Getting the most out of Clinical Pilates

It is difficult to tell if the Pelvic Floor muscles are engaging properly because we cannot see if they are becoming shorter or tighter. A lot of times people will overuse their glutes instead of activating their pelvic floor causing an uncomfortable amount of tension in your buttocks.

Getting the most out of Clinical Pilates Blog  Sports and Athletic Performance Posture Integrative Medicine Approach Core
Pilates is supposed to be an exercise of low impact, engaging the muscles along the spine as well as the pelvic muscles. It is extremely important that the correct technique and posture is being used so not to create issues.

When your ribs and low back are in alignment with your pelvis is when you have a ‘Neutral Spine’. You don’t want to flatten your spine or arch it too much because this can cause stress.

By having the bottom of your ribs and hip bones in alignment, you will be able to reduce to much stress on the joints and muscles in your low back. If you practice rolling your hips backward and forward and then stopping in the middle eventually, your posture will set automatically.

So what does it mean to engage your core? Your core plays a very important role in stabilisation and balance. You want to draw in your belly button inwards towards your spine. By doing this, your low back and hip area around the pelvis will tighten and create more stability before going into an exercise.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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