Capstone Practitioner Reflection

Reflective component for the Comprehensive Clinical Portfolio

Why I enrolled

I enrolled in this course because I really enjoy working with clients one-on-one as a Pilates instructor. More complex clients were coming to see me, and I lacked the skills and knowledge to support them effectively. I expected the course to build on what I already knew, but instead it has me questioning much of what I learned before. I am now in an awkward (but important) stage of growth, working out how to integrate modern rehabilitation concepts into my practice while still meeting clients’ expectations of what Pilates should be.

How my practice has changed

My Pilates training emphasised ‘perfect’ static posture (often braced, with a slight thoracic extension) and doing movements ‘the right way’. This course challenged that. I had always wondered why the more rehabilitation-informed instructors did not micromanage movement or pathologise asymmetries, and now I understand why. Now, when I see someone with plumbline ‘good’ posture, I look instead for postural variability and bracing patterns (Slater et al., 2019). I have reframed compensations as the body’s way of achieving movement, rather than something to always correct.

This has changed how I teach. I am more thoughtful about when and why I would offer a correction. One client was very rigid and braced; despite my cueing to soften, she couldn’t, until I changed my language and how I interacted with her. I reframed her compensations and let her explore the movement without me jumping in. Her movement quality increased significantly, perhaps because she felt more comfortable and supported rather than judged.

Key frameworks

The International Classification of Functioning, Disability and Health model (Stojic et al., 2025) has given my clinical reasoning more structure. It has helped me ask better questions, understand my client’s needs, and tailor exercises to their goals. Prior to this course, my main focus was on addressing the postural and movement imbalances I observed, with little consideration of what the client did outside the studio.

Pain science has been the biggest shift. My Pilates training reinforced avoidance of all pain during exercises, even though evidence suggests that pain during movement is not always harmful and can be beneficial (Smith et al., 2017). I am now far more confident working with people in pain. If a client says something hurts, rather than stopping the exercise, I ask about the pain’s sensation and intensity before discussing whether we should pause, regress, or continue.

I have learned to account for the effect of analgesic medication when monitoring exercise. For example, I see one client an hour or two after he takes his pain medication. The week before we covered this topic, he forgot his medication and was stiffer and sorer for our session. During this session, I realised that some movements that had ‘felt fine’ for him were usually putting his neck into an aggravatingly extended position. I now rely less on his in-session pain feedback and focus more on his neck movements and on how he responds afterwards. This has given me more confidence to load him appropriately.

My strengths

Clients regularly tell me that I create a safe, positive, playful space to explore movement. I prioritise whakawhanaungatanga; my first sessions are often exploratory, getting to know the client, their goals and values, and what they notice in their own body as they move. My clinical reasoning and range of exercise choices have expanded, and I feel much more confident working with diverse bodies and abilities (although I am looking forward to my clinical placements to build my confidence with more complex clients).

Where I need to grow

There is so much more that I would like to learn. My priorities are biomechanics, functional testing, and loading and progression (as I do not have a formal sports science background, my approach to load is currently more ‘gut feel’ than explicit reasoning).

I am also aware that my own history can bias me. A few years ago, I had a large disc herniation and sciatica that was not investigated for too long, and I have noticed that I am quicker to assume a disc problem in other LBP cases than one of the many other (and often, more likely) causes. I need to keep that in check when working with clients.

Finally, I want to be more precise with terminology. I notice sometimes I use specific terms interchangeably (e.g., ‘load’ instead of ‘resistance’, or ‘central sensitisation’ instead of ‘nociplastic pain’) when I should match my language to my intent.

Looking ahead

I plan to revisit the course content often. Applying this practically in the Pilates studio, and next year’s placements will help. I have connected with a few local mentors (the rehabilitation-focussed instructors I mentioned above) and set up regular supervision with them. I am excited to keep learning and growing as a practitioner.