Pilates has always had a place in rehab and was used frequently by those (think ballet dancers and performers) who needed a system of exercise that could challenge the neuromuscular system to bring them back to a high level of function. But Joseph Pilates created his “Method” to heal himself—he suffered from asthma, rickets, and rheumatic fever—and in doing so, made it suitable for all types of people at all stages of health and wellness.

Do you long to try that Reformer in your clinic but feel you have not had the training necessary to use it safely beyond a glorified squat machine? Come experience Pilates movement in my new course, Pilates Therapeutic Exercise in Pelvic Health, scheduled for May 3-4, 2025. By using your therapeutic exercise training, we will choose appropriate traditional Pilates exercises to apply to common pelvic floor and pelvic girdle dysfunction. This course is meant to focus on specific diagnoses like prolapse prevention, urinary incontinence, and postpartum abdominal wall activation. This is not Pilates training—there are many suitable courses for this goal - but rather it is to whet your appetite to further your training and give you explicit examples of Pilates exercises to help your patient.

We will review how to safely set up the reformer for patients and see how select exercises can transform core activation by doing rather than telling folks about the movement. Using the Reformer is a wonderful neuro reeducation tool -- utilizing springs, one can instantly create tension that will act as an active assist for muscle groups or modify it to be one that is resistive, creating activation of muscle contraction. Additionally, you can access many developmental postures on the Reformer that can help your patient succeed. Combined with good verbal and tactile cues, the Reformer is a go-to for my pelvic floor patients with pain, ROM issues, and/or weakness, and I can’t wait to share!

Pamela A. Downey, PT, DPT, WCS, BCB-PMD, PRPC is Senior Faculty with Herman & Wallace and is instructing the upcoming Pudendal Neuralgia and Nerve Entrapment scheduled for January 27, 2024. She is the owner of Partnership in Therapy, a private practice in Coral Gables, Florida where she treats women and men with pelvic floor dysfunction, related urogynecological and colorectal issues, spine dysfunction, osteoporosis, and complaints associated with pregnancy and the postpartum period. Her mission is to educate and integrate healthy lifestyles for patients on the road to wellness. Pam sat down with the Pelvic Rehab to discuss her upcoming course.

What makes pudendal neuralgia such a difficult diagnosis to treat?