Physical Therapist Samantha Schoeneman explains to her patient the relationship of the pelvis to the spine and how Pilates helps with this.

Over the years, Pilates has steadily grown within the ranks of PTs. Its reason for success is a simple one: Physical therapy is all about getting a client to a desired state of function. Pilates is all about learning to move with optimum functionality. The two essentially go hand in hand.

From a business standpoint, it can be both an extremely effective and potentially profitable form of therapy. “Pilates expands the services you can offer and provides a cash business to supplement your insurance payments,” says Nora St John, director of education for Balanced Body University (BBU), the educational arm of Pilates equipment manufacturer Balanced Body, Sacramento, Calif. “From a therapeutic perspective ,it greatly enhances your ability to get a client back to full function rather than just out of pain. It also creates a continuum of care from intensive ‘hands-on’ time to private Pilates sessions to group sessions.” St. John also adds that an affiliated Pilates program provides an ongoing source of referral as formerly injured clients frequently refer their friends and family.

So it’s no surprise that the number of clinicians turning to Pilates as a crucial adjunct to their practice continues to rise. But how exactly does a therapist become “certified” in Pilates? How much time does it take? What kind of investment is it?

BECOMING A PILATES-BASED FACILITY

Samantha Schoeneman is the co-owner and clinical director of Alpine Physical Therapy in Missoula, Mont. Situated within a 50,000-square-foot fitness club, Alpine offers both therapy services and a full Pilates fitness studio. Alpine Physical Therapy opened just 3 years ago with the goal of having it become a Pilates-based facility.

Roger Gonzalez-Hibner (BBU Faculty Pilates Instructor) takes PTs through the Hundred on the Reformer.

Physical Therapist Angela Vap uses arms supine to introduce basic Reformer work while increasing the challenge of the lumbopelvic stability for her patient.

Physical therapist Gary Gales works with spinal articulation on the Reformer.

“Six years ago I went to California and was comprehensively certified in Pilates over a 2-and-a-half-year period,” Schoeneman says. “I have always felt that its principles of incorporating the inner core, the inner pelvic floor, and breathing patterns are essentially how you are supposed to move. That’s why it is so effective. When I got back here, my goal was simple: to integrate Pilates into my therapy model.”

At first, Schoeneman was met with resistance as she struggled to get people to understand what was considered only a fitness exercise could do from a therapy standpoint. However, as more and more of her referral sources in the medical community saw what impact the treatment had on the patients and how much faster the patients seemed to be healing, she began to get much more buy-in from the medical community.

“The feedback that the clients were giving to their physicians was incredible. It began to grow rapidly by word of mouth. Then my colleagues were drawn to it as they began to see the benefits. They began to apply small pieces to their practice. But with the work of Pilates you need that comprehensive foundation so that you can truly understand the nature of the method.”

STARTING THE TRAINING

So she decided that her eight PTs needed to begin their certification. For Alpine’s beginning class, Schoeneman decided on BBU. BBU sent Pilates instructor Roger Gonzalez-Hibner to lead them in a 3-day training—18 hours total—at Level 1 (beginning) Reformer.

“I remember when I first started my certification I kind of thought that I really didn’t need to take some sections of the coursework because I knew anatomy and movement exercise in and out,” Schoeneman recalls. “But once I went through the course I thought, ‘This is brilliant—it’s something every PT needs to do.’ I think that my therapists went through this process as well. When Roger came to the clinic, my therapists asked, ‘Well, is he a PT?’ No, but it ended up being great because we just concentrated on learning and understanding the Pilates side of it. Roger was great because he acknowledged we would use Pilates as a rehabilitation tool based on our patients’ impairments and that as PTs, we would be more than qualified to make modifications or follow any precautions our clients may need.”

St John elaborates: “BBU believes that PTs already have the theoretical background to apply the method, but they need to understand Pilates as a system before they can use it with optimal results with their clients. We have several faculty members who are experienced working with PTs because they understand how best to apply Pilates in a clinical setting rather then a studio or fitness setting.”

The Level 1 class is the starting point for Reformer certification. Two other classes will follow along with actual teaching hours and a written test. But the prerequisites differ for PTs as opposed to others looking to become Pilates instructors because a therapist already has a background in anatomy and critical thinking.

“Obviously, the anatomy requirement is waived, but aside from that, PTs are free to learn just what they need to use in their practice,” St John says. “Because the licensure for PTs is much more rigorous than for Pilates instructors, many PTs just take the courses they need rather than completing the entire certification. If you plan to apply Pilates in a limited way, this can work fine. However, if you want to offer a full-service Pilates center, then you should complete the whole program so you understand the full potential of the method for your patients.”

MORE THAN JUST EDUCATION

Outside of the education her team received, Schoeneman felt that the training really helped them establish cohesiveness as a clinic: “Working together with one another and being able to establish some consistency with our Pilates work was critical. When we mention the exercise elephant, we all know exactly what the elephant is and what it can do. We were also able to discuss clinical reasoning and why we would use this particular exercise for this particular part of our practice, or what type of modification we could make. It was great to share and grow from the knowledge Roger provided us.”

	ON THE WEB: To find out more about how Pilates can be an effective and lucrative adjunct to a physical therapy practice, read “Adding Pilates to Your Practice,” in our February/March 2009 issue. Also, view numerous Pilates articles by searching our online archives for “Pilates.”
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“We paid for our therapists to take 10 private sessions at any Pilates studio. Then we paid for them to do the course. We thought it was important that they understood what Pilates was about before starting their training. You can’t just show up for a weekend course and hope to get great results. They needed to feel what it did in their bodies so they can better understand the work in their Pilates education and as they teach it to their patients.”

The end cost for the training was approximately $1,000 per PT. “It was a financial investment, yes, but the results speak for themselves,” Schoeneman says. “Alpine PT now provides Pilates rehabilitation in a capacity where the consistency and effectiveness of our Pilates work and our practitioners clearly lead the market in getting patients better faster.”

Daniel Wilson is a contributing writer for Physical Therapy Products magazine. Samantha Schoeneman, PT, CPI, can be contacted at . For more information, contact .