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Joseph Pilates adapted his exercise system from other methods, including Yoga. He called his method Contrology, and it emphasized fewer, more precise movements, requiring control and very specific form, rather than larger, wilder motions. He believed that mental and physical health were essential to one another and created what is a method of total body conditioning that emphasizes proper alignment, centering, concentration, control, precision, breathing, and flowing movement,

Pilates movements help to build strength and flexibility, with an emphasis on lengthening the body and aligning the spine, rather than on building muscle mass. Pilates' focus is on the "powerhouse" region of the body which includes the muscles of the abdominals and the lower back. These muscle groups are vital to control of the body. Because of its focus Pilates has become popular not only in the field of fitness, but also in rehabilitation, retraining injured muscles and making them more efficient and stronger than before.. The focus on strengthening the core/powerhouse muscles and improving postural awareness are effective treatment for the alleviation and prevention of back pain.

Pilates called the large group of muscles in our center (abdomen, lower back, hips, and butt) – the Powerhouse. All energy for Pilates exercises begins in the Powerhouse and flows out to the extremities. Physical energy is exerted from the center to coordinate one's movements.

It is essential to recieve very focused, specific instruction when starting on a Pilates program. Every exercise requires the proper focus, breathing, awareness, and muscle control in order to be effective. Watching a Pilates session, it is difficult to fully understand what is happening, and what muscles in the body must be activated in each pose. Sometimes it appears that there's nothing happening in a pose, but in reality, the person in the pose is tensing muscles invisible to the watcher, and if you tried to imitate the pose without understanding it, you would get nothing out of it. So make sure you get individualized instruction or get a good book or video with guidance on exactly what to focus on, how to position your body, and what muscles to activate in each pose.