Named after its founding father Joseph Pilates, what we now know as the Pilates method started out as a rehabilitation approach for injured soldiers in the First World War. It has since come a long way - with many variations and difficulty levels - but the principles remain the same: breath, concentration, alignment and flow.   

These days, Pilates can take place in a gym, at home, at a healthcare clinic, or a specialised Pilates clinic using equipment such as the Reformer (think of a movable bed with springs). Pilates is universally loved for being low impact but effective - it targets the smaller muscles of the body and can definitely create that ‘burn’!  

 

Benefits of Pilates for joint pain 

Studies have found that Pilates is generally a safe and effective choice of exercise for those with joint pain and osteoarthritis. In particular, it has been shown to: 

  • Increase quality of life, engagement in recreational activities and daily function 
  • Decrease pain and disability levels in those with knee osteoarthritis 
  • Increase range of movement (eg: flexibility) 

The ‘magic number’ for Pilates sessions in the research appeared to be 2-3 times per week for a total of 8 weeks. Given that the style of exercises used in Pilates can vary depending on the equipment used (or no equipment, in the case of Mat Pilates), the common themes for aiding joint pain included strengthening of the quadriceps, hamstrings and gluteal muscles, improving core and postural stability, balance, and whole body stretching.  

 

Which style of Pilates is for you? 

  • Mat Pilates: This style, as it sounds, is conducted completely on an exercise mat and is likely to be found in gym settings and Pilates studios, or can be done at home following along with a video. In a group, more people can attend, so you may get less 1:1 supervision from your instructor! It is a great way to strengthen your core and postural muscles and work on your flexibility.  
  • Reformer Pilates: As mentioned above, the Reformer is a piece of Pilates equipment which uses springs for resistance. The bed can be used for lying, sitting and even standing! For those with sore hips, knees, and backs, we find the Reformer to be particularly joint friendly. If you are going to a bigger class, however, note that your program is unlikely to be tailored to your specific needs.  
  • Clinical Pilates: Often found in a healthcare clinic, this approach to Pilates is led by an allied health professional such as a physiotherapist, exercise physiologist or osteopath who has undertaken further training in this area. In addition to the Reformer, you may come across equipment such as a Cadillac (bed with springs) and the Wunda Chair (chair with springs). Class sizes are kept small in this setting (between 3-5 participants) to ensure a high level of supervision and personalisation. A thorough assessment is often undertaken before participating in Clinical Pilates so that your program can be customised to meet your needs. 

 

Starting Pilates in the home 

If you are curious about Pilates but unsure where to start, these three movements should provide a good introduction to any class you go to in the future! 

1. Happy cat/angry cat stretch 

Coming on to your hands and knees, check that your wrists are directly beneath your shoulders and your knees are under your hips. You may place a towel or blanket under your knees if they are painful to kneel upon. Start by breathing in and dipping your stomach down towards the ground, looking forwards, and creating a gentle arch in your back. This is the ‘happy cat’ position. Now breathe out, draw your chin towards your chest and curve your spine in the other direction (like a rainbow), and tuck your tailbone under. This is the ‘angry cat’ position. Repeat both movements, 10 times through.  

2. 4 point position - core activation 

Stay in the hands and knees position, but this time bring your attention to your deep core muscles. Think about the muscles that you would recruit if you were holding on to going to the bathroom, and the ones that wrap around your spine. Lightly engage these muscles as though you were trying to lift your belly button up towards your spine. Can you still breathe as you do this? Try to lift and activate the muscles for 10 seconds each time, 3 times through. For an advanced option, engage the core as above, and then send one leg out straight behind you. Alternate sides, 10 times through.  

3. Bridges 

This is not only a Pilates classic but a staple of any joint pain program. Lie on your back with your knees bent and your feet flat on the floor. Inhale to begin. As you exhale, flatten your lower back and start to peel off the tailbone, then the lower back, then the upper back, until your hips are completely off the floor. Inhale, and reverse the pattern: upper back, lower back, and then tailbone come down to rest on the floor. When you lift off, think about pushing through the heels of your feet. This action will help to activate your gluteal muscles. 

 

To quote Joseph Pilates himself: “If your spine is inflexible at 30, you are old. If it is flexible at 60, you are young.” The Pilates method is a safe, effective and enjoyable way to move your body, and is well worth a try! 

  

References:  

Akodu, A.K., Fapojuwo, O.A. and Quadri, A.A., 2017. Comparative effects of Pilates and isometric exercises on pain, functional disability and range of motion in patients with knee osteoarthritis. Research Journal of Health Sciences, 5(2), pp.94-103. 

Erfani, M., Mehrabian, H., Shojaedin, S. and Sadeghi, H., 2011. Effects of Pilates exercise on knee osteoarthritis in elderly male athletes. Journal of Research in Rehabilitation Sciences, 7(4). 

Mazloum, V., Rabiei, P., Rahnama, N. and Sabzehparvar, E., 2018. The comparison of the effectiveness of conventional therapeutic exercises and Pilates on pain and function in patients with knee osteoarthritis. Complementary therapies in clinical practice, 31, pp.343-348.  

Saleem, N., Zahid, S., Mahmood, T., Ahmed, N., Maqsood, U. and Chaudhary, M.A., 2022. Effect of Pilates based exercises on symptomatic knee osteoarthritis-A Randomized Controlled Trial. Journal of the Pakistan Medical Association, 72(01), pp.8-12. 

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