Pilates Elephants

In this episode of Pilates Elephants, Raphael Bender and Dr. Kevin Wernli dive into the surprisingly nuanced relationship between movement and pain. They explore why changing movement patterns doesn’t always reduce pain, (and when it can!) the limits of the biomechanical model, and how beliefs and context play a crucial role. Discover actionable insights for Pilates instructors on fostering more effective, evidence-based approaches to managing low back pain.

Resources mentioned in the episode:

• Does movement change when back pain changes? Systematic Review here
• Kevin’s case series here
• Qualitative interviews here
• Gracely 1986 dentist study here

Watch this episode on YouTube here: https://youtu.be/vjpyxHr3lLY

About Kevin Wernlin:

Kevin is a Physiotherapist from Perth, Western Australia. He completed his PhD with esteemed supervisors Peter Kent, Peter O’Sullivan, Anne Smith, and Amity Campbell. His research investigated how movement, posture, and psychological factors relate to persistent low back pain, particularly as people recover. He has appeared on numerous podcasts and radio segments, published research in high-quality international research journals, and presented at national and international conferences. He has a passion for using technology to help make healthcare more equitable and effective, and translating research into the real-world, evidenced by his work as the former producer and co-host of the popular empowered beyond pain podcast, and now as co-founder of a digital health startup called Matilda Health which helps people undergoing endometriosis surgery optimise the pre and post-surgery journey.

Connect with Kevin Wernlin:

• A bunch of resources I’ve put together: https://www.backtoliving.health/givingbackresources
• Podcast: https://open.spotify.com/show/3ogpeLlDGLRLiHofEWvCje
• RESTORE clinical trial: https://www.restorebackpain.com/
• Social media links: Twitter|FB|IG|LinkedIn - @KWernliPhysio
• ORCID - 0000-0001-6035-9873

Connect with Raph on Instagram: @the_raphaelbender

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

In this episode, we break down four science-backed methods to help your clients feel that post-workout “burn” every time. Learn how to use the principles of the Repeated Bout Effect (RBE) in reverse to keep your classes feeling fresh, challenging, and effective. These tips will help you consistently create that sought-after soreness so clients feel like they’re progressing with each session!

What You’ll Learn:

• How the Repeated Bout Effect works and why muscles adapt to reduce soreness over time.
• Proven strategies to reverse the RBE using eccentric exercise variations and overload methods.
• Tips for balancing soreness to maintain high client satisfaction without risking burnout.

Key Points Covered:

• Rotate Eccentric-Focused Exercises: Prevent adaptation by introducing new movements each class.
• Increase Time Under Tension: Slow down the eccentric phase for greater muscle micro-damage.
• Vary Angles and Planes of Motion: Challenge muscles differently to increase soreness.
• Add Eccentric Overload with Bilateral Concentric/Unilateral Eccentric Movements: Use both limbs on the lift and one on the lower for targeted eccentric overload.

Related Links and Studies:

• Proposed Mechanisms and Mediators of the Repeated Bout Effect: Mechanism Overview: PubMed Link 1
• Supporting Study: PubMed Link 2
• Protective Effect on the Opposite Limb (Contralateral RBE): PubMed Link

Watch on YouTube

Prefer to watch instead of listen? Catch the full episode on YouTube: https://youtu.be/pplrScFQArY

Connect with me on Instagram: @the_raphaelbender

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info

Resources mentioned in the episode:

• Watch this episode on YouTube here
• Download the slides as a PDF here

Connect with me on Instagram: @the_raphaelbender

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info

Resources mentioned in the episode:

• Charlotte’s IG @aurorapilates here
• Corkinetic post on “compensations” here

Connect with me on Instagram: @the_raphaelbender

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info

You’ll have to listen to find out!

Resources mentioned in the episode:

• Systematic review on repetition tempo effects on strength, power and hypertrophy here

Connect with me on Instagram: @the_raphaelbender

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info

Well yes, but not how you might think!

Resources mentioned in the episode:

• Direction specific recruitment pattern of the rotator cuff in shoulder flexion here
• MORE load stimulates the rotator cuff MORE here
• Role of muscles is task specific here
• Any loaded arm movement strengthens the rotator cuff here

Connect with me on Instagram: @the_raphaelbender

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info

Resources mentioned in the episode:

• Emily’s study here
• All major high quality clinical guidelines recommend person centered care here
• Adding extra pain education did not improve outcomes over usual care here
• Patient led goal setting here and here
• Connect with Emily on Instagram: @emwalker_exphys and LinkedIn

Connect with me on Instagram: @the_raphaelbender

Download a free course guide:

• Clinical Certification
• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info

Rehab really is simple. Most people over-complicate it IMO. Here is my framework to rehab any injury.

Connect with me on Instagram: @the_raphaelbender

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info

Resources mentioned in the episode:

• All major high quality clinical practice guidelines recommend client centered care here
• Changes in TrA thickness and timing don’t correlate with reductions in pain after TrA retraining here
• Changes in strength & flexibility don’t correlate with reductions in pain after strength or flexibility training here
• When a person expects a treatment to work, it’s more likely to work here

Connect with me on Instagram: @the_raphaelbender

Connect with Emily on Instagram: @emwalker_exphys and LinkedIn

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info

This is my process for making any exercise harder - or easier.

Connect with me on Instagram: @the_raphaelbender

Download a free course guide:

• Pilates Certification
• Visualized Anatomy

Become a Breathe Education Mentor Affiliate: Program info