Lower back pain is the most common cause of work-related absence in society. Recent studies show up to 80% of adults in the general population will suffer this condition at some stage in their lives, and 15-30% will have lower back pain at any given time . While many individuals will recover within a month or two, most people will have recurrence of pain episodes within a 12-month period. One of the key factors in the recurrence of this condition is changes in postural control of the trunk muscles (i.e. poor core strength).
Various exercises therapies are used to retrain the abdominal muscles in the management of low back pain and other musculoskeletal disorders. One of these exercises programs is Pilates. In particular, learning awareness of neutral alignment of the spine and strengthening the deep postural muscles that support this alignment are important skills for the back pain patient.
Aims of Pilates exercises:
- To mobilise the lumbar and thoracic spine
- To facilitate gluteal activation and endurance
- To stabilise the scapulo-thoracic and gleno-humeral joint (both make up the shoulder complex)
- To retrain cervical (neck) control
- To re-educate upper quadrant posture In upright postures
- To maintain lumbo-pelvic control
- To increase level of activation through the abdominal muscles to provide increased suport to the lumbar spine and pelvis
Pilates is useful for many musculoskeletal conditions. Some examples are:
- General gluteal weakness
- Sacroiliac joint instabilities
- Tightness of hip flexors and pectoral muscles
- Cervical instability
- Hamstrings lengthening
- Groin rehabilitation
- Athletes requiring high levels of rotary pelvic control e.g. footballers, rugby players, dancers.
- Training the gluteals during pregnancy
- Reduced lumbar & thoracic mobility
The Pilates Rest Position
- Lie on your back with your knees bent, feet on the floor and your head supported on a small cushion
- Relax your head into the support
- Lengthen the back of the neck by pushing the crown of the head towards the wall behind you
- Gently drawn your shoulder blades down towards your waist and relax the neck and shoulders
- Soften the ribcage into the mat to connect the back of the ribcage on the mat
- Place your feet and knees (hip width apart)
- Imagine your pelvis is a bucket of water. Tip it backwards to spill some water out of the back of the bucket and you will feel your back gentry flatten onto the mat. Now tip it forwards to spill some water out of the front of the bucket and you will feel your lower back arch slightly. Find your ‘NEUTRAL SPINE POSITION’ by resting the bucket halfway between these two movements. There should be a small space between your back and the mat.
- Maintaining the neutral spine position; INHALE wide into the sides and back of the ribcage and then EXHALE.
One Leg Stretch
Start Position: Pilates Rest position
INHALE to prepare
EXHALE, slide the left heel forwards along the floor away from the sitting bone
INHALE, slide the left heel back along the floor towards the sitting bone to resume neutral spine starting position
REPEAT 8-10 times (each leg)
- Starting Position: Kneel on your hands and knees. Knees directly under hips and hands slightly forwards of your shoulders. Elbow joint soft. Head and neck liftem In alignment with your spine. Spine long In a ‘tabletop’ position.
- INHALE to prepare
- EXHALE, Reach your left arm forwards off the mat. Simultaneously slide the opposite foot along the floor away from the body, continue to stretch the leg lifting it off the mat
- INHALE and lower the raised arm and leg
- REPEAT alternating arms and legs 10 times
- Starting position: Pilates Resting Position with a small ball between the knees
- INHALE to prepare
- EXHALE and gentry roll the lower back into mat, lift the tail bone upwards towards the ceiling and continue to peel your spine off the mat, vertebrae by vertebrae until you are resting on your shoulder blades
- INHALE and hold the shoulder bridge position
- EXHALE and lower the shoulder bridge by drawing the breastbone down towards the mat, continue to peel your spine back onto the mat vertebrae by vertebrae until the tailbone touches the mat and the spine returns to neutral
- REPEAT 8-10 times