Clinical Pilates vs Reformer Pilates: An exercise physiologists perspective
The story of how Pilates came to be is a fascinating one. Created by Joseph Pilates in 1926 upon opening the first Pilates studio on Broadway, New York City, which largely attracted dancers and performers wanting to strengthen, improve technique, or rehabilitate their bodies for their careers. However, he did not call his method Pilates, instead it was called Contrology and his studio was referred to as a “body conditioning gym”.
The name Contrology, while not easy to say, is a good representation of what the Pilates Method entails. With the principles of Pilates being breath, concentration, centring, control, precision and flow, Pilates focuses on strength, stability, precision and control of both the core and joints.
Throughout the course of his career, Joseph Pilates developed a large repertoire of mat exercises as well as a variety of pieces of equipment including the reformer, trapeze table, Wunda chair, spine corrector and more. This equipment has largely remained unchanged in design over the years with today's studios representing the studio Joseph and his wife Clara owned in New York.
While the equipment itself has not drastically changed, it could be argued that the use of it has.
As in any industry, people take things and change them to keep up with evidenced based practice, or to stand out against the competition and generate a buzz or “fitness craze”.
Pilates has not been immune to this with examples of this at each end of the spectrum being Clinical Pilates and Group reformer Pilates respectively.
In this blog post I’ll cover:
1. What is clinical Pilates?
Clinical Pilates is the use of Pilates to treat and manage clinical musculoskeletal, neurological and other conditions. It can incorporate a combination of matwork exercises and equipment exercises and is delivered by health professionals such as exercise physiologists, physiotherapists or clinically trained Diploma qualified Pilates instructors.
As it became popular particularly with physiotherapists as a mode of treatment, scientific research has been conducted as to the effectiveness of Pilates in doing what it says it does, or as a method in particular conditions such as low back pain and pregnancy.
Like physiotherapists, exercise physiologists are university qualified Allied Health Professionals in Australia who use movement and exercise to treat and manage clinical conditions. We are therefore incredibly well placed to deliver Clinical Pilates services, when also having an appropriate Pilates qualification.
It is highly individualised with participants required to complete a comprehensive pre-pilates assessment to ensure Pilates is both suitable for the person and the correct exercises and equipment settings are prescribed. Sessions can be either one to one or group, with the group sizes 4 or less to allow for a high level of supervision and individualised programming.
The individualised nature of clinical Pilates and the versatility of the equipment, also makes it suitable for all levels from rehabilitation to elite athletes due to its focus on injury prevention, postural correction, and recovery inherent in the practice itself.
Clinical Pilates studios predominantly feature a variety of the Pilates equipment, however with the explosion of reformer Pilates it is not uncommon to see clinical Pilates classes using only Pilates Reformers.
2. What is reformer Pilates?
In contrast to Clinical Pilates, reformer Pilates is a group fitness class using medium to large numbers of reformer Pilates machines.
The class is usually delivered by a fitness instructor with a Pilates qualification and is often more upbeat than a clinical Pilates class with the incorporation of music and choreography involved in the class delivery.
While it is a group class, a good instructor will be able to provide different levels and equipment settings for different bodies and fitness levels.
It is popular predominantly with women seeking a lower intensity way to exercise, or those who want to incorporate a form of exercise focusing more on core and joint stability in their weekly workout schedule.
3. Key differences between clinical Pilates vs reformer Pilates
There are several key differences between the two forms of Pilates. These include:
A focus on rehabilitation: Clinical Pilates addresses specific conditions including musculoskeletal injuries or pelvic floor dysfunction in either a rehabilitative or rehabilitative nature, whereas Reformer Pilates focuses on overall strength, stability and flexibility.
Individualisation: Clinical Pilates is highly individualised, whereas Reformer Pilates is a group class where everyone performs the same routine.
Equipment: Clinical Pilates incorporates a variety of equipment, props and exercises, while Reformer Pilates is solely delivered on the reformer machine.
Supervision and expertise: Clinical Pilates is often supervised by a qualified exercise physiologist, or other health professional, ensuring safe and correct execution of the exercises, while Reformer Pilates is taught in group fitness classes
4. Benefits of clinical Pilates in musculoskeletal rehabilitation
Pilates is a form of exercise where precision and control is very important, therefore the combination of individualised exercise prescription and close supervision is a strong benefit of clinical Pilates.
And, due to being provided by clinically trained health professionals with a thorough understanding of clinical conditions, you can be sure you’re in good hands and that you’re benefiting from the sessions you’re doing.
Specific circumstances and clinical conditions that can benefit from Clinical Pilates vs reformer Pilates include:
Pelvic health: Clinical Pilates can benefit people with pelvic pain, pelvic floor dysfunction or who are pre and post gynaecological surgery.
Pregnancy & postpartum: A low impact way to exercise that can help you manage pain and discomfort, prepare for birth, and recover postpartum.
Chronic or persistent pain: improving strength, stability and muscle activation patterns through clinical Pilates can help treat lower back pain, neck pain, and other musculoskeletal conditions
Managing conditions such as fibromyalgia, osteoarthritis, rheumatoid arthritis and hypermobility
Injury rehabilitation and prevention.
Pre and post surgery.
5. Benefits of Reformer Pilates
With reformer Pilates becoming hugely popular in the last 5 years, studios have popped up everywhere and can range from 24 hour studios with classes delivered on a screen, to high intensity athletic style classes, to slower classes focusing on recovery and flexibility.
Reformer Pilates can be great for:
Those seeking a lower impact form of exercise
People who don’t like gyms or traditional strength training
People who like a group class atmosphere and sense of community
People who have general fitness goals
People who enjoy the challenge of a full body approach to movement
6. Which is right for you - clinical Pilates vs reformer Pilates
Whether clinical Pilates or reformer Pilates is right for you will depend on your circumstances and preferences.
If you have any injuries, pain, niggles, stiffness, pelvic floor dysfunction or clinical conditions to take into consideration then clinical Pilates is the best place to start as you can be confident that the instructor is providing safe, effective and individualised exercises based on your circumstances.
I would also encourage total beginners to begin their Pilates practice in a clinical setting as you will learn the Pilates principles, how to use and set up the equipment and receive instruction as to whether or not you are doing the exercises correctly. You will also receive an initial assessment which can be great for knowing areas you need to work on and which exercises will suit your body.
On the other hand, if you are already fit and strong with no injury or health concerns then a reformer class might be the right choice to provide balance in your weekly exercise routine. The upbeat and fun nature of group classes as well as the camaraderie can be a motivator in itself to attend classes and participate in regular exercise.
But just remember, too much of a good thing is not a good thing. I would not recommend doing reformer classes every day unless there is a variety in the purpose of each class from strength, to mobility to recovery. This is not easy to achieve well however as the reformers, while very versatile, do have limitations and are not as effective as other forms of exercise to achieve goals such as muscle growth and strength.
Another thing to remember when deciding between clinical and reformer Pilates is that just because Pilates is considered to be gentle and low impact, does not mean it is safe and appropriate for everyone. Certain conditions such as osteoporosis may benefit from a more loaded form of exercise and may also be considered a higher risk for some Pilates exercises particularly those involving spinal flexion as compression fractures can occur.
If you’re wanting to know if Pilates is right for you, or you’re ready to jump in and try clinical Pilates then come and see me in my exercise physiology and clinical Pilates clinic Ebb & Flow Exercise Physiology, Toowoomba.
Conclusion:
Choosing between clinical and reformer Pilates will depend on your circumstances and preferences.
It also does not have to be one or the other as a balance of the two can also be effective in helping you reach your goals. Clinical Pilates can help you understand the principles of Pilates and the safe use of the equipment which will in turn make your reformer class sessions more effective, safe and even challenging.
Where to next:
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Read more about my clinical Pilates Toowoomba services
Disclaimer: The information provided in this blog is intended for educational purposes only and is not a substitute for professional medical advice. Always consult with a qualified healthcare professional before starting any exercise or health program. By using this content, you agree that EBB & FLOW EXERCISE PHYSIOLOGY is not responsible for any injuries or health issues that may arise from your use of the exercises or advice provided.