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PHYSIO  October 2001

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Subject:

Pilates and Human Balance

From:

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- for physiotherapists in education and practice <[log in to unmask]>

Date:

Thu, 25 Oct 2001 04:51:55 EDT

Content-Type:

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Graeme Hilditch wrote:

< The main emphasis of pilates is to concentrate on training Transversus
abdominus. Being 3rd year I am sure you understand the role of T.A in
maintaining a strong middle. Pilates refers to it as a "girdle of Strength."
Keeping that strong will help to maintain standing balance. >>

***  Previous discussions have revealed that there is no definitive proof
that TA training enhances or normalises 'functional' performance in dynamic
daily and sporting activities.  At least you used the word "help", unlike
some others who seem to think that the centre of the physiological universe
is TA.

Moreover, as I have repeatedly pointed out, it is impossible to exhibit core
stability without the critical involvement of the periphery of the body.
Just undertake the simple exercise of spraining an ankle or injuring a knee
and see how inadequate "core stability" is in maintaining your overall
stability and performance. The idea of "core stability"  simply perpetuates
the isolated model of training. To enhance "functional stability", it is
essential to learn stabilisation of the entire body and not its various parts
under very different conditions such as those offered by Pilates, ball and
wobble board balancing.

Some folk believe that if we develop better posture through Pilates, Balls
and so on, then we automatically  transpose that improved posture to the
training  session, a belief that is not necessarily correct, because many
different postures are involved throughout every sporting action, each of
which is very  different from posture learned on balance ball or wobble
board.  This is supported by plenty of research which shows that balance also
 involves a great deal of specificity.  Competence in Pilates or Ball drills
does not reflexively result in improved balance in any different balancing or
movement situations.

In fact, the use of Pilates and other conditioning schemes abolishes the use
of a very fundamental aspect of  overall dynamic stabilisation, namely the
"stepping reflex" which all of us  use to ensure that we do not fall over if
our current state of balance is  perturbed by an outside agency.   The
inability to use such a reflex is a  major reason why low paraplegics, for
instance, who may have exceptional core  stability and strength, have very
poor overall stability.

In fact, the latter example raises a very interesting issue (one which is
very close to my heart, since I am married to a paraplegic lass) - those with
 spinal injuries cannot use their lower extremities, yet often can use
resistance training to develop exceptional "core strength and stability", so
how does this enhanced core function enable them to display better overall
balance and stability?

The answer is pretty obvious - to express general stability, it is necessary
to have effective peripheral stability, not only "core stability" - if anyone
 really cannot accept that, please have a spinal block (injection of an
analgesic into the spine at a suitable level) and temporarily eliminate the
ability to use your periphery, then try to balance on a ball, wobble board or
 what you will.  A simpler experiment, simply bandage your toes or ankle very
 rigidly to diminish peripheral  joint flexibility and see how much your
great  core stability will diminish.  Or sit on your legs until you
experience those  familiar "pins and needles: down your legs, then leap onto
a ball or wobble  board and see how well you express your "core stability".

The sooner we realise that the important issue is the development of overall
stability, not the isolated development of the "core", the better for all
sports training and rehabilitation.  By the way, when one is executing any
Pilates, ball or wobble board manoeuvres, the periphery of the body may be
relatively far more involved in the static stabilisation process than the
core, so that  it is a complete misnomer to refer to any of the popular "core
stability"  training methods as "core stability" methods!    Moreover, we
should never  forget the crucial balancing role played by certain little
balancing organs in the very peripheral head, especially the vestibular
system of the ears.   Notice, too, how much the eyes are involved in
balancing by trying the same  skills with eyes closed.

Dr Mel C Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

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