Pilates: A New Referral Consideration?

Kathleen Satterfield DPM FACFAOM

Lately, I have heard about Pilates quite a bit and have noticed that it is even drawing attention on the National Institute of Health’s PubMed with several dozen references within the past couple of years.

It has gone from being an unusual offering at strip malls to being featured in leading medical journals. This is quite a leap in a very short period of time. That march forward is being led by some of the leaders in our own profession. One of those at the forefront is Sheryl Strich, DPM, who is the President of the American Association for Women Podiatrists.

She moved from a southern California podiatric practice to a path toward certification in Pilates. Dr. Strich plans to concentrate on the elderly population. In addition, she plans to further specialize by combining Pilates and podiatric techniques.

“I am very concerned about how people lose their fluid gait as they age,” says Dr. Strich. “I feel it is because they have been walking incorrectly over the years. However, this can be improved through Pilates and orthotics. My plan is to combine the teachings of Pilates with podiatric biomechanical examinations and dispensing of orthotics.

“By combining gait and postural analysis with Pilates exercises (to help) prevent injury and encourage a healthy lifestyle, I feel the aging generation will definitely benefit.”

Dr. Strich says Pilates can be practiced by a variety of people ranging from young athletes to the elderly. She emphasizes that the practice of postural awareness, centering, concentration, control, precision and breathing inherent to Pilates can enhance movement and flexibility.

“With increased flexibility and strength, the result is a better quality of life,” explains Dr. Strich.

We are all going into old age, raging against the system, not wanting the predictable arthritic outcomes that our parents faced. Dr. Strich feels the same way about her clients.

“Pilates is very important for the baby boomer generation. As people age, joint movement decreases. With people living longer, there is a real need to maintain flexibility and movement. This makes a real difference in terms of quality of life.

“Pilates is a system of physical and mental conditioning developed by Joseph Pilates,” explains Dr. Strich about the man who developed the system, which was originally designed to rehabilitate ballet dancers. “He felt that achieving good health meant that the whole being – body, mind and spirit – needed to be addressed. Exercises are designed to condition the entire body.

In addition to the benefits of improved strength and flexibility, Dr. Strich says Pilates can facilitate relief of back and joint pain, a sleeker look, improvements in energy, endurance and sexual enjoyment, prevention of osteoporosis, and enhanced sleep.

Dr. Strich lives the life that she preaches. She is tall, lithe and graceful. She also advises her friends on poor posture and its outcomes, and offers gentle correction.

Pilates may indeed prove to be a natural outgrowth of podiatric medicine and a treatment that will prove beneficial for our aging patients.

Comments

Hi,

At last a fellow podiatrist who is interested in pilates and it's over all affect on the body especially in the support of the lower limb. I'd really be interested to hear how you are finding the biomechanics mixed with pilates, I've bored several colleagues with my belief that pilates can help with lower limb issues but so far not found any evidence. May be you can send me further information? estuartpodiatry@gmail.com

Kind regards
Emily

Emily,
Pilates is about strengthening and stretching. It strengthens and tones muscles, improves postures,and encourages flexibility.

With that in mind, the following is a description of the ideal body position when the knees are flexed in gait
Lumbar spine - hyperextended
Sacrum - nutated
Iscial tuberosities - widen
Gluteus Maximus (inferior fibers) lengthen
External rotators - shorten to stabilize sacrum
Rectus Abdominis - lengthens (vertically)
Femur (at the knee) - externally rotates
Hamstrings - shorten
Tibia (at the knee) internally rotates - gastrocnemius lengthens
Ankle - dorsiflexed
Talo Navicular - Anterior tibial shortens - stopping the complete collapse of the medial arch
Talo Calcaneus - Posterior tibial lengthens - allowing the heel to reach for the floor
Plantar fascia - stretches
Intrinsics - lengthen

Knee extension is the reverse of the above.

By maintaining correct body posture, stengthening and stretching and using the correct muscles for the appropriate actions, Pilates works to allow the above actions to occur properly. There are so many moving parts to the action of flexing the knee, that if one action is off, it will create a chain effect of deformity.

-Kathleen Satterfield DPM

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