Pilates

Injury type: Chronic

Category: Allied Health Options

Rating: No research

What is it?

Pilates exercise teaches awareness of breath and alignment of the spine, and strengthens the deep torso muscles. These muscles help to keep the body balanced and are essential for providing support to the spine. The overall aim of the exercises is to create a stable pelvis and trunk, and the ability to monitor one’s self kinaesthetically so that movement becomes effortless. A balance of eccentric and concentric muscle contractions promotes strengthening with minimal increase in bulk. The individual is taught to breath in relation to the movement to promote greater efficiency. Initially, exercises are taught to increase awareness that the body works as a whole and that an injured area is part of that whole. As the patient develops strong pelvic and thoracic core, increased resistance and dynamic activities are added. Pilates is used in relation to athletic training, rehabilitation and conditioning.

How does it work?

Pilates aims to selectively increase the strength and endurance of the deep, core muscles of the torso. Initially, the participant must learn which muscles to use, how to use them correctly, and then use them whilst performing movements. By targeting the deep postural muscles of the torso, this may increase the stability and balance of the body, improve posture and reduce the amount of work required by the superficial muscles. This in turn reduces the pressure placed on the spine. By reducing the amount of work required by the superficial muscles, this may also help release tight muscles and reduce pain.

Is it effective?

There are no studies assessing the effectiveness of Pilates for whiplash in the short or long term. A systematic review of existing clinical practice guidelines¹ identified that only one out of the four whiplash related guidelines included Pilates as part of its recommendations. Specifically, the guideline did not recommend the use of Pilates as a management option following any grade of whiplash, as there was no evidence of positive effect.

In contrast, there has been some research investigating the effectiveness of Pilates for chronic neck pain. A recent systematic review² identified consistently positive outcomes associated with Pilates in short term from two included studies. In particular, Pilates appeared equally effective to yoga or a standard physiotherapy encompassing isometric neck exercises, education and electrophysical agents, in terms of improving pain intensity and neck disability. Furthermore, Pilates was significantly more effective than a pharmacological treatment in improving pain intensity and neck disability in people with chronic mechanical neck pain.

Are there any disadvantages?

There have been no reports of disadvantages associated with Pilates, however it is likely to be more effective if individual one-on-one instruction is provided, which can be costly.

Where do you get it?

Pilates instruction should be given be a fully trained instructor.  Physiotherapists can provide Pilates therapy also.  There are some studios/gyms set up exclusively for Pilates.  A listing of instructors can be found in the Yellow Pages. 

Recommendations

Pilates cannot be recommended as an effective treatment for whiplash, either in the short or long term, because of the lack of scientific evidence. More research is required.