Joseph H. Pilates developed an exercise method over a span of 60 years. Utilizing both floor exercises, and specialized equipment which he designed, the system involves strengthening individual muscles as well as balancing muscular force at the joint level. It focuses on core control, which is activation of the deep abdominal muscles, in particular, the transversus, to achieve a stabilized torso and pelvis, while performing a wide variety of movements. In physical therapy terms, this would be comparable to dynamic stabilization.

The method also stimulates circulation through facilitating muscular flexibility, joint range of motion and proper musculoskeletal alignment. It promotes new, more healthful neuromuscular patterns and heightened body awareness, leading to a more precise coordination.

Mr Pilates was a German immigrant who arrived in 1926 with his wife, Clara, and settled in New York City. As a child, he was sickly and scrawny, suffering from asthma and rickets. His childhood health problems led to a lifetime interest in fitness and body conditioning, studying such disciplines as Yoga and meditation, and the physical fitness practices of the ancient Greeks.

Before World War I, Pilates went to England as a boxer, and was interned there during the war. While interned, he devised ways for fellow internees to begin exercise programs. He also worked with the bedridden, devising spring apparatus that could attach to the hospital bed. Success with these methods spurred him to develop the exercises and equipment which would provide the foundation of his lifework.

Contemporary practitioners of Joseph Pilates' work fall into two categories: those teaching the traditional method and those teaching Pilates-based techniques. The traditional method is essentially unchanged as devised by Joseph himself, passed on to selected students, and then to the current generation.

Pilates-based techniques are an evolution of the original work, developed in the sports medicine and dance medicine division of St. Francis Memorial Hospital in San Francisco in the mid 1980's, as well as many others. Pilates-based work has been influenced by contemporary clinical practices and scientific reformation: The Feldenkrais Method, The Alexander Technique, Laban Movement Analysis and Body-Mind Centering. Pilates equipment has also evolved in the Pilates-based work.

Both forms of the work are referred to as the method in the remainder of this chapter. The method is used for conditioning and rehabilitation. Dancers, in particular, have long revered the method for its ability to produce the long, lean look – achieving strength without bulk. Medical facilities across the US and abroad are beginning to integrate the work into their treatment protocols.

The method is used as an aid in rehabilitating a number of injury and chronic pain situations, including spine and disc pathologies. It aligns, strengthens and decompresses injured vertebrae, helping to relieve nerve and disc pressure.

Other rehabilitation scenarios include:

Those clients who are preparing for or recovering from pregnancies or surgeries - such as hip replacements or ACL reconstructions - have found the techniques effective in shortening the total length of time necessary for complete rehabilitation.

As both a rehabilitation and wellness program, the method provides a valuable complement to Physical Therapy, Chiropractic, Massage Therapy and many other therapeutic or physical fitness systems.

Sources: Pilates Center, Boulder CO; Jan Dunn, Superior CO.