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Writer's pictureVanessa Mansergh

5 Tips for Pain-free Movement with Pilates Rehab

Updated: Jun 27

I have recently completed a pilates course with APPI - Australian Physiotherapy and Pilates Institute. Glenn and Elisa Withers (the founders) modified Joseph Pilates' original pilates exercises into a rehabilitation program called the APPI Method. The main goal is to take those in pain or with restricted movement to a pain free place where movements are normal again.


Who experiences pain?

Everyone, at some point in their life. It is often the back that causes problems but it can be any part of the body.




Back ache examples:

  • Grandma or grandpa lifting a grand child or bending down onto their level

  • Gardener - repetitive action of digging, weeding, strimming the hedges

  • Dog groomer - awkward movements to reach a dog

  • Desk worker - poor ergonomics creating a poor posture, too sedentary

  • Rower -an athlete repeating the same movement without a strong core

  • Chef - standing for hours chopping, stirring, frying, baking

  • Massage therapist, physiotherapist, surgeon - leaning over a table


How does rehab help?

Joseph Pilates believed that injuries were caused by imbalances in the body and habitual patterns of movement. He noticed that when a person had a weakness or mal-aligned area (out of good alignment, poor posture) , they overcompensated or overdeveloped another area to achieve a certain functional movement. His solution was to correct the malalignment with good posture and to re-educate the body to prevent recurrence. This is very much used today as the basis of rehabilitation.


5 ways to be pain free

These are known as the 5 key elements in the APPI method and every exercise position (standing, lying down etc) starts with these.





  • Breathe better: pain can literally take our breath away. Imagine an elastic band around your ribcage that you are stretching outwards as you inhale and releasing on the exhale.

-Try 5-10 breaths daily. Start with 3 counts in, 4 out.


  • Centering: every movement should start from a central core of stability. To do this you need to engage your deep abdominal muscles, back muscles and pelvic floor in unison while keeping your low back in neutral. Although born with a natural curve in our low spine, 21st century lifestyles have reduced or exaggerated this curve. -Put your hands on your waist, tuck your bottom under with bent knees and stick it out. Neutral is between these two extremes. Now engage your pelvic floor muscles by imagining stopping passing urine and wind. Hold up to 10 secs and release fully. Repeat x 10.


  • Ribcage placement: when lying down on your back, the entire back of the ribcage should rest on the floor and not arch away. If it does... -Try to puff out your chest forwards while keeping your pelvis in neutral, and then back into a rounded position. Repeat x 5 -Pop your hands on the sides of your ribcage and try shifting your ribcage to one side while keeping your pelvis absolutely still. Try the other side x 5. Now stop in the centre.


  • Shoulder blade placement: Shoulder blades need to be in the correct position on the ribcage for ideal body alignment. They won't be if you slouch or have a previous shoulder or rib injury. -Roll your shoulders up to your ears and back and down gently x 10. Imagine them resting on a coat hanger. Pause, arms relaxed.


  • Head & Neck placement: Do you poke your head forwards? Most of us do! It adds a huge amount of weight and load onto our necks. -Imagine the crown of your head is a helium balloon floating up to the ceiling to lengthen your neck and tuck that head back into place.


Next Step

By addressing these 5 key elements you will start to improve your posture and address any aches and pains you may have. The next step is learning how to move from a central core of stability. If you have an existing problem, you will need to see a pilates rehab teacher on a 1:1 basis for a physical assessment and a tailored exercise program to correct your muscle imbalances.


For those who want to book a free trial group class in person or online with me, please email vanessa@threepillarsofhealth.co.uk.









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