Implementing Pilates Into My Practice

By Samantha Schoeneman, PT, CPI
As originally seen in the 2007/2008 Balanced Body catalog

In 2002 I ran a half marathon in Montana during the icy month of February. The next day I enjoyed a full day of powder skiing. It was the day after that when I noticed decreased motion, abnormal movements, and breath-stopping pain in my low back.

As a physical therapist, I used the skilled interventions of our profession as well as my colleagues to care for my low back pain and dysfunction. This helped but found I was still unable to achieve the last 20% of my full recovery and full return to activities such as skiing, rock climbing, running, or biking. As a very active 30 year old and a health care provider I was frustrated at my body’s inability to perform at an optimal level. This frustration and disability in a positive light gave me a deeper understanding and empathy of what some of my patients go through with chronic back pain.

Alternatives to heal my own injuries

By 2004, I began seeking alternative treatments for addressing my low back dysfunction. I had heard about the Pilates method of exercise using specialized apparatus so out of skepticism and curiosity invested in 20 private Pilates sessions. Within 10 sessions I was backcountry skiing for 10 hours and running my favorite 6-mile trail the next without a second thought of nagging low back pain. I realized the strengthening and muscle coordination that the Pilates equipment and expert instruction provided the missing elements I needed for proper spinal stabilization and control for high physically demanding activities.

Today Pilates is making a big splash all over the rehabilitation and physical therapy world. Many of the principles of Pilates addresses posture, muscle performance and motor control – the same concepts that form the basis of most orthopedic rehabilitation and therapy – yet Pilates techniques and equipment provide a platform where many individuals can facilitate and transfer these concepts to everyday movement and function. Many physical therapists like myself are now using Pilates to enhance the impact of specialized exercises, which are essential in rehabilitation.

Incorporating Pilates into my practice

After feeling the dramatic and effective influence Pilates training had on my body and its limitations, I was eager to incorporate this method and equipment into my practice as a physical therapist. I completed a PMA recognized certification from Body, Arts, and Science Institute (BASI) in 2006 and added a Studio Reformer to my clinic. It’s been an effective therapeutic method ever since. To me, the Pilates principle of proximal stability greatly enhances both distal mobility and the overall efficiency of body movement. Think of the body as a crane. If the crane has a strong base then its boom or crane arm will move more efficiently. It’s the crux of what we as PT’s try to educate our patients on – that strong core stability leads to much more efficient movement with less wear and tear on the joints and muscles. Most importantly, it improves the overall biomechanics and alignment of the body.

My clinic is called Alpine Physical Therapy and is located within the 50,000 sq. ft. Peak Health and Wellness Center in Missoula, MT. Alpine Physical Therapy has a 2500 square foot clinic with 6 physical therapists and an adjacent 400 square foot Pilates studios with three Pilates instructors. Within the studio we have 3 Studio Reformers, a Cadillac and various chairs and barrels. Having both the studio and
the clinic lets me offer the complete gamut of Pilates options – rehabilitation, post-rehab, specialize sports and population classes, and continuing fitness.

It’s been just a great setting because many of our Pilates clients in our studio were PT patients in the clinic at one time. At the same time we get referrals from some of the studio instructors who may notice a member with a dysfunctional movement and send them to the clinic if needed. We also get interested club members who have heard about the program or seen it and want to try it.

Marketing my Pilates program

Although I now get most of my clients via word of mouth, I built my customer base by actively marketing the clinic within the community – and it’s something I still continue to do. You can’t just expect people to walk through the doors. We’ve offered open houses, free initial sessions to the area doctors and their wives (which led to a good referral business), sessions aimed at specific audiences within the community (Pilates for older adults, golfers, skiers etc.), and session discounts to existing Peak Health and Wellness members.

They’ve all contributed to gaining new customers and I think it is important for any PT or studio owner to have a strong community outreach program.

Get educated

The other thing that is crucial for any PT looking to implement a Pilates program is to get educated. Pilates can be a very lucrative adjunct to your practice but you have to understand that there’s a difference between Pilates for rehabilitation and Pilates for general fitness. We are both in movement analysis by trade, but where it differs is that a physical therapist works on pathological disabilities and injuries that are beyond the scope of what a general Pilates instructor should be addressing. Conversely, the Pilates method should be understood and learned via a reputable Pilates training program to ensure proper exercise, equipment, cueing, principles, and practice.

With the proper education and a little business savvy, the sky’s the limit for PT’s and Pilates. In fact, you have a very active and financially stable demographic – the Baby Boomers – beginning to hit
their golden years. This is a group that is taking a more proactive role in their own wellness. However, much of the weight-bearing exercise they did 30 years ago is now too hard on their bodies. Pilates is a perfect fit – as a method of rehabilitation and as post-rehab activity.

Samantha Schoeneman, MPT, CPI is a Partner of Alpine Physical Therapy ( and the owner of Clinical Pilates Approach, Missoula, MT. She is also a Comprehensive Certified Training Pilates Instructor through Body, Arts, and Science International (BASI) Samantha’s professional practice belief is that everybody deserves to move, function, and breathe with efficiency, awareness, balance, and control.