Key Pilates Exercises for Back Pain and which ones to Avoid.

May 12, 2022 | Prevent or Correct Back Pain

Pilates exercises have been recommended for people with back pain for decades and for good reason. Strengthening the core helps to take pressure off the spine and discs. Getting better movement and being stronger at your hips allows you to move at your hips more freely thus requiring less movement at the back and less irritation. With this being said, not all Pilates moves were made equal. There are some key moves that will help strengthen the core and hips and not put excessive stress on your spine. Some Pilates moves should be avoided as they can stress your spine and discs and we will discuss them at the end of this article.

1. Superman/Bird-Dog

This exercise has two different names but has one big benefit! It involves lifting your opposite arm and leg while keeping up the stomach. The key to this exercise is to keep your spine in the middle neutral position. The BackAware Belt makes it easier to see that this is happening. This exercise helps to improve core stability without putting much stress on the spine. It can also help strengthen the back muscles.

Here is how you do it:
Start by keeping your hands under your shoulders and your knees underneath your hips.
Arch your back and then round your back. Find the middle position between these two points.
Using the BackAware Belt track your back position.
Keep your stomach up away from the ground but don’t change your back position.
Lift your opposite arm and leg.
Hold for 5 seconds.

2. Side Plank
This is another great exercise and is described by Stuart McGill as one of his Big 3 essential exercises for people with back pain. It has the highest activation (strengthening) of the oblique (Side core) muscles with the least amount of stress placed on the spine.

Here is how you do it:
I start this from my knees.
Have your feet behind you with your knees, hips and shoulder in line.
Lift your hips into the air.
You should feel this in the side of the trunk.
Hold this for 10 seconds and then take a 2 second break and repeat 3 to 4 times.
Key fault is to flare the ribs. Keep the ribs down towards the stomach and the pubic bone zipped up towards the belly button.

3. Glute Bridge
A main issue with back pain is that we use the back too much because our hips do not move as well as they should. The muscles mainly responsible for good movement at the hips are the glutes. A key exercise in Pilates is the glute Bridge. Again make sure you are keeping your spine in the middle position and then there should be no movement through the spine. All the movement should occur through the hips.

Here is how to do it:
Have your feet shoulder width apart.
Find your middle back position by arching your back and then flattening it and then staying in the middle position.
Use your BackAware Belt to make sure you stay in this neutral position.
Push your feet into the ground.
This lifts your hips into the air.
Keep your spine in the same position and pulse up and down about ¼ through your hips.
Repeat 5 pulses and do at least 10 reps or as many as you can manage with good technique.

4. Glute Clam
This again is a great exercise to get the glutes on the side working the way they should. It also helps again improve movement at the hip, which will in turn take pressure off the spine.

Here is a video how to do this exercise:

Pilates Moves to Avoid with Back Pain

While Pilates can be excellent for people with back pain it is important to know that not all Pilates moves are designed for people with back issues. Some moves while ok for people without back pain can irritate the spine in those with back pain. The main premise is that you do not want to be excessively flexing or arching your spine when recovering from back pain. Learn how to move correctly through the hips and upper back. Therefore, here are some exercises that flex the spine too much in Pilates.

1. Roll downs.
This is a classic starting exercise in Pilates and involves vertebrae by vertebrae flexing the spine to the ground. This move needs a lot of core control and in my opinion the juice is not worth the squeeze! Avoid it.

2. Imprinting the spine into the ground.
One of Prof. McGills key tenants is that the spine is safest when it is in the middle neutral position. This makes perfect sense. Any joint when moved to its end range is going to be more at risk compared to when it is centred. You wouldn’t try to do the splits and stay there and think you had less risk than when your legs are directly under your body. The same is true with your spine. Practising to keep the spine in the middle and then not moving it when lifting or exercising will benefit you most in day to day life and will not stress the discs of the body. Therefore, doing exercises that say press your spine into the ground makes you flex your back and while it will help activate core muscles will not teach you skills of how to position your spine when lifting or doing more complex exercises.

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