Medicine:Pilates

Short description: Physical fitness system

Pilates instructor demonstrating "All Fours"

Pilates (/pɪˈlɑːtiːz/; German: [piˈlaːtəs]) is a type of mind-body exercise developed in the early 20th century by German physical trainer Joseph Pilates, after whom it was named. Pilates called his method "Contrology". It is practiced worldwide, especially in developed countries such as Australia , Canada , South Korea , the United Kingdom and the United States . Pilates uses a combination of around 50 repetitive exercises to spur muscle exertion. Each exercise flows from the "five essentials": breath, cervical alignment, rib and scapular stabilization, pelvic mobility, and utilization of the transversus abdominis. Each exercise is typically repeated three to five times. As of 2023, over 12 million people practice Pilates.

Pilates developed in the aftermath of the late nine­teenth century physical culture of exercising to alleviate ill health. There is, however, only limited evidence to support the use of Pilates to alleviate problems such as lower back pain. While studies have found that regular sessions improve balance, and can help muscle conditioning in healthy adults (compared to doing no exercise), it has not been shown to be an effective treatment for any medical condition.

History

Pilates was developed by Joseph Pilates from Mönchengladbach, Germany. His father was a gymnast and his mother a naturopath.

Pilates said that the inspiration for his method came to him during World War I, while he was being held at the Knockaloe internment camp on the Isle of Man. Pilates spent four years there, working on his fellow internees, developing his method of a system of exercises intended to strengthen the human mind and body, believing that mental and physical health were interrelated.

In his youth, Pilates had practiced many of the physical training regimens available in Germany, and it was from these that he developed his own method. It has clear connections with the physical culture of the late nineteenth century, such as the use of special apparatuses, and claims that the exercises could cure ill health. It is also related to the tradition of "corrective exercise" or "medical gymnastics" as typified by Pehr Henrik Ling.

A reformer Pilates class.

Pilates accompanied his method with a variety of equipment, which he called "apparatus". Each apparatus was designed to help accelerate the process of stretching, strengthening, body alignment and increased core strength started by mat work. The best-known and most popular apparatus today, the Reformer, was originally called the Universal Reformer, aptly named for "universally reforming the body". Eventually Pilates designed other apparatus, including the Cadillac, Wunda Chair, High "Electric" Chair, Spine Corrector, Ladder Barrel and Pedi-Pole.

He published two books related to his training method: Your Health: A Corrective System of Exercising That Revolutionizes the Entire Field of Physical Education (1934) and Return to Life Through Contrology (1945).

His first students went on to teach his methods, including: Romana Kryzanowska, Kathy Stanford Grant, Jay Grimes, Ron Fletcher, Mary Bowen, Carola Treir, Bob Seed, Eve Gentry, Bruce King, Lolita San Miguel, and Mary Pilates, Joseph's niece. Contemporary Pilates includes both the "Modern" Pilates and the "Classical/Traditional" Pilates. Modern Pilates is partly derived from the teaching of some first generation students, while Classical Pilates aims to preserve the original work as Joseph Pilates taught it.

Description

Pilates teacher using verbal and tactile feedback to ensure proper form

A systematic review of Pilates in 2012 examined its literature to form a consensus description of it, and found it could be described as "a mind-body exercise that requires core stability, strength, and flexibility, and attention to muscle control, posture, and breathing".

According to The New York Times, pilates "can be tailored to a spectrum of fitness goals, ages and abilities". Pilates is not a cardiovascular workout, but rather a strength and flexibility workout. There are various elements that contribute to distinguishing Pilates from other forms of resistance training. For example, Pilates places a heavy emphasis on breathwork and creating a mind-body connection. Joseph Pilates even states "Above all, learn how to breathe correctly." Participants consciously use the core and breath for all forms of movement.

In his book Return to Life through Contrology, Joseph Pilates presented his method as the art of controlled movements, which should look and feel like a workout (not a therapy) when properly done. If practiced consistently, Pilates improves flexibility, builds strength, and develops control and endurance in the entire body. It puts emphasis on alignment, breathing, developing a strong core, and improving coordination and balance. The core, consisting of the muscles of the abdomen, low back and hips, is often called the "powerhouse" and is thought to be the key to a person's stability. Pilates' system allows for exercises to be modified in difficulty, from beginner to advanced or any other level, and to accommodate the instructor's and practitioner's goals and/or limitations. Their intensity can be increased as the body adapts itself to the exercises.

A number of versions of Pilates are taught today; most are based on up to nine principles.

Effectiveness

In 2015 the Australian Government's Department of Health published a meta study which reviewed the existing literature on 17 alternative therapies, including Pilates, to determine whether any were suitable for being covered by health insurance. The review found that due to the small number and methodologically limited nature of the existing studies, the effectiveness of Pilates was uncertain. Accordingly, in 2017, the Australian government named it a practice that would not qualify for insurance subsidy, saying this step would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence".

For the treatment of lower back pain, low-quality evidence suggests that while Pilates is better than doing nothing, it is no more effective than other forms of physical exercise. There is some evidence that regular sessions can help condition the abdominal muscles of healthy people, when compared to doing no exercise. There is no good evidence that it helps improve balance in elderly people.

From the limited data available, it would seem from the statistically and clinically significant findings that Pilates has demonstrated efficacy as a tool for the rehabilitation of a wide range of conditions.

Mat and reformer Pilates

A reformer apparatus in a Pilates studio in London

Pilates is continuously evolving through the use of modern equipment, but the core of the technique is tied to the movement patterns designed by Joseph Pilates. Pilates can be performed on both a mat or on specialized equipment. Pilates often incorporates spring-based resistance machines known as reformers, which consists of a box-like frame, sliding platform, springs, straps/ropes, and pulleys that help support the spine and target different muscle groups. For example, in order to target the upper back, a typical Pilates move on the reformer involves lying face-down on top of an accessory called a long box which is placed on top of the sliding platform. The participant then lifts their head and chest while pulling back the straps down toward their hips to slide forward with the moving platform and repeating a few times. The straps can be heavier or lighter depending on the resistance that is controlled by the springs.

With mat Pilates, people sit or lie with their body weight as the main resistance, using gravity to stabilize their core. For example, a common mat Pilates exercise is called "roll-up", where participants start by sitting on the floor with their legs straight out in front of them and their arms extended over their legs. Participants then slowly‍—Template:Spcsusing the breath to control the motion‍—Template:Spcsuncurl their upper bodies backward toward a supinated lying down position, until they are indeed lying down on their backs with their arms out over their heads. They then curl back up into the starting position as they exhale, repeating this process multiple times.

Accessories such as resistance circle rings or resistance bands may be used in both mat and reformer Pilates.

Comparison with yoga

Modern yoga, like Pilates, is a mind-and-body discipline, though yoga classes are more likely to address spiritual aspects explicitly. Both yoga and Pilates incorporate elements of stretching and breathing. Both are low-impact, low-intensity exercises, but there are key differences. When practicing yoga, individuals hold certain poses for longer periods of time and flow into others; when practicing Pilates, individuals move their arms or legs while in certain positions. With yoga, breath is used for relaxation and to hold poses. With Pilates, breath is used to power the muscles with more energy. Most pilates exercises start from laying down, whereas most yoga poses start from standing up.

Some poses are similar in the two disciplines; for example, open leg balance closely resembles Navasana (boat pose); roll over is similar to Halasana (plough pose); and swan and push-up are essentially identical to Bhujangasana (cobra pose) and Chaturanga Dandasana (low plank pose). Both disciplines develop strength, flexibility and fitness. Pilates, however, emphasises core strength where yoga emphasizes flexibility.

Legal status

Pilates is not professionally regulated.

In October 2000 "Pilates" was ruled a generic term by a U.S. federal court, making it free for unrestricted use. The term is still capitalized in writing due to its origin from the proper name of the method's founder.

As a result of the court ruling, the Pilates Method Alliance was formed as a professional association for the Pilates community. Its purpose is to provide an international organization to connect teachers, teacher trainers, studios, and facilities dedicated to preserving and enhancing the legacy of Joseph H. Pilates and his exercise method by establishing standards, encouraging unity, and promoting professionalism.

See also

• Calisthenics
• Meditation
• Squatting position
• Yoga

Further reading

• "Pilates Method for Women's Health: Systematic Review of Randomized Controlled Trials". Arch Phys Med Rehabil 96 (12): 2231–42. 2015. doi:10.1016/j.apmr.2015.04.005. PMID 25912668.