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Pilates For Treatment Of Low Back Pain

Pilates for back pain

Are You Nervous About Exercising Due To A Lower Back Injury Or pain?

With gyms being closed and exercise options reduced in the community, along with sitting for hours in front of a computer at home for work, do you feel your ‘bad back’ flaring up? Or maybe an old, haunting back injury makes you nervous about exercising, or perhaps you just don’t like ‘traditional’ methods of exercising. If this sounds like you then Pilates could be a good way for you both to manage your low back pain safely as well as build your overall body strength and fitness.

Is Pilates Right For You?

Pilates is supported by strong evidence as part of an effective rehab program for chronic and intermittent low back pain. There are 7 key reasons why Pilates exercise can be effective in managing this type of problem;

1. Pilates Targets Your Core Muscles

Pilates activates the muscles that support your low back and pelvis. This includes an important abdominal muscle, your Transverse Abdominis, in the majority of exercises. This muscle has been established as an important muscle in terms of spinal support and stabilisation. Other essential core muscles include your pelvic floor muscles, the diaphragm, and a muscle in your back called the Multifidus. These deep muscles can be difficult to develop in the same way as other larger muscles like your biceps.  Good activation of these muscles is taught through the foundations of Pilates principles, and exercises are then progressed to help build overall functional core strength.

2. Pilates Focuses On Both Stability And Mobility

The Pilates repertoire of exercises emphasise stability and mobility separately and in combination. This helps train correct control of joint movement through a full range of motion while being strong against external forces. This full-range control and strength helps increase your body’s capacity and confidence to do everyday things like picking up your toddler, carrying shopping, washing and cleaning, and sitting for longer periods and running around in the park.

3. Pilates Has Open And Closed Kinetic Chain Exercises

An open chain exercise is an exercise where your hands or feet move freely in space, i.e not touching a solid surface like the floor. This type of exercise is great to increase joint mobility and can be a gentle way to start strengthening as it is a non-weight bearing position. With a closed chain exercise your hands or feet are in contact with a solid surface and are taking some or all of your weight. This is very effective in promoting joint stability and control, and full body-weight exercises are beneficial for osteoporosis to promote bone density and strength.

4. Pilates Exercises Use Different Muscle Contractions

Your muscles can contract without a joint moving (called an isometric muscle contraction) or they can contract and move a joint. Both types of muscle contractions are needed in everyday life. Pilates trains your muscles to contract in many different ways making it a functional exercise program which trains your muscles for common activities of daily living. Whether you are recovering from a recent episode of low back pain or are 10 years post injury, Pilates exercises offer all different types of muscle contractions to suit your current stage of function and physical capacity. Building your back strength makes your back more resilient to whatever life throws at you at home, at work or during sport.

5. Pilates Exercises Are Functional

Pilates exercises are ideal for injury rehab and prevention because they can be designed to simulate everyday activities. The exercises and the equipment allows your physio or instructor to design a program specific to your daily tasks. Getting the muscles stronger and the joints more stable in positions that you use everyday is key to minimising the risk of future injuries. If you think about it, it makes perfect sense to strengthen the muscles in the positions you use everyday whether that be lifting shopping from the car, carrying a child, or reaching to get a cup from the kitchen cupboard.

6. Pilates Trains Efficient And Relaxed Breathing

In Pilates we breathe out as the back curls forwards and breathe in as the back extends backward. Many clients find increasing their awareness of their breathing during exercise and learning to maintain correct breathing patterns helps them to feel more flexible and relaxed during their sessions as well as during daily tasks. They report that being able to maintain a relaxed breathing pattern during activities helps them feel less tense and “braced up” when doing their normal tasks during the day.

7. Pilates Can Be Used For Many Different Populations

The versatility and adaptability of Pilates makes it suitable for just about any person. Pilates encourages a safe, positive movement experience for all ages, abilities, sizes, and injuries. There is no need to be anxious about a back injury coming into Pilates as the exercises are personally selected based on your needs and confidence levels.

Pilates As A Rehabilitation Tool At Central Performance

At Central Performance you will always be assessed individually when you begin a Pilates program. Your physiotherapist Pilates instructor will design a Pilates exercise program specifically tailored to address your problem, target your goals, and be ideally matched to your current level of fitness and confidence with exercise.

During the COVID lockdown period telehealth Pilates sessions are available as well as face-to-face sessions. This means that you can have your sessions in your own home via a secure video-link with your Pilates physio. No special equipment is necessary because we can use a mat-based Pilates exercise program to begin with. Once lockdown regulations are removed, if you wish you can come to the clinic and start using equipment such as the Reformer and Wunda chair in face-to-face sessions.

Pilates Is Suitable For Many Low Back Injuries Including

– Disc degeneration / Disc herniation

– Osteoarthritis

– Spondylosis

– Spinal stenosis

– Spondylolisthesis

– Facet joint syndrome

– Sciatica

– Sacroiliac joint (SIJ) dysfunction

The Common Low Back Injury Symptoms Pilates Can Help With Include

– Pain in the low back or pain that is referred from your back to your leg

– Spinal instability and feeling that your back feels weak with bending, lifting or carrying

– Leg muscle tightness

– Feeling like you have poor posture, slouch a lot, or get tight with sitting or standing for longer periods

– Stiffness around the low back, pelvis and hip regions

– Difficulty with movements like bending down or standing upright

– Pain with walking or changes to your walking pattern

– Feelings of low back weakness, tightness or heaviness

How We Use Pilates Exercises To Make You Feel Better

– Increase your confidence to start moving and exercising again

– Strengthen the core muscles that support your spine and pelvis

– Increase the strength in the muscles of your back and legs

– Improve your flexibility

– Increase postural awareness and proprioception

– Restore normal movement patterns of your lower back, pelvis and hips

Pilates Exercises For Low Back Pain That Increases With Bending Forwards And Sitting

One way to classify low back pain is by the direction of movement that makes the pain worse, i.e. bending forward and sitting (Flexion Dysfunction), versus arching backwards and standing (Extension Dysfunction). We use this system because research shows that diagnosing back pain as being due to a specific structure like a “disc injury” or an isolated joint or muscle is not really possible or necessary (see our post on Low Back Pain Diagnosis for more info).

Back pain that increases with bending forwards or sitting is called a flexion dysfunction, and it is the most common type of back pain. So, what type of exercises would be best for you to do if you have a flexion dysfunction type of low back pain? Well, although we always recommend seeing your physio for a full assessment to properly manage back pain, here are 3 gentle exercises you can try at home that don’t require any special equipment so they are great to get you started during lockdown.

1. Basic Back Extension

Lie on your stomach with a rolled up towel under your forehead, arms resting by your side, and your toes pointed. Inhale as you lift your head and shoulders off the mat slightly, exhale, and lower back down to the starting position. The emphasis with this exercise is on core engagement and gently turning on the muscles along the back of your spine. Repeat 10 times, 2-3 sets.

2. Leg Slides

Lie on your back with your knees bent and your feet hip width apart. Inhale and activate the abdominal and pelvic floor muscles. Exhale as you lengthen one leg away from your body, sliding the heel along the floor. Inhale as you return to the starting position, keeping your pelvis stable throughout the whole exercise. This is an excellent exercise to train the engagement of the deep abdominal muscles to support your lower back. Repeat 10 times each leg, 2-3 sets.

3. Freestyle Arms

Lie on your stomach with your arms overhead and palms facing down. Have your legs extended straight, toes pointed, and your forehead resting on the floor. Inhale, glide the shoulder blades down and back, raise the upper body and arms just off the mat. Exhale and start raising and lowering the arms, alternating sides. Depending on your current fitness you may do between 5-10 reps with each arm, and do this 10 times.

These three exercises are a good way to start some gentle low back exercises at home during COVID lockdown restrictions. Please remember that while you should feel your muscles working, the exercises should be pain-free. If you aren’t sure if they are right for you please call us on 9280 2322 or email our Pilates physio Sonja at Sonja@centralperformance.com.au for some free helpful advice.

Pilates With A Physiotherapist Is A Safe And Effective Way To Help Manage Low Back Pain

Pilates is a safe, fun, alternative and challenging way to exercise with chronic or intermittent low back pain. Don’t give up on exercise because you feel your back is limiting you or you may flare your pain up by exercising. Research has clearly shown for many years that doing the right type of exercise is the most effective way to manage chronic or recurrent low back pain.

Physiotherapists who are specifically trained in Pilates are ideally qualified and experienced to help you manage your back pain. Their physiotherapy background gives them in-depth knowledge of anatomy, injury diagnosis and rehab programming, and their Pilates training allows them to prescribe the ideal combination of exercises to rebuild your body’s stability, strength and flexibility. Many of our clients also report that they enjoy having the confidence of knowing that their Pilates instructor is also a fully qualified and experienced physio who is used to working with clients who have had back pain and other injuries.

Telehealth Pilates Exercise Sessions Are Also Available During COVID Lockdown

If you are keen to start home Pilates exercises to help your low back during the current COVID lockdown then our telehealth sessions are a great option. Led by a one of our Pilates-qualified physiotherapists Sonja or Ruben, we can provide you with personalised mat-based Pilates sessions to do at home with little or no equipment. Sessions can be booked at a time that suits you, and are claimable through private health funds. For more information please email Sonja@centralperformance.com.au. In-person sessions are also still available during the current COVID restrictions if you need face-to-face assessment and supervision.


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