When Pilates is Dangerous 

By Jonathan Oldham, MSPT

Pilates is geared to the needs of the individual. I was reminded of this at the Ron Fletcher Pilates Conference in May. I attended a workshop presented by Sherri Betz, PT, and entitled Fletcher Pilates for Osteoporosis. I was more convinced than ever that a "traditional" approach to Pilates is not for everyone. Traditional Pilates is a formulaic presentation of the Pilates work in which a series of exercises are performed in a specific order. Although this approach is helpful for a new teacher to organize their teaching, and is usually safe for someone with no physical issues, Mr. Pilates probably would not have taught this way. Joseph Pilates would have taught to the individual in front of him.

Traditional mat work emphasizes rounding the back, but for anyone with fragile bones (diagnosed with osteopenia or osteoporosis), this movement is contraindicated, and may be downright dangerous. However, individuals can continue a rigorous Pilates practice without being in danger of spinal fractures.

By Scott Swann, MPT, OCS

Since we started using MRI routinely to help treat back problems in 1994, success in treatment actually decreased. How can that be? For most orthopedic pathologies, the MRI (magnetic resonance imaging) is the diagnostic tool for physicians to determine the existence and severity of a problem. It is a non-invasive medical test that can help doctors diagnose and therefore know how to treat a variety of medical conditions. It can detect problems that traditional x-rays and CT scans cannot by providing images of soft tissue structures like discs and cartilage. So why then are we having less, not more success in treating back problems?

The reason success in treating back pain has gone down is because we see pathology on the scan and feel eager to fix it. And though the surgery takes care of what looks offensive, it often does not solve the core problem, or it creates another set of problems.