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Pilates is a physical fitness system pioneered in the early 20th century by Joseph Pilates in Germany. Pilates is a body conditioning routine that can help build flexibility, muscle strength, and endurance in the legs, abdominals, arms, hips, and back. It puts emphasis on spinal and pelvic alignment, breathing, and developing a strong core or center, and improving coordination and balance. There are an increasing number of studies which are showing the benefits of Pilates in the rehab population and patients with spine conditions. There are many books available on Pilates exercises. Some Physical Therapy practices are increasingly using Pilates techniques. The Treasure Valley has a growing number of Pilates instructors and many of the athletic clubs sponsor Pilates classes.