A bit of history
Developed at the beginning of the 20th century by the German born US citizen Joseph Pilates, this well known training method has become worldwide famous in the past 50 years, especially in the western countries.
As a child, Joseph Pilates was of a weak constitution and suffered from asthma and rheumatic fever. Poor health in his early age led him to research and study the anatomy and principles of movement of the human body, the training techniques of the ancient Romans and Greeks and the Oriental Philosophy, aiming to improve his own health condition. He eventually managed to overcome his physical restrictions and became a good boxer, gymnast and swimmer. What a guy!
Joseph developed his method over several years of practice, both on himself and on others, as an athlete initially, then as a trainer and rehabilitator, in the most diverse settings. It is well known that at some point during the first world war he helped bedbound wounded soldiers and veterans to improve their situation by applying springs, ropes and pulleys to their beds, so that they could exercise without needing to get up (These were the first prototypes of the famous Pilates training machines called Cadillac and Reformer).
The Pilates Method aims to achieve a synergic improvement of body and mind and was originally based on 6 principles:
-Concentration: the ability to focus your mind not only on the exercise you are performing, but also on the feedbacks your body is giving you.
-Breathing: Undoubtedly of oriental inspiration, the breathing technique is probably the first thing you will learn when starting Pilates, and if correctly understood it will help with increasing the blood oxygenation, with mobilising the residual air in your lungs and with stabilising your core.
-Precision: every movement must be extremely precise during the whole length of the exercise. Often Pilates exercises are slow and extremely specific and require a good level of body awareness. It may take a long time to master even basic exercises, and the very teachers often affirm that they never stop discovering new details, even after years of practice. Perfectly in line with the Zen philosophy, it is a pursuit of perfection.
-Centre: all Pilates exercises develop from and return to the core of the body. There is no Pilates without core stability. What is considered to be the centre of the body, according to the Pilates Technique, is the corset formed by the muscle layers connecting lower ribs, pelvis and hips, and include diaphragm, 4 abdominal layers, gluts, pelvic floor muscles and deep lower back muscles. As a Pilates practitioner the awareness of the activity of these muscles will become your bread and butter.
-Flow: exercises, although extremely precise, should be elegant, effortless looking and smoothly flow into each other during the session, in order to improve endurance, strength and stamina.
-Control: this does not only apply to the movements, but also to the settings. The use of body weight, springs and tools allows the training to take place in a perfectly controlled environment, where loads and weights are tailored on the practitioner’s needs.
Pilates and Evidence Based Medicine
Despite its undeniable popularity, there is little medical literature at present demonstrating the effectiveness of Pilates techniques, especially in relation to the treatment or prevention of conditions such as low back pain. It has been proven with randomized studies, that the Pilates techniques help with improving muscle strength, flexibility and stability of the lumbo-pelvic region in healthy subjects, however whether their effectiveness is higher than other training methods has yet to be verified. From an intellectual point of view it is fair to clarify that a technique whose effectiveness has not been scientifically proven does not necessarily mean it is useless or ineffective, it just means there are not enough studies to confirm it. That said, the popularity of this technique among rehabilitators, physiotherapists and physicians suggests that, at least from an anecdotal point of view, it has proven itself to be a useful tool. Worth giving it a go.
More studies are coming out nowadays, although they tend to still be few and far between. They mainly confirm the positive effect of low impact physical activity on both physical and mental health conditions, however the main challenge at this stage will be demonstrating if and how specific techniques are more effective than others in the training/rehabilitation process.
By the way, a pilot study at Colchester University Hospital has recently suggested a good level of effectiveness of Pilates techniques in improving mild to moderate cases of urinary incontinence, given the pelvic floor training techniques involved in its methods…so that is a good point.
For years, ever since it was created, no patent was put on the Pilates method nor a formal training was created for new teachers. This resulted in the creation of several groups, sub-methods and schools of thought which spread around the world. Nowadays you may come across Stott Pilates, Balanced Body, Body Control, Powmak just to name a few. This has created quite a bit of confusion along the years not to mention legal issues and long trials, however generally speaking you should be able to find pretty much the same principles and exercises in all Pilates schools (maybe with slight modifications). Some approaches tend to be more gentle, some others more energetic, it is perhaps worth to try 2 or 3 different schools before choosing the one that suits you best. It is advisable to go for an instructor who has obtained his certification with some recognised institution, who shows knowledge, empathy and will to help, and who is happy to tailor his sessions on his client’s needs.
According to the available literature what can be said about Pilates is that for sure it is a good training technique and considering the slowness of the movements and the low impact on joints (most of the exercises are performed while lying down) it sure makes a perfect tool for keeping active and healthy along the years… As for the rest the final judgment will be the one of the customer. Does it sit well with you? Does it make you feel better? And if the answer is Yes, then go for it!