Can Pilates help me reduce my low back pain?

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Pilates for low back painMany clients come in to our studio referred by their doctors, physiotherapists, osteopaths and chiropractors having been prescribed Pilates as a form of management for their lower back pain (LBP).

It is important to note at this point that the original classical series of exercises created by Joseph Pilates, despite being fantastic and life changing, are extremely challenging and are reserved for the trained body, free of any substantial injury. Although it is a programme to aspire to being able to perform, contemporary forms of Pilates, as taught by many studios today, always take into account the various limitations and injuries that clients present with, and aim to help by breaking down the exercises and providing variations so that the client can progress in a safe way.

Consequences of pain on the musculoskeletal system.

Pain can cause:

-Inhibition of activation of deep spinal and sacroiliac joint (SIJ) stabilisers such as the mulitifidii and transversus abdominis (TrA) (Hodges et al, 2010)

-Inhibition of postural muscles

-Protective global muscle spasm

-Reduced proprioception

-Muscle atrophy and compensatory activation of other muscle groups

-Incorrect movement patterns

All of which can lead to loss of control (Hodges & Richardson, 2008, 2010) and ultimately lead to:

-Reduced protection of local joints

How can Pilates help?

Contemporary Pilates takes into account spinal pathology research. The consensus is that correct activation of the primary sling i.e. the TrA, multifidus, pelvic floor, and diaphragm, a process called ‘centring’ in Pilates, can help provide segmental stabilisation to the spine and SIJ. A study by Hides et al 2001 showed that specific spinal exercises which targeted the correct recruitment of these stabilisers showed a significant decrease in the recurrence of LBP in patients both after 1 year and 2-3 years post treatment as compared to a control group (exercise group 32.5%<control group 79.5%, average values).

In addition to retraining the spinal stabilisers Pilates helps to strengthen, especially as the exercises become harder and more elaborate, the larger mobilising muscle groups which are essential for normal daily but also higher level (sporting) function.

So if I have LBP, how do I start Pilates?

Depending on the nature and severity, your Pilates teacher will be able to advise you accordingly. Generic LBP as result of bad posture and/or stiffness due to bad habits (e.g. long hours seated or standing) with no identifiable pathology is the easiest form to deal with. Your Pilates teacher can work with you individually if you wish, to help you become aware of your limitations and the factors causing your pain. If the pain is not severe, you may even be able to go straight on to the lower level classes, where the small numbers accompanied with our teachers’ attention to detail will help you progress slowly in a safe environment.

For more severe cases (e.g. disc pathologies, spondylolisthesis, spinal and SIJ osteoarthritis, severe osteoporosis or scoliosis) it is advisable to continue to work privately with your teacher. If you then reach a point where the symptoms vastly improve, you develop a heightened awareness of your body, and are feeling much more in control, you can then either move on to group classes, or join a studio session where you will be working on a tailored program designed to keep you strong whilst continuing to progress.

For more information or if you want to have a chat with us about your symptoms, give us a call and we’d be happy to help!