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Did you know that the advent of Pilates coincides with the conception of Physical Therapy?It's true!

Updated: Mar 6

The profession of physical therapy was first developed in the early 1900s for citizens to aid patients in recovering from polio and assist in rehabilitating soldiers returning from the First World War. Pilates became public practice between the world wars, which were not very far apart. Both PT and Pilates were born in the Interwar period.

In 1918, "Reconstruction Aide" referred to individuals practicing physical therapy. The first physical therapy school was established at Walter Reed Army Hospital in Washington, D.C., following World War I. Spinal manipulation was a significant component, and most physical therapists were women.

Joe Pilates developed his movement method as a comprehensive rehabilitative exercise system during and following WWI. He designed it to balance the body and mind, and legend has it through his technique; he kept his internment camp healthy during the 1918 flu pandemic. He coined his process, Contrology, now known as Pilates, which is revelatory in its thorough body and mind conditioning.

Pilates, a true believer in his method, believed it to be revelatory. (Like fired-up believers today, he was most likely annoying at dinner parties.)

"All new ideas are revolutionary," he wrote in a 1934 promotional pamphlet. "When the theory responsible for them is proved through practical application, it requires only time for them to develop and flourish."

Physical therapy is under the preview of medical science, while Pilates is often recognized as something sold to us at the strip mall or a passing trend on Instagram. But I'd argue in its original form, including all the apparatus, it's an applied science in its own right.

Depending on participant experience, physical therapy or Pilates can be a natural healing practice, a straightforwardly and thoughtfully choreographed exercise program, or a prescriptive workout regimen. In contrast to Pilates, PT is legitimized by regulatory bodies and higher degrees, while some Pilates certifications can be achieved in a single weekend. A gift from Capitalism! Or Pilates can be comprehensively studied over an absolute minimum of 750 hours or through 2.5+ year apprenticeships.


Pilates historically lived without regulatory agencies as the movement had been passed on from mentor to mentor/person to person. Regulation is so young in our industry that I taught Pilates through UW Madison Wisconsin Continuing Education Department without a Pilates certification more than 20 years ago. Pilates certification not being required, even by a significant institution, was standard back then.

Today, there is fervently active work on regulation within the industry. Still, I'd argue that the lack of a trademark thus far has created beautiful tools for creativity within the pedagogy—things most easily found outside regulatory bodies. Humans are unique and can often require a unique approach. A solid foundation and understanding of the original method with room to innovate within the said structure have created great things and, admittedly, many not-so-great things.

However, innovation is necessary; humans are unique and often require a unique approach.

Much of our medicine and the guidance offered in Physical Therapy is drawn from averages.

People can make an average together, but no human is a simple average alone.

For example, a T or (an even better score to work with) Z-score for bone density is an average bone density taken of select groups of people.

My average temperature of 97.6 is expected; 98.6 is just an average.

"That original study in the 1860s was done before antibiotics were available. Therefore, many people had infections that couldn't be treated, which would have affected temperatures if chronically sick," says Heidi Zapata M.D., Ph.D., a Yale Medicine infectious disease specialist. So, our average temperature may be likely incorrect!


Pilates Instructors are not allowed to diagnose or treat. Still, we have the gift of uninterrupted time and observation of our clients, giving us a way to address the why of an injury or stress pattern while uniformly strengthening the body. We get to spend time with our clients, giving them uninterrupted attention. The teacher and apparatus feedback can often help empower our clientele out of chronic pain, which we now know is not a mere biomechanical issue, and 'Return {them} to Life.'

PTs often are left to treat the simple fact of an injury. Excellent P.T.s also manage the why, but addressing the why is often not easily billable. Have you ever wondered why you and your (HMO-covered) P.T. only work on one side of the body when healing a muscle strain or joint issue? Your insurance often does not cover time spent on the other side. It's true! Not only are PTs up against HMOs in this way, but they also must leave it up to their patients to do their homework well. It takes more time and shared focus to heal and find trust in our bodies post-injury or surgery than most of us would like. Healing takes time, and our excellent PTs are well aware of it, but this is a time our insurance companies may not allow. Many PTs and Pilates instructors across the U.S. have joined forces, therefore.


One problem with how we look at healthcare is that we are not taught to see our bodies as a lifelong responsibility. (Though an endlessly confounding and adventure-filled commitment, where good and bad luck is real.) How is a white-coated man or a woman in a building the expert of the unique body through which we've experienced our entire life? Why do we not see cognitive dissonance? Doctors are indeed the most informed about all diseases and bodily trauma, but you are the expert of you. How can we have unique fingerprints and tongues (yes!) but all go after the same ideal T-score? Well, because we have so much to learn. Medicine is working hard and works with and for billions of people. But it is our responsibility to know our own body.

In life, we take our bodies on an experiential journey and are rewarded with a place to live and endless sensations. With Pilates or any mind-body practice, you can begin a relationship with your body outside of simple good and bad sensations and soon care for and help aches and pains on your own. Empowerment.

Choose a Physical Therapist to diagnose and help heal anything acute. But Pilates may be what your mind and body could use if you have seen a Physical Therapist and still walk around favoring your "good" hip.

We'd love to have you at our studio, but our goal is to give you the knowledge and conditioning so that you can take your comprehensive Pilates practice to other studios worldwide.

When choosing studios to visit, please look for comprehensively trained instructors with experience. This translates to more than reformer and chair. Those apparatuses are only a portion of Joe's method!

Check-in with your unique human being every day.





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