What is Clinical Pilates?
Clinical Pilates is a modification of Pilates adapted by a physiotherapist to be specific to the individuals attending. This may be in a class setting or on a 1:1 basis. Clinical Pilates is based on Joseph Pilates’ original method of exercises set in a treatment or class session tailored to the client population or individual. The exercises can therefore be modified as necessary to accommodate for any underlying pre-existing health conditions or injuries.
Many individuals can benefit from Clinical Pilates. This includes individuals with little or no previous knowledge of Pilates or exercise. It is suitable for individuals of all ages. The physiotherapist leading the class would usually meet with the individual prior to their first session to introduce them to the main principles of Pilates (5 key elements, including breathing, centering, rib cage placement, shoulder blade placement, and head and neck alignment). One of the main benefits of attending Clinical Pilates is having the reassurance of the physiotherapist instructing and observing the individual’s participation. This allows for any adjustment in the exercise technique and altering the exercises to the most suitable level for each person, whether advancing the exercises to make them more challenging or simplifying them to allow for pain-free participation throughout. Class sizes in Clinical Pilates are usually much smaller than other Pilates classes, allowing for enhanced observation and feedback during the class.

Benefits of Clinical Pilates
The benefits of Clinical Pilates are superior to regular Pilates for a number of reasons.
The role of physiotherapy in Pilates is exceptionally beneficial to those participating in the classes. Having the reassurance of the physiotherapist’s knowledge base leading the class is of great benefit for the understanding of each of the participants. Whether attending for general fitness or related to an underlying medical condition, Clinical Pilates is by far one of the best ways to exercise in a safe and relaxed environment.
The physiotherapist will have a good knowledge of underlying health conditions and be therefore able to adapt the Pilates exercises to a suitable level for both being safe and challenging, as appropriate. They are able to plan their classes to accommodate individuals requiring any adaptations, and similarly should be able to adjust the exercises reactively should this be necessary during a class setting.
The physiotherapist will take a medical history before participation in the class to obtain any relevant medical conditions or pre-existing injuries, which allows them to have a clear awareness of any issues which may be important.
Throughout the Clinical Pilates classes the physiotherapist will give options to progress the exercises according to the ability of the participants. Similarly, if there are participants with underlying health issues who need exercises more tailored to their condition (eg Osteoporosis, or previous joint replacements, or ante/postnatally), they will be advised to perform them in a certain way. This allows for confidence within the class setting, to ensure that the exercises are performed at a safe level.
By becoming a regular participant in Clinical Pilates, you can have the confidence that you are gaining benefits from improvements in strength and flexibility. This allows you to improve injury prevention and enhanced rehabilitation.
Classic Pilates v Clinical Pilates: what sets them apart?
Who was Joseph Pilates?
Joseph Pilates was born in Germany in 1883. As a child, he suffered many illnesses and was a sickly child. He had asthma, rheumatic fever and rickets. Due to this, he spent a lot of his life improving his physical fitness. His father, who was a keen gymnast introduced him to gymnastics, martial arts and boxing. He believed that bad postures and poor breathing patterns were prerequisite to poor health. This led him to devise a programme of exercises and training regimes to enhance people’s fitness and well-being.
During the 1st World War, Joseph Pilates was interned and moved to England in 1912. At this time, he developed resistance training exercises for bedridden patients from bedsprings and bedsteads. This demonstrated the benefits of resistance training. Following on from this he returned to Germany and developed his own training system after learning from other movement experts and dancers. Later he went to the USA, where he met his wife Clara. Together they opened the first Pilates studio in Manhatton. After Joseph Pilates death in 1967, Clara continued to run the studio.
The main principles of classic Pilates work through a sequence of exercises designed to move the body through a full range of movement. Additionally, classical Pilates focuses on mindful practice and uses breathing exercises to aid stress and anxiety. This is incorporated into the exercises to make them free flowing and progressive.
The classic Pilates exercises are based on the idea of maintaining a stable ‘core’ at the centre of your body and using the length of your limbs – extending away from the centre of your body to provide longer levers. This advances the exercises to make them more challenging for control. Once gaining better control with the longer levers, resistance may be added to challenge the body further. This could be in the form of small hand weights or resisted bands.
Clinical Pilates differs from Classic Pilates as the classes are led by Pilates trained Physiotherapists, whereas classic Pilates will be led by a Pilates instructor. This allows the Clinical Pilates setting to provide an environment for the class participant to attend with the reassurance that the instructor has a clear knowledge of their health and any associated injuries or issues that might affect their ability to undertake any of the exercises. The clinical Pilates instructor will be able to adjust any exercises where necessary to enable the participants to undertake the exercises at a suitable level. They will then be able to progress the levels of the exercises to make them challenging enough while ensuring that the technique is maintained. It is important that the individuals participate at their own level and ability for them to gain the most from the classes they attend. This enables a variety of participants to participate in the same class but at their own level according to their ability. Equally, it is essential that the exercises are not progressed too quickly as good control is essential for maximum benefit.

Differences between Classic Pilates and Clinical Pilates
Clinical Pilates classes tend to be smaller in terms of the number of participants attending compared to Classic Pilates classes. They are largely run by physiotherapists who have trained to become Pilates teachers, therefore the participants have the reassurance of the knowledge of the physiotherapist. The exercises can be adapted to suit any issues, current injuries or underlying medical conditions.
Classic Pilates tend to follow a more structured approach to their classes whereas Clinical Pilates may be able to offer a more flexible approach according to the participant’s requirements.
Within Clinical Pilates, there is a variety of small equipment that is often used. Commonly used equipment including:
Pilates small ball – a football sized inflatable ball that can be included for many exercises to either make the centre of balance less stable underneath the pelvis, or can be squeezed between the knees for additional control.
Magic circle – resisted circle which can be used for squeezing or pushing against – either with hands or legs.
Resisted band – can be used for either assisting exercises or resisting against
Small hand weights – for strengthening.
Other items include foam roller, spikey massage balls and balance pads.
How to choose between classic and clinical Pilates? – it depends on what you are looking for, however many individuals are attracted to the clinical Pilates setting as the classes are usually smaller and the instructors are fully trained physiotherapists who have the ability to alter the exercises with experience and confidence.
1 to1 Pilates
We also offer 1 to 1 Clinical Pilates which provides many benefits as the sessions are designed specifically for the individual participant. This is a great way to start your Pilates journey, learning about the 5 key elements and achieving a grounding of the principles of Pilates. The exercises are tailored to the individual depending upon their ability and taking into account any underlying injuries or health issues. This is especially useful prior to attending a class setting either as an introduction to Pilates as a beginner, returning to Pilates after a break or injury, or if you prefer a more specialised clinical Pilates class.