top of page

What is Clinical Pilates?

Updated: Oct 9, 2023

Pilates was developed by Joseph Pilates in the early 19th Century and is considered a ‘mind-body exercise that requires core stability, strength, and flexibility, and attention to muscle control, posture, and breathing’. The method was originally called ‘Contrology’ and included the use of apparatus such as the reformer.

Variations of the Pilates method have evolved over time, including Clinical Pilates, a term widely used to describe individualised prescription of pilates by a physiotherapist. However, it is a system of pilates adapted for therapeutic use 30 years ago by Physiotherapist Craig Phillips, into a treatment program that prescribes specific exercises that match an individuals’ direction preference. Today it is referred to as Clinical Pilates MBCT - Movement Based Classification and Treatment, to exemplify the point of difference. Many Clinical Pilates services are not direction focused.

Direction preference refers to exercises that are based upon extension or flexion and may involve the left or right side. The majority of patients with clinical conditions will have a direction of motion their body responds to – the opposite can worsen the condition. Clinical pilates programmes are actually a type of physiotherapy treatment, the goal is to feel better, have less pain, move better than when they arrived – not to have a ‘workout’.

A direction preference for extension is what we call 'extension bias', for flexion it is ' flexion bias' - this is in reference to the position of the spine. It can be any part or all of the spine. In the pictures here, the example is for the lumbar spine / lower back.

How we determine bias is based on taking a thorough history of the condition, physical examination and assessing response to exercises in either flexion or extension. Response may relate to pain, flexibility, balance, posture or strength. Changes in one or all, can be rapid.

Once bias is established, we design a programme that includes exercises that are in either flexion or extension. Assessment of a side bias to left or right is often required also, and will mean that each side of the body is exercised quite differently - the aim is not to do things evenly left to right. Programmes are progressed with complexity of exercises not via increasing resistance and will move towards a more multi-directional approach if appropriate. Some clients need to remain in their biased programme always.

Under the management of a physiotherapist, Clinical Pilates is claimable with private health insurance and billed as physiotherapy, individual or group. To qualify, there must be a condition requiring treatment and programmes are individualised. In small groups of 4, all participants have individual programmes that are adapted as needed session to session.

For general health and fitness, regular pilates is fantastic! It will push you harder than clinical pilates, will move you in all directions, and in many cases the same exercise is performed by all class members. Should you need to get fitter and stronger – seek out one of the fabulous studios we have in our local area. We are so lucky to have places like Movement Space, Cape Pilates, Cor Pilates, and Wellbeing Pilates.

If you are in pain, have an injury or a history of multiple injuries then clinical pilates is a great place to start, with a potential goal to transition to regular pilates, or the gym, or something else, once the condition is under control. At Balance Health, we practice Clinical Pilates MBCT - you need to be assessed for suitability and will require 1-2 individual sessions before proceeding to a class.

What conditions are suited to Clinical Pilates?

  • Spinal conditions especially chronic or recurrent injuries/pain

  • Osteoarthritis especially lower limb

  • Multiple regions of the body impacted by injury

  • Neurological conditions such stroke, head injury, or Parkinson's disease

  • Pregnancy support and post natal recovery

  • Hyper-mobility conditions and assistance with postural awareness

  • Pelvic floor protective exercise

  • Recovery of function post illness including cancer

  • Preference for small supervised group exercise due to mental health conditions, poor balance or mobility

  • Pre/post musculoskeletal surgery e.g. spinal fusion, total knee or hip replacements

How many people in a class and how long does it go for?

  • There are a maximum of 4 class participants each with individual programmes lead by the treating physiotherapist

  • Classes are for 50 minutes

What do you wear?

  • Whatever is comfortable if perfect for Clinical Pilates - activewear is not essential

  • Grip socks are required for classes for safety and hygiene. We supply a complimentary pair upon starting - please wash between classes!

Can I keep doing Clinical Pilates if my condition resolves?

  • Yes - many clients continue medium to long term as they feel the best they have in years and without it, they deteriorate

  • Your goals will help guide what you do following an initial course, such as transitioning to something else, continue to maintain feeling well, or keep going to work on other things

  • Many of our clients coming regularly find the classes can often replace the need for in-rooms physiotherapy as each class is exercise based treatment, as niggles can often be managed quickly before they turn into bigger issues


bottom of page