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How Pilates Can Help With Back Pain

Updated: Apr 28, 2022

People often conflate Yoga and Pilates, thinking that it’s all about stretching. But Pilates is much more than that.

The practice of Pilates is focused on spinal alignment and the tiny muscles that support your musculoskeletal system. In the modern world, we spend too much time hunched over screens, sitting on non-ergonomic chairs or couches and generally slouching. The muscles across our back become weak and strained, which over time, can turn into joint and disc issues. Pilates concentrates on strengthening the deep postural muscles, raising awareness of how one stands and the general alignment of hips, spine and head. This awareness alone can go a long way to improving posture and therefore back pain, but the strength that is built with specific, highly targeted exercises will support the spinal column.

However, it’s just like the old Skeleton Dance song: “the hip bone’s connected to the backbone…” and so we don’t just look at the back muscles in isolation. We always talk about the Pilates Powerhouse. This is made up of your deep abdominal muscles: your glutes (bum), obliques and back muscles. Each element works together to build a strong core surrounding your spine - especially the glutes. Think of your spine as a bendy straw. If you put that bendy straw in plasticine, it will just wiggle around. If you turn the plasticine into concrete, then the straw will be nice and stable. All that support and stabilisation will enable the muscles in your back to do the right job and hold you up nicely, relieving pain.

I work with many clients who have spinal issues. Some may have an issue in common, but their pain is very individual. They all ask how many times a week they should do Pilates. We would recommend a minimum of one full session a week, usually an hour, whether that’s as part of a class or in a one-to-one setting. However, it is really down to the individual and what they feel they are capable of, or need. That being said, it is a good idea to do a little something everyday. If you have been seeing an instructor on an individual basis, they will have created a plan for progression specifically for you. You can take that plan and break it down into bite-sized chunks. Maybe one day do a few glute exercises and another day some abdominal work. As Joseph Pilates said “movement heals” so even a little everyday can make a significant difference over time.

Even if you don’t manage to carve out 15 – 20 minutes a day, little stretches can really help. Think about your cats and dogs. When they wake, they stretch. Before they sit they stretch. Be more animal and stretch your muscles and spine as much as you can. When you make a cup of tea, have a little spinal roll down whilst you wait for the kettle to boil. When you have finished a piece of work or Zoom meeting on your computer, stretch through your upper spine to reverse your posture. Quick stretches like this will become habit and promote mobility, relieving pain.

Here are several moves that can really help with back pain.

The first is a glute bridge. This strengthens your bum and stretches your lower spine all at once. Think of your spine as a pearl necklace, you must roll your spine up, bone by bone, by curling your pelvis and pressing up with your bum until your body is in a straight line at the top. Then melt back down, ribcage first, still squeezing your glutes until you have landed your pelvis. These are great to do just after waking up, when your spine is still warm, relaxed and malleable.

Core work is key. Small crunches lifting from your midline abdominals, reaching your fingers forward to your feet as you lift. Maintain a still spine, tapping your toes on the floor with bent knees forces weight bearing and strength building. You can do either of these with your feet on the floor or with your knees up in a position called table top.

Thoracic lifts are good for building upper and middle back strength and go a long way to reversing the damage modern life exacerbates. Lie on the floor face down, with one hand on top of the other and your forehead on your hands. With your feet together, stretch your head away from your feet and come into a low hover as you inhale. Exhale to lower back down. Try to slide your shoulder blades down to your back pockets and open your collarbones as you lift to engage as many muscles as you can and support your lumbar spine.

Clams are a great way to build deep glute strength. Remember that yogurt? Lie on your side with your head supported. Stack your hips one on top of the other and try to lengthen your spine. Bring your feet in line with your bum, keep your feet together and lift your knee up as high as you can without moving your hip backwards.

A move that takes a little more practice is the hip twist. Lie back flat on the floor with your arms out wide, palms down. Stabilise your core and bring your legs into table top. Keep your back as flat as you can and twist your hips up and over to one side, then up and over to the other side, keeping your knees together.

But the best thing that you can do, all day every day, is pretend that your head and vertebrae are made of helium and are trying to float apart. Lengthen your spine and head upwards and straighter as much as you can and the resulting improved posture will help to reduce back pain.

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