Our approach
Clinical Pilates, explained.
Assessment-led, physiotherapist-supervised, and built around your body rather than a fixed repertoire. This is what makes the clinical model different, and how it applies to the specific conditions we see most often.
What it is
A healthcare model, not a fitness class.
Clinical Pilates uses the same core principles as traditional Pilates (breath, control, precision, centering) within a healthcare context. The difference is who delivers it and how a program is built: a licensed physical therapist assesses your mobility, history, and what's actually driving your pain or limitation, before any exercise is chosen.
Nothing is standardized. Exercise selection, equipment, and progression are all built around your diagnosis and goals, and adjusted session to session as your body changes. That's what makes it effective for rehabilitation in a way a general class isn't designed to be.
The approach is well evidenced. A systematic review in the Journal of Orthopaedic & Sports Physical Therapy found that Pilates-based exercise produced clinically significant reductions in pain and functional disability in chronic low back pain, and a second review in PLOS ONE found improved pain and disability outcomes across a range of musculoskeletal conditions compared with minimal or no intervention.
Curious how this compares to a traditional studio class, and who benefits most from each? Read our full breakdown: Clinical Pilates vs Traditional Pilates.
Newer than that, and not sure what Pilates itself is meant to do? What Pilates actually does is the plain version: what changes in your body, and where you would notice it.
Conditions we work with
Find your condition.
These are the conditions our physical therapists treat, with Pilates-based exercise as the method rather than the goal. Every article below is written by our clinical team: what the condition involves, which exercises help, what to avoid, and when to see a professional before starting.
Spine & Nerve Pain
- Low Back PainWhat the research says about clinical exercise for chronic and acute low back pain.
- Recurring Back PainFive root causes behind back pain that keeps coming back.
- SciaticaExercises that help, movements to avoid, and when to see a professional first.
- Neck PainRelief for chronic tension through whole-body strengthening.
Joints & Structural Conditions
- Knee PainExercises for osteoarthritis, post-surgical recovery, and everyday strain.
- Hip ImpingementA program built around your joint mechanics, not a generic template.
- Shoulder PainAddressing the specific mechanics behind shoulder pain.
- ScoliosisAsymmetric, individualized programming for spinal curvature.
Complex & Chronic Conditions
Recovery & Life Stages
Programs & Formats
- What Is Therapeutic Pilates?Who this style of Pilates is for, and how it differs from a fitness class.
- Pilates for Rehabilitation, OnlineThe pros, cons, and benefits of remote clinical sessions.
- Happy Body Pilates ProgramLivestream and on-demand sessions open to all levels.
- Medicare Coverage in San RafaelWhat Medicare actually covers for clinical Pilates and physical therapy.
- Clinical Pilates & Physical Therapy, TogetherHow the two disciplines combine in one program.
Also offered
- Chronic pain management
- For fibromyalgia, widespread pain, and persistent pain syndromes. A gentle, graded approach that builds movement capacity and reduces pain sensitivity over time, without loading the areas that hurt.
- Women's health
- Pelvic floor dysfunction, incontinence, pelvic pain, diastasis recti, and postpartum recovery, with pelvic floor assessment built into full-body rehabilitation.
- Gait analysis
- A structured assessment of how you walk or run, identifying the deviations behind pain or a performance limit. Particularly useful after a lower-limb injury, with a neurological condition, or where chronic pain has changed how you move.
- Fall prevention and mobility
- For older adults: balance, coordination, and lower-limb strength, to reduce the risk of falls and hold on to everyday independence.
- Neurological conditions and movement disorders
- Including autism spectrum disorder and developmental differences. Zeina works with children, teens, and young adults to build body awareness, coordination, and movement confidence through carefully adapted Clinical Pilates and neuromuscular retraining.
These don't have a guide of their own yet. Write to us and we'll tell you what a program would look like.
Ready to start
One team, two studios, ready when you are.
In Ascona, most clients start right in a group Pilates class, with a movement assessment available whenever they'd like one. In San Rafael, every private session begins with a physical therapist's evaluation. Same clinical training standard, either way. Synergy+ has worked this way since 2005, in San Rafael, in Ascona, and online.