Through the BASI Principles of Pilates, the physical pursuit becomes a mind-body conditioning, not just a physical process. This is the space and place in which healing, rehabilitation and re-education are realised as any pain inhibits normal and functional movement patterns.
Pilates is a great form of exercise to assist with rehabilitation for many reasons. There is an emphasis on breathing which gets rid of any unnecessary toxins from the body while oxygenating the body’s circulation, calming the body and mind, encouraging concentration and targeting specific muscles while addressing the whole body. There is a focus on the “powerhouse” which can be defined by BASI Pilates as “the strength of the muscles that support the pelvic-lumbar region, and the ability for them to work synergistically, in an integrated and efficient way”. Pilates gives the body a strong foundation in both stability and mobility while making the individual functionally strong for their lifestyle and needs.
As a Pilates Instructor, each of my clients’ needs and desires differ drastically. This is evident in both mind and body. One of my favourite groups of people to work with is athletes, and with this, one of the most common injury I come across is Iliotibial Brand Syndrome, mostly referred to as ITB. It is especially seen in runners, walkers, hikers, and cyclists.
ITB is one of the leading causes of side knee pain which can be described as having symptoms such as a stinging sensation, swelling, or a thickening of the tissue where the band moves over the femur. The IT Band is a superficial thickening of tissue on the outside of the thigh, going from the outside of the pelvis, over the hip and knee and inserting just below the knee. Lateral knee pain is even more evident when excessively increasing distance or load with poor biomechanics and muscular imbalances in the body. When there is a lack of stabilisation of the knee during repetitive extension and flexion it causes rubbing of the band over the lateral femoral condyle which inevitably causes inflammation.
There are many biomechanical reasons causing ITB, as well as external factors that can contribute too. This includes running on a banked surface, an inadequate warm-up and cool down, cycling with a toed-in position, increasing training load too quickly, excessive downhill training, running up and downstairs, hiking long distances, high or low arches, overpronation of the foot, and weak hip abductor muscles. It is also common during pregnancy as the connective tissues loosen and the mother gains weight.
When experiencing ITB a couple of precautions can be included such as avoiding jumping and high impact activities, rest and recover more, and pulling back on speed and distance. Going for massage and or foam rolling massage can loosen the muscles, however, with this, strengthening all muscles supporting the knee also needs to be included. These muscles include mostly frontal plane muscles - hip adductors and abductors. Dynamic stretching before exercising and static stretching after exercise should specifically include the hamstrings, calves, and quads. Promoting good tracking of the feet, knees and hips and knee stabilisation which initially focuses only on closed chain exercises (distal segment, the hand or foot, is fixed and cannot move) should be included weekly. As the client gets stronger so more variety can be considered while continuing to address the body in its entirety. Examples in the BASI Pilates Mat work could include: pelvic curl/shoulder bridge prep/shoulder bridge (strengthening and teaching control of abdominal/hamstrings), leg pullback (shoulder and hip extensor strength with trunk stabilisation), side lifts (lateral flexor strength and trunk stabilisation), sidekick (abdominal/back extensor strength and stabilisation and hip extensor and flexor control and stretch), side-lying gluteal series (gluteus strength and endurance), saw (hamstring stretch and strength), single-leg kick/double leg kick/swimming (hamstrings strength and upper back strength, co-ordination-cross patterning), rollover (abdominal strength, lower back stretch, hamstring stretch).
With retraining and reeducating the muscles, as well as a well trained mind-body connection, and a greater sense of awareness one has a greater ability to correct movement patterns and decrease recurrences. Thus allowing for success, healing and pain-free functional movement.