Pilates training rehab after total hip and knee replacement

Selena DeLeon

Sunday, November 11, 2018

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Several studies have been done to support the benefits of the Pilates method for post-operative surgical patient recovery in total hip and knee arthroplasty. — Clin Rehabil. 2005;19:465-474 Pub Med Ref List

YOUNGER more active patients currently account for an increasing population seeking total joint replacement.

As one would also imagine, these people are also primarily seeking to return to complete function in the fastest possible time frame. Pilates, as a rehabilitative method, has proven itself over and over again to be the number one orthopaedic surgeon recommendation across the first world.

Not only does it benefit the patients who are seeking recovery and transition back into whole health and fitness, it is a means by which the insurance companies can be assured that the patient will not be seeking prolonged physiotherapy and repeat invasive surgical treatment, to bring them back into full function.

Rapid rehabilitation pathways are more effective and safer using Pilates under the proper guidelines in pre- and post-operative programmes, as opposed to limiting recovery to only physical therapy. This relates to the overall health and fitness benefits that Pilates offers in the long term physical health of the patient. It is important to be guided by a certified and experienced Pilates instructor and follow the protocols for targeted rehabilitation exercise as well as a whole body approach before and after the surgery.

Pilates was developed by German-born Joseph Hubertus Pilates from the 1920s. Joseph himself suffered from many ailments including asthma and rheumatic fever, and sought ways to overcome these conditions through fitness focusing on improving his strength without developing bulk. The Pilates method combines boxing, gymnastics, dance and fitness training and has increased from 1.7 million participants in 2000 to 10.5 million in 2004. It gained popularity in New York during the late 1960's, as a rehabilitation programme in the performing arts community amongst dancers who suffered from ankle, back and knee injuries, and has been growing steadily ever since.

From this point, it's foundation was developed and uncovered a mass of rehabilitation fundamentals which aided in many other types of recovery needs such as post-mastectomy reconditioning, rotator cuff syndromes, back and neck pathologies, just to name a few.

The concept of strengthening the superficial and deep muscles of the core to stabilise, align and move the trunk combined with increasing joint mobility has proven to decrease pain and disability over a 12-month period, in treating many patients suffering from chronic back, hip and knee pain compared to traditional physical therapy.

While connecting physical training to breathing and mental happiness, quality movements are emphasised in the Pilates method, while maintaining a neutral spine, and can be continued as a long-term fitness and health maintenance regimen.

For best results, patients are encouraged to begin their Pilates training pre-operatively to increase their fitness base level and core stability which is crucial to establishing balance as a safe base for movement to occur from the extremities post-surgery.

Based on the surgeon's approach and invasiveness of the procedure, there may be individualised modifications necessary. Relative to the patient's long-term physical goals, Pilates can be an excellent gateway to meeting the challenge of recovering and even exceeding previous physical fitness levels ever before attained. The method of Pilates is a one size fits all, you can hobble into your first session and literally perform a high jump within a relatively short time frame.


The benefits of training in alignment for knee replacement patients go far beyond the standard strengthening of the muscles. Moving the knee joint in such a way that the joints glide inside of the track provided by the shape of the bones, allows for the proper discharge of the patella and optimizes the job of the meniscus and ligaments which are built to distribute stability evenly.

Balancing the work of the muscles to the front, inside, outside and back of the leg help to keep the joint strong, as well as provide benefits to overall balance, which assist the core in holding your body in good congruence no matter how unstable your environment may be.

Building back the hips

The web of ligaments and muscles which attach the large thigh bone (called the femur) to move around freely inside the hip socket can be strengthened by performing Pilates exercises called leg circles or feet in straps on the Reformer machine. The benefit to using the pulley system provided by Pilates machines is that it assists in holding the weight of the legs during movement, which is better suited to persons who are post-operative and beginning their strength building programme.

In propping up the weight of the leg, it puts less pressure on the lower back and hip joints respectively. Mobilizing the leg inside of the hip socket increases mobility in the hips as well as strengthens the small muscles which tie the leg into the joint socket, and develops the deep core stabilizer muscles which assist in keeping the pelvis stable whilst the legs are in motion. This is a dream for persons who are seeking to get back into full range of motion and out of tight muscles which can develop from lack of proper movement.

Rehab done right, in a fun and safe environment with others who are likely to need the same treatment measures is the way to go into recovery — motivated. Find a studio, find a class and you don't have to write your body off as old, just because your joints are newly reconstructed.

Selena DeLeon has been a personal and group fitness trainer for 16 years. She recently transitioned into the world of Pilates and has a studio in Kingston called Core Fitness, where she helps people to move and live better.

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