The Pilates Debate: Is Pilates for Rehab?

Pilates as Rehab?
Is Pilates just Exercise?. Getty

If I had a nickel for every time this topic came up. Pilates is a system used by many people for diverse goals and objectives. As a result, it falls into the grey zone with people classifying it solely as exercise and just as many labeling it a type of rehabilitation.

So, is Pilates actually rehab? Many Pilates experts in the field today will say “Yes. And No”. I’m going to radically depart from such a statement.

My answer is “No. And Yes".

Let’s start with the industry guidelines. Pilates has a definite scope of practice as outlined by the umbrella organization that represents thousands of Pilates instructors worldwide known as the Pilates Method Alliance.  This scope of practice outlines what we can and cannot do as qualified Pilates teachers.  A quick overview of this guideline clarifies that instructors may “train” but not “treat”.  They may not diagnose. They may administer exercise but not therapies that fall under the purview of chiropractors, physical therapists, massage therapists or other licensed medical professionals.

And yet, scores of injured people show up to Pilates seeking therapeutic intervention from the safe, smart exercise that is Pilates.

With that out of the way, let me elaborate on my “No”.

Pilates is exercise. Pilates is resistance training. The goal of Pilates is to increase performance whether you define that performance as better daily function or improved athletic competition.

Pilates addresses strength, mobility, agility, balance, posture, alignment and more. It is total body training within a limited paradigm. Will you run faster because of Pilates? Probably not. Will you be more aware of your alignment and form because of Pilates. Absolutely. Might that make you a better runner?

It might indeed. Can Pilates heal your tennis elbow? No. Can your Pilates workouts train the rest of your body while your elbow is out of commission? Yes. When your elbow Is healed, might you be smarter about how to use your body safely and symmetrically because of Pilates? You might indeed.

At the end of the day, a qualification as a Pilates teacher is not a license to heal. And again, instructors legally cannot and must not diagnose or treat, two necessary elements of rehabilitation.

That about sums up my “No”.

But what about that “Yes”?

Walk back with me in time to the origins of Joe Pilates' technique. Joe called his method “Corrective Exercise”. One of the original signs on the door claimed to “Correct, Develop and Reduce”.  The early Pilates studios had a long history of inviting people with disabilities to correct, develop and reduce body parts galore. One of Joe’s earliest and most profound success stories involved the recovery of Eve Gentry from her radical double mastectomy. Despite being left with minimal use of her arms, she returned to Pilates and became a star pupil regaining full motion and a high degree of strength.

This heritage is important because it laid the groundwork for Pilates trainers of the future. This is a group of people with a high degree of interest in the body and an unique interest in the quality of movement. Pilates teacher training programs are far lengthier than ordinary personal trainer certifications. Pilates teachers routinely study anatomy, rack up continuing education and additional trainings.

If you have been a patient of a physical therapist, you may have seen Pilates teachers or Pilates equipment in your clinic. Physical therapists recognize the unique benefits of alignment and strength training with springs and Pilates is simply one additional modality or mode of treatment that therapists can opt to include in their treatment plans. That doesn't quite mean that Pilates is rehab but that elements of Pilates can be effective within the context of a complete rehab program. 

We know that movement itself heals. And mindful movement even more so.  Couple this mindful resistance training with the attentive focus of a one on one highly educated instructor and you have created a fully therapeutic environment; a setting where anyone with a weakness or limitation would progress and thrive. So while Pilates is not rehabilitation and should not take the place of your proper physical therapy it is a valuable adjunct to your PT and a terrific post-rehab tool. 

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