Pilates can benefit people of all body types, fitness levels and ages. With its low-impact exercises and emphasis on the abdominal area, clients can work around injuries and physical limitations. However, to reap the full rewards of Pilates' versatility, clinicians should tailor workouts to meet clients' specific needs.

First Impressions

Pilates instructors should begin assessing the way a client moves from the moment she walks in the door. Many instructors can immediately detect subtle problems, such as a slight limp or minor scoliosis. Is one shoulder higher than the other? Are the hips twisted? These preliminary observations provide critical information about muscular imbalances or tension that need to be corrected. In addition, a thorough patient history listing any major health issues helps determine appropriate protocols.

One of the first things you need to consider when designing a Pilates program is the general fitness level and health of the client. Creator Joseph Pilates had a mantra: "In 10 sessions you'll feel better, in 20 sessions you'll look better and in 30 sessions you'll have a whole new body."

To achieve these results, active, healthy people should attend three to four sessions per week, especially in the beginning. This population often includes professional athletes, dancers and exercise enthusiasts, who can continue to challenge themselves with more intense one-hour private lessons.

Clients who are frail or ill should start with 30-minute private lessons two to three times per week. This population needs time to recuperate from sessions and may not have the stamina for longer workouts.

Gender can be instrumental in designing a Pilates workout and determining the rate of progression. Men tend to be stronger and have a higher center of gravity. They often need to work on flexibility, as well as general strength training, and want a challenging upper-body workout. Stronger men can use Pilates' push-up series, which can be interchanged with the arm spring series, Pedipole or pull-up series. These exercises all aim to strengthen and align the entire body, while giving the client a thorough upper-body workout.

Women tend to be smaller but more limber, with a lower center of gravity. Many beginners may complain of body aesthetic issues, such as flabby thighs, big bottoms or sagging stomachs. With these clients, you can focus on firming them up and targeting specific areas of concern. For example, women who are unhappy with their legs usually see good results after using the leg springs, which help lengthen and strengthen the lower extremities.

The Whole Package

Regardless of gender, Pilates exercises strengthen and stretch the entire body while focusing on the "powerhouse," which includes the abdominals, lower back, hips, waist, buttocks and upper thighs. The key is the equipment, and each apparatus has a specific intention to benefit the body.

Depending on the device, you can work both sides of the body simultaneously or independently to isolate a particular muscle or muscle group. As a client improves, you can reduce the amount of assistance the equipment provides so that she must work harder to maintain the benefits of the exercise on her own.

Each apparatus accommodates dozens of different exercises. Consider the following pieces of equipment when designing a protocol to meet your client's goals.

Arm Chair. This small chair sits low to the ground and has a slightly inclined backrest. The backrest connects to the seat with a hinge, which allows it to move back and forth. Springs with handles connect from behind the top of the backrest. Clients can sit on the seat with the back supported by the backrest and use the resistance of the springs to build strength in the arms, chest and upper body. For this reason, the chair is a good choice for children, the elderly and people with arm, shoulder or upper-back issues.Clients should keep their entire back pressed flat into the backrest by engaging the abdominals and buttocks. This allows the client to work most of the body, as well as the lungs.

Pedipole. The Pedipole is a 7-foot-high vertical pole that's attached to a solid board at the bottom and a shorter pole at the top. The unit-which resembles a T-features springs with handles on the two tips of the top pole.

Clients stand on the board with their heels at the bottom of the pole. Holding the handles, they line up the spine against the pole and attempt to maintain this position while moving the arms and torso against the resistance of the springs. The Pedipole is beneficial for tall men who exhibit stiffness and for dancers experienced in the Pilates system.

Cadillac. The Cadillac resembles a twin-size canopy bed and accommodates exercises that target the legs, arms and lungs, and work on flexibility and articulation of the spine. The arm springs on the Cadillac function similarly to those of the Pedipole, but allow clients to lie down while performing the exercise.

Clients must maneuver the springs while keeping the back flat and shoulders pinned to the mat. By stabilizing the torso, they strengthen the upper body. Instructors can increase or decrease the level of difficulty by sliding the client forward or backward to create more or less resistance on the spring. Leg springs provide a similar exercise for the lower body and legs.

Reformer. The Reformer's main component is a gliding platform that accommodates numerous exercise positions including sitting, kneeling, standing or lying. Users push and pull off the foot bar using their arms and legs to slide along the rails, while the spring tension gently works muscles.

The Reformer can be used to help square off the body and realign the spine in patients with scoliosis. Because of the way the equipment is designed, the weaker sides associated with the scoliosis have to work harder, and the stronger parts feel more of a stretch.

Other equipment includes the High Chair, Wunda Chair, Ladder Barrel and Spine Corrector.

Despite the gentle nature of Pilates strengthening and stretching, make sure clients are cleared for participation by a doctor. In addition, Pilates instructors should be certified.

The best outcomes involve goal-oriented instruction, close observation and open communication between client and teacher.

Brie Adina Neff is director and senior certified instructor of Equilibrium Pilates in Philadelphia. Reach her at www.equilibrium-pilates.com