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by Dr. Rachel Miller, PT, DPT
There’s been a lot of talk lately about whether Pilates falls under fitness or wellness. The truth? It can be both, but it will depend on the studio/environment. There are many Pilates studios opening that are fitness focused which can still be beneficial, but are often missing the foundational piece especially in a group class environment. Pilates is a journey. The more you learn about movement and the Pilates concepts, the more benefit you will gain from your practice which is what we focus on here at The Pilates PT. Our bodies are designed to be efficient. When we move, the body naturally chooses the easiest path to get the job done, usually by recruiting the strongest and most accessible muscles. But what your body needs is often using the smaller, harder-to-find muscles. Pilates is Brain Work Pilates is just as much mental work as it is physical. The more you understand where your body is in space and which muscles are initiating movement, the more precise and effective your practice becomes. Subtle adjustments such as like changing your breathing pattern or alignment can completely transform an exercise. Returning to foundational movements, experimenting with different verbal or tactile cues, and working with an experienced instructor can all help you connect more deeply to your body. Getting the Most Out of Your Pilates Practice So how can you make sure you’re getting the maximum benefit from Pilates? 1. Education Knowledge is power—especially when it comes to movement. Understanding why and how your body moves builds awareness and control. Our Core Connections videos are designed exactly for this: educational exercise that helps you move smarter and more efficiently. 2. Personalized Attention Private sessions are the best way to truly “wake up” the smaller stabilizing muscles and address your individual needs. Once you have a solid foundation, moving into a duet or small group classes can help you apply what you’ve learned while still receiving personal guidance. *Our Pilates intro package combines 2 private sessions with our Core Connections videos and is an amazing deal... 3. Addressing Limitations If you’re dealing with pain, tightness, or mobility restrictions, it may be helpful to start with physical therapy. Working with a Pilates-trained Physical Therapist can bridge the gap between rehab and movement, helping you transition to Pilates safely and confidently. Pilates is more than just a workout, it’s a practice in awareness, precision, and connection. When you combine education, mindful movement and expert guidance, you create a foundation not only for strength and flexibility but for overall well-being.
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By: Rachel Miller PT, DPT
Pilates is known for its incredible benefits in core strengthening—but is it possible to engage your core too much? The answer might surprise you. The Core Should Be Functional, Not Just Strong Our deep core system is designed to be reflexive, meaning it should automatically engage and relax as we move through life. For example, if someone bumps into you while you’re standing, your core should naturally activate to keep you balanced. But what happens if your core muscles are already contracted all the time? They lose the ability to respond effectively. Just like any other muscle, the core needs to be able to both contract and relax to function optimally. A Tight Muscle Is a Weak Muscle Over the years, I’ve worked with many patients who habitually clench their glutes, suck in their stomach, or hold tension in their pelvic floor. While these patterns are common, they can actually lead to muscle weakness and dysfunction over time. The causes vary:
The first step toward a healthy, functional core is awareness. Take a few moments throughout your day to check in with your body:
Once you can release unnecessary tension, you can start rebuilding balanced strength. If you struggle to feel your glutes or deep abdominals engage during exercise, it might be because they’re already “on” all the time. Gentle release work or mindful breathing can help reset your system so your muscles can start firing appropriately again. Contract and Relax Here’s a simple example: If you flex your bicep right now and then try to contract it even more, you can’t. The muscle is already shortened. You would need to straighten your elbow first to relax it before you can contract it again. The same principle applies to your core. For your muscles to activate effectively, they must first be able to let go. As you move through your Pilates practice (and your day), remember this simple truth: A functional core isn’t one that’s always tight... it’s one that knows when to engage and when to release. By: Rachel Miller PT, DPT
The core is our center. It stabilizes the trunk while arms and legs are moving. It not only includes our abdominals, but also our back and scapular musculature, pelvic floor, and gluteal/hip muscles. The core is supposed to help you with daily activities. The more strenuous an activity or exercise is, the more the core should help. Unfortunately, when we have pain or surgery in this area, it affects the core muscles and can cause weakness and the core to not function optimally. The good news is that the core can be retrained, and all of these signs of core weakness can be improved. 1. You have neck or back pain While there are many causes of neck and back pain, core weakness can be one cause. Pain with prolonged sitting or standing, or pain with change in positions such as sit to stand or rolling over may indicate core weakness as a contributing factor. 2. You tend to slouch Sitting or standing for long periods of time can be challenging. Our postural muscles are endurance muscles- meaning they need to work a little bit, but for a long period of time. None of us have perfect posture all of the time. That is fine, variety is good for us. But if you are in a slouched position for hours every day, that leads to a forward head position, pec/chest tightness and excessive flexion of the upper back. This can lead to back and neck pain as well as core weakness. 3. You have poor balance Our core and especially the muscles in our hips/pelvis are important for balance. If these muscles are weak, your balance will be affected. Often one side of your body is weaker or has more difficulty with balance so see how you feel with a single leg balance test. As we get older, balance becomes more challenging so incorporating balance training into your workout routine is important. 4. Core exercise or heavy lifting are difficult It seems obvious but if you struggle with core exercises, you likely have a weak core. The only way to get better is to practice. But keep in mind that the deeper core muscles that provide stability should be working with our outer muscles that our movers so working with someone that can teach proper form and muscle activation is highly recommended. Do you tend to hold your breath with exercise? If the answer is yes that is a common compensation for core weakness. Remember that your core is meant to help you with real life, not just core exercise. When you lift a heavy bag of groceries, do you feel your stomach muscles automatically tighten? That is what we want- a reflexive core. If you find heavy lifting or strenuous activities are difficult, or if you don’t feel your core engaging, that is something that you can change. 5. You leak urine with sneezing, laughing, coughing, jumping or exercising This is a sign that your pelvic floor muscles are not doing their job. Either there is a pelvic floor muscle issue, or your deep core system is not working together properly. If you are leaking even just a little bit, even just sometimes, while it is common, it is not normal and pelvic floor Physical Therapy can help. You may now be thinking what is the best way to strengthen my core? I believe that it takes some body awareness and education, along with exercise with proper form. Pilates does exactly this, and our Pilates intro package is the best starting place. It gives you access to over 2 hours of educational exercise videos called Core Connections that focus on teaching you proper form and core activation as well as core exercises for the entire core system. The intro package also includes two private Pilates sessions- either in our studio or virtually so you can get feedback and guidance from an expert. By Rachel Miller, PT, DPT
It is estimated that 50% of adult women experience urinary incontinence. There are a few different types of incontinence. Stress incontinence is leaking urine when you sneeze, laugh, cough, jump or exercise. Urge incontinence is leaking because you can’t hold long enough to get to the bathroom. Mixed incontinence is a combination of both. Risk factors for incontinence include increased age, obesity, type 2 diabetes, and history of former or current cigarette smoking. Birth history also is a factor, a vaginal delivery or multiple births increase the risk more than c-section. A hysterectomy also shows increased risk of incontinence after. So, ladies, let’s get real. If you have given birth and are getting older (is anyone getting younger?), statistics are not fabulous. Is it possible to decrease your risk? I believe you can. Keep reading if you want to learn how… and no, the answer is not daily kegels (pelvic floor muscle contractions). First, check in with your pelvic floor muscles. Are they doing their job well? If you are noticing occasional leaking- even just a little bit, even just sometimes; that is a sign that your pelvic floor muscles need some attention. Seek treatment now- pelvic floor Physical Therapy is the #1 recommended intervention and can not only help you not leak now, will likely help set you up for better success in the future. If you are not having any leaking right now, that is great but I want you to explore a little deeper. Do you have hip pain, low back pain or hip tightness? Do you have pelvic pain (pubic symphysis, SI joint) or pain with gynecological exams or intercourse? If the answer to any of those is yes, the pelvic floor muscles may be involved and are often hypertonic (too tight). How do you know for sure? Get assessed by your OBGYN or a pelvic floor therapist. How strong is your pelvic floor? Next time you go to the bathroom, can you stop the flow of urine? Do not do this frequently as it can cause problems, but as a one time check it can at least tell you if you know where your pelvic floor muscles are if they are strong enough to accomplish this task. If you cannot do this, it can mean that the muscles are weak, or sometimes all it means is that your brain doesn’t know where the muscles are. If you can do this but are experiencing any of the other issues or occasional leaking, it can be a timing or coordination issue of the muscles. It could also possibly be a hypertonic pelvic floor - if the muscles are already contracted/tight, then there is no additional help when you need it. If you have ever given birth or had a pelvic or lower abdominal surgery, request PT. It is not the standard of care but when the muscles are overstretched in pregnancy/birth or cut through (c-section or surgery), having a little help to reconnect after can be so helpful. Don’t worry, it is never too late to make changes. Also, minimize all other risk factors you can. If you have a high BMI, focus on weight loss. If you are a smoker, consider stopping. Set yourself up for success. You can start by taking action now! If you are experiencing incontinence or other pelvic floor issues, schedule a free virtual discovery session with a Physical Therapist to help determine what is the appropriate next step for you. If you are not having issues but want to be proactive, schedule a Mommy Tune Up- a private wellness session with a women’s health Physical Therapist that will assess core strength, flexibility, and more. And now includes a screening of your pelvic floor muscles with real time ultrasound (that is performed on the lower abdominal wall) so we can make sure your pelvic floor muscles are doing their job! |
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December 2025
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