Clinical vs Traditional Pilates … What is the Difference?

What is Pilates?

Pilates is a form of exercise that utilises a person’s body weight or the resistance of equipment. It combines movement and breath control to improve strength and flexibility. Pilates has become a popular form of exercise over the last decade. You will find classes at most gyms, community centres and physiotherapy clinics.

Where did it start?

Joseph Pilates, who was born in 1880, is the father of Pilates. Joseph worked as a nurse during WWI. He started giving the men who weren’t strong enough to get out of bed exercises to do. He would attach springs and pulleys to their hospital beds. He began to find that this resistance-based training improved both their strength and function. Joseph later went on to open a studio in New York. He began teaching his method of exercise to professional ballerinas and stage performers. This type of exercise is now known as Pilates.

What is the difference between traditional and clinical Pilates?

Most gyms run traditional Pilates classes. Everyone attending the class is given the same things to do. This is because the focus is on exercise rather than a specific purpose.

At Physiotas the Pilates we offer has a clinical focus. This means those attending our individual or group sessions are there for a reason. Often it is to help heal an injury. Sometimes it is to help manage pain. Other times it might be to improve their performance in a specific sport.

Clinical Pilates is a patient-specific treatment method. This means we take into account your problem and goals when giving you specific Pilates exercises to do.

For example you might have what we call a movement bias. This means your pain might be better or worse with certain movements. You might find that your pain increases when you sit, but eases off when you stand. Or you might be able to ride a bike without pain, but can’t swim because it increases your symptoms. We take this information on board so we don’t give you exercises that will make you worse. Instead we give you exercises that help ease the pain.

Something else we consider is whether you have a left or right-sided bias. Or what we call a ‘problem side’. Some people find all their injuries occur on the same side of the body. This could be due to weakness or tightness on one side of the body. If this is the case we prescribe Pilates exercises to help balance things out again.

Does Clinical Pilates focus on the breath?

As long as you are breathing we are happy. Keep it simple. Don’t think too hard and your body will find the best pattern of breathing for the exercise you are doing.

Does Clinical Pilates focus on stretching?

Stretching can relieve some people’s pain and symptoms. Other people seem to get stiffer the more they stretch.

Remember those super flexible, “double jointed” kids at school? The ones that could bend their thumbs back, touch their toes or do the splits. It’s likely these kids had hyper mobility joint syndrome. People like this often find the more they stretch the stiffer their muscles feel. They are the ones that say they feel more flexible after doing nothing while away on holiday.

When a muscle is stretched the nerves are also put on stretch. If a muscle and its nerve are continually pushed to the end of their range two things can happen. The muscle will tear or the nerve will react to protect tissue damage in the muscles or ligaments. In hyper mobile people it is normally the later that occurs. The nerve reacts to protect the tissues from damage. It reacts by causing the muscle tone to increase, resulting in stiff and tight muscles.

On the other hand people with stiffer joints and who are less flexible benefit from stretching. Their nerves and muscles never reach the end of their range. This means there’s no need for the nerves to protect the tissue. For these people stretching can help with flexibility and function. This is another way Clinical Pilates can be more beneficial than traditional Pilates, as the exercises are more specific to the person’s needs.

There can be many symptoms, other than pain, that people experience after an injury. These symptoms include dizziness, nausea, feeling faint, headaches, fatigue, stomach churning and feelings of a racing heart. The list goes on. Often there’s a medical reason for these symptoms. In the absence of a medical reason however these symptoms can simply be due to poor communication throughout the nervous system. You can think of this poor communication like a bad phone signal. If messages aren’t getting through it leads to an imbalance between your body’s sympathetic nervous system (the fight or flight response) and your parasympthetic nervous system (rest and digest). Research has found that this imbalance is most common in the hyper mobile population. Clinical Pilates can also help rebalance these systems through specific exercises.

How we can help?

If you struggle with recurrent injuries, unexplained symptoms or just want to improve your sports performance then please feel free to get in touch with one of our Clincal Pilates instructors at Physiotas.

About the Author:

Monique Clark is a Physiotherapist at Physiotas in Launceston.


Monique located from Launceston to study Physiotherapy at the University of South Australia.  Following this she worked at the Launceston General Hospital, gaining experience in rehabilitation and post-operative physiotherapy. Monique is interested in a wide range of musculoskeletal areas of physiotherapy, including sports injuries, paediatrics and Pilates.  Outside of work Monique has a keen interest in fitness, taking part in local fun runs, triathlons, rowing and surfing in her spare time.