Pilates and Chiropractors

The inclusion of Pilates training into Chiropractic School could broaden the future of back treatment and chiropractic medicine such that doctors are recognized for their additional skills as back exercise specialists. Adding Pilates to the treatment process of patients not only improves services but also expands marketability and provides doctors with a competitive edge.

SES is a unique therapeutic exercise program that combines flexion, extension, self-traction, stabilization, flexibility and trunk strengthening for patients with back pain. The principles of Pilates are grounded in contemporary research from the fields of Exercise Physiology, Physical Therapy and Motor Learning. The Spinal Exercise System is a focused yet simplified combination of traditional physical therapy, Pilates Method and Alexander Technique.

Pilates teachers, propose that Chiropractic Colleges offer a certification courses for its current students and graduates. The curriculum would include lectures and exercise labs on stabilization, muscle recruitment, core strength and posture.

Pilates programming would be divided into two parts:
Part 1: Floor Exercises using a Stabilization Ring and Body Bar
Part 2: Pilates Xercizer equipment for the Chiropractic Office

Pilates Floor Exercise
Pilates Floor Exercises use a stabilization Ring and light weight Body Bar (which can be merchandised to the patient). The Ring is used to teach the patient pelvic, ribcage and spine stabilization techniques.

Pilates Xercizer
The Xercizer is an advanced Pilates Reformer which operates on spring resistance. The resistance helps to hypertrophy muscles that have been deconditioned from age, inactivity or chronic injury. The Xercizer is like having a complete gym in one unit because it allows a wide range of exercises which address the fitness of the Legs, Hips, Upper Back, Lower Back, and Abdominal Wall. SES requires the patient to recruit the TrA, PF, ES and other central muscles for support prior to a limb movement. Full range of motion strengthening helps to build mobility in the spine and hips. The sequences on the Xercizer are simple and easy to learn; yet they help the patient organize complex postural adjustments and stabilization.

Background
It has been determined by the US Department of Health and Human Services that many patients with back problems receive inappropriate care. Many treatments do not yield long-term results; in fact some treatments are considered detrimental for the patient.

Common treatments for back problems include chiropractic adjustments, physical therapy, surgery, and medication. Chiropractic adjustments are the favored course of treatment for low back pain. Physical agents and modalities such as heat, ice, massage, transcutaneous electrical nerve stimulation (TENS), passive flexor/extensor activities, and ultrasound do not typically produce long-term changes in the patient's spinal strength and alignment. In general studies have shown that passive therapies are less effective than active mobilization and that exercise programs seem more effective for long-term results. Research on repeated back surgeries concluded that many patients become more disabled.

Many Doctors of Chiropractic would agree that most treatment strategies for patients with back conditions have failed to provide any long-term vision for "Spinal Fitness". Many clinical back exercise programs seem crude and elementary considering the new findings about spine stabilization, muscle recruitment and posture adjustments in persons with low back pain (LBP). The Spinal Exercise System (SES) could enhance Chiropractic Medicine by offering the patient a an exercise system that changes the Spine Stabilization System.

No one disagrees that stabilization exercise is necessary for strengthening the lumbar extensors; but there is no universal system of instruction. There also is no clear consensus on what kind of muscle recruitment patterns are effective for creating bilateral strength in the hips and spine. For example, pelvic floor training could have a profound effect on pelvic stabilization and low back alignment but is rarely taught in a clinical setting as part of pelvic stabilization. Typically a patient misunderstands the details of an exercise and thus loses the effect. The Pilates Program is a formula for teaching patients proper back exercise. It aligns itself with the philosophy that you must "turn on" the muscles, improve the alignment and strengthen the integrity of the spine.

Research by scientists such as Paul Hodges elucidates the role of exercise in the treatment of back pain. These studies support the fundamentals that are taught in the Pilates Program.

Pilates is a specific type of training designed to help patients overcome habitual movement patterns and improve spinal flexibility and strength. It teaches the patient to alter spine stabilization patterns within varied exercises and loads.