Joseph Pilates developed his signature exercise method as a means of overcoming his own physical limitations. Many orthopedists and physical therapists still see its therapeutic value. In 2007 the Bulletin of the NYU Hospital for Joint Diseases featured a Pilates exercise protocol for patients undergoing knee replacement. Although insurance restrictions may limit the number of available physical therapy sessions, Pilates exercise provides a viable pre- and post-operative home-based or studio-based exercise method. The therapeutic exercises may also function as preventative medicine.
Leg Circles
When National Academy of Sports Medicine spokesperson Mike Clark lectures at fitness conferences, he advises instructors to "look beyond the site of the crash" when evaluating knee injuries. Factoring in the interactions between different joints and muscle groups provides a holistic view of the problem. Limited hip rotation is often a crucial issue. The knee is not designed as a rotary joint, but people with limited hip rotation may try to initiate the movement from the knee. Consider the old-school ballet master: She hits the dancer's knee with a baton to get her to turn-out. These dancers had short-lived careers. Modern instructors know better, which is why many embrace the Pilates method. The Pilates leg circle exercise opens the hip. Lie supine, with your legs extended. Lift one leg, and extend it toward the ceiling. Perform five clockwise and five counterclockwise leg circles. Repeat on the other leg. This basic Pilates exercise, suggested in the NYU Bulletin article, lubricates the hip sockets and provides movement freedom.
Reformer Foot Work
Physical therapist and Pilates instructor Dane Burke own Pilates of Northstar in California. Burke explains, in an article in the Balanced Body Coreterly, that the reformer functions as a therapeutic and assessment tool for knee problems. Knee alignment issues become immediately apparent and easily corrected during the reformer footwork series. The client lies supine on the reformer carriage, with his feet on the foot bar. He bends and extends his legs, first with his feet in a flexed position, with his heels on the bar, and then with his toes pointed, with his toes on the bar. The exercise works all the muscles in what is called the kinetic chain, which is a series of linked muscle and joint reactions during a specific movement. These include the foot, ankle, hamstring quadriceps and gluteal muscles. If the knees do not track correctly during flexion and extension, the instructor uses tactile cues to place them in their proper alignment.
Heel Slides
Pilates heel slides are particularly useful for anyone who has suffered from an ACL tear, or any type of injury that limits flexion and extension. Australian physical therapists Tele Demetrious and Brett Harrop, who created the Physioadvisor website, recommend this easy exercise. Lie supine, bending one knee with the foot flat on the floor. Bend the other knee, placing the heel on the floor. Maintain a neutral spine, which means that your back is neither arched nor pressed flat into the floor. There should be a small curve at the base of your spine. Slowly slide you heel along the floor and extend your leg, without any spinal movement. Perform 10 repetitions on each leg.
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