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Pilates and MS: Part Two with Mariska Breland

In Part Two of our interviews that look into the world of training people affected by MS in Pilates, we talk to teacher, health professional, trail-blazer, and neuroscience enthusiast Mariska Breland.

After a 2002 diagnosis of MS, Mariska became a yoga and pilates devotee, then, a teacher. She began the Pilates program at DC’s Flow Yoga Center, and then went on to found Fuse Pilates, where she teaches today. As part of her comprehensive certification through Body Arts and Science, International (BASI Pilates), she completed a research project on Pilates for multiple sclerosis patients, which she expanded into an in-depth Pilates for MS advanced teacher training, incorporating the latest research in neuroplasticity and neurorehabilitation into a Pilates program design for MS and other neurological conditions. Aya Sato asks her about her experience in Pilates and MS, both as a practitioner and as someone with the disease.

I understand why Pilates might be highly beneficial to a person with MS - balance, proprioception, and strength are surely big goals for anyone with the illness.  I'm interested to learn why it is helpful, or how you've found it to be helpful,  for yourself in particular?

I think Pilates offers the perfect exercise environment for MS.  First of all, it's easy to modify, so you can work with people of various abilities, and no two cases of MS are the same.  It teaches proper muscle recruitment, and proper muscle recruitment helps reduce fatigue (a major problem in MS).  It uses dynamic range of motion exercises to build flexibility which is shown not to exacerbate spasticity or weakness, unlike some other forms of stretching regimens.  It can help with balance, proprioception, single side weakness, bladder difficulties, etc. In fact, I divide my Pilates for MS workshop by symptom so that it's easy to figure out a program for someone with MS.

For me, I was fortunate to find Pilates very early on.  I've been doing it almost since I was diagnosed.  I haven't been symptom-free all that time, but I've been able to manage well, and I think Pilates is a big reason for that (and my doctors and physical therapists agree).

How has your own understanding of MS grown since practicing Pilates specifically to aid its effects?

I have always been a curious person and wanted to understand exactly what MS was potentially doing to me.  I've studied neuroscience because of that, designed the Pilates for MS training course, and was just invited to design similar courses for stroke and Parkinson's disease.

My research for designing my course introduced me to the science of neuroplasticity - how the brain is changeable.  For someone with a neurological disease, there is no greater hope than knowing that the brain has an innate and profound ability to rewire itself around damage.

Could you describe the differences your MS clients have described in their overall well-being after a session?

Many people with MS (and many people without anything wrong with them) just don't move enough.  If you want to keep moving, you have to move.  I have several students with MS, and have met others over the years. The thing that stands out most is that people who exercise do better. Plain and simple.

After a session done by someone who understands how to work with specific symptoms, a person with MS should feel challenged, but not exhausted.  He or she should feel stronger, more flexible, more graceful. It might not happen after just one session, but often, improvement can happen pretty rapidly.

The mental health aspect of MS, coupled and often intertwined with physical challenges, can be very debilitating. How do you think the practice of Pilates can play into the need for MS patients to cultivate a positive attitude and a special mental strength?

Pilates is a great mind-body exercise. Let's face it - MS can be depressing.  In fact, statistically, persons with MS have higher rates of depression and shockingly higher rates of suicide. If you can get connect to your body in a positive way - celebrating what it can do, challenging it to do more than you may think, you can help to stop the spiral of negative thinking.  For me, my main MS symptom is pain - and it's a kind of pain that isn't well-managed with medication.  Movement takes my focus off of that and onto something positive.  I always feel better afterwards.

How had your experience with MS and training clients with MS influenced you as a trainer? For example, is this now the main focus of your practice and expertise, or more just one of the areas adding to your total skill set as a teacher?

I have two main focuses as a teacher. First, I teach a very athletic-conditioning based form of Pilates, mainly in a group setting.  My studio - Fuse Pilates ( ) - is all about creating fun and challenging workouts that yield results. That is my first passion.  Second, I teach and lecture on exercise for neurological conditions and even on how the mind-body connection works to improve exercise results in healthy populations.  I have seen a lot of unnecessary disability because our medical system fails people with chronic conditions. It gets people to a "good enough" stage and lets them go.  People with MS and other diseases should be monitored by physical therapists and exercise specialists.  A slight weakness over time can lead to disability that is much, much more difficult to fix than it would have been to prevent.

Luckily, the medical community is starting to realize this.  I just returned from teaching in England, where the UK MS Society offered grants to physical therapists and Pilates instructors to take my Pilates for MS workshop and follow up with work with 10 case studies each.  Their hope (and mine) is that finding ways to enable patients to be more active will ultimately improve outcomes.