Clinical Pilates can Potentially Reduce your Back Pain

Joseph Pilates‘Core strength’ has become a fad term in the fitness industry over the last 20 years and associated with the growth of Pilates in the early 2000’s.

Joseph Pilates, while ahead of his time in many ways with respect to exercise, did not actually know about the role of the deep stabilisers such as the pelvic floor and deep abdominal muscles in providing stability to the spine when exercising or in normal activities of daily living especially when bending or lifting. He used a technique often referred to as ‘bracing’.

Many people believe they have a strong ‘core’ but when asked to lift their pelvic floor and gently engage their deep abdominal muscles below the belly button they can’ t do so and make attempts to ‘suck in their gut’ or push their belly out.

Next time you get up from a lying position on your back or attempt a sit up – look down at your navel. If your see a dome in the middle rather than a flat abdomen – you are not engaging your core.

Many people go to Pilate’s classes and are not doing the exercises correctly. Many end up with a sore back because they are doing advanced level exercises without adequate strength and endurance of the core stabilisers.

One of the advantages of clinical Pilate’s instruction with a trained physiotherapist (in an initial private consultation) who can assess the pelvic floor and deep abdominal muscles with real time ultrasound is that both the physiotherapist and client can identify these muscles and targeted training can accelerate correct engagement and strengthening of these muscles.

Between 80-90% of the general population experiences a severe bout of back pain at least once in their lifetime. Professor Paul Hodges, of the School of Health and Rehabilitation Sciences at the University of Queensland, says there is no ‘one size fits all’ approach to exercise and back pain.

Research has shown that in chronic episodes of pain there is ‘inhibition’ of the deep supporting muscles of the spine and the receptors in many of these muscles (proprioceptors) that constantly feed information to the spinal cord and brain about what each joint is doing – its position in space and direction of movement etc, becomes disrupted.

With misinformation from these damaged proprioceptors – the neural pathways to these muscles from the brain and spinal cord also alter, so correct coordination of muscles is lost resulting in altered firing and recruitment of muscles and altered movement patterns.

There is increasing body of evidence that correct core stabilisation does help restore muscle function and reduce back pain. At Canberra University we are fortunate enough to have Cherie Wells doing a PhD in Pilates and low back pain and we anxiously await the outcome of her work in this area.

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About the Author

Jennifer Kellett established Hawker Place Physiotherapy in 1991 and is the principal practitioner of the family run practice. Jenny has served the local communities of Belconnen and North Canberra with commitment and pride for over 26 years. She is a strong advocate for maintaining fitness, health and well being across all age groups and has a keen professional interest in combining Pilates with weight training for treating postmenopausal women at risk of osteoporosis.

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