Expert advice on staying active after being diagnosed with a neurological condition

Although she’s the owner and founder of 314 Pilates, an integrative movement studio in University City, Natalie Sutto thinks of herself more as an investigator. That’s because, in her daily work helping clients with chronic and neurological conditions regain movement, Sutto is tasked with not only getting them active, but identifying the source of their pain.

“Everyone is different,” Sutto says. “Two people with multiple sclerosis are not the same. Two people with Parkinson’s are not the same. Our movement patterns are instilled in us before we have a chronic condition or cancer, so how our bodies react to those things determines a lot about how we approach movement after a diagnosis. It’s fascinating.”

For the past decade, Sutto has been working to find accessible movements for clients who are struggling with debilitating health issues, assisting them as they strive to regain their lives after their bodies have betrayed them. For this week’s Wellness newsletter, Sutto spoke with St. Louis Magazine about her work and how she helps people diagnosed with chronic and neurological conditions keep moving.

Although Pilates is in your company’s name, you do so much more than that. How did you end up in this line of work? I was a nurse and hospital administrator in the Air Force. Then, when I got out, I was a functional space planner for an architecture firm. When our youngest son was born in 2013, he had a traumatic birth injury and needed physical therapy. So I quit my job to take care of him. Eventually, I went a little stir crazy and got certified at Pilates just to have something to do. Because of my background in health care, I took on clients that had something major going on. Maybe they had been through a couple of instructors, or they had failed physical therapy. I just started accumulating certifications—a client with breast cancer would come to me, so I would get certified in breast cancer. Then I would get a client with MS, so I got neurological certification. I then went back and did another Pilates program, which was rehab based, to tie it all together. I really enjoy problem solving.

What does your client work look like in practice? Before someone even comes in, I have them fill out a detailed health history. Do you have pain? Where do you have pain? What medications are you on? Then, we talk on the phone and I ask any questions I need to know ahead of time, like if they’re in a wheelchair, or if they have good or bad times of the day. When they come to see me, I ask them to walk if they’re ambulatory. I use a movement analysis program called Dartfish Pro, which allows me to slow things down and pinpoint asymmetries that I see in their gait, which parts of their body are overworking, which parts are not working, and so on. Then, I need them to give me at least one personal goal.

Are the goals pain-focused, or movement-focused? They have to be something that they used to do, something that they want to do, something they want to do more of, or something they want to do without pain. One of my clients is a world-renowned brain surgeon who has secondary progressive MS. When he came to me, his goal was to golf again. I told him that it may not look like golf did before, but he was going to get back out on the course. I helped locate an organization called Stand Up and Play—they make ParaGolfers—and now he’s golfing again.

Beyond accomplishing goals, what are some of the other benefits that clients, particularly those with neurological conditions, experience with this movement therapy? I see—and research supports—a decrease in anxiety, depression, better sleep, and less pain. 

Are there any conditions that are beyond your scope of influence? Not really. Even with high-level spinal cord injuries, we can access the diaphragm to act as as abdominal stabilizers. It’s important for people to know that movement has healing effects throughout their entire life. Clients come to see me and give me their goals, and some of them say, “It’s too much, right?” Well, there is no such thing as too much. We’re going to figure something out and we’re going to make progress along the way. The human body is amazing, and the human spirit is even more amazing.