Saturday 1 October 2016

The link between Physiotherapy and Pilates when addressing Spinal Injury.

Today we have guest blog from Gordon Ellis from; Gordon spent 12 years a 1st Team Physio at Sunderland AFC, and he also was physiotherapist to His Highness the Crown Prince of Dubai - to name but a few of his roles!  He now has his own practice in County Durham, and I work closely with him as a Pilates instructor to ensure the best outcomes for our patients.  Find out more at his website at the link above.

Here is my personal view, explanation and in-ways education, to patients/clients who suffer with spinal (back) trauma or spinal injuries. 

Patients are usually referred for a course of Pilates as they are at that stage of functional rehabilitation recovery that the musculature surrounding the injured area, or the damaged muscle/tissue, requires further intervention by way of dynamic stability, to promote postural stability and improved function. In many cases the patient will self refer as they feel they need what Pilates offers.

Around our body there is an ongoing equation taking place between mobility and stability of joints; with the joint stating it requires range of movement and the musculature stating it needs to create stability and fixation for its movements, and postural support. One of the many systems working alongside this is our nervous system, with reciprocal innovation taking place (the interplay of muscles being stimulated or relaxed, for our posture and support). For good joint function there has to be balance between them all. It's well documented that the more functional a joint is through increased range of movement, stronger stable musculature, increased neuromuscular communication, the more chance it will have to repair. 

There are also associated problems that come with spinal trauma such as referred symptoms into the limbs, compensatory effects, atrophy (wastage) of associated muscles that work in synergy with the spine, decreased cardiovascular/respiratory function - as a result of inactivity throughout the pain and decreased functional capability period; and without question decreased communication of the nerves or nerve trauma, not to mention the psychological and social demands these injuries create. 

It has to be stated that Pilates is neither a replacement for treatment or a resolve from the spinal conditions. In many cases the trauma still exists even following post operative surgery where through time, scar tissue, adhesions and degeneration take place.

An experienced Pilates teacher will discuss a patients case history with the Physiotherapist, and where possible, the patients GP or consultant, establishing the contraindications (what not to do, or is dangerous to do) whilst working alongside each other in their fields of expertise to:

1) Preserve the rest of the body's functions.
2) Prevent the clients condition deteriorating.
3) Promote to full recovery without reoccurrence where possible.
4) Create an on going management plan with the Physiotherapist and Client. 
5) Educate the Client as part of a multidisciplinary approach to the nature of their condition in tandem with a home exercise program, that seeks to support through a bespoke set of exercises that are visually demonstrated and verbally explained, to obtain the correct technique, administering the intensity through reps, sets, time, duration etc.. that's at the clients correct stage of recovery.
6) Keep the Patients GP updated & work with their advice.

Both Therapist and Pilates teacher should periodically review the patients progress but also obtain regular feedback from the individual to ascertain if the program of treatment, therapy, exercises are achieving what there purpose is. It also gives valuable information for all parties for future patients. 

In summary it is important that the Physiotherapist/Patient acknowledges and understands the value of Pilates though its ability to retrain and develop musculature in a controlled safe environment, with the added benefits to bring awareness of correct breathing techniques, postural control, relaxation and create strong muscular foundations to the rest of the body, to say but a few. 

The Pilates teacher/Client must also acknowledge and understand the value of periodical and on going reviews/ treatment/rehabilitation from the Physiothetapist to identify any new problems and catch them early or maintain the ongoing cellular pathology related to the condition.

Without the above being put in place and kept to we run the risk of not only reoccurance, but more complicated spinal trauma emerging".
Gordon Ellis ( September 2016)

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