Health Matters

Pilates effective for strength, flexibility

Conway McLean, DPM, Journal columnist

Fitness fads have come and gone over the years. Who can forget the entertainment value of Richard Simmons, or the popularity of “Jazzercise?” The fitness craze has blossomed from a fringe activity, pursued by a few “oddballs” in the 70’s, to the billion dollar industry it is today. The business of gyms alone totals 97 billion globally according to estimates, and doesn’t include the on-line market, equipment, or supplements. This is clearly big business.

The pursuit of weight loss and better health takes many forms. The jogging craze is going strong after all these years and shows no sign of abating. Although difficult for many Americans, either because of orthopedic issues, or simply age, running is pursued by millions and has obvious benefits as well as many hazards and potential complications. Yoga is another option, although drastically different in almost every way from running. Yoga studios have popped up in cities and towns throughout the US, with numerous variations and permutations promoted.

The origins of yoga are buried in antiquity, developed as a component of Buddhism about 5,000 years ago in India. It involves a series of poses, performed in combination with breathing exercises. It can be compared to a similar activity, Pilates. Although less commonly practiced, it has grown substantially since it was introduced and now has a devoted following. And the last decade or two has seen a dramatic rise in the popularity of Pilates.

Pilates is a physical fitness system, and though primarily associated with exercises for your core, it has many other benefits. Pilates is practiced worldwide but is most popular in Western countries, eg. Canada, Australia, the US. A major advantage is the lack of equipment necessary to practice it. Although many participate in classes, all that is necessary is a mat. An instructional video can be helpful if you are not intimately familiar with the positions comprising a good Pilates workout. This lack of expense makes it an attractive option for many participants.

The core principles involve gentle stretching, and strengthening through slow, controlled movements. Most of the positions are performed while sitting or lying down, therefore taking stress off various joints. This absence of impact means Pilates entails minimal danger to thin or weakened bone.

Pilates is renowned for increasing muscle strength and tone, especially of the abdominal and lower back muscle groups. Other “core” groups are benefitted as well, including the hip and butt muscles. One result is improved balance and posture, and stability in stance. Having balanced muscle strength aids in postural stability, basically meaning an enhanced ability to stay upright.

Pilates has numerous benefits including its ability to improve flexibility. Studies have shown improvements with eight weeks of Pilates. One way it achieves this is by applying an enduring, sustained stretch on the affected muscles. Another consequence of the sustained practice of Pilates is a stronger, more stable spine.

The origin of this practice dates back to the 1920’s when it was created by Joseph Pilates. He designed an exercise program with the objective of increasing muscle strength, endurance, and flexibility. The stimulus for his approach was his ill-health as a child in Germany. He was determined to build up his strength and used body-building to do so. He was so successful that by his teens he was getting work as a model for anatomical drawings.

His was a new approach to exercise and body-conditioning. Pilates was well ahead of his time in many respects. He recommended and used gym equipment, which he referred to as apparatus. Perhaps his best known piece of equipment was the “Reformer,” which is still in use today.

He researched every kind of exercise available at the time. And then tried them. From classical Greek exercise regimes to body-building, to gymnastics, Pilates investigated the Eastern disciplines of yoga, tai chi, and martial arts. He even studied anatomy and the movement patterns of animals.

But it was in America that his method gained a wider audience. Prior to his move to the United States, Pilates taught self-defense techniques to Scotland Yard detectives and worked as a circus acrobat. He was also an expert diver and skier. It was during his internment by the Germans during World War I that the Pilates method took root. He used this time to study exercise and body-conditioning on his fellow interns.

While working as a nurse during his internment, Pilates modified some of the hospital beds to provide some form of exercise to bed-bound patients. He used some of the springs in these beds and attached them to ropes, using the resistance of the spring to work various unused muscles. Thus, his long-lived invention, the Reformer, was born.

Pilates made the crossing in 1923 and landed in New York where he opened his first studio. His method caught on with professional dancers who found it an excellent way to recover from injury and prevent their recurrence. His new approach was a hit, even utilized by such dancing luminaries as Martha Graham. Gradually, he gained a wider audience for his teachings which he called ‘Controlology.’ Only later did it become known by his surname

Little research supports the benefits of Pilates. Most of the published studies lack adequate controls and poor reliability of the techniques used to measure strength and flexibility. The result is they lack statistical power, making it hard to draw definitive conclusions. But this doesn’t mean Pilates isn’t extremely beneficial; only that a study has not yet been constructed to prove it. Ask any participant after a Pilates session if they got a good workout and it becomes easy to make some generalizations. One Pilates fan interviewed for this article was adamant in their certainty about the benefits of Pilates. It’s their most effective exercise technique, improving both their strength and flexibility significantly.

Joseph Pilates surely holds an important place in the pantheon of fitness guru’s, up there with Jack LaLanne and, yes, even Jane Fonda. He is considered by many to be the first individual to combine Western and Eastern ideas about health and physical fitness. Although Pilates classes are impossible to find in many parts of the country, videos and tapes are available. There is some form of exercise for everyone, a concept Pilates subscribed to. Perhaps his method would work for you. Do some research, peruse the internet, and find an approach that is appealing. There’s something you need to know: the human body needs to move.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula. Dr. McLean’s practice, Superior Foot and Ankle Centers, has offices in Marquette and Escanaba, and now the Keweenaw following the recent addition of an office in L’Anse. McLean has lectured internationally, and written dozens of articles on wound care, surgery, and diabetic foot medicine. He is board certified in surgery, wound care and lower extremity biomechanics.


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