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Clinical Pilates versus fitness Pilates

Published: 28 September 2017 - Fitness and Training

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It’s a common question we get asked as physios: what’s the difference between a Pilates class in a gym (which may have upward of 30 participants) and a clinical Pilates session (which has between 1-4 participants).

What is Pilates?

Many gyms now offer Pilates classes which focus on improving core strength, balance and flexibility. Clinical Pilates focuses on rehabilitation and injury prevention and uses a combination of specialised equipment including reformers and trapeze tables complimented by floor-based exercises depending on your needs.

The differences between clinical and fitness Pilates


For those seeking rehabilitation, it is the cause of the problem that needs to be addressed, not just the symptoms.

Before participating in a clinical Pilates session, your physio will do a thorough assessment. This assessment will uncover the physical factors (movement patterns, weakness, flexibility, balance, etc.), lifestyle factors (office work, lifting technique, etc.) and psychological factors (stress, coping strategies, etc.) causing your injury or concern.

Personalised program

One size doesn’t fit all. A 20-year-old athlete working to rehabilitate a knee injury has very different needs, injury causes and rehab goals to a post-natal mother with neck pain from breastfeeding. They will need to complete different programs to address their particular injuries or concerns and long-term wellbeing goals. Smaller class sizes allow for individually-tailored programs.

Changing the way you move

To paraphrase an old saying: the definition of insanity is doing the same thing over and over and expecting a different result.

Although some things require persistence, when it comes to exercises, technique is just as important as the exercise itself. Your brain has a pre-programmed sequence of muscle activation and the good news is that if you have great technique, you can maintain these movement patterns easily by repetition in your day-to-day life.

Unfortunately, it is very common for us to see clients present with persistent pain due to how they move especially when they are fatigued or under load.

We often see clients who have gone to a large group fitness Pilates class and felt no improvement (or feel their injury/concern is worse) and concluded that Pilates wasn’t going to help them.

Consistent progression

The smaller class sizes utlised in clinical Pilates allow your physio to vary each participant’s exercise program week to week depending on how quickly they are progressing and how they are feeling.

We are also able to re-test key exercises as a measure of progress.


While not exclusive to clinical Pilates, the individualised approach taken in clinical Pilates allows us to educate our clients on their specific injuries. We believe the better informed our clients are, the better decisions they can make for their long-term health.

Although each case is unique and will require a slightly different treatment plan, your initial assessment with your physio will give you will have an understanding of the root cause of your problem and the best way to maximise results and reduce your risk of re-injury.