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Prescribe Pilates routines for rehab

This is an excerpt from Pilates for Hip and Knee Syndromes and Arthroplasties w/Web Resrc by Beth Kaplanek,Brett Levine & William Jaffe.

Getting Started With the Pilates Exercises

No two clients begin at the same level pre- or postoperatively when starting a Pilates routine. Each client has a varying ability to concentrate, visualize, feel the movement working from the correct source, and engage the core. Some clients may stay in the pre-Pilates stage for several weeks before being introduced to the beginner Pilates exercises with modifications for their postoperative rehabilitation. Clients with a knee or hip syndrome for which surgery is not performed also vary in ROM and flexibility without pain. Movement without pain is the key to building confidence and the desire to continue to exercise. Start slowly and build the foundation for movement and core development.

In order to give a better understanding of how to begin a Pilates routine, this section presents several examples of client profiles and suggested regimens. This information should help you to see how to begin an exercise regimen for a client with a history of a hip or knee condition. The examples presented here are merely a few of the many profiles that can be encountered. It is always advisable to take a good medical and surgical history from the client and know the client's exercise history, potential, and goals. When choosing an exercise routine for a client with a syndrome, select exercises that are modified to match the client's ability to move without pain and stay within the prescribed precautions noted earlier in this chapter and dictated by the physician's preference for the client. Here are the scenarios:

1. A client comes in to learn Pilates, has no previous Pilates exercise experience, and is 6 weeks postoperative from an arthroplasty.

• Begin with a selection of pre-Pilates exercises and stay with this system until the client demonstrates the ability to work from the correct source and engage the core.
• Start the mat exercises for 6 weeks to 3 months after surgery, progressing along an appropriate and well-tolerated time frame.
• Limit ROM based on the client's ability to engage the core musculature and protect the back.

2. A client comes in to learn Pilates, has a preoperative history of regular Pilates exercise, and is 6 weeks postoperative from an arthroplasty.

• Warm up from a selection of the pre-Pilates exercises.
• Start the mat exercises for 6 weeks to 3 months after surgery, progressing along an appropriate and well-tolerated time frame.
• Apply baseline recommendations for ROM and modifications for 6 weeks postoperative.

3. A client comes in to learn Pilates at 3 to 6 months postoperative from an arthroplasty and has no previous Pilates exercise history.

• Begin with a selection of pre-Pilates exercises and stay with this system until the client demonstrates the ability to work from the correct source and engage the core.
• Start the mat exercises for 6 weeks to 3 months postoperative.
• Limit ROM based on the client's ability to engage the core musculature and protect the back.
• Advance to the next level (3-6 months postoperative) only when the client can demonstrate correct form and core stability.

4. A client comes in to learn Pilates, has no previous Pilates exercise history, and has a hip or knee syndrome.

• Begin with a selection of pre-Pilates exercises and stay with this system until the client demonstrates the ability to work from the correct source and engage the core and move without pain.
• Start exercises in the 6 weeks to 3 months postoperative section. Use yoga blocks, pads, pillows, or towels to support the adjacent joints and help the client to move comfortably without pain.

These four clients provide only a small glimpse of the many case scenarios that you will encounter as a Pilates instructor. Initially, start with the basics and keep the routines simple. Limit the number of repetitions and work within a comfortable level at which the client can experience success with the exercises. Chapter 7 includes several case scenarios with exercise program sequences for knee and hip syndromes as well as knee and hip arthroplasty that can be used as sample programs.

More Excerpts From Pilates for Hip and Knee Syndromes and Arthroplasties w/Web Resrc

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