Pilates Method is excellent for building strong, flexible backs.

The Pilates Method is an exercise program that focuses on the core postural muscles that help keep the body balanced and are essential to providing support for the spine. In particular, Pilates exercises teach awareness of neutral alignment of the spine and strengthening the deep postural muscles that support this alignment. This proper alignment is important to help alleviate and prevent back pain.

Pilates works by re-balancing the body, altering the way in which you recruit muscles to produce movements. It changes the way you use your body, the way you move - restoring natural, normal movement.

Pilates works on strengthening the stabilizing muscles, which lie close to and support the spine. Transverse abdominus is the deepest of the abdominal muscles, wrapping around the trunk horizontally, acting like a "corset" when engaged. Two other muscles are important in providing good stability in the trunk—the multifidus muscle in the low back, and the pelvic floor. This creates the solid cylinder around the central spine, helping to prevent shearing forces being applied to the vertebrae, ligaments and discs.

Contemporary Pilates emphasizes neutral spine

The important principles of Pilates are consistent with an exercise program that promotes back health. Learning awareness of neutral alignment of the spine and strengthening the deep postural muscles that support this alignment are important skills for anyone with back pain.

Individuals with pain stemming from excessive movement and degeneration of the intervertebral discs and joints are particularly likely to benefit from a Pilates exercise program. In addition, postural asymmetries can be improved, thus decreasing wear and tear resulting from uneven stresses on the intervertebral joints and discs. Pilates improves strength, flexibility and suppleness of the muscles of the hip and shoulder girdle. Fluid and supported movement through these joints helps prevent unnecessary torque on the vertebral column.

The Pilates program also teaches awareness of movement habits that may stress the spine, and helps the patient change these habits to those that preserve neutral alignment. Awareness of excessive tension and the use of proper focus helps the patient use the body efficiently. Pilates exercises are gentle, progressive, and performed slowly with good postural alignment at all times, These controlled movements are therefore unlikely to lead to re-injury. Keep the fundamental Pilates Principles in mind throughout your Pilates practice.

Pilates considerations for indivuals with back pain

1. Check with your physician or physiotherapist first.

Before starting any new exercise system, it is always advisable to check with a physician or other healthcare provider. Before starting a Pilates exercise program, it is important to check that the potential instructor has received training in the Pilates exercise system, and that he or she understands your specific back problems. If you start Pilates after physical therapy, your physical therapist should outline the exercise principles identified as particularly important for your rehabilitation.

2. Learn proper Pilates technique from a skilled instructor.

Individuals with significant back problems may benefit from several one-on-one Pilates sessions with a qualified Pilates instructor. While more expensive than a group class or mat class, the time, money and effort devoted to learning the exercises correctly can be well worth the investment, as exercises performed incorrectly can make a back problem worse. Initially, twice-a-week sessions tend to be helpful to learn the program more quickly. After that, weekly Pilates exercise sessions may be enough if the individual practices between sessions.

3. Simple exercises will have significant benefits.

The principles of movement important for back health are taught in some of the simplest exercises of the Pilates system. One cannot underestimate the benefit of simple exercises that support the deep postural muscles of the trunk, awareness of neutral alignment, and supple use of the shoulders and hips. It is best to learn exercises that can be practiced correctly at home between scheduled Pilates sessions.

Some of the movements in the Pilates system are very difficult and challenging. Many of the advanced exercises should be modified or avoided by individuals with significant back pain or degenerative disc disease. As a general rule, back patients should avoid exercises that push the spine into extremes of flexion (forward bend) or extension (backward bend), or combine flexion with side bending or twisting the spine. These motions place excessive stress on the intervertebral discs. Also, it is important to avoid fatigue—either mental or physical—which is when proper form is lost and injuries more likely to occur.

3. No pain required for Pilates benefits.

The exercises in the Pilates system should be challenging (both mentally and physically) but not so difficult that they cause anyone to struggle or experience pain. If an exercise causes pain—stop immediately and tell the instructor. The exercise may be too difficult, or the person may need additional help to do it correctly. Pilates exercises can be modified to address individual conditions.

3. Be patient and stay committed to your Pilates practice.

As with any rehabilitation program, it may take awhile for the full benefits of a Pilates exercise program to be realized. Just as the problems that create most back pain can happen gradually over time, learning to use one’s muscles in a way that support—rather than stress—the spine takes time and commitment.

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