What are the Clinical Equipment classes all about, and what is the difference between these and general strength training?
The prime underlying focus in our Clinical Equipment classes is achieving a precise recruitment of the specific deep postural muscles, commonly referred to as the core, involved in stabilising the spine prior to and during movement. These postural muscles consist of the deep abdominal (transversus abdominis), deep back (lumbar multifidus) and pelvic floor muscles. All three postural muscles are designed to simultaneously subconsciously activate immediately prior to movement in order to provide stability to the spine and pelvis in anticipation of the spinal shearing forces brought about by even the lightest of movements. When activated, these muscles tighten to create a corset-type hold on each individual spinal segment to withstand and cushion the shearing forces.
Stability training is designed to retrain this automatic postural reaction that is commonly lost or weakened in people who are pregnant, experience or have experienced low back pain or other injuries, or have muscle imbalances due to repetitive heavy lifting or stresses on the back. Re-establishing this innate postural response to movement is achieved through repeating precise conscious activation of these muscles prior to movement until it becomes a subconscious response again. The classes involve progressively loading and challenging the body through increased complexity of movement and increased balance demands, whilst retaining the quality of movement.
Over-recruitment of the stronger outer muscles (without adequate spinal stability), targeted in gym-type strength training can exacerbate any pre-existing muscular imbalances and override the postural muscles, causing a broad bracing, rigid hold on the spine, potentially restricting movement and leaving the spine vulnerable to injury. Our classes will provide an overall muscular workout, toning your whole body. In the presence of any injuries, sensitised structures or movement restrictions, exercises can be individually tailored to facilitate pain-free movement and work towards regaining movement which was previously restricted.
What is the difference between Pilates and yoga?
The Pilates Method was originally designed by Joseph Pilates in the early 1900s, drawing influences from yoga, zen meditation and dance. Therefore Pilates and Yoga do share similar themes, however they differ in their underlying principles and emphasis. Yoga generally involves end-of-range movement patterns with static postures, held and synchronised with the breath. Pilates, on the other hand, emphasises fluid movement, each change in movement synchronised with a change in breath (inhalation versus exhalation) where the specific breath facilitates spinal articulation or stability muscle activation with exertion. The fluid movement in Pilates can avoid strain on the neck that may be brought about by sustained overhead arm postures common in yoga. Yoga has more of an emphasis on meditation, relaxation and breathing patterns and technique. Pilates focuses on developing heightened body awareness, with movement control and precision, and optimal sequencing of muscle recruitment.
How do your Clinical Equipment classes differ from the Pilates offered at the gym?
Our Clinical Equipment classes run by physiotherapists involves the use of specialised spring-loaded machines, designed purely to activate your deep postural muscles. The emphasis is on submaximal, variable resistance work in potentially unstable positions in order to specifically target the stability muscles. Gym Pilates is based on matwork, with use of small toning balls, fitballs, resistance bands or other small equipment. While we also utilise this small equipment in exercise sessions, the exercises are largely based on the Reformers, Trapeze Table or Wunda Chair. These machines provide variable resistance in a closed-chain environment (your working extremity is always holding onto something), which has been shown by research to be much more effective at facilitating activation of your deep postural muscles, as they are given a specific task to do with heightened feedback through the springs as the coils elongate when stretched, and recoil back to their resting level. The stability muscles are facilitated and challenged, irrespective of whether you are consciously aware of the muscle activity or not. Our Clinical Equipment classes have a much more targeted and individually tailored approach to achieving rehabilitation of your injuries and health condition/s, and they utilise exercises drawn from Clinical Pilates, in addition to balance exercises, pelvic floor exercises, myofascial release and stretches, and particular muscular activation and strengthening exercises in order to achieve treatment outcomes and goals. Pilates offered at the gym is not run by experienced physiotherapists who will have better awareness of your injuries and how to best rehabilitate them.
Will I find the Clinical Equipment classes difficult? Do you need a lot of co-ordination?
The most challenging component of the Clinical Equipment classes initially is the level of concentration required to precisely recruit the correct muscles and co-ordinate this with breathing and movement. The postural muscles are unlike the outer strong (global) muscles which can be felt to squeeze with maximal effort in strength training regimes, or seen to activate by lifting a weight. Instead they are situated deep close to the spine, affording no visual feedback when they contract, and are only activated at a low level of intensity (if contracted any more, the global muscles would kick in and take over) and held for prolonged periods of time, in order to provide a stable base on which movement can occur. Therefore it is much harder to perceive or feel when they are being switched on. To activate a muscle to only a slight degree, be able to perceive small increments of activation, and to sustain its contraction statically (i.e. without the muscle directly causing movement of a segment, which would otherwise provide constant sensory and visual feedback) is quite a challenge, but a skill that can and will be developed.
This gets easier and easier until it becomes subconscious, but in the initial stages, you will be required to concentrate quite a lot to maintain their activation. As your technique in performing the exercises improves, they will be progressed to further challenge your co-ordination and strength, but never sacrificing quality. This form of exercise is not difficult once you get the hang of which muscles to switch on, and exercises can always be simplified or challenged to adjust to your ability.
How many sessions does it take to start to feel the benefits?
This may depend on the individual in terms of what your goals are, what state your body is in to begin with in terms of physical fitness and injury, and how frequently you do the Clinical Equipment classes. However for most people, it takes roughly four or five sessions to gain a sound, conscious awareness of engagement of the pelvic floor and deep abdominal and back muscles, and to sustain this with movement and breath. After this point, to gain overall muscular toning, it may take a further four to six weeks.
Because we are trying to retrain the postural muscles to protect your spine and pelvis against shearing forces and stresses encountered during everyday activities in the presence of an imbalance, the key element is repetition, repetition, repetition. The more times you practice this concept of stabilisation before movement, the faster it will become ingrained into your subconscious, and the more effective it will become with more benefit felt.
What is the ideal amount of times a week I should attend for maximum results?
The average attendance is one 60 minute session a week. You may achieve faster results attending two classes a week initially, however generally once is sufficient. Fortnightly is not as desirable as results are not as effective to retrain a muscle system with less repetition and reinforcement, however if finances prevent anything more frequent, then you are more than welcome to attend fortnightly.
Will I lose all the benefits if I stop doing the Clinical Equipment classes?
As with any form of exercise, once you cease regular training, the benefits will decline. The classes help you to gain a better awareness of your posture and movement patterns, and therefore the benefits should carryover into everyday life, as long as you continue to engage your pelvic floor, deep abdominal and back muscles before and during general activity, housework, gardening and changes in position. This should become automatic, but you may need to frequently remind yourself to draw these muscles in. They work a lot more effectively when given a specific task to do, with some resistance to work against, which is the focus of our classes. The prescribed exercises are specifically designed to target activation of these muscles in order to maintain a balanced, stable spine whilst performing exercises in inherently unstable positions.
Static isolated muscle activity does not guarantee carry over into the dynamic situation, which means that if you only practice drawing these muscles in whilst being still (i.e. at traffic lights or lying in bed), they may not activate as they should when you start to perform a movement, unless they are trained in this manner. You may feel once you cease regular classes that you lose the efficiency of movement and core control that you have gained, since you do not have the same level of stimulus that the classes provides to these muscles.
Can I still do the Clinical Equipment classes if I have an injury?
The Clinical Equipment Class exercises can be adapted to suit any individual, and adjusted to provide pain-free movement in the presence of most musculoskeletal injuries. Pathologies are generally sensitive to load and direction of movement, which means that if you perform an exercise that puts pressure directly onto your injury site and you move in a direction that may compress that injury, you may worsen it. Some injuries like compression, some respond better to distraction. This must be determined in the first couple of sessions to establish an exercise program that unloads the pathology to protect it, and allow muscle activity to occur in a pain-free environment. You may need to perform exercises away from a neutral spinal alignment initially (with your spine bent, extended or leaning to one side) so that the stability muscles are not inhibited by pain, and over time the exercises may be progressed to allow your spine to tolerate the ideal neutral posture again, once the pathology (injury) has settled down.
Whenever there is a pre-existing injury, it is advisable to consult your doctor or medical specialist prior to beginning or continuing an exercise program, to ensure there are no contra-indications to exercise. I am more than happy to liaise with your medical practitioner or your physiotherapist/osteopath/chiropractor prior to your commencement of the Clinical Equipment classes and thereafter. Being a physiotherapist, I am well trained in injury rehabilitation and will ensure you do not perform any exercises that will exacerbate your injury. During exercise sessions, it is important that the exercises be pain-free so that they do not elicit stability muscle inhibition, and potentially worsen the pain or stress on injured structures.
Is there still benefit in me doing Clinical Equipment classes if I don’t have an injury?
There most certainly is. Our Clinical Equipment classes carry many benefits, including more efficient muscle control and athletic performance, firmer and flatter stomach muscles (giving you the appearance of a narrower waist), effective trunk stabilisation and enhanced balance (reducing the risk of falls), overall body toning with leaner and longer muscles, improved postural awareness, reduction in pain and greater resistance to injury, improved cardiovascular fitness (not sufficient on its own for weight loss, but certainly a large part), and improved general well-being and mental focus. They also provide an effective rehabilitation mechanism post-surgery for most joints. The other added benefit is that they will bring more awareness to your pelvic floor muscles, helping with continence and prolapse of your pelvic organs, a very common problem experienced by women and some men.
Are your Clinical Equipment classes a safe form of exercise to do during pregnancy?
Our Clinical Equipment classes are most certainly a safe form of exercise to do during pregnancy. Pilates itself is well recognised as one of the preferable exercise programs for pregnant women. When pregnant, it is always advisable to consult with your doctor prior to commencing or continuing any exercise program, as there are certain aspects to a pregnancy that may contra-indicate exercise. I am happy for you to discuss this with me prior to commencing classes. During pregnancy, the body undergoes significant changes, largely governed by hormones released. This results in an inherent lack of stability around the pelvis in particular, and therefore care must be given to avoiding any exercises that may exacerbate this instability. The exercise repertoire is easily tailored to the pregnant women as the prime focus is on stability, however exercises are specifically adapted to this stage in life and to each individuals experience. Certainly there are quite a few modifications that need to be made to accommodate the changes in the pregnant bodies. It is very important to ensure pregnancy modifications are made, therefore attendance at a generalised Pilates class where deep knowledge of the effects of pregnancy were not known, could be injurious to the woman, especially in the presence of pelvic instability (characterised by sharp, unrelenting groin and/or buttock pain, exacerbated by stair-climbing, walking up/down hills or uneven ground and standing on one leg). At Sculpt & Reform Physiotherapy and Clinical Pilates, you can be relaxed in the knowledge that your pregnancy needs will be catered for, and you will be closely guided through a specifically tailored exercise program that will be safe and effective for each stage of your pregnancy.
Can I bring my baby to Clinical Equipment classes?
You are more than welcome to bring your baby or child to Clinical Equipment classes, as long as you provide all the necessary games and entertainment he/she may need to sit fairly still and allow you (and others who may share a class) to concentrate fully on your exercises. The machines are all spring-loaded, therefore during exercises the springs are constantly coiling and uncoiling, which can be dangerous for young children to poke their fingers.
Will the Clinical Equipment classes help me to lose weight?
In order to lose weight, your body is required to reach and sustain a certain elevated heart rate, afforded by a certain intensity of training. This is achieved by regular cardiovascular training such as walking, running, cycling or swimming. You would also need to watch your caloric intake through your diet. The Clinical Equipment classes will improve the efficiency of your muscular system and create overall toning of your muscles, but on its own is not of sufficient high-intensity to burn fat. The movements are largely slow and controlled, emphasising postural awareness, movement precision, balanced movement patterns, and correct activation of postural muscles. There will possibly be integration of more fluent movements, raising your heart rate at times, however not sufficient to achieve cardiovascular fitness. A more toned muscular system achieves a faster basal metabolic rate, which means you burn more calories at rest, let alone with cardiovascular exercise, therefore these classes in combination with regular cardiovascular exercise (at least three days a week for 30-60 minutes) and a calorie-controlled diet will enable you to lose weight most efficiently.
In the presence of any injuries or conditions that may deem the majority of aerobic activity painful and thus impossible, promoting a vicious cycle of weight gain, the low impact exercises, modified to your needs, puts less pressure and strain on the joints, enabling you to complete a whole range of exercises that comfortably support your injury and reduce the level of your pain, potentially giving you a bit more freedom of movement and tolerance of aerobic activity.
What is appropriate clothing for Clinical Equipment classes?
Try to wear comfortable clothes that allow you to move around freely, but not too loose so that it is difficult to visualise how your spine is moving with movement. Please bring a sweat towel and drink bottle. You will be required to remove your shoes when using the exercise equipment, however bare feet or socks are fine. Specialised grip socks are provided complimentary with your initial visit (and extra pairs available for purchase if you desire), which enable a safer grip on the machines for improved balance and comfort.
Do you have facilities for me to change or go to the toilet?
Sculpt & Reform Physiotherapy and Clinical Pilates is set in a home studio, therefore there is plenty of room for changing and convenient toilet facilities.
Will I be able to claim the Clinical Equipment sessions on my private health insurance?
If you are deemed to have a Health Condition that is benefited by Physiotherapy, and you have an Initial one-on-one Assessment at our studio, you can claim the Clinical Equipment sessions on your private health insurance if you have extras cover for physiotherapy. The HiCaps machine on site enables automatic private health insurance rebates, where you only pay the difference. I have credit card and eftpos facilities as well. The amount of money you will receive on rebate will depend on which health insurance fund you are with, and your level of cover (you will need to contact your fund to find out exact rebates). Your first visit will attract a higher rebate. The code used for the Clinical Equipment classes is 560 (Physiotherapy group consultation). Rebates on average tend to range from $8 – $30, but please check with your health fund for exact amounts.
What is HiCaps?
HiCaps is a like an eftpos machine for your private health insurance. You swipe your card and the machine automatically deducts the rebate from your bill, and you then only pay the remainder. Most private health insurance companies are registered with HiCaps. If they are not, you will have to pay the full amount here and mail your tax invoice to the insurance company, who will then mail you a cheque for the rebate (in the end you pay the same).
What is your cancellation policy?
It is expected that you provide at least 24-hours notice of cancellation of a Physiotherapy Clinical Equipment class appointment, in order for me to have the option of filling your spot. A cancellation fee of $40 applies if notice is under 24 hours. Please refer to Fees/Times for details.
What access do you have to public transport?
There is a bus stop right near the corner of Gladeswood Drive and Jacksons road, about 400m from my house, with buses 691 (Bayswater to Waverley Gardens), 850 (Dandenong to Glen Waverley) and 862 (Dandenong to Chadstone) (zone 2). Route 900 (Rowville to Caulfield) bus stops near the corner of Jacksons and Wellington roads (about 1km from my street). There are no train stations within walking distance. My street is under 1km from Waverley Gardens Shopping Centre, where many buses stop.
What parking facilities do you have?
I ask that all clients park on Maygrove Way alongside Mulgrave Primary School (on the same side of the road as the school), and walk down our court, to avoid congestion in the court. The studio is about 150 metres down from the court entrance.
Do you have any pets that may affect my allergies?
I have a cat and Labrador who reside here, however they will not enter the studio during classes. If you have severe cat or dog allergies, please take your preventative medication beforehand or bring it with you just in case, and let me know at the time of booking.