Pilates Vs. Yoga…Thoughts of a Physiotherapist

By; Liam Roberts M.C.S.P.

Primarily, when dealing with conditions such as lower back pain and sports injuries, our patients often ask for our thoughts on their commencing a course of either yoga or Pilates classes, with many unsure of the difference between what is encompassed in each discipline and what the actual aim of each is. Once an understanding of each is gained, the choice of class is generally based on the patient’s health status (and perhaps nature of their pain), the nature of the condition with which they have attended physiotherapy, and their ultimate goals when attending such an exercise class.

Pilates is a form of movement exercise, where great emphasis is placed on stability and conscious control of normal movement patterns. The subject of special focus are the postural and stability muscles – the area of the lower “core”, encompassing the pelvis floor muscles, abdominals (both front and oblique/side), and lower lumbar muscles, & the upper “core”, encompassing the deep neck stability muscles and the muscles responsible for positioning the shoulder blades. This specific recruitment of these muscles induces a strengthening effect, this core strengthening being one of the primary benefits of Pilates. These muscles serve to stabilise the spine and pelvis, ensuring optimal postural positioning and safe movement. Dissociation of movement is also a primary aim of Pilates – being to keep one body segment or muscle group (typically the core) active and stabilised while moving another body part freely and in controlled manner. Essentially, the strong core acts as the central stable “base” off which the spine and limbs can work. Ensuring a strong core reduces the likelihood of injury in the spine or limbs, especially in the lower back.

Pilates also provides a good workout, due to the need for repeated holding of challenging postures and positions. Pilates does also focus on the patients breathing pattern, though more to ensure smoothness of movement rather than for relaxation purposes.

Yoga is another form of movement exercise. Not placing as much emphasis on core activation and control of movement, yoga is more concerned with freedom of movement and flexibility, and relaxation. This freedom of movement is achieved via focusing less on achieving what would be considered as “normal” movement, and simply moving the body through what happens to be its most natural planes of movement. Yoga focuses on bringing the body through various paths of movement and into a multitude of positions, positions which the individual is unlikely to engage on a regular basis. It is by doing this, that yoga maintains joint mobility, soft tissue extensibility, and generalised flexibility.

The relaxation element of yoga is achieved via ensuring a balance and rhythm between the timing and speed of movement, and the patient’s breathing pattern.

Generally when choosing between yoga & Pilates, we at K.M. Woods Physiotherapy will recommend Pilates to any patient whom has been attending for an injury related to instability or weakness. In this case, Pilates can act as a continuation of the process of rehabilitation initially began in physiotherapy, whereby any end stage issues of instability or weakness can continue to be addressed by the patient in their Pilates class after their cute physiotherapy treatment has been completed. This is especially the case when patients are dealing with a recurrent condition, and this condition is felt to be contributed to by the patient’s lifestyle habits. In this instance, the regular undertaking of a Pilates class can go some way to offsetting the potentially harmful effects of these habits – be it prolonged sitting at a desk daily etc.

We typically recommend yoga to those patients who are simply seeking to undertake some stress-relieving form of exercise, as much for the benefit of psychological well being as for the physical benefits. Due to the greater focus on relaxation and breathing, yoga is seen as being more effective in terms of stress relief. yoga however, is not recommended for those who present with a notable underlying weakness of the core, or who may lack sufficient bodily awareness to maintain good postural positioning and undertake safe transfers between positions.

Ultimately, should one opt to part take in either Pilates or yoga, benefits will no doubt be derived. Not only is the individual engaging in a challenging form of exercise which engages both the physical and psychological sides of fitness, but it allows the individual one hour in the week to themselves, away from the stresses of home and work. The importance of such “self” time cannot be overstated, especially in terms of energy levels, mental well being, and physical functioning.

Physiotherapist Lead Pilates

We strongly recommend that every patient intending to do so should seek to attend a Pilates or yoga class undertaken by a qualified physiotherapist. Having a specialist background in physiotherapy, the class instructor can pay close attention to each class member in light of any existing injuries, and tailor their exercise routine accordingly. The physiotherapist is also ideally qualified to offer a range of exercise progressions and alternatives, to allow each member to part-take at an intensity and level with they feel comfortable, and which is unlikely to aggravate any underlying musculoskeletal injuries.