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DR BARRY TRIESTMAN, D.C.

11464 E Ridge Rd

Truckee, CA 96161

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Tel: 530-550-1688

Fax: 530-550-1688

Pilates Rehabilitation

Pilates Rehabilitation is an essential, exciting and unique way to regain control, strength and flexibility after an injury! Focusing you on your ability to control the whole body and maintaining ideal posture and mobility. Pilates Rehabilitation is an amazing addition to your treatment program. You will feel more balanced and have improved performance in sports or daily activities and reduce your chance of re-injury.  I have trained with STOTT PILATES® Rehab Master Instructor Trainer Melanie Byford-Young, BHSc. PT.  She has created the new rehabilitation program for Stott Pilates. She brings a traditional physical therapy background to the training. The new STOTT PILATES Rehabilitation Series has been updated in order to incorporate the latest research in rehabilitation, introduce new exercises and modifications on all equipment including the new V2 Max Reformer™, and providing more progressions in order to treat acute and specific sports-related injuries. Balanced Body has a similar program that Brent Anderson P.T. has developed. I would suggest that you see someone trained by one of them.

 

Please note that as you go through our Pilates Rehab you will understand this explanation better and by reading it several times during the process you also deepen your control and awareness.

I will break down the process of motor reeducation to the body into three phases.

 

Phase I  Stabilization/Mobilization

When we start we need to establish and feel the body parts that are disconnected both the injured and adjacent body parts. Tactile and verbal cues are used to help you get in touch and are repeated to help associate each correct movement with the desired task. At the beginning we need no movement and then movement with light resistance. The amount of resistance will be low whether we are using the springs of the reformer or light weights. The importance of this in any rehab program is essential. The small amount of resistance enables you to re-connect with your body. If we ad resistance too early, there will be too much muscular activity making it impossible to feel what you need to feel. Often we will use springs to assist the movement. Assisting movement with the use of springs can allow for a decrease of unwanted muscle activity or guarding often associated with increased muscular activity which will propagate pain or weakness.  Phase I, can be broken into parts. These parts will exist simultaneously. 

Disassociation often entails isolating movement at the hip or shoulder girdle, independent of pelvis or spine movement. This is done even if we have a knee, ankle, foot, elbow, neck, and shoulder or hand injury.  This isolation can begin by creating an environment with a large base of support and feed back (i.e. on the reformer carriage lying on the back). Disassociation combined with stabilization provides a favorable environment for preventing further trauma. The large muscles that are often guilty of the unwanted splinting (i.e. quadratus lumborum, hamstrings, rectus femoris, psoas, pec major, gluteus maximus, and erector spinae) can be taught to lengthen, allowing the joints and muscles to absorb and distribute potentially harmful forces to the body. 

Stabilization In the early phase, the interest is in recruitment of deep stabilizers mainly the power house (i.e. transversus abdominus,  pelvic floor and multifidi muscles).  Mobilization is the restoration of mobility to affected joints and muscles. A chiropractor or physical therapist can contribute to the pathology if mobilization is too aggressive or premature.  An increase in pain and stiffness would be an indication of this. More often a lesion may be traumatized further if normal mobility is not restored. This is why the use of assistance (i.e. with the reformer) is so crucial to restore the desired movement properly and the concomitant use of manipulation of the joints and release of the restricted tissues with Active Release Techniques is so important in the beginning of treatment. The Pilates rehab environment allows the chiropractor or physical therapist to use appropriate feedback and assistance to facilitate successful movement. As the chiropractor or physical therapist restores mobility to a target joint and surrounding joints, the force can be distributed in a more balanced way, minimizing destructive forces and decreasing the chance of creating new injuries.

 

Phase II: Dynamic Stabilization

Dynamic stabilization involves challenging the newly acquired control, mobility and stability in a more functional way starting to mimic your sports and daily activities with additional assistance and partial gravity dependent environment. By progressively decreasing the assistance and base of support or increasing the length of the levers, a movement or exercise difficulty increases. Once the desired movement is learned, the newly acquired movement can be challenged at a level appropriate for goals and expected outcomes. Efficiency of movement is the goal. By incorporating the breathing and movement principles early in phase I activities, the ability of the patient to recruit secondary stabilizers (i.e. erector spinae, external and internal abdominal obliques, and latissimus dorsi) improves. The focus in this phase is still control.

 

Phase III: Specific Functional Reeducation

Specificity functional reeducation are the goals of this phase. Fully mimicking activities that you do in your sports or daily activities and making them more challenging with the idea of deepening your control. We use unstable surfaces (i.e. rockers, balanced boards, balls) or taking away your base (i.e. by having you stand on one leg, By using springs, weights and bands to pull you out of balance. Every time you achieve mastery we will progressively make it more challenging with the ultimate goal of making these movement patterns part of your body. The final goal is to become autonomous with the movement.

 
 
 
 
Detailed Pilates Rehab explanation: