Pilates for Low Back Pain. Is it any use?
Pilates for Low Back Pain
Everyone is raving about Pilates, doctors are recommending it for management of Low Back Pain but why?
We have seen in my recent blog on ‘Why I love Pilates’ the benefits I see Pilates has as a physiotherapist but why specifically Low Back Pain?
As far as I’m aware there is not much research out there to show that Pilates influences Low Back Pain but what Pilates does is encompass many aspects of known benefits for Low Back Pain.
What does the research show that helps Low Back Pain that we can find in Pilates?
Rule 1: Keep moving
One of the main findings of research into Low Back Pain is to keep moving. Pilates is great to get spinal movements; many the exercises are designed to get the spine moving and keep it moving. Pilates’ moves not only look at the lower back, but they also get the upper back moving. Often if we get stiff in our upper back the lower back takes some of the impact.
The spine needs to move as a whole structure and we need to keep it moving through its full range especially as we get older otherwise stiffness sets in and then this can lead to injury. Pilates works us through flexion (bend) and extension (arching backwards) and both movements are important but on our own we are not sure how much or how often we need to do this.
Before we start our Pilates though we do need to be aware of what our backs can cope with as in a class environment its very hard to be specific to your condition. If you are not sure, then it’s probably best to have a 1:1 before you get started. This also helps the instructor to understand how you move.
Rule 2: Get strong
There is also a body of evidence that suggests that we need to get strong. Everyone bands around the term core strength, this to me is strengthening around your abdominals and your back muscles but also the need to strength through the hips and the legs. Strengthening your whole body is important so that your legs and arms can do the work instead of your back. Core strength needs to feel like a work out, gone are the days when gentle hollowing of your tummy is thought to have any impact. Good Pilates Classes will encompass strength in all your body. Principles of Pilates which I think is really important is focusing on good technique and precise movements so that you work your core but also are aware how not to aggravate your back.
Rule 3: Reduce your anxiety to move
One of the big factors that effects the progress of your recovery is fear of movement. I see many people who have suffered the pain of their backs and are fearful of setting it off again so avoid bending or moving enough. They use strategies such as never bending in the back. As a result your back will get stiff and then wont want to move. Pilates is a great way to start this gentle process of movement, learning how to move again and feeling confident that you can bend properly. Once again if you have concerns of moving then its best to start with a 1:1 so you don’t get lost in a class environment.
Rule 4: Increase your awareness of how you move
Pilates focuses a lot on how you move making you aware of which part of your body you are moving. This has many effects, firstly it brings your attention to quality of movement that with time you will use in other areas. For example, if in every class we spend time teaching you how to do the perfect squat then when you go off to the gym and start squatting those patterns will have been taught to you.
Secondly being aware of where you move from will make you understand what areas are stiff or weak in your body.
Thirdly bringing you aware of your movement if a form of mindfulness and will help you zone in to the know, helping to reduce your stress and anxiety to movement.
Rule 5: Reduce therapist dependence and promote self-management
There is much research on the topic of creating independence of your injury. I am a firm believer in this. You need to have the tools to help you manage any injury. The therapist can help alleviate some pain and stiffness with any hands-on work, but this is just to allow you to get going and start building strength and mobility. Pilates is a way to help get you moving and strong which helps to reduce the need for hands-on work.
Rule 6: Class environment keeps you going. Maintenance.
Keeping up with your exercises is the key to success, exercises that physiotherapists give you maybe boring and hard to maintain which is why classes are a good way to keep up the good work.
Rule 7: Sitting… What are we going to do about that?
A quick note on sitting as I always must bring it into the equation… Sit less… nothing more to be said.
Just be aware that the class you do is the right one for you. How will you know? If you feel any pains after or it feels too hard to maintain or you just stop looking forward to going. Consider then that this Pilates isn’t the one for you and discuss with your teacher your options.
Should I start Pilates when my back is in a Flare up?
Finally, a very important note, if you have an acute flare up of your back or your back isn’t settled or managed well then Pilates may not be right for you at this stage. You will need to let your symptoms settle down and understand what helps and then you will make the most of the Pilates.
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