Clinical Pilates

General Benefits of Clinical Pilates

  • Improved postural awareness and flexibility
  • Improved core stability of the trunk, shoulder and pelvis
  • Decreased recurrence and incidence of back pain
  • Improved sporting performance and injury prevention
  • Ability to identify and rectify underlying movement dysfunctions that lead to injuries
  • Firmer and more toned stomach and body muscles
  • Improved breathing control
  • Safe and effective way of exercising during pregnancy to minimise pressure on the spine
  • Based on scientific research

History of Pilates

Pilates is a system of exercises that was originally developed by Joseph Pilates in the early 1920’s. Joseph Pilates was born in Germany and grew into a fitness enthusiast who enjoyed boxing, diving and gymnastics. At the age of 32, he travelled to the UK where he was employed by Scotland Yard to train detectives in the art of self defence. During his time in the UK, he also worked as a circus performer and acrobat.

When World War I broke out, he was transferred to the Isle of Man, where he first began to use his fitness knowledge to help rehabilitate those injured in the war. Joseph Pilates experimented with springs attached to the hospital beds to encourage patients to begin moving at an early stage and strengthening their muscles. This early experimentation with springs and pulleys was what inspired the development of much of the traditional Pilates equipment we use today.

After the war, Joseph Pilates returned to Germany for a short period of time before moving to New York with his wife Clara. It was here where he opened his first Pilates studio in 1923. His work spread initially to the west coast of America and then onto London in the mid seventies.

Great interest in research had developed in the early 1990’s which indicated the importance and efficacy of retraining the stability of certain core muscles in managing low back pain. As physiotherapists we began to recognise Pilates as an effective vehicle through which we could apply what we were learning through research into clinical practice. Pilates in its original form has had to be modified and developed to improve its safety and efficacy into what we now term as “Clinical Pilates”.

What is Clinical Pilates ?

There are three basic styles of Pilates which have evolved over the years. Repertory, Modern and Clinical Pilates.

The Repertory style is based on the original teachings of Joseph Pilates and is mainly aimed at the dance population. The Modern style is a modification of the original form but similarly, both these styles have an emphasis on stretching and strengthening with close attention to exercise accuracy and technique. Classes can be both mat or equipment based and most of the exercises particularly in mat classes are done lying on your back.

There is currently no evidence to support the efficacy of these two styles in the management of low back injuries and the prevention of low back pain. These styles of Pilates can provide a general form of exercise but for those people who may have an underlying problem, it may explain why they continue to have recurrent problems and why for some people it may even make them worse.

Research is showing that a different approach to these traditional strengthening programs are required to improve the control and efficiency of the way our deeper core muscles function to stabilise our spine, shoulder and pelvic girdles. The Clinical Pilates repertoire is research based and is focused on improving the quality and control of movements rather than retraining strength and power. Unlike Joseph Pilates who discouraged mindless exercise this is the essence of what we try to achieve with Clinical Pilates. As your core muscle control improves the exercises should become mindless and automatic just like any other motor skill you acquire with practice and improved co-ordination.

Specialist Training

Physiotherapists undergo specialist post-graduate training before beginning to teach Clinical Pilates. DMA Clinical Pilates is a leading international pioneer of physiotherapy based Pilates training. The Australian Physiotherapy and Pilates Institute also provides specialist training Courses for Physiotherapists.

Much of the efficacy of the Clinical Pilates program is in the ability of physiotherapists to adapt and modify the program to meet the specific needs of the patient. The program can also be used as an effective tool in diagnosing and identifying underlying causes of many injuries.


Sonia Coleman, Jennie Cottrell and Elizabeth Shaladan have all undertaken extensive DMA and APPI Pilates training in order to effectively and comprehensively teach Clinical Pilates within Active Solutions.

Prevention and Optimising Performance

Many of our patients/clients do Pilates as a safe and effective means of maintaining regular exercise and preventing injury. This applies for those that have sedentary jobs and for those people who are very active in sport and also want to improve their performance.

The Clinical Pilates Program

While Clinical Pilates can be done in small group mat classes, it is often more effectively performed using the equipment and individualised programs. The equipment provides an effective way of challenging the efficiency with which the core muscles work, thus enabling them to learn how to improve their control. The equipment allows this process to happen dynamically and this is important because it is more functional and essentially when we need the stability the most.

Before beginning the program, an initial 1 hour assessment is carried out to identify any underlying problems and determine the most appropriate and effective intervention regime. As appropriate, our clients begin with a few 1-1 sessions. Some may continue to work on a 1-1 basis and others may then choose to move onto a closely supervised group session. These sessions will include no more than 2-3 people at any one time. All sessions are booked in 1hour intervals and clients continue to work on individual programs.

As clients become more confident and independent, there will be the option of progressing from supervised to unsupervised sessions.

Physiotherapy managed Pilates programs are covered under private health schemes.