A lot of GPs and doctors often recommend Pilates for people with back pain but is it a good idea? Dr.
Eoin Everard, chartered physiotherapist discusses the pros and cons.
The pros.
1. It can strengthen the core
A lot of back pain is caused by too much pressure being placed on the passive structures of the back.
Disc bulges, facet or back joint and ligament strains are essentially the injuries that occur when these
structures are overloaded and worked too hard. Having a strong core allows the musculature of the trunk
to take a lot of the force placed on the spine, thus helping to take pressure off the discs, joints and
ligaments allowing less injuries to occur.
2. It strengthens the hip and glute muscles.
In a normal functioning body, most movement when we are lifting should occur at the hips and the glute
muscles should take most of the force. Unfortunately, because of the amount of sitting we do, the glutes
can become weak and the hips can become tight. This forces the back to to move too much rather than
the hips. Even worse because the glutes are weak the force is also taken by the back muscles which are
not equipped to take all this force again leading to possible injury. A main focus of Pilates is to targets the
glute muscles with exercises, such as the glute clam and bridge. These exercises help to “wake up” the
glute muscles again and get you moving better at the hips, which helps restore normal functioning and
therefore takes the pressure off the back.
3. It improves posture
A lot of the Pilates exercises target postural muscles. These deeper muscles can often get neglected
with other forms of exercises. Therefore, working these postural muscles through Pilates routines can
help improve posture and our movement. Poor posture and poor lifting technique are contributing factors
to back pain and so improving these things can only benefit your back.
The cons
With a lot of pros for Pilates it would seem like a no brainer to do Pilates. However, there is a word of
caution with some Pilates exercises and routines.
1. Some Pilates exercises can stress the spine.
Exercises like Roll downs, and imprinting the spine to the floor for ab exercises would not be
good for someone with back pain. These exercises cause excessive flexion of the spine which
can stress the discs of the back and cause further back pain. It is important if doing Pilates you do
a routine that is back friendly and doesn’t include these exercises. As a general rule try to avoid
exercises that move the lower back too much. As mentioned day to day life stiffens up the upper
back and hips causing us to move too much at the low back. Therefore it doesn’t need more
movement!
2. Make sure you are doing exercises at an appropriate level.
Like with any form of exercise, doing exercises above your ability can lead to further problems.
Trying exercises that are too difficult can be counterproductive. There are a lot of Pilates
exercises that are tricky so make sure to start at an achievable level and progress. For example,
take a difficult plank exercise. If this is too difficult for you there will be a tendency to arch your
back rather than train your body to hold your spine in the safe middle position. Doing a modified
plank exercise will allow you to strengthen your core muscles correctly and get much more out of
the routine in the long run rather than over doing exercises at the start and causing pain.
3. Pilates is only beneficial when the exercises are done correctly.
A Professor Stuart McGill says “its not about doing core exercises but doing them correctly”. Like
the previous point it is important that you can do the exercises correctly. Doing a plank exercise
incorrectly can actually worsen your spine and not strengthen the core at all. Doing Glute bridges
with excessive arching in the spine can again overwork the back and not actually improve glute
strength or your movement in the hips.
The verdict.
I feel the benefits of Pilates far outweigh the cons. However, it is important to do exercises
correctly and at your level. I have developed a Back Pilates programme with the BackAware Belt.
The BackAware Belt is a wearable technology that gives instant feedback on your back position.
The Irish Times says its like having every lift and exercise supervised by a physiotherapist
Our Back Pilates is for Beginners and is a follow along course to get your back and core strong.
The BackAware Belt gives you feedback to make sure you are exercising correctly so you get the
benefits from the time and effort you put into helping your back.
For a trial click here.
