow. This pain has occurred from overuse of the hand, wrist and forearm musculature. The term “Tennis Elbow” was given after a high proportion of tennis players developed the condition through repeated stress of the common extensor tendon of the elbow. Despite the origin of its name, Tennis Elbow is not limited to the tennis population 1.

Tennis elbow occurs either acutely or gradually over time.  The bony part on the outside of the elbow (lateral epicondyle) is where the muscles and tendons converge to form a common tendon. This tendon attaches to the bony prominence and they permit movement of the hand and wrist (Fig 1).

Figure 1: (http://www.bristolhandsurgery.co.uk/wp-content/uploads/2015/03/tennis-elbowjpg.jpg )

Health professionals will define tennis elbow as an extensor tendinopathy; this refers to pain and possibly inflammation around the lateral epicondyle.  Another common term used to describe pain around the elbow, is ‘golfer’s elbow’.  This is referring to pain on the inside of the elbow (medial epicondyle) and is also known as flexor tendinopathy.

Tennis elbow is prevalent on the side used for repeated gripping, high levels of resistance and movement at the wrist. This is why the condition most commonly affects people on their dominant side, though, can occur in both arms 2.

Symptoms of Tennis Elbow

Symptoms vary from person to person, common presentations include:

  1. An ache or pain experienced during or after gripping or squeezing objects

Aching or pain around the area of the lateral epicondyle may slowly develop over time. The onset of pain can also occur quickly, though this is not common

  • Aching or pain is worsened by forcefully moving the wrist. Some activities may include handling kitchen utensils like:
  • Using a knife to cut firm vegetables
  • Opening a jar or a door
  • Turning on the taps
  • Using carpentry tools or gardening tools that require you to grip or twist
  • Cleaning tables and windows.

Who gets Tennis Elbow?
Tennis elbow has been found to affect between 1% and 3% of the population and the incidence for repetitive tasks is 30% and among tennis players has been extremely high, with up to 40% of tennis players being affected during their careers 1 .

Tennis elbow more commonly occurs in men than women and is frequently present between the ages of 30 and 50 years. However, Tennis Elbow can affect people of any age 3.

Despite being highly prevalent among tennis players, Tennis Elbow may affect anyone who participates in work or leisure activities involving repetitive use of the elbow, hand and wrist. The likelihood of tennis elbow occurring from these other activities is increased by the force during gripping as part of the action.

How is Tennis Elbow diagnosed?

Tennis elbow can be diagnosed by your Physiotherapist. During the consultation, your Physiotherapist should ask you a number of questions about your symptoms before they take you through a series of tests to determine the source of pain.

Only a small proportion of people require other imaging such as an ultrasound or CT.  This will typically be because the symptoms may not fit the expected diagnosis. Other structures may be involved, or a person may not be responding to the usual management of the condition.

Treatment

Tennis elbow is successfully managed with Physiotherapy treatment and a rehabilitation program. Other possible treatment includes cortisone injections, and in severe cases, surgery if there is no improvement with conservative means.

The management of tennis elbow is tailored to an individual and will be influenced by your medical history, pain levels, hand and wrist function and other medications you are currently taking.

The goals of treatment are to:

–              decrease and eliminate pain, swelling and inflammation

–              promote healing around the muscle and tendon

–              change or modify the loads on the elbow

–              restore function, movement and strength to the elbow, forearm and wrist

How to Reduce Pain and Promote Healing of Tennis Elbow

Some modalities to reduce pain would include:

  • Regular application of ice to the area
  • Taping the elbow, or using a brace, as per your Physiotherapist’s instructions
  • Taking anti-inflammatories (NSAIDS), in consultation with your GP
  • Avoiding movements that cause unnecessary pressure or stress through the forearm muscles and elbow

When the pain and discomfort have begun to subside, your Physiotherapist will take you through some specific exercises to stretch and strengthen the muscles and tendons surrounding the elbow. There will be specific movements that you will be advised to avoid. This will include any activity that causes pain to the elbow either during or afterwards.

Your recovery may also be assisted with taping of the elbow / forearm or the use of a specific brace fitted by your Physiotherapist.

What is the recovery rate for people with Tennis Elbow?

Generally, 95% of people will make a full recovery with Physiotherapy treatment and management. Around 5-10% of people require surgical intervention to repair the muscle and tendon around the elbow. In the 5% who undergo surgery, 80-90% experience pain relief and restoration of function 1.

Written by Sophie Halsall-McLennan, Fresh Start Physiotherapy

  1. Bisset,L.,  Vicenzino, B.,  Sesto, M., MacDermid, J. (2013) Tennis Elbow: The Evidence, The Science And The Clinical Experience 
  2. Brukner, P., & Khan, K. (2009). Clinical Sport Medicine (revised 3rd Ed.). McGraw-Hill, North Ryde.
  3. Skirven,T., Osterman, A., Fedorczyk, J., & Amadio, P. (2011). Rehabilitation of the Hand and Upper Extremity (6th). Elsevier. Philadelphia

 

About The Author

Sophie Halsall-McLennan is the owner of Fresh Start Physiotherapy and has a special interest in Hand Therapy and Shoulder Rehabilitation.  She has a Bachelor of Physiotherapy from Charles Sturt University, over 13 years of clinical experience as a Physiotherapist and is registered with AHPRA. She is also a lecturer at Deakin University.

RISE: Our New Balance Rehabilitation Program

At Fresh Start Physiotherapy, we see all too often clients that present with injuries from falls, trips, stumbles and overbalancing.

As humans, if we experience something that shakes us up a bit, we have a tendency to lose confidence in our abilities and avoid tackling the problem head on.

Herein lies a problem.  If we become less mobile and less adventurous with our walking and daily activities, our body decreases its ability to respond the same way in those particular circumstances. We become less conditioned to moving, bending, twisting, balancing and our body’s response to overbalancing or a trip is significantly impaired.

The real question is “how do we fix this?”

Fresh Start Physiotherapy has a solution.

By becoming a participant in our program RISE, you will be taken through a series of tests to determine which of your body’s mechanisms are not responding at the optimum capacity in a 1:1 consultation. We can discuss your goals in relation to where you would like your body’s capacity to be.

Our program runs over a six week period, one hour per week for six consecutive weeks. The session involves two parts. Part 1 is a series of warm ups, balance exercises and stretches that are tailored to your individual needs over a 30 minute period.

Part 2 involves 30 minutes of education from a health care professional in relation to managing your balance issues with medications, footwear, set up of your home and others.

After your six week participation, we will take you through your initial tests and measure your improvement. You will then have the option to continue a further six weeks of progressed balance exercises to further improve your confidence and function.

Our goal is to restore your confidence in your body’s capabilities, reduce the fear of falling and get you back on your feet with a smile.

For more information, please make an appointment online by visiting freshstartphysio.com.au/book-now or call the clinic on (03) 4201 5074.

Visit Us

4 Centennial Boulevard, Curlewis, 3222

Hours

Monday – Thursday:  9am – 2pm


About Us


Sophie Halsall-McLennan is a mother of two, has a passion for rowing, skiing, classical ballet and spending time with her family.

Staying continually up-to-date with the latest evidence-based practice, including treatments and rehabilitation programs keeps Sophie at the forefront of Physiotherapy. With these skills and knowledge, she can equip her clients with the best available information and treatment.

Newsletter Signup


Opening Hours:


  • Monday:  9:00 am – 2:00 pm
  • Tuesday:  9:00 am – 2:00 pm
  • Wednesday:  9:00 am – 2:00 pm
  • Thursday:  9:00 am – 2:00 pm
  • Friday:  Closed
  • Saturday:  Closed
  • Sunday:  Closed