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Posted by on Jun 7, 2016 in Business & Education, Featured, Pilates | 0 comments

Compliance – Alliance

Compliance – Alliance

Adhering to your home program

Being a practitioner of the healing arts is a great job. It is immensely satisfying to precipitate a client’s recovery or improvement and then nurture them along the way to full function. But…it is probably safe to say that one of the most frustrating aspects of being in the field of injury and pain rehab is client compliance with home programs and prescribed exercises.

Before I launch headlong into a mini-rant, I must preface it with a little story about someone I know quite well.

A few years ago I was suffering from a chronic eye infection that I nursed myself with home remedies until it became clear that it was not going to shift without professional help.

I went along to a highly respected ophthalmologist, paid vast amounts of money for his expertise and 2 separate prescriptions (one bottle of eye drops and a scrip for a very specific antibiotic) and then proceeded to do it my way. Which is to say I used only the drops.

Initially my eyes improved using only the drops. Wonderful. The tablets were known to cause photosensitivity and it was summer so no time for sun-avoidance! But within a few weeks, my eyes started to go red, sore and swollen again. I took my gritty, bloodshot eyes back to the ophthalmologist who admitted that he was surprised that his prescribed remedy didn’t work.

Doc: “Did you use the drops I gave you and finish them?” he said rubbing his chin with puzzled medical gravitas.

Me: “Yes!”

Doc: “Strange. This type of infection usually responds well to the tandem protocol of the drops and the tablets.”

Me: “Oh. I didn’t bother with the tablets. I wanted to go to the beach.”

The doctor peered at me intently. Scary.

And then he asked me to leave.

Yes. Leave.

I was horrified to be thrown out of a doctor’s surgery. After apologising and promising to be a good girl, I convinced him to keep me on and he issued another prescription for the drops and told me to take both medications as directed.

I did. My eyes cleared up and the painful infection never came back.

Blink, blink.

Now I never have (nor will I ever) throw anyone out of my studio, but that anecdote illustrates the frustration of pulling everything possible out of the professional toolbox to help your patients or clients only to have them fail to help themselves.

I am as guilty of being lazy (and human) as anyone and it usually takes blinding pain or the price of a Lamborghini to induce me to assiduously follow health care advice – in other words, desperation – but I am getting better as the cavalier luxury of youth slithers ever farther away.

Oh, for the magic bullet or elixir that you could take once and be done with it.

Unfortunately, the time required to correct a postural issue or an injury is generally commensurate with its chronicity – that is to say how many months or years the faulty pattern or injury has had time to embed itself into your body

And the moral of this story?

If you’re the patient, comply with your healthcare provider or therapists advice. After all, you’ve likely paid handsomely for it and they have trained and studied long and hard to bring it to you. Make the most of the time and money you’ve spent. If, after complying with your prescribed program, you do not see the desired or expected progress, discuss it with your practitioner but please, DO YOUR HOMEWORK, so that if nothing else your practitioner will be able to adjust your program or refer you to someone who may be better able to help. If you don’t do your home program, you’ll never know if it works.

If you’re the practitioner, ask your patients/clients questions they must answer, e.g. “Will you do your home program at least three times a week?” instead of, “Don’t forget to do your homework.”

Studies show that asking people to state their intention out loud helps encourage compliance. Enter into a written agreement or ‘contract’ with your client. Make it clear that you are in their recovery TOGETHER. “Fix me” is not part of the therapist/client lexicon.

If all else fails, try scare tactics – cue sinister laugh – for example, “What colour would you like your mobility scooter?” For some, fear of the negative is more incentivising. It worked on my father. He now religiously walks 1.5 miles everyday, rain or shine.

The threat of an incontinent future also works a treat. Try it on your women clients. Incontinence pads are NOT sexy.

All kidding aside, set aside the time in your busy schedule of juggling plates to invest in you. You’ll be a better mother, father, provider, employer, employee, and lover, –whatever – if you and your body are happy companions.

Please get in touch if you have any tips or helpful hints on this blog topic!

Until the next time…

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Posted by on Aug 22, 2014 in Anatomy & Physiology, Featured, Health, Pilates | 0 comments

Pilates For Total Hip Replacement: What We Need To Know?

Pilates For Total Hip Replacement: What We Need To Know?

Due to changes in our NHS service more & more Pilates teachers are being referred clients following hip replacement surgery. Once, patients would have been on a hospital ward for at least a week receiving Physiotherapy daily. This ensured that they could confidently perform their post op exercise regime and climb stairs safely. However, these patients are now discharged after 2 – 3 days with an exercise booklet and a quick mobility check.

As a result many patients turn to Pilates looking for an alternative rehab programme to enable them to restore normal hip function and mobility. So what does the Pilates teacher need to know? There are shutterstock_94626565-e1368042178741several hip replacement procedures, the most common of which is the total hip replacement (THR).This involves the removal & replacement of the femoral head with a prosthesis and the acetabulum is deepened and resurfaced. These prosthesis’s are commonly made from metals such as titanium, stainless steel & polyethylene.

During surgery the hip is dislocated to enable the prosthesis to be fitted and as a result post operatively the hip joint will be more unstable. Therefore the main objective is to strengthen the muscles around the posterior & lateral region of the hip to help regain stability. As the muscles start to gain strength the clients balance and mobility also need to be restored.

Due to the invasive nature of this surgery you often find post op that the gluteas maximus & medius as well as the external rotators and abductors will be weak, and that you will also be presented with a protective shortening pattern of the anterior element of the hip around the TFL, rectus femoris and even the psoas. This tends to gives the impression of the ilium hitching and the head of femur sitting forward of the joint. This can often be observed if the client is lying supine with knees flexed, feet on floor & you will also be able to palpate this shortening.

Therefore, as well as strengthening the effected posterior and lateral element of the hip we also need to rebalance the pelvic and femur placement by careful positioning and cueing.

The biggest fear that many patients have is will their hip will dislocate after surgery. This is very rare and with the correct rehabilitation exercises over 6 – 9 months the hip will be as strong as it was before. However, like any recovery process it must be paced. Initially there will be vast improvements but then the pace will slow down as it reaches its potential. So it is important that the client be guided to reach progressive goals.

There are a few contraindications that need to be given attention initially after surgery to prevent dislocation, they are:

• Hip flexion > 90 degrees • Leg adduction
• Hip rotation
• Crossing legs

As a Pilates teacher it is necessary to be aware of these contraindications during the early stages of rehab. However, due to our deep understanding of movement, we are well equipped to take the client through a gradual rehab programme that will address the weaknesses that have arisen during surgery.

As I mentioned earlier the THR is the most common hip replacement available but in the instance of trauma or congenital abnormalities the procedure and contraindications may differ. It is extremely important in this instance that the Pilates teacher liaises with the patients Physiotherapist to check the safely precautions with that specific situation.

To learn more about the steps to follow after hip & knee surgery see Maryʼs workshop; hip & knee post op workshop.


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Posted by on Oct 6, 2013 in Featured, Pilates, Social | 0 comments

Pilates for Breast Cancer Events

Pilates for Breast Cancer Events

We thought it would be great to summarise some fantastic Pilates events held in many places around the UK for breast cancer charities.  We will keep adding on new events as we received them, so please keep emailing us on

1>  The first event we received was from Pilates Clinique, they held a coffee morning on the 27th September and collected £793.  Well done!!

“We are holding a Coffee and Cake charity morning plus more on Friday 27th September, here at
Pilates Clinique .
From 11am till 1:30pm”

“Thank you, thank you, we manage to raise so far £793 for today morning coffee on behalf of Macmillan Cancer support. You still can do your part by donating though their website. Thank you for those who baked their cakes and contributing to it, thanks to Vicki for her nutritional advise to our guest. Well done everybody for making this a worthy cause. We thank you and Macmillan thank you!!”



2>  TenPilates are running some special events for the Breast Cancer Awareness month of October, Her are some details and check out their pink page!

Classes for £18.50 with a 50p donation.
Private sessions for £65 and £85 for Master trainers with a £5 donation.
Any private, non insurance funded TenPhysio treatments will also get a £5 donation.
Everything has gone pink in the studios, from the website and Twitter feeds to the yoga mats and instructor’s uniform.



 3> Posture Perfect Pilates held Macmillan Exercise Morning!  

Friday October 4th 9am – 1pm in the studio.  Thank you to everyone who took part and donated, we have reached £400 so far and we are awaiting the text total.



4> Pilates Studio Kildare


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Posted by on Aug 12, 2013 in Anatomy & Physiology, Featured, Pilates, Workshops and Further Education | 0 comments

Pilates4Amputees – A Unique Challenge

Pilates4Amputees – A Unique Challenge

The amputee client has many unique challenges in order to move in a functional and rewarding way.  They have the practical issues of asymmetry, altered lever arms, altered muscle origins and insertions, stump care, the huge challenge of prosthetic function to learn and adjust to.  Added to this is the nervous system changes and challenges of altered body perception, new neural patterns, phantom symptoms such as pain or other various “false” or “altered “ neural messages.

The unprepared mind of the traumatic amputation or the semi prepared mind of the elective amputation make a difference to the client’s mindset and how they adjust and take part in movement re-education.

That’s why these clients are such a rewarding group to work with as a movement teacher. They stretch you and your practice, mentally and practically, which in turn enhances your movement, and psychological skills, positively enhancing all other aspects of your teaching.

Whilst all movement disciplines have plenty to offer any client, Pilates is a wonderful movement teacher for the amputee. I have been rehabilitating amputees on and off since the early 80s when I looked after the injured from the Falklands and Ireland. While I have recently seen so many more from recent conflicts and we have wonderful new medical and prosthetic technology, one thing remains constant. Excellent movement re-education is the crucial key to successful function.

Due mainly to cardiovascular disease, in recent years the statistics for amputation, carried out on the civilian population, shows a both arising number and a younger group. These are all potential clients for the Pilates community who can offer a wonderful road to improved life through better movement.

The Pilates4Amputees workshop sprung out of people asking for help with the amputees who were coming into their studios. The workshop is designed to give relevant information on the main issues and type of amputation.  Furthermore it looks at the prevalent movement problems and uses adaptions to the Pilates repertoire to allow teachers to have confidence in giving the amputee client a fruitful and amazing Pilates experience. The most recent workshop had some amputees clients volunteer to come along and be practiced on which also passed on the clients’ perspective. It was great to see the workshop participants being made to feel at ease discussing stump care and the practical issues about being an amputee in the Pilates environment.

As a physiotherapist who trained a long time ago with springs and ropes and pulleys!! I have always had a firm exercise background. It took me a while to “get” Pilates when I first trained in the 90s.  Opposition and the whole Pilates ethos make it more than just a bunch of exercises. That is why I know that Pilates offers a unique opportunity to all to move better and reap the “feel” better rewards that come with that. Recent initiatives have seen wounded servicemen being exposed to pilates also in growing numbers. This programme supplements some of these initiatives.

The next workshop is being held at Alan Herdman’s studio in Canary Wharf on September 21/22, 2013.  Contact –

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Posted by on May 8, 2013 in Anatomy & Physiology, Featured, Pilates | 0 comments

Pilates & Total Hip Replacement

Pilates & Total Hip Replacement

A total hip replacement (THR) is a common orthopaedic surgical procedure. It is generally necessary when a hip is diagnosed with osteoarthritis by X-ray or MRI and the individual experiences persistent pain. The client will probably complain of pain in the groin radiating down the anterior aspect of the thigh sometimes also effecting the knee especially when weight bearing & gait. They also present with limited movement of the hip with rotation abduction & adduction.THR can also be performed following trauma to the hip resulting in fracture to the neck of femur or also with congenital hip formation.

Reason for THR:

  • Pain relief
  • Improved function & hip movement
  • Improved quality of life

Ideally it is preferable to assess a client pre operatively to gage their hip range of movement and general physical ability, however this may not always be possible.

Pre operatively the client could be taught posture, basic pelvic tilts, spinal curls, breathing and ankle mobility in sitting or lying.

Before the client is discharged from hospital – normally within 48 hours of surgery – a physiotherapist will ensure that they can walk with a walking aid and climb the stairs. They will also be given basic lower limb circulatory & breathing exercises to prevent clots, as well as quadriceps, abductor and gluteal exercises. Your client should have a booklet outlining these exercises for you to clarify the aims of rehab for the next 6 – 8 weeks post surgery. At 6 weeks the client will be reassessed by the orthopaedic team to determine if the scar and hip movement is healing sufficiently.

There are several movements the individual will initially be told to avoidto prevent dislocation of the new joint these are:

  • Hip flexion above 90 degrees
  • Leg adduction
  • Hip rotation

The aims of the pilates teacher is to continue to follow the rehabilitation guidelines by gradually progressing these movements to strengthen not only the operative leg but to create balance in the bodies function.


  • Strengthen hip abductors & extensors, quads.
  • Balance & agility
  • Gently increase hip flexion
  • Disassociate hip & lumbar movement
  • Create balance in lower limbs
  • Improve posture & gait

The hip will continue to improve over 6 -9 months after surgery but recovery is also dependent on the clients medical history, age etc.


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