REHABILITATION

TABLE 4. STRETCHING TECHNIQUES PILATES EXERCISES MUSCLE TO BE STRETCHED

PILATES EXERCISE

Lower back Hamstrings

Psoas

Quadratus lumborum Hip abductors Hip adductors Quadriceps Gluteals Piriforms

Hip rotators

Tibialis anterior Gastrocnemius Soleus

Rectus abdominals Obliques

Latissimus dorsi Pectoralis major Pectoralis minor Trapezius

Anterior deltoid Posterior deltoid Biceps Triceps

Neck flexors Neck rotators Achilles tendon

Wrist flexors/extensors Double leg stretch. Pelvic stability. Scissors.

Double leg stretch. Hamstring lengthening. Scissors. Leg circles. Open leg rocker. Spinal curls. Scissors. Swimming. Hip opening. Spinal curls. Side reach. Big squeeze. Roll downs.

Leg circles. Hip opening. Open leg rocker. Single knee kicks. Swimming. Mid back stretch. Open leg rocker. Hip opening.

Leg circles. Single knee kicks. Hepp drops. Tennis ball raises. Roll downs.

Roll downs. Wall slides. Dart.

Superman. Spinal curls. Double leg stretch.

Double leg stretch. Arm opening. Arm opening.

Mid-back stretch. Shoulder rotation. Double leg stretch. Threading a needle. Threading a needle. Dart.

Arm circles.

Diamond press. Dart. Neck rolls. Roll downs.

Tennis ball raises. Heel drops. Wrist opening.

TABLE 5. THE APPLICATION OF SPORTS PILATES TO SPECIFIC SPORTS SPORT

APPLICATION OF PRINCIPLE

Swimming Running

Gymnastics Horse riding

Breathing focusing co-ordination, sequencing Alignment, lengthening, sequencing Co-ordination, centring, lengthening Relaxation, concentrating, alignment

Tennis Concentration, centring, co-ordination

rectly in a less tense state, tension in muscles may lead to pulls or demands on these muscles that may create incorrect movement patterns or methods of under- taking the exercise. 2. The presence of pathology to a specific structure or tissue

This responds well to specific exercises that are directional or load specific (detailed programmes are illustrated in the Sports Pilates Book (1)).

The pattern or selection of the Pilates exercise: a) Removes the strain on soft tissue such as ligaments or muscles by preventing muscle inhibition or spasm which will contribute to muscle imbalance or a reduced dynamic stability to the

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structures involved. b) Reduces the derangement on the structures and allows the return to an ideal anatomical position. The principle of

alignment is undertaken in the exercises. Alignment refers to a dynamic state and must be applied in the ideal position for the activity. It also needs to be undertak- en in the sport in question. c) The need to restore early mobility in structure is widely acknowledged as a key element in the early rehabilitation of sports injuries. Early introduction of controlled movement allows good devel- opment of proprioception and enhances the environment for the inflammatory phase in the healing process. The progres- sion into the repair and remodelling phase needs to utilise the Pilates principles of sequencing and co-ordination. d) Specific direction and load of the exercises selected need to be able to sta- bilise the cause of pain, possible joint instability or tissue length differences without provocation of pain initially. e) After an episode of pain or the presence of pain with movement, correct exercise selection will help reduce the fear of movement at the level the athlete is working or progressing to. 3. Breathing pattern The breathing pattern is optimal to the teaching of the Pilates method because it is integral to all exercises. 4. Musculoskeletal considerations These considerations can be divided into two separate components: Articular component - the main element influencing the articular component is the achievement of joint stabilisation applied to the Pilates programme. This can be referred to as core stability as illustrated in the Pilates model. Furthermore to aid stability, Pilates exercises allow for the mobilisation of a stiff adjacent segment while maintaining the baseline stability in the whole body system, subject to the exercises used.

Muscular component - Pilates exercises

TABLE 6. INFLUENCES OF GOOD AND BAD BREATHING PATTERNS ON EXERCISE PERFORMANCE

GOOD BREATHING PATTERN

• Moves the contents of the abdomen, thereby avoiding the creation of ten- sion at the start of the exercise

• Allows minimal effort to be used during the exercise

• Enhances the co-contraction of the stabilising muscles of the lower abdominals and pelvic floor.

BAD BREATHING PATTERN

• Increases the effort needed to exercise

• Alters the circulation • Leads to loss of control of pelvic neutral position while exercising

• Holding of the breath increases the intra-abdominal pressure which leads to poor muscle recruitment/movement ability.

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