Pilates Low Back Pain Exercises
A strong back can withstand more stresses and can protect the spine much better than a back that has not been conditioned through exercise. The goal of low back pain exercises is to strengthen the muscles surrounding the spine and take the pressure off the spinal joints. Read more....
This is done by retraining the deep abdominal muscles (transversus abdominis, pelvic floor, multifidus and internal obliques) with the aim of increase spinal stability. Our 'core' muscles can provide back pain relief because they may provide stronger spinal support, maintaining it in alignment and facilitating supported movements that extend or twist the spine.
Re-patterining movement skills and retraining the deep stabiliser muscles of the trunk should help improve muscle activation timing, force and muscle thickness. In turn, the spine can reduce shearing forces within the spinal segments. La Touche et al. (2008), found positive effects of Pilates exercises such as increased general function and pain reduction in patients with nonspecific low-back pain.
Can Pilates Low Back Pain Exercises help?
The aim of Pilates low back pain exercises is to improve spinal mobility. "Stabilising the give, moving the restrictions" A spine that does not move well segmentally may put more stresses on hyper mobile segments. In other words, think of a bicycle chain that has links that are stuck. Something will have to give to move the chain. When the spine moves, segments that are not restricted will compensate for the restricted ones, carrying more loads and moving in excess. This may lead to faster wear and tear at some segments. Pilates low back pain exercises aim to move the restricted segments of the spine segmentally in order to decrease stress on the overloaded joints. Unlike other forms of movement, Pilates exercises work on spinal articulation, which in turn improves the overall health of the spine and reduce pain and disability.
Pilates and the Deep Inner Core Unit
Not all Pilates exercises recruit the deep spinal stabilising muscles. It is up to your instructor's understanding of the muscle function classification system and ability to design the correct programming.
The best programming for Pilates low back pain exercises should aim to optimise the limbo-pelvic region. This is done by:
- Exercising under painless conditions: Pain can cause inhibition of the type 1 muscle fibres. Programming should be directed at stimulating these fibres.
- Decreasing stress on the joints: To minimise the effects of inhibition, the joint should be positioned in the mid-range, which is specifically relevant in acute pain where there may be inflammation or effusion present.
- Use of Low-Load Exercise: Often times people like to feel the burn and think that working with more load or resistance will make the stronger.
In normal situations, that is true. Resistance can facilitate muscle contractions. However, in pathological situations, muscle activity may be inhibited by resistance to contraction. In this context, inappropriate loading can cause non-inhibited muscles to overwork and compensate to create the movement pattern.
How do you Retrain the Deep Core Unit?
Use non-fatiguing low-load exercises
Maintain a mid-range joint position
Use of isometric/tonic holding positions in different planes to develop endurance of the position sense.
Decrease contributions overactive muscles and rigidity.
At Core Kensington out instructors are trained to assess and provide exercise programming for those clients with low back pain. Working under the supervision of a registered osteopath, we can help you retrain your deep limbo-pelvic stabilisers and be on your way to a better back.
We offer the best Pilates for low back pain exercises instruction in London, right in the heart of Kensington.
What if I have chronic pain?
Chronic pain may change how your body perceives pain. A long lived pain stimulus produces an altered behaviour in the individual and may persist even after the pain source has been eradicated. In other words, even if the issue in your back is resolved, sometimes the brain may still feel pain.
"Repeated stimuli changes how the body processes pain. Pain signals become faster an stronger and more intense, depleting the body’s own pain blocking substances substances (e.g. norepinephrine, serotonin)”. (Caballero Goodman, 2013 p.127). This may be the case with people who, for example, have been diagnosed with lumbar disc injuries and after months of recovery, they still experience pain. The approach is then to asses how the pain has affected the person.
It is recommended that the focus for chronic pain management is towards "maximising functional abilities rather than treatment of pain"
In this case, Pilates may be able to help change the client's perception of pain by retraining the brain through neuromuscular retraining. By working each time towards managing how the body moves through pain, and learning how to control it. Strengthening the injured structures and lengthening the shortened tissues can change the muscle spindles and signals to the brain, in turn decreasing pain signals. According to Caballero Goodman, 2013 p.127 "In chronic pain, uncontrolled and prolonged pain alters both the peripheral and central nervous system through processes of neural plasticity and central sensitisation and thus, the pain becomes the disease itself"
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La Touche, R., Escalante, K., Linares, M.T., 2008. Treating non- specific chronic low back pain through the Pilates method. Journal of Bodywork and Movement Therapies 12, 364e370.
Caballero Goodman, C; Snyder, T. 2013. Differential Diagnosis for Physical Therapists Screening for Referral. 5th Edition. Elsevier.