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Exercise Spotlight: Pilates and Arthritis

Posted on 13 April 2010

What do dancers, athletes and movie stars all have in common? They are all devotees of Pilates, a not-so-new range-of-movement (ROM) exercise designed to build strong backs, firm abdominals and increased flexibility, all while giving you the sleek muscles of a dancer. Is Pilates safe for arthritis? Absolutely! So drag out that mat and make like Julia Roberts…

Chances are, if you’ve bought a  People magazine—especially the Hundred Most Beautiful People issue—you’ve heard about Pilates (as in Pi-lah-tees…not as in Pontius Pilate). Hollywoodites, trendy as ever, have latched onto the exercise that gives them long, lean muscles and helps them keep and stay in shape during rigorous filmmaking.

Think Pilates is just another Hollywood fad like that sudden yoga/Buddhism trend (which is, like, soooo ’98)? Well, don’t take Julia’s word for it…how about the great dancer/choreographer George Balanchine? Both he and the late Martha Graham were early pioneers of the Pilates method. Dancers have known for years—more than seventy years—about the benefits of this method of body conditioning.

Mr. Pilates

Joseph Pilates was born in Germany in 1880, a frail child who grew to become obsessed with fitness. Devoted to the idea of transforming his health, Pilates became an accomplished gymnast, boxer and circus performer, as well as a student of yoga and karate. Students of the Pilates method claim that he incorporated elements from each of these fitness regimens, but it was while interned in a prison camp during World War I that he began to develop his method in earnest.

During his stay at the prison camp, Pilates used whatever props were available—his bunk, the bedsprings, a chair—along with the core of his work, which he referred to as “the mat work”. While other prisoners grew sick and weakened, Pilates thrived. After teaching his method to the other prisoners, the guards were so impressed that it became a mandatory exercise for the entire camp. This was during the worst pandemic influenza of the twentieth century and yet not a single prisoner died. Later, he was hired to train the most elite cadres of British troops.

Over the years, many athletes—including boxer Max Schmelling—included this method into their training, while choreographer George Balanchine was so enamored of the Pilates method that he incorporated its mat routine into the dance piece, “Seven Deadly Sins”. Dancers, always vulnerable to injury, discovered that using Pilates led to quicker recovery time and have consistently used this method from its inception to this day Alas, Pilates did not catch on with the general public. Earlier in the century, Pilates predicted it would be fifty years before the importance of his work was recognized. Apparently, he was right. It is probably to his credit that he lived to be a healthy 87.

So, What is Pilates?

Although Pilates is usually shown being performed on huge, complicated-looking machinery, Pilates first defined his series of 34 specific exercises to be performed individually, on a mat, without aid or assistance from any machinery or equipment. In the Introduction to his 1945 book of exercises, Return to Life Through Contrology (guess he decided to change the name!), Pilates says: “Contrology is complete coordination of body, mind, and spirit. Through Contrology you first purposefully acquire complete control of your own body and then through proper repetition of its exercises you gradually and progressively acquire that natural rhythm and coordination associated with all your subconscious activities.”

In other words, this isn’t the exercise to do while watching the soaps. This method requires full participation, as it focuses on the whole body. There is no flailing about; huffing and puffing is not necessary nor is it desired. Instead, the upper and lower muscle systems are coordinated within the body’s center, working very specific areas with careful, fluid movements. All movements are extremely slow and rhythmic, allowing weaker muscles to be located, which leads to better support for the joints.

“Girdle of Strength”

Joseph Pilates often referred to the “girdle of strength”—the area including the abdominal muscles, extending out to the buttocks and the latissimus dorsi (the muscles in the back that control shoulder and arm movements)—claiming that the strength needed for the exercises originates in the abdominal muscles. If these muscles are not in control, then other muscles such as those in the back, neck or shoulders can be damaged. It is by using the abdominals and learning correct breathing that leads to strength and improved posture.


Open any book on Pilates (and there are dozens, at least) and proper breathing will be emphasized, over and over again. Each movement is tied to a specific manner of breathing and the way that you breathe is just as important as the movements themselves…especially since most of us breathe “wrong”, expanding only the top part of our lungs. Instead, you should breathe from the diaphragm so that your stomach rises and falls, rather than your chest. Practice this way of breathing for five minutes and you should actually feel yourself relaxing.


Often, we become so distracted by our various responsibilities that we are complete unaware of our movements. In Pilates, the movements focus on a very specific area of the body; concentration is essential.


One of the reasons that Pilates is an ideal ROM exercise for arthritis is that the movements are very controlled; chances for injury are minimal. In the beginning, these movements may feel clumsy, but once you have a grasp of the move, you will be able to execute the movements with grace and control.


Each exercise leads to the next, moving seamlessly from one to the other. Even though each movement has a beginning and ending, you blend the movements into each other, stretching and continuing, so that the end of one movement gracefully becomes the beginning of another.

Are Those Exercise Machines or Torture Chambers?
Many people shy away from Pilates because they’ve seen it performed on huge, complicated machinery. Repeat after me: you do not have to use the resistance machines. Joseph Pilates designed 500 different movements, but they all evolved from the 34 core movements, what he called “mat work”. So if money is a problem or you live in a small town where even the fitness instructors say, “Pi-who?”, rest assured, you can still benefit from Pilates.

However, if you live near a Pilates studio, using the resistance machines helps you become more aware of how the movement works each muscle, which can also help you improve your mat work. Also, it creates an intensity which is hard to achieve on your own. If at all possible, at least try to find a qualified “mat work” instructor who can guide you, adjust your posture, demonstrate breathing and correct movements and add new exercises as you become stronger. Even in little ol’ Radford, Virginia, pop. 15,000 (with students; more like 12,000 without), we have a certified Pilates “mat instructor”.

Pilates and Arthritis

So, is Pilates safe for arthritis? Sure. Not only has Pilates been used (in conjunction with medical treatment) to treat rheumatoid arthritis, it has also been used for back and neck pain, osteoarthritis, mastectomies, joint replacements, scoliosis, lupus, fibromyalgia, chronic fatigue syndrome, and joint and muscle injuries. In fact, many physical therapists, orthopedists, and chiropractors have integrated the Pilates method of body conditioning into their rehabilitative programs. The slow, controlled movements are ideal for protecting joints and improving alignment. Even so, consult your doctor and/or physical therapist before starting any exercise program, especially if you’ve been sedentary for an extended period of time.

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