Evolution of Pilates Part 1 : Development and Diversification

Dr Penelope Latey 2024
Cert Pilates(UK, USA), Dip Pilates Movement Therapy, MSc, PhD

Abstract
Pilates is increasingly being used for fitness, rehabilitation and chronic disease management. This paper is part one of two on the evolution of Pilates.  This discussion paper explores the diversification of Pilates, from a mind-body exercise system for maintaining wellness even with comorbidities, to assist biomechanical malalignments and pathological conditions, for rehabilitation, and gym exercise providing cardio workouts. The scope of this paper traces the development of Pilates principles and modifications that have contributed to the diversification of the Pilates method from Classical Pilates to comprehensive, therapeutic, clinical Pilates and gym/fitness Pilates and the acceptance of Pilates as an allied healthcare workers treatment tool. Popularisation, and commercialisation of Pilates has produced a confusing range of Pilates providers, with markedly different philosophy, educational pathways and competencies. The substantial disparities between the skills, accreditation and the service provided by the various types of Pilates need to be recognisable for students, course providers, consumers, public health funding bodies and private health insurance funds.

The Pilates profession(s) require accurate and distinctive descriptors of provision of service. Clear labelling of the different types of Pilates supported by transparent independent regulation will improve safe practice.

Key words:  Pilates, fitness, mind-body exercise, rehabilitation, Allied Healthcare, Complementary Medicine.

1.1 Background
Over the last 40 plus years, Pilates has undergone a dramatic shift from a little-known mind-body exercise system practiced by performing artists to being available to the wider public. Pilates can be found in a range of settings – from the gym, taught by fitness instructors or group Pilates teachers, to independent Pilates studios and allied health clinics as a therapeutic exercise intervention provided by Pilates teachers, and allied health practitioners.

1.1.1 Historical development
Initially, the Pilates exercise system Controlology, was utilised by gymnasts, dancers and boxers to maintain and improve whole body wellness[1]. From the late 1930’s Joseph Pilates taught group exercise classes to dancers, and semi-private studio sessions primarily to performing artists, using mat and various Pilates apparatus. Individually prescribed programs were provided for those with problems or conditions and dance or sports injury recovery [2]. Up to the late 1970’s Pilates was primarily taught by ex-dancers, commonly to performing artists and was not well known outside these professions.

After the late 1980s, Pilates expanded considerably beyond the world of the performing arts. Various Pilates teachers reinterpreted and modified the traditional Pilates method making it safer and more accessible for those from a non-dancer background [3].  From the early 2000’s with an increase in popularity and broadening of the client base, the brand ‘Pilates’ was marketed widely. Pilates became the ‘in thing’ for fitness and injury recovery, a new style of gym exercise and a therapeutic treatment modality [4].

1.1.2 Fundamentals of Pilates
Controlology, developed by J H Pilates during the 1920s, is a comprehensive body-conditioning method directed toward development of the whole person [5] for the “PERFECT balance of mind and body …that cured (many conditions) through corrective exercise” [6]. His principles included: the body guided by the will; striving for a straight posture and flexible spine; using deep coordinated thoracic breath with the abdomen held in [2], from the powerhouse at the mid torso [7].

After Pilates’ death his Contrology principles were elucidated as: concentration, control, centering, flow, precision and breathing [1] and the method renamed Pilates. From the 1980s onwards several Pilates teachers began to reinterpret the principles [8], exercises were modified, and new exercises introduced. The ‘Center’ or powerhouse was expanded down from the top of the pelvis to include the pelvic floor and breath engagement was modified [3, 7, 8].  Pilates ideal spinal alignment of a straight flat back was modified to a natural or neutral spine [3, 9], although there are different opinions on what constitutes neutral spine [10-13].

The Pilates system of body conditioning is more than an exercise routine, founded on stabilising the core musculature [14], while performing a controlled range of motions [15, 16]. The principles have been altered by some Pilates training providers for allied health care workers, and gym-fitness Pilates providers [17]. Physiotherapists are reported to perceive Pilates as an exercise approach requiring core stability, strength, flexibility with attention to muscle control, posture, and breathing [18, 19]. However, physiotherapy thinking has, until recently, been focused on the physical functioning of the biomechanical body [20] suggesting that the adoption of Pilates’ emphasis on the complete integration of mind and body remains challenging. Some gym Pilates providers have reduced the principles to: strengthening core, gaining toned muscles, improving balance and posture [21]. The importance of mind-body awareness that is fundamental to Pilates is left out. The popularisation of Pilates may have financial benefits for some stakeholders however clearly distinguishing between types of Pilates is important for consumer safety.

1.1.3 Types of Pilates
The Pilates Method has evolved and diversified, with different types of Pilates providing different services. The significant differences are multifaceted and include the setting, content, delivery, client population and intention (Table 1). These differences are also reflected in levels of skilled competency and the education of providers. Types of Pilates include Gym large group Pilates classes, small group population specific classes, Studio based Classical, or Comprehensive Pilates, modern therapeutic Pilates and clinical physical therapist provided Pilates.

Gym (fitness) Pilates involves teaching the same exercises to a large group, at a gym, fitness facility, multidiscipline health practice or dance studio and may involve the use of minimal equipment such as mat or barre Pilates or uses a single apparatus such as the Reformer. GymPilates group classes can be beneficial as is general exercise/physical activity [22], when taught to a fit and well client.  However, like any exercise modality if inappropriately taught, can cause harm.

(a) Figure 1. a) Group Mat GymPilates [23]              
(b) Figure 1. b) Group Reformer GymPilates [24]
Figure 2 Fully equipped therapeutic Pilates studio. 
Figure 3. Therapeutic Pilates for Bill a person with Parkinsonism

Classical and Comprehensive studio Pilates sessions are delivered using a mixture of specific Pilates apparatus[25, 26] (Figure 2). Classical Pilates closely adheres to the Contrology exercises described by JH Pilates [2, 6], as well as information from original film footage and work passed on by some of those trained by him and his partner, Clara [27]. The Classical method is more physically demanding as there is assumed pre-existing physical skill, flexibility and coordination.

Comprehensive Pilates is taught in both private and semi-private sessions using Pilates apparatus. This style of Pilates includes various exercise modifications. Some undertake a brief movement assessment with exercises graded into basic, intermediate, and advanced [28]. Commonly if the client has any conditions or problems, Classical exercises are removed from the program and some modified or pre-Pilates exercises used [26]. Usually, pathologies or conditions are not directly addressed.

Modern Therapeutic Pilates is taught using multiple Pilates apparatus and additional specialised equipment [12, 29] (Figure 3). It can be practised by anyone, regardless of age or level of fitness, and is usually taught in individual sessions or semi-private sessions and can be used for rehabilitation [30].  After initial assessment, a treatment plan and tailored programme is devised. Ongoing assessment, program modification, guidance to manage any conditions and ensure enhanced performance skill continues over the course of the sessions [31].

Clinical Pilates provided by a registered allied health care worker is taught in both private and semi-private sessions usually with limited Pilates apparatus. After assessment, a treatment plan and an initial exercise programme is provided. An exercise sequence is devised to address specific injury rehabilitation needs [32] and is different from generic Pilates [33]. Notably, ongoing supervision may be provided by a physiotherapist or exercise physiologist, an allied health assistant, comprehensive or therapeutic Pilates teacher or uncertified Pilates instructor.

Small group, population specific sessions can also be provided by a comprehensive, therapeutic Pilates teacher or allied health worker. This entails an individual assessment to determine suitability for inclusion. Exercise progressions from basic small range of movement are to be mastered before more complex and challenging exercises introduced. Group classes of up to eight participants with the same condition or problem may exercise together effectively.

Pilates classes or treatment sessions range from 45 to 90 minutes in length. Some Pilates teachers provide individual homework programs. Various online classes are also available. The highly variable provision of service of different types of Pilates are further complicated by extensive inconsistencies in the education of Pilates providers.

 Table 1 Characteristics of the different types of Pilates

1.2 Development of Pilates teacher training courses
Pilates teacher training was initially only by apprenticeship. This process started with a client or student of Pilates embracing the method and wanting to learn more. Students learnt by example and in discussion with the teacher. Some Pilates teachers trace their qualifications back to those who originally learnt the method with Joseph or Clara Pilates[27]. While learning by apprenticeship still occurs today, it is more common for  trainee teachers to undertake formal structured courses, work placement and mentoring. Although there are differences in Classical or comprehensive Pilates teachers, both adhere to a similar training framework [34].

During the 1990s, formalised training courses were developed by studio and independent  private course providers [35]. Pilates training providers flourished in the early 2000’s with most teacher training businesses initially offering comprehensive courses. Some of these courses continue to be offered around the world [36-38].

Moves to legitimise Pilates teacher training courses came from Pilates associations, course providers, and the fitness and allied health industries. Many private course providers were involved with professional Pilates associations who sought to regulate the profession, linking membership to certification. Some courses were recognised by various government training organisations providing certification from level 3 to diploma level [39]. While Pilates classes were available at a few universities, there were no tertiary teacher training courses except the Graduate Certificate in the Pilates Method (2001 to 2005) in Australia [40]. During that time students applying for a comprehensive or graduate entry Pilates course were required to have prerequisites of tertiary level anatomy, physiology and Pilates personal practice then undertake workplace practice as well as learning and applying the mind-body movement philosophy for course completion. Passing all invigilated exams on course work theory and face-to-face assessment of personal practice and teaching skills were compulsory for certification. It is unknown if these requirements continue to date for privately run courses.

Perceived financial benefits may have led course providers to change the comprehensive training courses and provide stand-alone repertoire courses. Short repertoire courses were promoted by training providers to gyms, fitness facilities, and some allied health business, who then began to advertise group mat and/or reformer sessions at prices considerably less than comprehensive semi-private studio Pilates sessions. Large group Pilates sessions are promoted as having all the benefits of comprehensive or therapeutic Pilates. However, Pilates-based repertoire is only a small component of the method and group reformer classes are equivalent to using your ‘core’ while exercising with a multi-gym resistance machine. Since all types of Pilates have a fitness component for clarity, the large group classes should be identified as GymPilates.

Even though various mind-body exercises flourished in the early 20th century [4], Pilates’ Contrology was not embraced by the registered allied healthcare professions during his lifetime. With the modifications made to the method and increasing high profile of Pilates as a functional exercise modality, in the late 1980s some physiotherapists began to train and use Pilates as a treatment tool. Research on lumbar stabilisation [41] and therapeutic exercise for low back pain [42] created interest in core strengthening [43] which is strongly associated to the Pilates powerhouse or Center [44], was published. Pilates teacher training expanded to allied health professions, with some physiotherapy-based Pilates course providers encouraging their profession to incorporate Pilates into their treatment toolbox for rehabilitation [45, 46] and as an adjunct to their practice  [14]. Physiotherapy expanded with a renewed interest in exercise as medicine [47, 48]. From the mid 2000’s Pilates began to be integrated into various allied health practices and recognised as a treatment tool within some government and private health schemes [49].

Significance
The evolution of the Pilates method has in part led to its popularisation. The subsequent diversification of the method has also led to a confusing range of provision of service and types of Pilates. Clearly naming and independently verifying the skills of Pilates providers and the potential risks of practicing the different types of Pilates is vital. The differences need to be recognisable for those interested in becoming a Pilates teacher, consumers, public health funding bodies and private health insurance funds. Large group mat or reformer GymPilates classes are substantially different from studio provided Pilates sessions.  The differences between the various styles of studio Pilates are harder to determine. Often there is overlap between Classical, comprehensive, therapeutic and clinical Pilates making occupational boundaries challenging to determine [50]. Some of the differences are most observable on review of Pilates teacher training, qualifications, or accreditation and on reflecting on the intention of the provision of service which will be discussed in the second part of this two-part series on the evolution of Pilates.

Declaration of interest: none

Dr Penny Latey is an internationally recognised Pilates Instructor with over 45 years’ in professional practice. Over the years, Penny has contributed significantly to the Pilates community, establishing the first qualified Pilates studio in Australia, co-founding the Australian Pilates Method Association, and pioneering structured Pilates teacher training. Author of "Modern Pilates 2000" and several publications, Penny holds a Ph.D. Measuring and managing foot muscle weakness. Currently an Adjunct Lecturer in the Faculty of Medicine and Health at The University of Sydney, she specialises in complex foot and lower limb issues.

Passionate about the holistic connection of mind, body, and spirit, Penny advocates for a person-centered, therapeutic Pilates approach to enhance overall well-being. You can find Penny here.

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