Pilates as Rehabilitation

The Reality of Back Pain

Back pain plagues many individuals, more so than most of us would like to admit. In fact, only second to the common cold, back pain is the top reason Americans call out sick from work. And at some point in our lives, three of five of us will suffer from backache. When muscles are under stress, a person’s body will look for the easiest way to complete a movement. The brain recruits 'strong' muscles in preference to weaker ones, leading to certain muscle overuse and deterioration of others.

Over time, a non-optimal pattern of movement becomes habitual and these "cheating" mechanisms start to feel normal. It is only when back pain, or other pain, arises that the person recognizes something is wrong that has often been building over an extended period of time.
Unfortunately, at this point what feels natural, it a
bad habit of posture or bad movement patterns
which continue to reinforce pain. To help eradicate
chronic back pain, patients must break these habits,
but how? From surgeons to chiropractors to physical therapists, to alternative therapists such as Pilates instructors, most medical and fitness professionals agree on one thing—exercise helps.

After patients meet with a health professional for proper diagnosis and exercise prescription, they are free to engage in movements that keep the back healthy. And, they should. One of the most important recent changes in medical thought is recognition of the importance of self-management. Patients are being encouraged to take ownership of their body, their pain, and ultimately their healing. While some back conditions do require surgery, many others can be managed non-operatively.

While exercise itself is beneficial in most instances, there are certain programs that are specifically designed to create strength and flexibility in areas that help back pain sufferers. In fact, Pilates practice has caught the eye of many physicians as it has shown success in alleviating current discomfort and preventing recurrent back pain episodes. As noted by Sports Medicine Physician, Dr. Mary Holden, recent research from the Physiotherapy Department at Queensland University has demonstrated that by increasing the co-ordination and strength in the deep abdominal muscles, e.g. transverse abdominals, the lumbar spine is stabilized and protected. These are the same conclusions that Joseph Pilates arrived at in the 1920's.[1]

Created to help rehabilitate soldiers during World War I, Joseph Pilates’ Body Contrology method was used to engage one’s entire body to heal itself. With prominent focus on abdominal strength, the program successfully strengthened participants’ core muscles, promoting proper posture and better redistribution of pressure and weight throughout the body.

Noted by Dr. Beth Glosten, “Patients with pain stemming from excessive movement and degeneration of the inter-vertebral 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 inter-vertebral joints and discs.”

How Pilates Works

Pilates movements work the patient in ways that strengthen the pelvic floor and trunk muscles, and create greater range of motion by reducing tightness often found in the legs. The exercises work the patient deeply, but gently, to rebalance posture and change the person’s habits.

Pilates helps to recondition the body by breaking down those cheating mechanisms. It challenges a person physically and mentally to re-learn posture, re-distribute weight, and build the strength required to execute proper movement. Specifically, Pilates works the stabilizing muscles, those that prevent movement, as well as the mobilizing muscles to ensure both share the effort. These muscles groups working in tandem to initiate movement and maintain balance will help prevent wear and tear on the joints.

Steps to a Healthier Back through Pilates

• Before starting, it is advisable to check with a physician or other healthcare provider

• Seek a certified Pilates instructor with expertise in back rehabilitation, not all back pain is equal
  and your instructor must know the appropriate movements and modifications for your injury

• Avoid exercises that push the spine into extreme flexion, extreme extension, or combine flexion
  with side bending or twisting—if pain occurs, alert your instructor so he/she can modify the exercise

• Remember that as non-trauma back pain arose over time, to reverse the pain, you’ll also need time.
  The full benefits of Pilates will happen gradually as you learn to use your muscles in a way that
  supports the spine

About the Author:
Jenna Componovo is a certified Pilates instructor and co-founder of the Pilates of Charleston studio and wellness center in Mt. Pleasant. Certified in apparatus, mat and spine corrector work, she focuses her practice on Pilates as a rehabilitative method and conditioning program for athletes.

Sources: Examination of the Spine & Extremities by Hoppenfeld, Stanley M.D.; Medic8® Family Health Guide website; Spine-Health.com; The Sports Medicine Patient Advisor by Rouzier, Pierre M.D.

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1] Medic8® Family Health Guide, PILATES - the best kept secret in back rehabilitation, Mary Holden, M.D.
-Sports Medicine Physician