What Makes Physio-Led Pilates Different? By the Auckland Physiotherapy Team · 6 min read · Auckland Physiotherapy, Newmarket
Pilates has never been more popular — and for good reason. It builds strength, improves posture, and leaves most people feeling better in their body. But not all Pilates is the same, and if you are dealing with an injury, recovering from surgery, managing persistent pain, or returning to exercise postpartum, the difference between a general fitness class and physiotherapist-led clinical Pilates is significant.
Wondering if clinical Pilates is right for your situation? You'd need a 45-minute session with one of our physios to properly assess where you're at and design a programme that matches your body and your goals. 👉 Book a free call | Book now
What is clinical Pilates?
Clinical Pilates is a form of Pilates that is prescribed and supervised by a physiotherapist. It uses the same foundational movements and equipment — including the Reformer — as general Pilates, but the programme is individually designed based on a thorough physiotherapy assessment of your posture, movement patterns, strength, and the specific demands of your condition or goal.
At Auckland Physiotherapy, we ask everyone joining our studio classes to complete a 45-minute one-on-one session first. This is not a formality — it is how we make sure you start in the right place and progress safely.
The key differences
It starts with a proper assessment. In a general fitness Pilates class, the instructor observes the group and offers general cues. In clinical Pilates, your physiotherapist assesses how your individual body moves before you do a single exercise. This includes looking at your posture, breathing mechanics, how you activate your deep stabilising muscles, and any movement compensations that may be driving your symptoms.
The programme is built around you. Your clinical Pilates programme is not a set class sequence — it is designed specifically for your body, your history, and your goals. Two people in the same session may be doing entirely different exercises, because what each person needs is different.
Your physio can identify what is actually happening. A Pilates instructor can see that your hip drops when you do a single-leg exercise. A physiotherapist can tell you why — whether it is a hip abductor weakness, a pelvic control issue, or something in your movement history — and correct the cause, not just the symptom.
Progression is clinically guided. In general Pilates, you progress when the instructor observes that you are ready or when you feel comfortable. In clinical Pilates, progression is based on your physiotherapist's assessment of whether your neuromuscular system is genuinely ready for the next load — which protects you from re-injury or reinforcing poor movement patterns.
Related reading:
Who is clinical Pilates suited to?
Clinical Pilates can be beneficial across a wide range of presentations. At Auckland Physiotherapy it is commonly used for:
It is also used alongside general physiotherapy treatment — your Pilates sessions and your physio appointments can complement each other as part of a single, coordinated care plan.
Can I also join a group class?
Yes. At Auckland Physiotherapy, group Pilates classes are available through the Loft Pilates studio, including Reformer, Studio, and Reformer/Mat formats. Classes are kept small to ensure every participant is exercising safely and effectively, and the instructors can provide variations to suit different levels. The individual 45-minute session before joining a class means your instructor already understands your body before you walk through the door for the first time.
Is it covered by ACC or health insurance?
Clinical Pilates at Auckland Physiotherapy can be accessed under ACC for eligible conditions, and some Southern Cross health insurance plans also cover clinical Pilates sessions. Contact our team on 09 366 4480 if you have questions about what applies to your situation.
Related reading:
Ready to try physio-led Pilates?
You'd need a 45-minute one-on-one session to get started — this is how we make sure your programme is built around your body, not a generic template. Not sure if it's right for you? Book a free call first.
👉 Book a free comp call | Book now
How we can help:
This article is for educational purposes only and does not constitute medical advice. Please consult a qualified health practitioner before beginning any new exercise programme.
Tags: Clinical Pilates · Physio-led Pilates · Reformer Pilates · Core strength · Rehabilitation · Newmarket
Postpartum Abdominal Weakness: What's Normal, What's Not, and How to Rebuild By the Auckland Physiotherapy Team · 7 min read · Auckland Physiotherapy, Newmarket
Having a baby changes your body in profound ways, and one of the most common concerns we hear from new mums is that their core just doesn't feel like it belongs to them anymore. Weakness, heaviness, a soft or domed tummy, or back pain that wasn't there before — these are all signs that your abdominal system needs some targeted attention. The good news is that with the right approach, most women can rebuild meaningful core strength and get back to the activities they love.
Experiencing postpartum abdominal weakness or pain? You'd need a 45-minute session with one of our pelvic health physios to properly assess what's happening and build a plan that's safe for your stage of recovery. 👉 Book a free call | Book now
What happens to your abdominals during pregnancy?
During pregnancy your abdominal muscles — including the rectus abdominis (the "six-pack" muscles), the obliques, and the deep transversus abdominis — are stretched significantly to accommodate your growing baby. The linea alba, the connective tissue that runs down the centre of your abdomen, also stretches and widens. This is a normal and necessary part of pregnancy.
After birth, many women find their abdominals feel weak, unresponsive, or simply different. This is not a failure on your part — it is a predictable consequence of what your body has been through. The question is not whether your core has changed, but how to help it recover well.
What is diastasis recti?
Diastasis recti refers to the separation of the two sides of the rectus abdominis muscle along the midline. Some degree of separation is present in the majority of women by the third trimester — it is how your body makes room for your baby. What matters postpartum is not simply whether a gap exists, but whether the linea alba has sufficient tension and load transfer capacity to support normal function.
Signs that diastasis may be affecting you include a doming or coning along the midline when you sit up, lower back pain, pelvic girdle discomfort, or difficulty with activities like lifting, carrying, and returning to exercise. A pelvic health physiotherapist can assess this properly and tell you exactly what you are dealing with.
Related reading:
What about the pelvic floor?
The abdominal system and pelvic floor work together as part of the same pressure management system. Weakness or poor coordination in the pelvic floor often accompanies postpartum abdominal weakness, and vice versa. This is why a postpartum assessment should always look at both — not just the tummy, but also how the pelvic floor is functioning, particularly if you are experiencing any leaking, heaviness, or prolapse symptoms.
If you have any of these symptoms, they are worth getting assessed. They are common after having a baby, but they are not something you simply have to accept.
A proper postpartum assessment looks at both your abdominals and your pelvic floor together — not just one or the other. 👉 Book a free call | Book now
When is it safe to start exercising again?
There is no single universal answer to this, because the right timeline depends on your birth experience, how your body is healing, and what type of exercise you want to return to. General guidance includes:
The "six-week check" with your GP or midwife is a useful milestone, but it does not replace a dedicated postpartum physiotherapy assessment. Many women leave that appointment without any specific guidance on core or pelvic floor rehabilitation.
What does good postpartum core rehabilitation look like?
Effective postpartum rehabilitation starts from the inside out. Rather than jumping straight to planks or sit-ups, the focus initially is on reconnecting with the deep core system — the transversus abdominis and pelvic floor — and ensuring these muscles are both activating and relaxing correctly. From there, exercises are progressively loaded to rebuild strength and tolerance for the demands of everyday life and, eventually, exercise.
Common areas addressed include:
Pilates is often an excellent tool at this stage, particularly clinical pilates supervised by a physiotherapist who can monitor your form and progress your programme safely.
What to avoid in the early postpartum period
In the early weeks, certain exercises can place more load on the healing abdominal and pelvic floor system than it is ready for. These include traditional crunches and sit-ups, double-leg lowering exercises, high-impact activity, and heavy lifting without proper bracing technique. This does not mean these things are permanently off limits — it simply means the timing and sequencing of your return matters.
Related reading:
Ready to start rebuilding with confidence?
You'd need a 45-minute session with one of our pelvic health physios to properly assess your abdominal and pelvic floor function and build a plan that's right for your stage of recovery. Not sure where to start? Book a free call first.
👉 Book a free comp call | Book now
How we can help:
This article is for educational purposes only and does not constitute medical advice. Please consult a qualified health practitioner before beginning any postpartum exercise programme.
Knee pain during running is one of the most common complaints we see in clinic — but "knee pain" is not a single diagnosis. Where exactly it hurts, when it comes on during a run, and what makes it worse are all important clues. This guide walks through the most likely causes, how to tell them apart, and what to do next.
Not sure what's causing your knee pain? You'd need a 45-minute session with one of our physios to properly identify the cause and get a clear plan. 👉 Book a free call | Book now
The most common causes of runner's knee pain
Most running-related knee pain falls into one of five categories. Each has a distinct location and pattern — understanding which one fits your symptoms is the first step toward the right treatment.
Patellofemoral pain syndrome (front of knee) Aching around or behind the kneecap, worse going downhill or on stairs.
IT band syndrome (outer knee) Sharp or burning pain on the outer edge of the knee, usually starting 15–20 minutes into a run.
Patellar tendinopathy (below kneecap) Localised pain just below the kneecap, often stiff in the morning and at the start of a run.
Pes anserine bursitis (inner knee) Pain and tenderness on the inner side of the knee, approximately 5 cm below the joint line.
Meniscus irritation (inside joint) Joint-line pain, often with a sense of catching or locking, especially when twisting or squatting.
Related reading:
How to identify which type you have
Location is your best guide. Use this table to match your symptoms to the most likely diagnosis — but keep in mind that some presentations overlap, and a clinical assessment is the most reliable way to confirm.
| Pain location | When it hurts most | Most likely cause |
|---|---|---|
| Around or behind the kneecap | Downhills, stairs, sitting long periods | Patellofemoral pain syndrome |
| Outer edge of the knee | 15–20 min into a run; downhills | IT band syndrome |
| Just below the kneecap | Start of run, after rest, jumping | Patellar tendinopathy |
| Inner knee, below joint line | After long runs; morning stiffness | Pes anserine bursitis |
| Along the joint line | Twisting, squatting, deep bending | Meniscus irritation |
What causes these conditions?
Most running knee injuries don't come from a single traumatic event. They develop gradually, usually due to one or more of the following factors.
Training load errors Increasing weekly mileage too quickly is the most common driver of overuse injury. A general guideline is to increase total volume by no more than 10% per week — though this needs to be individualised based on training history and recovery capacity. Sudden introduction of hills, speed work, or back-to-back long runs without adequate adaptation time also puts disproportionate load on the knee.
Biomechanical factors Running gait, hip strength, and foot mechanics all influence how load is distributed across the knee. Weakness in the hip abductors and external rotators is frequently associated with patellofemoral pain and IT band syndrome, as the femur tends to rotate inward during the stance phase of the gait cycle. Overpronation — excessive inward rolling of the foot — can also alter knee tracking.
Running surface and footwear Hard surfaces such as concrete and asphalt absorb less impact than grass or trail. Worn running shoes that have lost their midsole cushioning can increase ground reaction forces at the knee. Most running shoes should be replaced after 500–800 km of use, though this varies by shoe construction and body weight.
Muscle tightness and weakness Tight hip flexors and quadriceps can increase patellar compression forces. Weak glutes reduce pelvic control during the stance phase. Both patterns are common in people who spend a lot of time sitting during the day.
A 45-minute session lets our physios properly assess what's driving your knee pain — including a full movement and gait screen. 👉 Book a free call | Book now
When to stop running and seek help
Not all knee pain means you need to stop running immediately — but some symptoms do warrant prompt professional assessment. Running through the wrong type of pain can convert a manageable overuse injury into a more serious structural problem.
⚠️ Seek assessment if you experience any of the following:
Mild, consistent aching that eases within a few minutes of stopping is often manageable with load modification and targeted exercise — but it still benefits from a proper assessment to confirm the cause and guide the rehab approach.
What treatment looks like
The right treatment depends entirely on the confirmed diagnosis. That said, several principles apply across most running-related knee conditions.
Short-term load management This rarely means complete rest. More often it means temporarily reducing volume, removing the specific trigger (e.g. downhills for IT band syndrome), and maintaining fitness through lower-impact cross-training such as swimming or cycling while the tissue settles.
Targeted strengthening Strengthening the muscles that support the knee — primarily the glutes, hip abductors, and quadriceps — is a core component of rehabilitation for most running knee conditions. The specific exercises, load, and progression depend on the diagnosis and individual presentation.
Running technique modifications For some presentations, small changes to cadence, step width, or trunk lean can meaningfully reduce knee load without requiring significant mileage reduction. These changes are best guided by a practitioner with running assessment experience.
Footwear and orthotics In specific cases where foot mechanics are contributing, footwear changes or custom orthotics may help. However, orthotics are not a standalone fix — they work best as part of a broader programme that includes strengthening and technique work.
Related reading:
Can knee pain be prevented?
Not all running injuries are preventable, but the risk can be substantially reduced with sensible training habits. Key factors include:
How we can help
Running injuries service | Knee pain | Meet the team
Ready to find out what's causing your knee pain?
You'd need a 45-minute session with one of our physios to properly assess the cause and build your plan. Not sure where to start? Book a free phone call first.
👉 Book a free comp call | Book now
This article is for educational purposes only and does not constitute medical advice. If you are experiencing knee pain, please consult a qualified health practitioner before continuing to run or beginning any exercise programme.
Most people are familiar with their chronological age — the number of years they’ve been alive. But an equally important question is:
How well is your body aging?
This is where the concept of functional age becomes valuable.
Functional age refers to how well your body performs in everyday life. It reflects your strength, balance, mobility, endurance and confidence with movement — all factors closely linked to long-term independence, quality of life and healthy aging.
At our clinic, we use a range of evidence-based physical assessments to help identify areas of strength, detect early decline, and create personalised strategies to help people stay active, capable and independent for longer.
Two people can both be 70 years old but have vastly different physical abilities.
One may:
Another may struggle with:
Research consistently shows that physical function is one of the strongest predictors of:
The good news is that many of these factors can be assessed early — and improved with the right support.
Our Longevity Screen focuses on key markers of physical function that are strongly linked to long-term health and independence.
Balance naturally changes as we age, but poor balance is not simply something people must accept.
Balance assessments help identify:
Strength is one of the most important predictors of healthy aging.
Reduced muscle strength is associated with:
We assess functional strength through clinically relevant movement tests designed to reflect real-life activities.
Mobility is essential for maintaining an active lifestyle.
We assess:
These assessments help identify restrictions that may impact comfort, confidence and physical performance.
Simple movement-based tests can provide valuable insight into how efficiently the body is functioning.
These tests may include:
Together, these measures help create a broader picture of physical capacity and resilience.
Healthy aging is not just about lifespan — it is about maintaining the ability to do the things you enjoy for as long as possible.
Research has shown that measures such as:
In many cases, declines in physical function appear years before more significant health limitations develop.
By identifying these changes early, targeted exercise and physiotherapy interventions can help:
Our goal is not simply to “test” people — it is to help them better understand their body and provide practical strategies to support healthy aging.
Following the assessment, we provide personalised recommendations which may include:
Every person ages differently, and the right approach should be tailored to the individual.
Many people wait until pain, injury or loss of confidence significantly affects their lifestyle before seeking help.
A proactive assessment can help identify opportunities to improve strength, mobility and balance before small issues become larger limitations.
Whether your goal is to:
If you would like to learn more about our Longevity Screen, our team would be happy to help. Please call 09 3664480.
Auckland Physio5 min read
Menopause is a natural transition — but the symptoms it brings, from bone loss to muscle decline, are far from inevitable. Research is increasingly clear: the habits you build in your 30s and 40s can dramatically shape how your body moves, feels, and functions for decades to come.
THE SCIENCE
As oestrogen levels decline during perimenopause and menopause, women experience accelerated loss of bone density and muscle mass — a process called sarcopenia. Studies show women can lose up to 3% of bone density per year in the first 5 years after menopause, and muscle mass naturally declines from around age 30 onwards if left unchallenged.
The good news? Strength training is one of the most evidence-backed interventions available — and it works at every age. But starting earlier gives you a significant head start.
3% Bone density lost per year in early menopause
30s When muscle mass begins to slowly decline
2×Fracture risk reduced with regular resistance training
RESEARCH INSIGHT
Bone density peaks in your late 20s to early 30s. After that, how much you preserve depends on how hard you challenge your skeleton. A landmark review published in the Journal of Bone and Mineral Research found that women who engaged in regular weight-bearing and resistance exercise before and during perimenopause maintained significantly higher bone mineral density than those who were sedentary — reducing fracture risk by up to 50%.
"The best time to plant a tree was 20 years ago. The second best time is now — and the same is true for strength training."
Starting in your 30s also means you build neural pathways and movement confidence before hormonal changes kick in — making it easier to stay active through perimenopause, when fatigue and joint changes can otherwise become barriers.
Journal of Bone & Mineral Research Menopause Journal British Journal of Sports Medicine
WHY IT MATTERS
YOUR JOURNEY
30S — OPTIMAL WINDOW
Build your foundation
Peak opportunity to maximise bone and muscle mass before hormonal shifts begin. Start 2–3 sessions of resistance training per week. Even walking with load counts.
40S — PERIMENOPAUSE
Protect what you've built
Hormonal fluctuations begin. Strength training becomes even more important to maintain metabolism and bone density. Progress intensity gradually with guidance.
50S+ — MENOPAUSE & BEYOND
It's never too late
Studies confirm strength gains are possible well into your 70s and 80s. Starting now still dramatically improves quality of life, balance, and independence.
HOW WE CAN HELP
Starting something new — especially after time away from exercise — can feel daunting. And if you've got a niggling knee, a sore back, or a shoulder that doesn't quite behave, it's easy to put it off. That's exactly where our physio team comes in.
At Auckland Physio, we work with women at every stage of this journey. Whether you're brand new to strength training, navigating a previous injury, or just not sure where to begin — we can assess your movement, address any pain or limitations, and build a programme that's safe, progressive, and genuinely enjoyable.
We also integrate Pilates-based rehabilitation, which is particularly effective for building core strength, improving posture, and restoring confidence in movement — all areas that matter deeply as your body changes through perimenopause and menopause.
Book a complimentary call Today to get started.
As a parent, you want to do the "right" thing. Recently, I found myself in a common debate at home regarding my daughter’s hockey practice. My instinct has been that she actually does better—more focused, more independent, more "in the zone"—when I’m not there. I prefer to drop her off, let her cope with the drills and the social dynamics on her own, and then show up for the games to support the competitive side she loves.
My wife, however, raised a fair point: shouldn’t we be watching the practices to provide a "safe environment"? Is our physical presence the security blanket they need to thrive?
It’s a classic parental tug-of-war between being there and giving space. However, from a psychological welfare perspective, "dropping and going" isn’t just a convenience—it might be one of the best developmental gifts you can give a young athlete.
1. The "Observer Effect" and the Glance Back
In sports psychology, the Observer Effect is real. When a seven-year-old knows a parent is watching, the practice session changes from a "learning lab" to a "performance."
Practice is supposed to be messy. It’s where kids should feel free to fall over, miss the ball, and make mistakes without looking toward the sidelines to gauge a parent’s reaction.
If your child is more engaged when you aren't there, it’s often because they’ve moved from seeking external validation to finding internal drive. They aren't "Paul’s daughter" in that moment; they are just a hockey player.
2. Autonomy: The "Social Lab" of Sport
Sports practices are as much about social hierarchy and peer bonding as they are about skills. When we "drop and go," we allow our children to navigate social friction and coach instructions entirely on their own.
This builds self-efficacy—the internal belief that "I can handle this." By giving them that hour of independence, we are providing a "psychologically safe" space where they are the protagonists of their own story, not just a character in ours.
3. Active Modeling vs. Passive Spectating
There is a strange phenomenon in youth sports today: the "spectator culture." You’ll often see sidelines full of parents who are sedentary, perhaps even overweight or disconnected, watching their kids "try their best."
There is a massive psychological gap here. Children are highly tuned to Social Modeling. They notice when a parent values their own physical "engine" versus when a parent is merely a passive consumer of the child’s effort.
If you maintain your own fitness and lead an active lifestyle, you are providing a more powerful form of "support" than a parent sitting on a folding chair for sixty minutes. You are showing them that physical competence is a lifelong standard, not a childhood phase.
4. Redefining "Safety"
My wife is right that a safe environment is vital, but for a child who thrives in competition, "safety" is often found in the consistency of the return. Psychological safety for a young athlete is knowing that regardless of how the practice went, the person picking them up is a "consistent base"—someone who is interested in whether they had fun, rather than a technical critique of their footwork.
The Verdict
If your child is happy, competing hard, and growing in your absence, it isn’t a sign that you’re "missing out." It’s a sign that you’ve raised a child secure enough to venture out into the world without needing to look back over her shoulder.
The best support we can give sometimes isn't our eyes on the field—it’s the active example we set in our own lives and the space we give them to own their own game.
By Paul White, Running + Hockey Physio + Dad
Modern office work creates a perfect storm for musculoskeletal problems: prolonged sitting, repetitive computer tasks, static postures, and the chronic stress that accompanies demanding jobs. At Auckland Physiotherapy, we treat countless office workers each year with neck pain, back pain, headaches, and repetitive strain injuries - conditions often exacerbated by poorly designed workstations and unmanaged workplace stress.
The solution isn't as simple as buying a standing desk or doing occasional stretches. Evidence-based ergonomics requires understanding how your body responds to sustained postures, how stress manifests physically, and what actually works to prevent and manage office-related pain.
Let's explore the science of office ergonomics, separate fact from fiction about standing desks, understand the body-stress connection, and provide practical, evidence-based strategies to protect your musculoskeletal health in the modern workplace.
We've all heard that "sitting is the new smoking." While this comparison is overstated, prolonged sitting does create significant health concerns.
Increased Spinal Disc Pressure: Sitting increases pressure on lumbar (lower back) discs by approximately 40% compared to standing. Over hours and days, this sustained pressure contributes to disc degeneration and back pain.
Muscle Deactivation: Sitting "turns off" certain muscles, particularly the glutes (buttocks). Research shows that even 30 minutes of sitting significantly reduces gluteal muscle activation. Over time, this creates weakness and altered movement patterns.
Hip Flexor Tightness: Prolonged sitting keeps hip flexors in a shortened position for hours daily. This tightness pulls the pelvis forward, contributing to lower back strain and altered posture.
Upper Cross Syndrome: Extended computer work creates a predictable pattern: tight chest and neck muscles, weak upper back and neck stabilizers. This results in forward head posture, rounded shoulders, and neck pain.
Reduced Circulation: Static sitting impairs blood flow, particularly to the lower limbs, contributing to swelling, discomfort, and potentially increased cardiovascular risks.
Studies demonstrate that office workers sitting more than 6 hours daily have:
However, the solution isn't simply replacing sitting with standing.
Standing desks have become enormously popular, marketed as the solution to sitting-related problems. But what does research actually show?
Reduced Sitting Time: Studies show standing desks reduce sitting time by 30-60 minutes per workday - a meaningful reduction.
Lower Back Pain Improvement: Research indicates that alternating between sitting and standing can reduce lower back pain by 20-30% in people with chronic pain.
Increased Energy and Focus: Some studies report improved alertness and concentration when using standing desks, though effects are modest and vary between individuals.
Calorie Expenditure: Standing burns approximately 0.15 calories more per minute than sitting. Over a full workday, this amounts to roughly 50-60 extra calories - equivalent to a small apple. The metabolic benefits are minimal.
Not a Complete Solution: Simply standing instead of sitting doesn't address poor posture, static positioning, or stress. You can have equally poor ergonomics while standing.
Potential for New Problems: Prolonged standing creates its own issues:
Mixed Research Findings: Recent systematic reviews show standing desks provide modest benefits for some outcomes, but are not a cure-all. The evidence for improved productivity, long-term health benefits, or significant pain reduction is weak to moderate at best.
Research consistently shows that movement and postural variation matter more than whether you sit or stand:
Key Finding: Alternating between sitting and standing every 30-60 minutes provides benefits superior to either prolonged sitting or prolonged standing alone.
The Sweet Spot: Evidence suggests a ratio of approximately 1:1 or 2:1 sitting to standing throughout the day works well for most people. For example, in an 8-hour workday: 5-6 hours sitting, 2-3 hours standing, with frequent transitions.
Whether sitting or standing, proper workstation setup is crucial.
Chair Setup:
Desk and Screen:
Keyboard and Mouse:
Phone Use:
Desk Height:
Monitor Position:
Footwear and Mat:
Standing Posture:
Proper setup is only half the equation. Regular movement is essential:
Micro-Breaks (Every 20-30 Minutes):
Movement Breaks (Every 60 Minutes):
Active Habits:
Work stress isn't just psychological—it manifests physically in ways that directly contribute to musculoskeletal pain.
Muscle Tension: Stress triggers increased muscle activity, particularly in:
This tension, maintained for hours daily, creates pain, trigger points, and movement restriction.
Altered Breathing: Stress often causes shallow chest breathing rather than deep diaphragmatic breathing. This:
Pain Sensitivity: Chronic stress increases pain perception. Research shows stressed individuals have lower pain thresholds and experience pain more intensely than non-stressed individuals with identical injuries.
Inflammation: Psychological stress increases inflammatory markers in the body, potentially exacerbating pain conditions and slowing healing.
Poor Movement Patterns: Stressed individuals often adopt protective, guarded postures and movements that create additional strain.
Reduced Recovery: Stress impairs sleep quality and duration, reducing the body's ability to recover from daily physical demands.
Stress creates physical tension and pain. Pain creates more stress and anxiety. This cycle perpetuates both psychological and physical symptoms, making each worse.
Managing stress isn't just good for mental health—it's crucial for physical wellbeing and pain prevention.
Diaphragmatic Breathing: Research shows this reduces muscle tension, lowers stress hormones, and decreases pain perception.
Technique:
This technique involves systematically tensing and relaxing muscle groups, teaching awareness of tension and how to release it.
Studies show it reduces muscle tension, anxiety, and pain intensity in office workers.
Brief Practice:
Physical activity is one of the most effective stress management strategies, with strong research support showing:
Aim for 150 minutes of moderate activity weekly, but even brief movement breaks provide benefits.
Time Management:
Environmental Control:
Research shows strong social support reduces stress impacts and improves pain outcomes. Stay connected with colleagues, friends, and family.
These exercises can be performed at your desk throughout the day.
Neck Stretch:
Chest Stretch:
Seated Spinal Twist:
Hip Flexor Stretch:
Wrist Stretches:
Chin Tucks (10 Repetitions):
Scapular Squeezes (15 Repetitions):
Glute Squeezes (15 Repetitions):
Desk Push-Ups (10-15 Repetitions):
Seated Marching (30 Seconds):
Standing Hip Circles (10 Each Direction):
Cat-Cow Stretch (10 Repetitions):
Week 1: Assessment and Setup
Week 2: Establish Movement Routine
Week 3: Stress Management Integration
Week 4+: Refinement and Maintenance
Consult Auckland Physiotherapy if you experience:
Ergonomic Assessment:
Manual Therapy:
Exercise Prescription:
Pain Management:
Prevention Planning:
Modern office work creates unique physical challenges. The combination of prolonged sitting (or standing), repetitive tasks, static postures, and chronic stress creates the perfect environment for musculoskeletal problems. However, these issues aren't inevitable.
Evidence-based ergonomics goes beyond buying the latest standing desk or ergonomic chair. It requires:
At Auckland Physiotherapy, we understand the demands office workers face. We've helped countless Auckland professionals optimize their workstations, address pain, and develop sustainable strategies for long-term musculoskeletal health.
Your body wasn't designed for 8+ hours of static positioning and repetitive tasks. But with the right setup, regular movement, stress management, and early intervention when problems develop, you can work comfortably and pain-free.
Don't wait until pain becomes unbearable. Small changes now prevent major problems later.
Experiencing office-related pain or want to optimize your workstation? Visit www.aucklandphysiotherapy.co.nz or contact Auckland Physiotherapy today to book an ergonomic assessment and take control of your workplace health.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
This blog provides general information and guidance. Individual ergonomic needs vary. For persistent pain or specific concerns, consult with a qualified physiotherapist for personalized assessment and treatment.
Pelvic health issues affect far more athletes than most people realize, yet they remain one of the least discussed aspects of sports performance and wellbeing. At Auckland Physiotherapy, our pelvic health physiotherapists work with athletes across all sports and levels - from recreational runners to elite competitors - helping them address conditions that significantly impact training, performance, and quality of life.
The silence around pelvic health problems often leaves athletes suffering unnecessarily, believing their symptoms are normal consequences of sport or childbirth, or feeling too embarrassed to seek help. Let's break this silence and explore the common pelvic health issues we see in sport, understand why they happen, and outline evidence-based solutions that can restore function and confidence.
The pelvic floor is a group of muscles, ligaments, and connective tissues forming a supportive hammock at the base of the pelvis. These muscles perform crucial functions:
Just like any other muscles, the pelvic floor can become too weak, too tight, poorly coordinated, or injured - all of which can cause symptoms and functional limitations.
What It Is: Involuntary leakage of urine during activities that increase intra-abdominal pressure - such as running, jumping, coughing, sneezing, or lifting weights.
How Common Is It? Research shows that 25-45% of female athletes experience urinary incontinence, with higher rates in high-impact sports. Studies of elite athletes find rates up to 80% in trampolining and gymnastics, and 50% in running and team sports.
Why It Happens:
Sports Most Affected: Running, CrossFit, gymnastics, trampolining, netball, basketball, volleyball, tennis, high-intensity interval training.
Impact on Athletes: Many athletes modify or stop activities they love. Some wear pads during training, limit fluid intake (which creates other health problems), or withdraw from sport entirely. The psychological impact - embarrassment, shame, loss of confidence—can be as significant as the physical symptoms.
What It Is: Descent of pelvic organs (bladder, uterus, or rectum) from their normal position due to weakened support structures. This can create sensations of heaviness, dragging, bulging, or visible protrusion.
Prevalence: While exact rates in athletes are unclear, studies suggest 40-50% of women who've had children have some degree of prolapse, many asymptomatic. Athletes who return to high-impact training too quickly postpartum have increased risk.
Why It Happens:
Symptoms: Sensations of pelvic heaviness or pressure, feeling of something "dropping down," visible or palpable bulge, difficulty emptying bladder or bowel, lower back ache.
Sports Most Affected: Weightlifting, CrossFit, running (particularly postpartum), gymnastics.
What They Include:
Why They Happen:
Sports Most Affected: Cycling (saddle-related issues), rowing, horse riding, gymnastics, yoga (extreme positions).
Impact: Pain can occur during sport, interfere with sexual function, affect daily activities like sitting, and significantly impact quality of life.
What It Is: Separation of the rectus abdominis muscles (six-pack muscles) along the midline, most commonly occurring during pregnancy but also seen in heavy lifters and some male athletes.
Why It Matters for Pelvic Health: The abdominal wall and pelvic floor work as an integrated system. When abdominal integrity is compromised, the pelvic floor often compensates, leading to dysfunction, pain, or incontinence.
Symptoms: Visible bulging or doming along the midline with exertion, poor core stability, lower back pain, pelvic floor symptoms.
Sports Most Affected: Weightlifting, CrossFit, gymnastics, any sport requiring significant core strength.
What It Is: Dysfunctional breathing patterns that create excessive downward pressure on the pelvic floor, often involving chronic breath-holding, bearing down, or paradoxical breathing.
Why It Matters: Poor breathing mechanics can create constant downward pressure on the pelvic floor, contributing to weakness, prolapse, or incontinence. Many athletes hold their breath during exertion, creating massive intra-abdominal pressure spikes.
Signs: Breath-holding during lifts, chest breathing rather than diaphragmatic breathing, inability to coordinate breathing with movement.
Understanding barriers to care helps us address them:
Normalization: Many athletes believe leakage during sport is normal or inevitable, particularly after childbirth. While common, it's not normal and is treatable.
Embarrassment: Pelvic health remains a taboo topic. Athletes feel uncomfortable discussing intimate symptoms.
Lack of Awareness: Many don't know pelvic health physiotherapy exists or that these issues are treatable.
Fear of Being Told to Stop Sport: Athletes worry they'll be advised to quit activities they love.
Minimization by Healthcare Providers: Some athletes report their concerns being dismissed as "part of being a mum" or "just do more Kegels."
The reality? Pelvic health physiotherapists are specialists who understand sport demands and work to keep you active while addressing symptoms.
Pelvic health physiotherapy begins with thorough assessment:
History Taking:
Physical Examination:
The internal examination allows direct assessment of pelvic floor muscle strength, tone, coordination, and presence of trigger points or pain. This is optional but provides valuable information that guides treatment.
Functional Testing:
Pelvic Floor Muscle Training (PFMT): The gold standard treatment for SUI, with strong research support showing 40-70% cure rates and significant improvement in most others.
Effective PFMT requires:
The Knack: A timing strategy where you pre-contract the pelvic floor just before activities that cause leakage (like jumping). Research shows this significantly reduces leakage episodes.
Load Management: Modifying training loads temporarily while building pelvic floor capacity, then progressively increasing demands.
Breathing Coordination: Teaching proper breathing patterns that reduce downward pelvic pressure during exertion.
Whole-Body Strengthening: Addressing hip, core, and lower limb strength that supports optimal load distribution.
Pessaries: Medical devices inserted into the vagina that support pelvic organs. Research shows sports pessaries can effectively manage symptoms during high-impact activity while you build pelvic floor strength.
Conservative Management:
Surgical Intervention: Reserved for cases where conservative management doesn't provide adequate symptom relief. Post-surgical physiotherapy optimizes outcomes.
Return to Sport: Structured, progressive return to impact and loading. Research suggests 12 weeks minimum before returning to high-impact activity postpartum, often longer with prolapse.
Pelvic Floor Muscle Relaxation: For overactive muscles, treatment focuses on downtraining, relaxation, and stretching rather than strengthening.
Manual Therapy:
Dilator Therapy: Progressive use of vaginal dilators for conditions like vaginismus or dyspareunia.
Pain Education: Understanding pain mechanisms and that pain doesn't always equal damage.
Stress Management: Addressing psychological factors that contribute to muscle tension.
Behavioral Modifications: Adjusting activities or positions that aggravate symptoms while working on underlying causes.
Functional Core Restoration:
Realistic Expectations: Some separation may persist, but function can be fully restored. The goal is effective core function, not complete gap closure.
Diaphragmatic Breathing: Teaching proper breathing mechanics that create balanced pressure distribution.
Exercise Integration: Coordinating breathing with movement patterns (exhaling during exertion, for example).
Pressure Management: Avoiding excessive breath-holding or bearing down.
Common Issues: Stress urinary incontinence, pelvic organ prolapse symptoms, pelvic pain.
Solutions:
Common Issues: Prolapse symptoms during heavy lifts, stress incontinence during box jumps or double-unders, diastasis recti.
Solutions:
Common Issues: Pelvic pain, pudendal neuralgia, vulvar pain, numbness.
Solutions:
Common Issues: Very high rates of stress urinary incontinence, pelvic organ prolapse risk.
Solutions:
Prevention is always better than treatment. Here's how to maintain pelvic health:
Include Pelvic Floor Training: Just like training other muscle groups, include pelvic floor exercises in your regular routine. Even 5 minutes daily makes a difference.
Breathe Properly: Never hold your breath during lifts or exertion. Exhale during the effort phase.
Progress Gradually: Avoid sudden jumps in training volume or intensity, particularly postpartum.
Maintain Healthy Body Weight: Excess weight increases pressure on the pelvic floor.
Manage Constipation: Chronic straining damages pelvic floor support. Address with adequate fiber, hydration, and proper toileting posture.
Postpartum Considerations: Return to sport gradually with professional guidance. The standard 6-week clearance doesn't mean you're ready for high-impact training.
Regular Check-Ups: Consider pelvic health assessment part of your athletic preparation, especially if planning pregnancy or experiencing any symptoms.
Consult a pelvic health physiotherapist if you experience:
Early intervention prevents minor issues from becoming major problems and allows faster return to full training.
Specialized Expertise: Pelvic health physiotherapists have advanced training in pelvic anatomy, function, and dysfunction. We understand both the clinical aspects and the demands of sport.
Individualized Treatment: Cookie-cutter advice doesn't work. We design programmes specific to your symptoms, sport, and goals.
Empowerment: We teach you to understand your body, recognize warning signs, and manage your condition long-term.
Sport-Focused: Our goal is keeping you active. We work with you to modify, adapt, and progress training while addressing underlying issues.
Collaborative Care: We may work with your GP, obstetrician, sports physician, or other healthcare providers to ensure comprehensive care.
As pelvic health physiotherapists, we're passionate about changing the culture around these issues. Pelvic health should be discussed as openly as knee or shoulder injuries. Leaking during sport isn't a badge of honor or inevitable consequence of motherhood—it's a treatable condition.
By seeking help, speaking openly, and sharing experiences, athletes help break down stigma and encourage others to get the treatment they deserve.
Pelvic health issues affect countless athletes but remain undertreated due to embarrassment, lack of awareness, and misconceptions about what's normal. The reality is that these conditions are common, treatable, and should never force you to give up activities you love.
At Auckland Physiotherapy, our pelvic health physiotherapists provide specialized, evidence-based care in a comfortable, non-judgmental environment. We understand the unique demands athletes face and work to restore function, eliminate symptoms, and keep you doing what you love.
You don't have to suffer in silence. You don't have to accept leakage as normal. You don't have to give up sport. With appropriate assessment and treatment, most pelvic health issues improve significantly or resolve completely.
Experiencing pelvic health symptoms affecting your sport or daily life? Visit www.aucklandphysiotherapy.co.nz or contact Auckland Physiotherapy today to book a confidential appointment with our pelvic health physiotherapists.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
This blog provides general information and is not a substitute for individual assessment. Pelvic health concerns require personalized evaluation and treatment. All internal examinations are performed with full consent and are optional.
When most people think of Pilates, they picture toned abs, lean bodies, and celebrities sharing their latest workout routines on social media. While Pilates certainly strengthens the core, reducing it to an "ab workout" dramatically understates its therapeutic value. At Auckland Physiotherapy, we integrate Pilates-based exercises into rehabilitation programmes because the research demonstrates benefits far beyond aesthetic core strength.
Pilates is a mind-body exercise system developed by Joseph Pilates in the early 20th century, emphasizing controlled movements, breathing, concentration, and precision. Modern research has validated many of its principles, showing measurable improvements in balance, mental wellbeing, pain management, and functional movement across diverse populations—from older adults preventing falls to athletes optimizing performance, and chronic pain sufferers finding relief.
Let's explore what the evidence actually says about Pilates and why it deserves consideration as more than just another fitness trend.
Before examining the research, it's important to understand what defines Pilates:
Concentration: Mindful awareness of body position and movement quality throughout exercises.
Control: Precise, deliberate movements rather than momentum-driven actions.
Centering: Focus on the "powerhouse" (core muscles including abdominals, back, pelvic floor, and hip muscles) as the foundation for all movement.
Breathing: Coordinated breathing patterns that facilitate movement and enhance core engagement.
Precision: Attention to alignment, technique, and form in every exercise.
Flow: Smooth, continuous movement connecting one exercise to the next.
Mat Pilates: Exercises performed on a mat using body weight, sometimes with small props like resistance bands, circles, or balls.
Reformer Pilates: Uses a specialized machine with springs and a sliding carriage that provides variable resistance.
Clinical Pilates: Adapted by physiotherapists for rehabilitation, addressing specific injuries or conditions with individualized exercise prescription.
While equipment and settings vary, the fundamental principles remain consistent across all forms.
Let's start with what Pilates is best known for: core strengthening.
Multiple systematic reviews and meta-analyses demonstrate that Pilates effectively improves:
Core Muscle Activation: Studies using electromyography (EMG) show increased activation of deep core muscles—particularly transversus abdominis and multifidus—during Pilates exercises compared to traditional exercises.
Trunk Stability: Research indicates significant improvements in trunk stability and endurance following 8-12 weeks of Pilates training.
Functional Strength: Unlike isolated ab exercises, Pilates develops functional core strength that transfers to daily activities and sport performance.
Core strength isn't about aesthetics—it's about function:
One of the most compelling bodies of research examines Pilates for balance improvement, particularly in older adults.
A 2020 systematic review of 14 studies found that Pilates significantly improves both static and dynamic balance in older adults. Improvements were observed in:
Single-Leg Balance: Ability to stand on one leg with eyes open and closed increased by an average of 4-6 seconds after 8-12 weeks of Pilates.
Dynamic Balance: Tests measuring balance during movement (like the Timed Up and Go test) showed improvements of 10-15%.
Functional Reach: How far people could reach forward while maintaining balance improved significantly.
Berg Balance Scale: A comprehensive balance assessment showed clinically meaningful improvements after Pilates training.
Falls are a leading cause of injury and loss of independence in older adults. In New Zealand, one in three adults over 65 experiences a fall each year. Balance training through Pilates addresses multiple fall risk factors:
While fall prevention research focuses on older adults, balance improvements benefit everyone:
Emerging research demonstrates significant psychological benefits from Pilates practice.
Multiple studies show that regular Pilates practice reduces stress and anxiety levels:
A 2018 study of women practicing Pilates twice weekly for 8 weeks found:
A 2019 systematic review concluded that Pilates produces small to moderate improvements in anxiety and depression symptoms, comparable to other forms of exercise.
Mindful Movement: The concentration and body awareness required during Pilates promotes present-moment focus, similar to meditation.
Breathing Patterns: Controlled breathing activates the parasympathetic nervous system (rest-and-digest response), reducing stress hormones.
Physical Accomplishment: Mastering challenging movements builds self-efficacy and confidence.
Social Connection: Group classes provide community and social support.
Body Image: Improved strength, posture, and movement quality can enhance body satisfaction and self-perception.
Research shows that regular Pilates participation improves multiple quality of life domains:
A 2017 study of breast cancer survivors found that 12 weeks of Pilates improved quality of life scores by 18-25% across multiple domains.
Perhaps the most clinically significant research examines Pilates for chronic pain conditions.
Low back pain is where the evidence is strongest. Multiple high-quality systematic reviews conclude:
Pain Reduction: Pilates reduces pain intensity by an average of 1.5-2 points on a 10-point scale—a clinically meaningful improvement.
Disability Improvement: Functional disability scores improve significantly, allowing people to return to activities they'd avoided.
Long-Term Benefits: Unlike some interventions that provide only temporary relief, Pilates benefits persist for 6-12 months after training ends, suggesting lasting improvements in movement patterns and muscle function.
Comparative Effectiveness: Research comparing Pilates to other treatments (like general exercise, physiotherapy, or minimal intervention) consistently shows Pilates produces equal or superior outcomes.
A 2015 Cochrane Review (the gold standard of evidence synthesis) analyzed 10 randomized controlled trials involving 510 participants and concluded that Pilates reduces pain and disability in people with chronic low back pain.
Research on neck pain is growing:
Studies show that Pilates-based programmes:
A 2016 study comparing Pilates to conventional physiotherapy for chronic neck pain found both groups improved, but Pilates participants showed greater improvements in pain, function, and quality of life at 6-month follow-up.
Fibromyalgia—characterized by widespread pain, fatigue, and cognitive difficulties—is notoriously challenging to treat. However, research shows Pilates can help:
Pain Reduction: Studies report 20-30% reductions in pain scores.
Improved Function: Better physical function and ability to perform daily activities.
Reduced Fatigue: Significant improvements in energy levels and fatigue symptoms.
Better Sleep: Improvements in sleep quality and duration.
Enhanced Quality of Life: Overall quality of life improvements of 15-20%.
A 2017 systematic review concluded that Pilates is an effective intervention for fibromyalgia, producing improvements in pain, function, and quality of life.
For people with knee or hip osteoarthritis, Pilates offers:
Several mechanisms explain Pilates' effectiveness for chronic pain:
Improved Movement Patterns: Pilates retrains dysfunctional movement patterns that contribute to pain.
Muscle Balance: Addresses imbalances between weak and overactive muscles.
Core Stabilization: Supports the spine and reduces mechanical stress on painful structures.
Mind-Body Connection: The mindful awareness component may help "rewire" pain processing in the nervous system.
Graded Exercise: Pilates allows progressive loading at appropriate intensity, building tolerance without aggravating symptoms.
Low Impact: Controlled movements minimize joint stress while maintaining beneficial loading.
Modern life—sitting at desks, looking at phones, driving—creates predictable postural problems. Research shows Pilates effectively addresses these issues.
Studies demonstrate that Pilates:
Better posture translates to:
While not its primary focus, Pilates significantly improves flexibility and range of motion.
Studies show Pilates increases:
A 2016 systematic review found that Pilates improves flexibility to a similar or greater extent than traditional stretching programmes.
Adequate flexibility:
Athletes across various sports incorporate Pilates for performance benefits.
Research with athletes demonstrates:
Improved Core Endurance: Enhanced ability to maintain core stability during prolonged activity.
Better Movement Control: More precise, efficient movement patterns.
Injury Prevention: Reduced injury rates in athletes practicing Pilates regularly.
Enhanced Proprioception: Better body awareness improving technique and coordination.
Cross-Training Benefits: Active recovery that maintains fitness without high impact stress.
Studies in specific sports show:
Research demonstrates benefits across diverse groups:
Studies show Pilates during pregnancy:
Postpartum Pilates:
Beyond balance benefits, research shows Pilates helps older adults:
Emerging research examines Pilates for conditions like:
Research shows Pilates helps cancer survivors:
At Auckland Physiotherapy, we practice Clinical Pilates—Pilates principles applied within a physiotherapy framework.
Individualized Assessment: Comprehensive evaluation of movement patterns, strength, flexibility, and specific conditions.
Targeted Exercise Prescription: Exercises selected and modified based on individual needs, not generic class sequences.
Progressive Rehabilitation: Systematic progression from basic to advanced exercises as function improves.
Integration with Other Treatments: Combined with manual therapy, education, and other physiotherapy interventions.
Evidence-Based Practice: Application of current research to guide treatment decisions.
Injury-Specific Modifications: Adaptations for injuries, surgeries, or chronic conditions.
While Pilates is generally safe, following these guidelines optimizes benefits and minimizes risks:
Look for:
Begin with Basics: Master fundamental exercises before progressing to advanced movements.
Focus on Quality: Perfect form matters more than quantity or difficulty.
Communicate: Inform instructors about injuries, pain, or medical conditions.
Progress Gradually: Don't rush through levels or push into pain.
Be Consistent: 2-3 sessions weekly produces better results than sporadic practice.
Consider physiotherapist-led Clinical Pilates if you:
Research provides realistic expectations:
Pain Reduction: Often noticeable within 2-4 weeks, with continued improvement over 8-12 weeks.
Strength and Stability: Measurable improvements after 6-8 weeks of consistent practice.
Balance: Significant improvements typically seen after 8-12 weeks.
Flexibility: Noticeable changes within 4-6 weeks.
Postural Changes: May take 8-12 weeks for lasting improvements.
Mental Wellbeing: Stress reduction and mood improvements often noticed within 2-4 weeks.
Consistency is key—benefits accumulate with regular practice and may diminish with prolonged breaks.
While research supports Pilates benefits, it's important to acknowledge limitations:
Not a Complete Programme: Pilates should be part of a balanced fitness approach including cardiovascular exercise and, for some people, higher-intensity strength training.
Skill Required: Proper technique matters. Poor form reduces benefits and may increase injury risk.
Not a Quick Fix: Results require consistent practice over weeks and months.
Individual Variation: People respond differently. Some experience rapid improvements while others progress more gradually.
Contraindications: Certain conditions or acute injuries may require modifications or alternative approaches initially.
The research is clear: Pilates offers evidence-based benefits extending far beyond core strength. From reducing chronic pain to preventing falls, from improving mental wellbeing to enhancing athletic performance, Pilates serves diverse populations with varying needs.
At Auckland Physiotherapy, we've witnessed these benefits firsthand in countless clients. Whether you're managing chronic back pain, recovering from injury, wanting to prevent falls as you age, seeking stress relief, or optimizing athletic performance, Pilates-based exercise can be tailored to support your goals.
The key is finding the right approach—whether group mat classes for general fitness, reformer sessions for variety and challenge, or Clinical Pilates with a physiotherapist for specific rehabilitation needs.
Your body deserves movement that's mindful, controlled, and purposeful. Pilates offers exactly that, backed by growing scientific evidence demonstrating real, measurable benefits for every body.
Interested in exploring Clinical Pilates or learning whether it's right for your needs? Visit www.aucklandphysiotherapy.co.nz or contact Auckland Physiotherapy today to book an assessment and discover how Pilates can support your health and wellbeing.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
This blog provides general information and is not a substitute for individual assessment. People with existing health conditions should consult with healthcare providers before beginning any new exercise programme.
