26th February 2014
Movement Analysis for Movement Health
Movement Health could be described as the goal that Pilates Teachers strive for in their clients. Movement Health implies that preventing factors that produce musculo-skeletal injury, or at the other end of the scale, improving movement efficiency, is the aim of the Pilates Teacher rehabilitating their clients from pain or injury.
Pilates is typically a second or third career choice that follows another, sometimes movement related - such as professional dance, or movement un-related, such as those coming to teach Pilates as a deliberate attempt to change their life from careers involving office work and regular 9 to 5 hours. Still others have a ‘road to damascus’ moment when they discover Pilates as a rehabilitation tool. But so too do Pilates Teachers leave this still young profession, to move on to other things. A significant proportion go on to train as a therapist of some kind, some to incorporate their knowledge of Pilates but others move on completely.
Why do Pilates Teachers leave? Early in the career and in training, there is so much to learn, not least the repertoire, both classical and adapted, and all the possible medical and orthopaedic conditions that clients present with and the requirement to provide as safe as possible an environment for them. After only a few years with hundreds of hours of classes and individuals taught, the challenges may decrease and a Pilates Teacher could become restless, repeating the same exercises to the same clients over and over. Rewards do come when a client changes dramatically before the Pilates Teachers eyes in a few short sessions, but frustrations also present when clients return with the same issues time and time again, despite previous painstaking break downs of the most appropriate exercises for them.
Clearly some clients do not retain physical learning, or their poor working positions dominate their postural and movement behaviours. Some clients continue with other misguided exercise choices, or suffer from overuse syndromes from repeated activities such as running and other sports. Other frustrations may involve clients being unable to afford, in time or money, more regular classes or the one to one sessions they ideally should have.
With the ethic of continuing professional development (CPD) comes tools to reinvigorate a Pilates Teachers enjoyment and reward, as a greater knowledge leads to a greater choice in problem solving a clients issues. So to avoid Pilates Teacher ‘burn out’ a Teacher should plan their CPD. Safety and repertoire is an early focus, but later, concentration on the elements that serve to improve job satisfaction and increase the challenges for a Pilates Teacher should be an important component of CPD choices.
Along with the CPD a Pilates Teacher should deliberately adapt the format in which they structure their client contact. A common aim amongst Matwork teachers is to develop more ‘one to one’ clients, but actually structuring their week so there is no time for the ‘one to one’s’ means this won’t happen. This suggests that a Pilates Teacher needs to take risks from time to time, stopping a class run for years and swapping that for something more potentially professionally rewarding, may help maintain a Pilates Teachers interest and keep them fresh and enthused.
Looking for different markets or a different approach might be an important step in keeping a ‘love for teaching Pilates’. Pilates as a technique has always been developing which suggests that changing the approach to your clients is relevant and necessary. A Pilates Teacher may need to differentiate themselves from other Teachers in an increasingly choked local market. Pilates has often been fused with other techniques which have sometimes proved popular with clients. These have developed as Pilates Teachers have looked outside Pilates and seen how Pilates concepts can add an extra dimension to the activity. Pilates Teachers could benefit by taking in concepts from other approaches. Looking at similar professions such as Personal Training and cherry pick elements that may benefit their business model. Personal Trainers trade on ‘motivation’ and they use measures to aid goal setting and attainment.
Perhaps looking at trends in Physiotherapy whose research arm often provides the scientific framework that the validation on which the Pilates approach hangs may mean a Pilates Teacher can be ahead of the game before a trend becomes more mainstream.
Current trends include an increasing realisation within some research teams that ‘movement control’ is increasingly important for movement health and that measures of muscle length or joint range of movement may not be as important as the ability to recruit musculature to prevent uncontrolled movement. Research is coming out that demonstrate that managing ‘control impairments’ in which a subject has full range of movement but has pain, is part of the solution for those with chronic low back pain (Fersum et al., 2013). Other research points out that movement control is different for those with low back pain and those without (Luomajoki 2010). Research also identifies that movement control testing can predict injury in dancers (Roussel et al., 2009).
Movement testing is now gaining momentum as an analytical tool. Sarah Mottram from Movement Performance Solutions, developers of the Performance Matrix movement testing system, Author and Physiotherapy Researcher points out that, ‘analysing familiar movements such as those practiced in a Pilates class may show successful movement control, but when testing the same movements during unfamiliar non-Pilates movement styles a client may fail to show control.’ This suggests that only using Pilates exercises to assess a Pilates clients improvement may explain some clients inability to take what they have learned in Pilates out into the real world. They may do well in Pilates but exhibit poor control in more (pre-)functional tasks using the same muscles.
Mottram advocates a more formal movement analysis to help a Pilates Teacher to; priority set the clients problems, identify the specific movement control issues an individual exhibits, and modify exercises to specifically address the identified issue. By analysing the whole movement system all the movement control problems can be identified giving a Pilates Teacher greater information for the priority setting component of the process. Mottram says, ‘Movement analysis often shows up significant issues in other areas of the body which need to be addressed that would otherwise have been missed.’
This means that Pilates Teachers may need to take a leaf out of the Personal Trainer handbook and dedicate some Pilates sessions to testing to get objective markers to help plan forthcoming sessions and improve client motivation through goal setting (McNeill and Blandford 2013). Being adaptable as a Teacher to create an environment where the format of the time with the client doesn’t have to be the same as last weeks class. Educating a Pilates client as to the benefits of this approach in advance can help the client buy in to a new way of working, and keep both the Pilates Teacher and the client actively involved in a process that includes the attainment of goals.
The Performance Matrix’s movement analysis system uses a skill set Pilates Teachers have already honed - observation and a large repertoire of exercises. It does not take a Pilates Teacher long to learn how to perform the tests from the Performance Matrix online system. It not only generates video’s of the test being performed, but yes/no questions on whether a direction of movement of a body part was controlled. The system then generates a report and a score, which enables the Pilates Teacher to adapt rep to give a specific fix for the specific problem identified by the whole body testing.
A current editorial in the Journal of Bodywork and Movement Therapies, ‘Ranging beyond neutral’ (McNeill 2014a) and a companion piece ‘Ranging beyond neutral - A practical discussion (McNeill 2014b) discuss how specific exercises aimed at improving movement control issues are already undertaken by Pilates Teachers, and further discusses, that full range and inner range exercises. are extremely important types of exercises for fixing faults found within the movement control system.
Movement Analysis for Movement Health, teaches in 3 days, a solution for movement analysis for Pilates Teachers. Access to the online screening tool and reporting is included and enables a Pilates Teacher to add another element to their professional toolbox which can aid client retention and motivation. The key aim however is to develop the Pilates Teachers ability to focus on the clients key movement control issues to produce better outcomes in a shorter time frame. More information about this solution can be found at http://www.theperformancematrix.com/what_is_it/training_modules/movement_analysis_for%20movement_health
Warrick McNeill is a London based Physiotherapist with a Pilates Training, who teaches the Performance Matrix. He is an Associate Editor for the Journal of Bodywork and Movement Therapies, writing on Pilates topics. He wants to write a book, ‘Does my dog need to do Pilates?’ warrick@physioworks.co.uk
References
Fersum, K., O’Sullivan, P., Skouen, J., Smith, A., Kva ̊le, A., 2013. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. Eur. J. Pain 17, 916e928.
Luomajoki, H., 2010. Movement Control Impairment as a Sub-group of Non-specific Low Back Pain. Evaluation of Movement Control Test Battery as a Practical Tool in the Diagnosis of Movement Control Impairment and Treatment of this Dysfunction. Doctoral Thesis. University of Eastern Finland. Dissertations in Health Sciences.
McNeill, W. 2014a. Editorial. Pilates: Ranging beyond neutral. Journal of Bodywork and Movement Therapies. 18 (1) 119-123
McNeill, W. 2014b. Pilates: Ranging beyond neutral - a practical discussion. Journal of Bodywork and Movement Therapies. 18 (1) 124-129
McNeill,W., Blandford, L.. 2013. Editorial. Pilates: Applying progression and goal achievement. Journal of Bodywork and Movement Therapies. 17 (3) 371-375
Roussel, N.A., Nijs, J., Mottram, S., Van Moorsel, A., Truijen, S., Stassijns, G., 2009. Altered lumbopelvic movement control but not generalized joint hypermobility is associated with increased injury in dancers. Man. Ther. 14 (6), 630e635.