Monday Medical: Pilates for physical therapy |

Monday Medical: Pilates for physical therapy

Susan Cunningham For Steamboat Today

You probably know that Pilates can help you get in shape and improve your posture. But you may not realize that Pilates can be a powerful tool in physical therapy.

"I use Pilates with a lot of my patients," said Carolyn Christiano, a physical therapist with the UCHealth SportsMed Clinic who's also certified in Pilates. "It's not always obvious because there are some exercises that seem really familiar. But the way you do them can be more refined and more Pilates-like."

Pilates was developed by Joseph Pilates in the 1920s and focuses on breath, flexibility, core control, efficient movement and proper alignment.

"Basically, you're using these exercises to learn how to properly and efficiently move," Christiano said.

Pilates can be helpful for patients of all ages: Christiano has used it while working with teen ski racers, as well as a couple in their eighties.

She's found Pilates to be especially useful for people suffering from low back pain or SI joint issues, but it can help in anyone's recovery. When someone is injured or dealing with a chronic challenge such as poor posture, they can end up compensating with other muscles and tightening or guarding the injured area.

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"Pilates can help retrain those muscles to work properly and improve your posture and alignment so it decreases your risk of injury," Christiano said. "There are lots of exercises to help with mobility of the spine and to teach proper core control and how to let guarding muscles relax so the deeper ones can kick in."

In a physical therapy session, Christiano uses manual therapy and various other treatments, along Pilates-based exercises. A patient might start with just a few Pilates moves, working up to harder moves as they begin to heal.

"It's important to know what to do or not to do with specific injuries, and how to modify exercises appropriately to make them safer," Christiano said. "I can see immediately if someone's not doing an exercise properly, and have learned to have an even more specific eye for whether certain muscles are guarding."

A trained instructor can also help cue patients with various images or methods so they're able to engage the correct muscles. Take a basic bridge exercise: through using the Pilates method, people roll up and down into a bridge, moving one vertebra at a time to help activate deeper core muscles.

"By moving that way, it automatically kicks in the muscles that should be activated," Christiano said. "It's one of my favorite exercises because it's a really simple modification that makes a big difference in its effectiveness."

There's a large focus on breath, which is used to help facilitate movement. Breathing properly helps relax the body and prevent guarding and overcompensating.

And movements are done slowly with great concentration.

"That's the one thing about Pilates to forewarn people about – you do need to have some patience to be able to take your time and concentrate on doing it properly," Christiano said. "It's certainly not a rushed exercise. It's about doing it slowly and mindfully, which can be challenging for some people."

But the effort can be worth it. Christiano knows from experience: When she started her Pilates certification, she was dealing with posture challenges and a back injury, and even faced abdominal surgery during the program.

She found Pilates offered a great way to recover.

"It was the perfect rehabilitation," Christiano said. "After the Pilates program, I was an inch and a half taller because I had improved my posture so much."

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at