Difference between Clinical and Studio Pilates

Pilates Image by @studiopp_

As a physiotherapist and Clinical Pilates instructor, I am commonly asked about the difference between Clinical Pilates and Studio Pilates.

Pilates has really taken off in the past few years, but in truth this innovative method has been around since the early 20th century. Pilates was first introduced to the world by a man named Joseph Pilates, who turned to exercise and athletics to battle his childhood illnesses. During World War 1, he developed his own system of exercises to help with the rehabilitation of those that were injured or bed-bound by attaching springs and pulleys to the hospital beds, hence the birth of Pilates. Since then, many forms of Pilates have been developed including reformer, mat and Clinical Pilates, just to name a few.

Clinical Pilates
Clinical Pilates is the use of Pilates exercises and equipment (reformer, mat work, and trapeze table) to provide an individualised, tailored program with consideration of a patient’s injury history, directional bias, and specific goals. Let me explain.

Injury History
Particular injuries are going to respond better to particular exercises. For example, if you have disc related low back pain, generally these patients are happier in an extended (bending backward) position. Prolonged periods of flexion (bending forward) exercises may increase their pain or even send referred pain down their legs. Of course, this is not always the case, and varies from patient to patient.

In a Clinical Pilates class, these patients would start out exercising in their “happy place” and slowly graduate into more provocative positions, as they develop control and strength.

Pilates Image by @universalpractice

Directional Bias
Regardless of injury, the majority of the population has a directional bias. This means that your body will have a direction, in which it prefers to move, your very own “happy place”! If you exercise into your “happy place”, you should notice a rapid improvement in strength and flexibility, conversely working against your bias may diminish these gains.

Clinical Pilates classes are supervised by Clinical Pilates trained physiotherapists and the result is an instructor who has in-depth injury knowledge, knows your history, and your limitations to exercise (when to push you and when to back off).

Class Sizes
Clinical Pilates classes are capped at 4 patients per class, to allow adequate supervision and correction.

In many instances Clinical Pilates classes can actually be cheaper than a Studio Pilates class. Most private health funds now allow you to claim Clinical Pilates classes as they are run by a physiotherapist however your rebate will depend on your level of cover. It is best to speak to your specific health fund for more information regarding this.

Pilates Image by @brigxx

Studio Pilates
In contrast, a Studio Pilates program will likely consist of non-specific exercises, which are multidirectional (multi-bias) in nature, targeted to suit the average population. This style of class is great as long as you aren’t injured and already have some experience with resistance training. If you do happen to develop any niggles or injuries, here are a few tips on how to manage them during your class.

  1. Get to the class early so that you can talk to the instructor without feeling like you are holding up the class or being listened to by 10 other pairs of ears.
  2. Let your instructor know if you have been given specific instructions to avoid or focus on particular movements by your treating therapist. Well-trained Pilates instructors have a huge exercise base and should be more than happy to give you modifications or alternatives.
  3. Stop doing the exercise if it is exacerbating your pain, even if that’s in the middle of a class. Trust me, no one else in the class is looking at you, they're all too busy worrying about making it through the 15 reps of lunges.
  4. If your injury has not resolved within 1-2 weeks of modification, seek professional help. As a physio who sees this all the time, let me just say it is much easier (and speedier) to treat a problem that has been around for a couple of weeks than a couple of months.
  5. The most important lesson is to listen to your body, and be able to differentiate between the good pain and the bad pain. I.e. the “my muscles are working hard” pain and the “something isn’t quite right” pain.

Finally, I’d like to mention that it is a common misconception that you need be injured to be able to start Clinical Pilates. The beauty of Clinical Pilates is its tailor made program for your body and your goals, whether they are to rehabilitate from an injury, improve strength, increase tone or flexibility or even improve athletic performance. It’s up to you!

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