Chronic pain is a complex issue. Our current models of pain tell us that chronic pain is a matrix that involves physical injury, the nervous system, psychological responses, and mental attitudes that all contribute to the perpetuation of pain.
One of the key contributors to the development of chronic pain is kinesiophobia, or the fear of movement. It’s very common for a person to experience some type of injury or painful event, and then develop a fear that activity or movement might result in more injury. This psychological response to trauma actually makes it more difficult to get out of pain, as movement is a key part of restoring mobility to the body and restoring the normal neuromuscular function.
It is believed that Pilates and other movement therapies are useful for chronic pain because they work to counteract the cycle of pain that results from kinesiophobia. Because Pilates is based on careful, controlled, and balanced movement, it’s the perfect way to gently show chronic pain patients that movement is safe and actually helps recovery from pain.
This theory was put to the test in a recent study conducted by two English researchers. In this new study, the authors looked at 22 patients with chronic pain (15 women and 7 men) who had been participating in Pilates classes. Twelve of the patients had been doing Pilates for 12 weeks; seven of the patients had 12 months of Pilates training. This study was qualitative, meaning that the objectives were to study and analyze patient responses and subjective experiences reported by the patients. All of the patients took part in a focus group where there experiences were discussed and recorded.
During the focus group discussion, the authors identified five specific categories of improvements that the patients experienced from Pilates:
Anyone who does Pilates knows the physical benefits of the practice, and this was reflected by the patients in the study:
“The majority of participants agreed that their core strength had increased, both in performing the Pilates exercises and also in the carryover effects to function in everyday life. Many participants felt that a loss of strength was an inevitable part of ageing or was the result of their condition, and were surprised at how much the Pilates had “turned the clock back”. Many felt that they were still improving, even after several months of exercise, despite the advancement of age, and this motivated them to continue to attend the exercise classes.”
The patients reported that the improvements in core strength and stamina that they enjoyed from Pilates resulted in improved performance at work, better posture, and increased levels of sport and recreational activities.
“The majority of participants said that they enjoyed a feeling of well-being both during and after the classes, and the relief of tension and stress was as real as the physical effects. The consensus was that focusing on exercises stopped them from focusing on other worries…”
Many of the patients reported that the structured and tailored exercises they learned in Pilates enabled them to better manage their pain condition on their own. Patients also were likely to do daily Pilates at home as a way to lessen pain.
“All participants agreed that to maintain benefits they had to continue with either group exercises or a home programme of exercises. The main motivator for all participants was the exercise class with instruction, as they said that they were unlikely to set aside a full hour for themselves to exercise independently. They enjoyed the protected time of the class being on the same day, at the same time, every week, and it was part of their routine. If they were unable to make the class, they were able to swap onto a different class within the same clinic depending on their ability. The primary motivation to continue to do Pilates was the actual physical benefits, along with the links to an active lifestyle, mental wellbeing and reduced pain. There was agreement with all participants that when they did not attend for a week or so, they felt the stiffness and symptoms returning, and this motivated them to continue.”
As this and other recent studies show, Pilates not only has physical benefits, it also confers other benefits that help patients recover from pain in a holistic way. Since chronic pain is a psychological and social issue as much as a neurological one, the fact that Pilates is shown to help with those issues is an important one.
Gaskell L, Williams AE. A qualitative study of the experiences and perceptions of adults with chronic musculoskeletal conditions following a 12-week Pilates exercise programme. Musculoskeletal Care. 2018 Nov 6. doi: 10.1002/msc.1365. [Epub ahead of print] PubMed PMID: 30402992.