By Edward J. Yuiska, PT
http://www.physicaltherapyandwellness.com

As the consumer seeks to improve their physical well being, reduce their "aches and pain", and approve their overall health, they increasingly turn to non-health care individuals for answers to their problems while healthcare practitioners struggle to educate the consumer to seek their services.

Physical Therapists and healthcare practitioners need expand their practices with wellness programs by providing Functional Conditioning Exercises. More individuals are seeking wellness programs that improve endurance, reduce stress and help one to look and feel better and to improve their efficiency playing a recreational sport, golf or tennis. Healthcare practitioners should consider offering the program to former patients and to employees from companies referring their workers compensation patients, members from specialty organizations (American Heart Association, Diabetes Association, and Osteoporosis Association) and the consumer directly.

Functional conditioning exercises are performed to enable an individual to function more efficiently with activities pertaining to daily living, work, recreational or competitive sports based on each individuals fitness level. To create specialized exercises, it is necessary to have an assessment of the skill or activity and the condition of the individual. After the assessment, a functional conditioning program can be developed to obtain the goals of the individual.

The key to improving ones' functional condition is through proper core conditioning to develop trunk strength initially. This approach to core control supports the theory of movement advocated by Pilates-evolved practitioners. Just as a tree needs a strong trunk to survive so the branches can grow long and strong and survive wind and rain storms, humans are the same, requiring a strong trunk to make it easier to perform functional tasks whether pertaining to work, recreation or home living.

People are beginning to realize how ineffective the exercises of the 1990s were, the old exercise regimes have failed us as they are based on isolating muscles and working each area of the body individually rather than treating the body as the integrated whole. We now realize exercise should be an important part of our lives, it should add and not take away our enjoyment of a full life. The poor physical condition many of us are in today is the result of the engaging in complicated, inefficient exercises that isolate certain body parts while neglecting others.

If the goal in exercising is to balance our bodies, improve circulation, reduce stress, improve endurance, look better and feel great, we should utilize the one method that has proven its ability to achieve all these things. The Pilates Exercise Method is a unique system of stretching and strengthening exercises developed over 90 years ago by Joseph H. Pilates. The exercises strengthen and tone muscles, improve posture, provide flexibility and balance.

Pilates was developed to create a healthy body, a healthy mind, and a healthy life. It was Pilates' belief that core control was the essence of controlling human movement. Core conditioning is not thought to restrict movement of the spine, instead to facilitate controlled movement.

Without properly caring for our bodies it is impossible to feel good, most if not all of our stress and fatigue comes from poor posture, imbalances in the body and lack of proper breathing. We must first learn to properly strengthen and control our muscles before subjecting them to the rigors of daily living.

One of the biggest misconceptions in exercise is the belief that more is better. It is like doubling up on your medication to get better faster. Just because the exercise does not burn does not mean it is not working. Quality is better than quantity when it comes to improving ones physical condition.

Core strength has two basic benefits: improved exercise technique and improved economy of movement. For example, when runners have weak core muscles, their hips tilt from side to side as they run. Core strength improves technique because the limbs are better supported.

Improved strength in these posture muscles also allows more efficient movement by using fewer muscles, less oxygen and less energy. In other words, this type of strength helps exercisers achieve a higher level of endurance because the body is not fighting itself via compensatory motion.

All Pilates based exercises initiate from the muscles of the abdominals, lower back, hips and buttocks. The band of muscles that circle the body under the beltline and are termed the "Powerhouse". The sequential contraction of the muscles are essential for optimal core stabilization. If these muscles do not fire in the appropriate sequence, spinal stability does not occur. This is the shortcoming of many "core" programs. The participants most likely, do not have the body awareness or muscle tone to appropriately contract specific muscles in the correct order to accomplish stabilization.

Even minor improvements in core strength can lead to big improvements in performance and enjoyment. Take running for example: if stronger abdominal and back muscles help stabilize the pelvis, the stride length will be symmetrical and appropriate in length, resulting in increased efficiency, decreased metabolic demands and ultimately, decreased times. The same kind of results applies to other sports and especially activities of daily living whether at work or home.

There are several educational programs where healthcare practitioners can learn Pilates based exercises from mat exercises to exercise apparatus. Stott Conditioning and Polestar Education are two educational programs offering certification programs. Polestar Education, LLC is under the direction of a Physical Therapist, Brent Anderson, PT, OCS. Many of the workshop courses are directed toward rehabilitation. As the world changes, therapists need to change, we can still practice in the wellness arena as a Physical Therapist.

Providing programs to assist the consumer achieve a fuller lifestyle while improving their fitness level is a winning situation for all, including employers having healthier employees, plus employees being able to retire and enjoy their later years without spending so much time in the physicians office waiting to be treated or consoled, along with the younger future leaders of our nation enjoying their "best years".

Healthcare practitioners need to start thinking "outside of the box" on what can be accomplished to improve the lifestyle of individuals of all ages.

References:

• Anderson B, Larkin E: Polestar Education, Approach to Rehabilitation in the Pilates Environment. Miami, Polestar's Rehab Course manual for Continuing Education, 1997
• Anderson B, Spector, A: Introduction to Pilates Based Rehabilitation. Orthopedic Physical Therapy Clinics of North America. 1059-1516, 2000
• Black, Stephen: Training the Core, Fitness Management, Oct.2001
• Coleman-Brown: The Pilates Method of Body Conditioning. APTA CSM, San Antonio. 2001
• Siler, B. The Pilates Body. New York, NY. 2000
• Stott, Moira, Stott Conditioning. Toronto, Canada.