Tissue Repair Stretching Strength MSK Rehabilitation

Why the same exercise can help or harm.
Same movement, weeks apart, opposite result.

Most people who arrive at the studio have been given exercises before — by a physio, a chiropractor, an osteopath, a gym instructor or a video. They did them. Some helped for a while. Some made things worse, and it was never clear why. The explanation is usually simpler than it looks: most of these choices have a wrong answer on each side, and the symptom looks much the same either way.

Teejay Sogunro, Applied Pilates specialist, in the London Colney studio

Teejay Sogunro

Founder, The Sogunro Practice · Applied Pilates & Osteolates Therapy · Published 21 Aug 2026 · 5 min read

Man reading an article on a tablet with a cup of coffee

Choosing the right Pilates studio — the questions that matter, from The Sogunro Practice, London Colney, St Albans.

Almost everyone who arrives at the studio has been given exercises before, usually by someone qualified to give them. The problem is rarely the exercise in isolation. It is that the exercise was chosen for the site of the symptom rather than for the stage of repair and the cause underneath it.

The same movement can be right and wrong within a few weeks. Nothing about how the area feels will tell you which, which is why an assessment has to come before the prescription rather than after the first flare-up.

This article sets out the four places it most often goes wrong: stretching a repair before it has set, failing to stretch it once it has, strength taken too far in either direction, and range gained at the cost of stability.

About this article. This article reflects 25 years of clinical practice in Applied Pilates rehabilitation and 35 years of total experience, and draws on peer-reviewed literature in musculoskeletal physiology. Sources: Khan KM, Scott A. Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. Br J Sports Med 2009;43(4):247–52 (PMID 19244270). Killian ML, Cavinatto L, Galatz LM, Thomopoulos S. The role of mechanobiology in tendon healing. J Shoulder Elbow Surg 2012;21(2):228–37 (PMID 22244066). Bleakley CM, Glasgow P, MacAuley DC. PRICE needs updating, should we call the POLICE? Br J Sports Med 2012;46(4):220–1 (PMID 21903616). Solomonow M, Zhou BH, Baratta RV, Lu Y, Zhu M, Harris M. Biexponential recovery model of lumbar viscoelastic laxity and reflexive muscular activity after prolonged cyclic loading. Clin Biomech 2000;15(3):167–75 (PMID 10656978). Frank CB. Ligament structure, physiology and function. J Musculoskelet Neuronal Interact 2004;4(2):199–201 (PMID 15615126). Behm DG, Chaouachi A. A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol 2011;111(11):2633–51 (PMID 21373870). Probst D, Stout A, Hunt D. Piriformis syndrome: a narrative review of the anatomy, diagnosis, and treatment. PM R 2019;11(Suppl 1):S54–63 (PMID 31102324). This article is for informational purposes. Consult your GP or specialist for medical advice.

Injured tissue lays down collagen and guards itself. That guarding feels like tightness, so the instinct — and often the advice — is to stretch it out.

The stiffness is often the repair, not the problem.

In the acute stage that is the worst available option. The new fibres have not set. Stretch into them and they tear, and the repair begins again from the start.

Every session resets the clock. The tightness returns, which feels like proof that more stretching is needed. It is the most self-confirming mistake in musculoskeletal rehabilitation.

Peer-reviewed physiology · loading and repair

Mechanical loading is what drives repair. Khan and Scott, writing in the British Journal of Sports Medicine, describe how controlled mechanical load is converted into cellular signals that stimulate tissue repair and remodelling. Correctly dosed exercise does not merely avoid harm to a healing structure; it actively improves the quality of the repair.

Timing changes the outcome, not just the speed. Killian and colleagues, reviewing the mechanobiology of tendon healing, show that altering the mechanical environment alters how the tissue heals, and that both insufficient and excessive loading degrade the result.

Rest is no longer the default alternative. Bleakley, Glasgow and MacAuley proposed replacing PRICE with POLICE — Protection, Optimal Loading, Ice, Compression, Elevation — precisely because the loading decision, not the resting decision, is the one that determines recovery.

“Without the necessary foundation in anatomy, musculoskeletal movement and associated pathologies, the most well-intentioned instructor will be unable to define an appropriate routine for each individual. If your instructor doesn’t understand the clinical nature of a prolapsed disc, sciatica or facet joint syndrome, clearly they won’t understand which exercises will aggravate or worsen your condition.”

— Teejay Sogunro, The Sogunro Practice

Scar tissue repairs strong but disorganised — the fibres lie in every direction rather than along the lines the tissue actually has to work in. At this stage gentle, progressive stretching is exactly what it needs. It remodels those fibres along the lines of load, and the repair finishes better than it would have on its own.

Once the collagen is laid down, it reverses.

Same movement. Weeks apart. Opposite result. That single fact is the clearest argument I know for assessing before prescribing, because you cannot read the stage of repair from the symptom.

Ligaments creep, and they recover slowly. Solomonow and colleagues measured lumbar viscoelastic laxity following prolonged cyclic loading and found that the resulting creep, together with the disturbed reflexive muscle activity accompanying it, took substantially longer to recover than the loading itself lasted. Range acquired this way is not range earned. It is a temporary loss of passive restraint.

Ligament is not muscle, and does not behave like it. Frank’s review of ligament structure and physiology sets out why: ligaments are specialised connective tissue that adapts slowly, and whose mechanical behaviour differs fundamentally from contractile tissue. Treating a ligament with the stretching strategy you would use on a muscle is a category error.

Ligament and muscle mechanics

Static stretching has a measurable acute cost. Behm and Chaouachi’s review of the acute effects of static and dynamic stretching found consistent reductions in force and power output after prolonged static stretching. Stretch changes a muscle’s mechanical behaviour, not simply how it feels.

Muscle can compress nerve. Piriformis syndrome is the clearest documented instance: Probst, Stout and Hunt’s narrative review describes sciatica generated by compression of the sciatic nerve by the piriformis muscle itself. A muscle worked in the wrong direction is not a neutral event for the structures passing through and around it.

At The Sogunro Practice, the maximum of 7 clients per session is a hard limit. At 7, every client can be observed, corrected and remembered between sessions. That limit exists because of clinical understanding of the Reformer and MSK rehabilitation — not as a marketing claim.

Read: Caution about large group Pilates classes →

Strength has the same two-sided problem, and it catches people who are doing everything they were told to do.

Too weak, or too strong.

A muscle that cannot hold its job leaves the joint unstable, and instability is its own source of pain and of further injury. That much is widely understood.

Taken too far the other way, though, a muscle shortens and compresses. Compression is how a nerve ends up impinged — and the person doing the strengthening usually believes they are doing the safe, conservative thing. Strength is not the goal. The right amount, in the right muscle, is.

“Effective instruction is not about delivering an entertaining variety of exercises to maintain client or group interest. It is about the application of the right exercise. Without the necessary foundation in anatomy, musculoskeletal movement and associated pathologies, the most well-intentioned instructor cannot define an appropriate routine for each individual.”

— Teejay Sogunro, The Sogunro Practice

At The Sogunro Practice, the starting point for every new client is a £85 movement assessment — a 60-minute one-to-one session that identifies the specific drivers of each client’s issue. Only after that assessment does a programme begin. By the time a client enters a small group session, Teejay already knows how they move, what is driving their pain or limitation, and which exercises are appropriate or contraindicated for them specifically.

Read: Which type of Pilates is right for me? →

Stretch a ligament and it stays long. Ligaments have poor elastic recovery, so that is not range gained — it is passive support lost, and the joint has less holding it together than it did before.

Too much range is its own error.

Overstretch a muscle often enough and it loses its recoil. It stops returning energy and starts handing its work to tissue that was never built to do it.

01
What qualifications does the instructor hold, and do they include rehabilitation training?
A Level 3 Mat Pilates qualification is the industry minimum and does not include rehabilitation. Look for additional training: STOTT PILATES Injuries & Special Populations, STOTT PILATES Rehabilitation certification, or equivalent clinical rehabilitation credentials. If the answer is “Level 3 Pilates” and nothing further, treat that as insufficient for MSK conditions.
02
Do you understand the clinical nature of my specific condition?
Ask them to describe what is happening in your body with your specific condition — prolapsed disc, sciatica, facet joint syndrome, hypermobility, post-surgery. If they cannot explain it clearly, they cannot safely prescribe exercises for it. A knowledgeable instructor will answer this question with confidence and without hesitation.
03
Which exercises in your programme would be contraindicated for my condition?
This is the most revealing question. An instructor who understands MSK rehabilitation will immediately identify specific exercises that are inappropriate for your condition and explain why. An instructor without that knowledge will not be able to answer this question. For a prolapsed disc, for example, deep spinal flexion exercises must be avoided or significantly modified.
04
How many clients are in a group session?
For general fitness classes, class sizes of 10–15 may be acceptable. For rehabilitation purposes with MSK conditions, this number should be significantly lower. Industry guidance from Pilates Foundation, Body Control Pilates and EMD UK consistently identifies that meaningful individual observation becomes impossible above approximately 10 on Reformers — and experienced specialist instructors argue the real limit for safe, high-quality work is considerably lower.
05
Is there a movement assessment before I start?
Any studio that places you into a group class without first assessing your movement patterns, history, and specific condition is not operating at a clinical rehabilitation standard. An assessment is not optional for someone with an MSK condition. It is how the instructor finds out what exercises are safe and appropriate for you specifically, rather than assuming the class programme applies to everyone equally.
06
What is your experience working with my specific condition?
Experience matters alongside qualifications. An instructor who has worked with 200 clients with sciatica has pattern recognition that a recently qualified instructor does not — even if both hold the same qualification. Ask specifically about your condition. Ask how many clients they have worked with who have presented the same way as you. The answer tells you about depth of experience, not just formal training.
07
What does a progressive exercise plan look like for my condition specifically?
A qualified, experienced instructor should be able to outline the broad shape of a progressive plan for your specific issue — what the early sessions will address, how the programme will progress, and what the goal of rehabilitation looks like for your condition. Vague reassurance is not the answer. Clinical knowledge produces a specific, reasoned answer.

How The Sogunro Practice approaches this

25 years of clinical practice. The full STOTT apparatus. Maximum 7 clients. Assessment before everything.

Stretching

STOTT PILATES Full Comprehensive & Rehabilitation Certified. Qualified Sports Therapist. Certified Physio Club Rehab Trainer & Master Rehab Trainer. BSc (Hons) Osteopathy, Middlesex University. Watford FC Rehab Pilates Sports Therapist 2015–2018.

Experience

25 years professional clinical practice. 35 years total experience. Founded 2001. Creator of Osteolates Therapy. 4.9 ★ on Google · 123 reviews. Many clients attending for 10–14 consecutive years.

Class size

Maximum 7 clients per session. Hard limit, not a target. Every client is observed, corrected and known individually throughout the programme.

Assessment

£85 / 60-minute movement assessment before any programme begins. Identifies the specific drivers of your condition. No group session until assessment is complete.

About the author

Teejay Sogunro, Applied Pilates specialist, in the London Colney studio

Teejay Sogunro

Founder, The Sogunro Practice · Applied Pilates & Osteolates Therapy, London Colney, St Albans

STOTT PILATES Full Comprehensive and Rehabilitation certified. Qualified Sports Therapist. Certified Physio Club Rehab Trainer & Master Rehab Trainer. Studied BSc (Hons) Osteopathy, Middlesex University. Rehab Pilates Sports Therapist, Watford FC 2015–2018. England Masters squash representative, world ranked over-60s. Founded The Sogunro Practice 2001. Creator, Osteolates Therapy. 25 years professional clinical practice and 35 years total experience.

Full credentials and bio →
How the Practice approaches this

Start with the assessment.
Everything else follows from it.

None of this is readable from the symptom. It is readable from the stage of repair, the tissue involved, and the cause rather than the site of the pain. A 60-minute one-to-one movement assessment with Teejay identifies what is specifically driving your condition. No group session until that is complete. Free parking on site. 2 minutes from M25 J22.

Book Your £85 Assessment
Or call Teejay directly 07734 578959

info@thesogunropractice.co.uk

The Sogunro Practice · Applied Pilates & Osteolates Therapy
Unit 5, Hertfordshire Business Centre, Alexander Road
London Colney · St Albans · Hertfordshire · AL2 1JG


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