Pilates Plus / Clinical Pilates

Everyone! Clients range from young children to the elderly, from office workers and weekend warriors to elite level sportsmen and women, as well as ante-natal and post-natal ladies. Conditions range from poor posture and mild discomfort to rehabilitation following extensive traumatic injuries caused by car accidents or sporting injuries.

The initial assessment is a detailed one-hour examination involving a postural assessment and specialised movement dysfunction tests. With the clients permission, photographs and video are taken and utilised to explain what postural and movement dysfunctions the Physiotherapist has found, how they may contribute to the current problems the client is experiencing and how they may be modified through exercise.

In order to contribute to clinical research, clients complete appropriate research questionnaires at the start, during and at the completion of the rehabilitation phase of treatment. Our research shows that within 5 sessions there is a significant improvement in pain levels and perceived disability with most clients finishing the rehabilitation phase between 8-12 sessions.

Follow-up sessions are always one-hour in duration but the client can choose different appointment types – for example a private session or sharing with 1 or a maximum of 2 other clients. Pilates Plus does not run classes where all the clients are performing the same exercise. The clinic uses the reformer, the trapeze table (Cadillac) and Wunda Chair as well as various smaller pieces of exercise and feedback equipment to provide the most effective treatment possible.

Everyone is different and the speed of recovery depends not only on the present level of dysfunction but also on the amount of pain, structural changes and the level of inflammation. Our experience in Hong Kong over the last 25 years has shown that significant improvements should be seen within 6 sessions with most clients finishing the Rehabilitation phase of treatment at around 10 sessions on average. At approximately the 8th session the client will be reassessed – using photos, video and our research outcome measures to objectively measure their progress.

The majority of clients choose to continue attending Pilates Plus as a Conditioning client in order to maximize their improvement. If your condition has not improved substantially within 10 sessions then your Pilates Plus trained Physiotherapist will re-evaluate your condition in order to understand why you haven’t responded as expected and will devise an ongoing treatment plan which may include further investigation or onward referral.

Some clients are referred by their Doctor or other health professionals to attend our clinic for Rehabilitation Pilates Plus. They have ongoing pain, structural or movement dysfunctions that require close attention, continual adaptation of treatment and regular contact with their Doctor and other treating health professionals. If the client is claiming back the cost of treatment from their insurer, detailed reports and progress letters are often required by the insurer. Their treatment progress will be more gradual and the exercises will be at a more basic level.

A typical Conditioning Pilates Plus client presents with a postural issue post-pregnancy or due to a  poor work posture which generally doesn’t cause significant pain or restriction of daily activities. Their progress will be more rapid, the difficulty of their exercises more challenging and they will be more independent during their exercise sessions.

The first session is spent entirely on postural and movement analysis. Please bring along any investigation reports such as X-ray, MRI and your referral from your Doctor or other health professional. Bring along suitable clothes – comfortable t-shirt and shorts for the men and t-shirt and yoga pants for the ladies as well as a pair of socks. Don’t worry if you forget – we have clean clothing (T-shirt, shorts and non-slip socks) for you to borrow.

Each Pilates Plus session lasts 60 minutes. Unlike most Physiotherapy treatments, Rehabilitation Exercise using Pilates Plus is active – the client is guided through specific muscle activation and movement patterns, joint mobilisations, stretching and strengthening exercises. The Pilates equipment and other small pieces of equipment provide resistance, assistance and feedback thereby promoting more efficient and effective movement control. The founder of Pilates Plus has created an extensive list of exercise handouts for clients to take home with them in order to educate, promote self-help and self-maintenance and to continue the healing process outside of the clinic.

Comfortable t-shirt and shorts for the men and t-shirt and yoga pants for the ladies as well as a pair of socks are all that are required. If you forget your exercise clothes, don’t worry, we always have clean t-shirts, shorts, and non-slip socks for you to use at the clinic.

YES! It is encouraged that you continue your everyday life activities, sports and hobbies (unless they cause you pain) but at the same time you are asked to actively incorporate what you learn from Pilates Plus into your everyday activities such as running, playing golf, sitting at a desk, repeatedly picking up a small child or carrying groceries. By repeating the correct muscle activation and movement pattern in your everyday life, you will break poor movement habits faster and turn a conscious postural correction into an automatic one.

YES! Pilates Plus is a gentle form of exercise, which is not harmful to either the Mother to be or the baby. The majority of ante-natal clients continue attending Pilates Plus right up until just prior to giving birth. The treatment positions and exercise focus are adjusted according to the stage of pregnancy and take into account any specific pregnancy related problems such as Sacroiliac Joint instability or postural hypotension. When pregnant, it is always advisable to check with your doctor first before starting any new activity.

NO! The exercises are designed to help relieve pain by improving muscle activation, correcting muscle imbalances and improving bony alignment. The only pain felt should be mild muscle pain induced by the specific activation of weak/inhibited muscles or joint discomfort caused by mobilising previously restricted joints. All treatment-induced pain should completely disperse within 48 hours. If you feel pain for greater than 48 hours after your last session be sure to let your Pilates Plus Physiotherapist know.

If you feel any pain with the homework exercises, cease the exercises immediately and contact your Pilates Plus Physiotherapist.

At Pilates Plus we assess your entire posture not just the specific area where you feel the pain or stiffness. Our aim is to provide a complete appraisal rather than a “band-aid approach”, providing a clinically reasoned and evidence-based approach to the prescription of rehabilitation exercises. Our ongoing research shows that we have a significant effect on pain and functional restrictions on many different types of conditions. Our experience over the last 25 years has shown that the clients who continue their home exercise programme after discharge from active treatment, maintain and in most cases continue to improve on their results.

Our motto at Prohealth Posture Plus is to Restore, Improve, Maintain and Educate.

NO! However, there are physical conditions where certain movements or positions are contraindicated or need specific modification. All Pilates Plus Physiotherapists have undergone extensive training with the founder of Pilates Plus, Judith Anne Gould and have extensive experience and specialised knowledge in pathologies affecting the neuro-muscular-skeletal systems – training which sets them apart. They are therefore able to modify and prescribe the appropriate exercises for any existing special conditions or pathology.

At Pilates Plus, all Rehabilitation Clients complete relevant scientific research questionnaires and all clients who consent, have photos and video taken of their posture and relevant movement dysfunctions when they are first assessed. The questionnaires, photos and video are retaken after approximately 8 sessions to measure the improvement. Over the last 17 years, the data we have gathered has shown that pain was significantly decreased and functional disabilities were significantly improved in a variety of conditions such as: Low Back Pain, Sacro-Iliac Joint Instability, Neck Pain and Headaches, Recurrent Ankle Sprains, Deep Gluteal Syndrome, Scoliosis, ITB Syndrome – “Runners Knee”, Shoulder Rotator Cuff Tears, and Post surgery (disc replacements, shoulder and knee reconstructions).

In most cases the body continues to change in a positive direction over time following Pilates Plus intervention, especially if the client continues their homework exercises after discharge. However, as people may suffer further injuries, accidents or stressful times they may slide back into their “default” dysfunctional posture. So, additional sessions in the future may prove to be useful.

After completing the rehabilitation stage of treatment, most clients prefer to continue attending for postural maintenance as a conditioning client. Generally, the conditioning sessions are not covered by medical insurance but we do offer a package discount for these sessions. Other clients prefer to continue independently with their home exercise programme and return intermittently for progression of their home exercises or a Pilates Plus “posture check up”.

All clients are provided with an individually designed home exercise programme both during their active treatment and at discharge. Long-term experience (25 years and counting) has shown us that the home exercise programme is a vital tool to enhance not only the speed of recovery but also the maintenance of the postural improvements.

We do not run traditional mat or equipment classes where everyone in the room is doing the same exercise. While each client is treated as an individual case, after the initial assessment, they may choose to continue as a private client (1 client to 1 Physiotherapist) or to share a session with 1 or 2 other clients. All our clients have a specific treatment and home exercise programmes, which are devised and constantly monitored and adapted by their treating Pilates Plus Physiotherapist.