Pilates and Osteoporosis: Moving safely and Confidently
Pilates, developed by Joseph Pilates to help prisoners of war recover from injuries, is a form of exercise that focuses on building strength, flexibility and body awareness through controlled movements. He was influenced by a variety of exercise forms such as martial arts and yoga, and devised a spring mechanism attached to beds, allowing exercises to be performed while bed-bound. This was the beginning of the development of the equipment you see today in Pilates studios.
In the 1920’s the dance community was the early adopter of Joseph Pilates approach to exercise. Over the years, Pilates has grown in popularity with mat classes being offered in studios, gyms and online. A growing number of studios also offer classes with some Pilates equipment such as the reformer and the cadillac. Pilates based exercises can be incorporated into many physiotherapy treatment plans.
Pilates has become particularly popular with mid-life women. This period of life has its own unique challenges with physical and hormonal changes leading to changes in muscle mass, balance, flexibility and an increased risk of decreased bone density or osteoporosis. During these peri-menopause and post-menopausal years, life can be very busy with work and family demands. Many women experience fatigue and find it challenging to allocate time for exercise. They are looking for exercise that feels sustainable, strengthening, restorative, and of course, enjoyable. Pilates fits the bill for many women.
Benefits of Pilates and Considerations for Bone Health
What Pilates Can Help With...
- Core and hip strength: While there are exercises within the Pilates repertoire that address upper body strength, most of the exercises focus on core and hip strength.
- Posture and Spinal Health: With a focus on core/trunk strength along with mobility of the spine, Pilates improves posture which has a positive impact on spinal health.
- Balance and Fall Prevention: Pilates trains coordination, proprioception, and control of movement which are important factors in reducing fall risk and improving confidence in movement.
- Joint Friendly and Adaptable: Pilates is low impact and its poses are easily modifiable, making it easily adaptable across all fitness levels, ages, and injury recovery.
- Mind- body connection and Stress Relief: The breath is an integral part of Pilates coupled with the mindful nature of moving through the poses. This focus of mindful movement and breath help to calm the nervous system and helps to alleviate stress.
What Pilates Can’t Do….
While Pilates is a great form of exercise and has a lot to offer, it can’t do everything.
- Pilates is not a cardio workout - it cannot replace aerobic exercise such as walking, cycling, swimming, dancing, or running. We still need that 150 minutes of moderate to vigorous activity each week for our heart health.
- Pilates alone will not build bone density. It cannot replace the benefits of progressive resistance training with external resistance to build muscle mass and improve bone health.
For many who are not doing any strength training at all, Pilates can be a great place to start. Pilates, unfortunately, does not provide the same progressive load that resistance training does. At some point, the addition of resistance training for the bigger muscle groups to your fitness routine will be beneficial. It doesn’t mean you have to abandon your Pilates classes as they still provide a great challenge for trunk and postural strengthening.
Special Considerations: Pilates and Osteoporosis
When living with Osteoporosis, consideration of the stress and load on the thoracic spine is important to decrease the risk of a vertebral compression fracture. This is another reason why working on postural strengthening, particularly back extensor strength is so important.
It is equally important to limit flexion of the spine (forward fold or rounding of the spine) and rotation of the spine, particularly when combined with flexion.
If you have already been exposed to Pilates, you will realize that there are many exercises that involve flexion and/or twisting of the spine. Luckily most of these poses are easily modified to make them safe for someone living with Osteoporosis.
Safe Pilates Practice for Bone Health
- Emphasize neutral spine alignment
- Focus on controlled and mindful movements
Exercises to avoid
- Deep forward bends (roll ups, roll downs, spine stretch forward)
- Full twisting or rolling exercises (rolling like a ball, spinal twists, the saw, open leg rocker, corkscrew, jackknife, teaser, seal)
Exercises that can be modified
- Hundreds
- Single and double leg stretch
While it feels like there are a lot of exercises to eliminate or modify, there are still a lot of exercises in the Pilates repertoire that can be included!
Exercises to focus on
- Breast stroke preps and Breast stroke
- Swimming
- Single leg circles
- Side leg lift series
- Leg pull front
- Push ups
- Single and double leg kicks
- Swan
And then there are lots of variations on the classical Pilates exercises that add variety and challenge to any Pilates program designed for someone managing osteoporosis.
How Fit for Life Physiotherapy can Support You
Fit for Life Physiotherapy has Bone Fit (™) Trained Physiotherapists and Kinesiologists who can help design an exercise program that is safe for you if you are living with Osteoporosis. Miriam Mulkewich, Registered Physiotherapist is also trained in Pilates and has been incorporating Pilates into her treatment plans for over 20 years.
One on one Pilates - based exercises can help you:
- Rebuild strength and improve posture safely
- Manage osteoporosis safely through movement
- Transition confidently into a studio class or home program.
If you are dealing with an injury or learning to live with Osteoporosis our team can help you feel confident in your body again.
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Miriam Mulkewich is a registered Physiotherapist and co-owner of Fit For Life Physioterapy. In addition to her training as a Physiotherapist, Miriam is a Pilates and Yoga instructor and avid runner! Miriam is passionate about helping women thrive through the menopause transition, helping them feel their best so they can do the things they love. |