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Combine Osteopathy & Pilates


Osteopathy and Pilates in ArundelOsteopathy and Pilates are holistic practices which focus on the way we move.  Both Osteopathy and Pilates aim to change or enhance our movement but they do this in different ways.

Osteopathy is a treatment.  People who chose to see an Osteopath are usually in pain and have difficulty moving.  Pilates is a form of exercise: it is a movement therapy.  In order to do Pilates you need to be an active participant.  This is not necessarily the case with Osteopathic treatment where, at least initially, the Osteopath tends to be doing most of the work!  However, as your Osteopathic treatment progresses, you will find yourself spending less time on the couch and more time doing exercises or simply staying active.

Not so very long ago bed rest was commonly prescribed for ‘putting your back out’.  This is no longer considered to be good practice.  Even if your pain is recent and severe, you are encouraged to stay as active as possible.



If it’s less than two weeks since you started to feel pain, I will probably focus more on Osteopathic treatment. This could include soft tissue work or massage, mobilisation techniques, stretching and so on.  The aim of treatment is to aid the healing process, reduce discomfort and increase mobility.

When appropriate I will add exercises and to begin with these exercises tend to be done on the Pilates apparatus.  This is because I can use the equipment to support you.  During this period patients are often troubled by pain, or the fear of pain.  Along with a fear of pain comes a fear of movement.  If the equipment is supporting you, you can relax better, the pain becomes less troublesome and you can move more easily.  It’s not unusual to find that a lot of the pain you have been experiencing has come from tense muscles. If you learn to release these, your discomfort will decrease.  The Pilates apparatus is great at giving you the opportunity to learn how to cope with pain while performing movements or exercises.  Once you get the hang of these exercises the pain will often start to ease off.  Many of these movements can be later taught as mat exercises that you can do at home.  You shouldn’t be in pain when you are doing these exercises so we will find a way of making the movement as pain free and pleasant as possible.

As your pain reduces and your mobility improves, the emphasis on activity increases.  You will spend less time on the treatment couch and more time on the Pilates equipment.  The exercises will gradually become more challenging whilst still making you feel well supported.  I can do this in a variety of ways because the Pilates apparatus is so adaptable that I can both challenge you and keep the exercises tailored to your needs.  An early return to activity is now regarded as highly desirable for many musclulo-skeletal problems, in particular non- specific low back pain.



Many people suffer from what is known as ‘chronic pain’.  Often people have had pain for years.  Sometimes the pain goes away only to flare up again and this can happen again and again.  Sometimes the pain seems to spread.  Sometimes you have pain that does not seem to relate to any movement or activity and makes little sense to you.  In a nutshell, chronic pain can leave you with the feeling that your pain is out of control and this can cause all sorts of anxieties.  Chronic pain is often accompanied by reduced mobility, people may have had to give up activities that they liked doing and sometimes they even have to change job or give up work completely.

If this sounds like you my preference would be to teach you Pilates. The aim here is to focus on what you can do and then gradually increase the range of exercises.  The only exception being when you have had a recent flare up which needs Osteopathic treatment to help calm it down.


There are lots of reasons for people in chronic pain to do Pilates or exercise in general.  One big reason is that pain is not necessarily an indicator of damage to the tissues of the body.  Body tissue has lots of nerves that can detect different things, for example heat or movement, however, we don’t have nerves that detect ‘pain’ as such, but rather they detect danger.  This is a very important point because danger does not mean that there is actual tissue injury but rather that there is something that the body as a whole considers a threat. This may mean that a ‘pain’ signal is sent to the brain and we react accordingly.  Another problem is that many different tissues such as muscles, discs, joints and organs, may be fed by the same nerves.  Some may be close by, others further away.  The brain cannot always distinguish which of these body tissues is detecting danger and sending a ‘pain’ signal.  This is linked to the phenomena of both referred pain and something called central sensitisation.  Central sensitisation happens when areas of the spinal cord become so bombarded that they and the brain become confused and you start to feel pain in lots of different areas, almost randomly with little or no reason.  When this happens it can cause a great deal of anxiety.

Our emotions, beliefs and fears can amplify our sensation of ‘pain’.  One of the big problems with chronic pain is fear of movement.  This is where Pilates can be very helpful.  The apparatus can be adjusted to your needs.  It should support you but still challenge you.  By getting you to focus on what movement you can do and giving you a pleasant experience of moving, it can calm any fears or anxiety.

Activity has many benefits.  Lots of structural and biomechanical changes occur when you move in a positive way.  Movement may help to calm the central nervous system.  Exercise leads to the release of endorphins: your ‘happy’ hormones.  The rhythmic movement of joints helps to lubricate them.  Your brain gets better at controlling your co-ordination and balance.  The gradual strengthening of muscles and deeper understanding of your body enables you to regain control of your movements and get back to doing the things that you enjoy doing.  This applies to everyone, but for people with chronic pain it’s especially important.

Having a positive movement experience makes people want to move more and being active is a treatment in itself.  You might occasionally experience a set-back or flare up, but almost certainly you’ll cope better with them, as a result of what you have learnt.  Sometimes you may need Osteopathic treatment, sometimes not.  But if you understand the nature of ‘pain’ and why it’s vital to keep active, you’ll find yourself in a better place.