The most common physical condition that one associates with the onset of later life is back pain. This is probably the single most common reason for people being off work, away from sport and having a reduced quality of life with some eighty percent of the population likely to suffer. Whilst hereditary causes are most likely to present in the mid-40s, back pain can strike at any time resulting from modern-day lifestyle and work habits, obesity and poor posture. Most of us spend eight to ten hours sitting, usually in front of a computer, and on our journey to and from work so that the suggestion is that ‘sitting is the new smoking’, leading to suffering in later life.
Arthritis affects around 10 million people in the UK. The most common form is Osteoarthritis in knees or hips, which can develop from your late 40s onwards. It is physically debilitating and almost seven million people report depression when their pain is worst, bringing additional misery, impinging on their quality of life. Despite this, Arthritis Research in 2017 showed that only some eighteen percent of sufferers have any kind of care plan to address their condition.
Similarly, some three million people suffer with osteoporosis, a condition that reduces bone density. It develops slowly and is often only diagnosed when a patient suffers a fracture, most commonly in the wrist or hip. Other indications of the disease present in some older people who develop a stooped posture indicating that the bones in the spine cannot properly support the weight of the body. Women lose bone rapidly in the first few years after the menopause and tend to be at greater risk of osteoporosis than men, particularly if the menopause begins early.
In general, the ageing process combined with poor posture tends to alter our centre of balance, leading to susceptibility for falls and spinal issues.
In my practice I encounter many people who do not understand their condition and have been misadvised. They have accepted inadequate solutions, often in the form of steroid injections (which may mask the pain but do nothing to address the underlying condition), often needless surgical procedures or inappropriate exercise programmes.
Pilates will help in all of these conditions. An exercise regimen first developed for rehabilitation in the early 20th century, Pilates has become a powerful tool for both rehabilitation and prevention, promoting the patient’s biomechanical performance. It aims to strengthen the body in an even way with emphasis on core strength to improve general fitness and wellbeing, incorporating whole body movements, attention to breathing, balance, control and posture.
Embraced by the leading exponents of orthopaedics, surgeons and consultants it has significant benefits for those suffering from or with the potential to develop these conditions and can be a conservative alternative to replacement surgery.
In its clinical application, its focus on core stabilisation are the same concepts that form the basis of most orthopaedic rehabilitation. A patient will first be assessed using visual evaluations of posture and spinal movement and a series of specific movement tests and, given the versatility of Pilates, the extensive exercise repertoire can be modified to be bespoke to each patient meaning that everyone can work to a treatment programme that is right for them.
The principles of Pilates are ideal for rehabilitation as well, following injury or surgery, but if they are not used in conjunction with proper clinical diagnosis and therapy techniques it could do more harm than good.
Physical therapy techniques may prove inappropriate on their own as the exercises may be too hard for the patient or may cause too much pain, or, as is often the case, the patient’s body awareness is not adequate to enable them to achieve maximum results. Physiotherapy per se is purely site specific whereas Pilates in a clinical application using especially formulated machines uses a holistic approach and teaches you to work the whole body.
A patient receives personal direction on a Reformer machine from Jane Collins in her Clinic
The most commonly used machine is the Reformer – originally invented by Joseph Pilates and looking like a cross between a bedstead and a medieval torture device! On the bed frame is a flat platform which is attached to one end of the frame by a set of springs set to differing levels of resistance according to the patient’s body weight and capabilities. This allows the patient to lay in position on the platform and roll back and forth by applying pressure either to a foot bar or by using legs or arms through a series of straps. The exercises can be done lying down, sitting, standing, and with the addition of supplementary attachments the therapist can address many parts and dynamics of the body, but always ensuring the patient’s body is fully supported and in the correct position for the type of exercise.
A patient uses the Reformer with Cadillac/trapeze in Jane Collins’s Clinic
Looking forward to later life, clinical Pilates is a very successful preventative therapy. We build bone faster when we are young but after the age of 30 the rate at which our bone tissue dissolves increases, and bone building decreases. Think of it as a ‘bone-bank’ with deposits and withdrawals. The formulated Pilates exercises undertaken using the machines include load-bearing movements to help maintain bone density and adding stock to your bone-bank at any age, to reduce the risk of the onset or exacerbation of osteoporosis. Pilates also assists with building muscle performance – especially the core – to help support the spine and hip and knee joints (don’t worry it won’t turn you into a weight lifter!) and posture to help reduce spinal movement and stooping, to address back pain and arthritis. The improved motor control that regular Pilates engenders is also known to help provide better protection from slipped or herniated discs in your spine.
There is a huge difference between Pilates using a mat on the floor as a way of exercising – how most people have encountered the technique or understand the term – and applying it as form of therapy from a health professional. Hence, it is important to ensure that your therapist is a qualified clinician with physical therapy experience and prepared to treat you on a one-to-one basis until such time as the condition is under control when you could then join a class.
In addition to those conditions discussed, I use it successfully in rectifying specific issues like scoliosis and improving the quality of life for those suffering from Parkinson’s and other chronic conditions which benefit from building muscle or those going through menopause, whilst helping everyone remain fit and mobile after 50.
Jane Collins is a Sports Therapist and Rehabilitation Specialist who has been in private practice for 12 years. Having worked with elite sportspeople as well as people suffering from degenerative spinal and joint conditions, she has devised special programmes combining manual therapies and low-level laser therapy. And is one of the few therapists in private practice in the UK offering radio frequency therapy. By combining these leading-edge technologies with clinical Pilates, she has developed a unique and very successful approach to pain relief and rehabilitation
For more information visit Janes Collins Sports Therapy & Clinical Pilates