Easing Your Back Pain with Pilates

By Ellie Herman from Pilates For Dummies

Most of the Pilates mat exercises strengthen the muscles necessary to properly support the spine and bring an awareness about what proper posture actually is. It's not enough just to do Pilates mat exercises; if you want to improve your posture and heal your back pain, you must incorporate Pilates into your daily life. You must translate the Neutral Spine, the feeling of length, and the Abdominal Scoop into your desk job. If you can incorporate the deeper Pilates concepts into your daily life, you'll notice changes immediately — in your back pain, in your posture, and in your sense of well-being.

Most back pain is due to faulty posture — the posture in which you probably spend most of your days.

Do you sit at a desk and stare straight ahead? Unfortunately, most people do, and they find it very difficult to sit up with proper posture for eight hours at a time. It becomes a vicious cycle: First you sit for long periods of time in a way that doesn't properly support the spine (generally, in a slightly hunched-over position). Then you lose strength in your postural muscles by not using them day after day, and then you can't sit up properly even if you wanted to because you've lost strength! What to do? Well, guess what? Pilates!

Understanding the common causes of lower back pain

Again, most back pain is a result of bad posture when sitting, standing, or walking. The main things to remember to prevent bad posture are to sit and stand up tall, keep your belly pulled in, and keep your shoulder blades pulling down your back. When you find your correct posture, you should feel the ease it creates in your whole back.

You may need to slowly work up to sitting properly for long periods of time. Even your postural muscles need to get in shape. But the more awareness you have, the better you will feel. If you stand a lot, think of keeping your knees soft; don't lock them. Try to keep even weight on both legs. Keep your belly pulled in.

But bad posture isn't the only culprit. A sedentary lifestyle is also often to blame. Let's face it: People just weren't meant to sit at a computer monitor for eight hours a day — or to sit on a chair at all, for that matter. Sitting isn't easy on your back. If you think about it, when you sit in a chair, the back muscles have to work all the time to keep you upright. Your legs are not able to help out at all. Furthermore, staying in one position doesn't promote good circulation and muscle tone. Break up your work day by getting up regularly from your chair and stretching out, going for a walk, or doing a Pilates series, if you can.

Avoiding loaded flexion

Most construction workers have terrible backs by the time they're 40, because they spend much of their day bending over and lifting up heavy objects. Even if you maintain perfect alignment when lifting, you can't avoid loading the spine in flexion if you're installing a floor, say, or doing much of anything below the waist.

Flexion is the rounding forward of the spine when standing or sitting, or what your spine does when rolling up in a sit up. Loaded means . . . well, loaded. An example of loading the spine in flexion is the Rolling Down the Wall exercise if you have free weights in your hands. As you roll forward, the weight of your head, body, and the free weights is dropping down. The muscles and ligaments of the back are supporting that weight. Another example of loaded flexion is the Hip-Up exercise. As you lift your hips, the weight of the butt and legs is now on your back. If you roll back too far, the weight of your whole body will be on your neck. The neck is especially vulnerable to having too much load because it is made up of small, fragile vertebrae that are not meant to hold up anything but your head when standing. When you get very strong in your core, your spine can support more weight without being traumatized.

Flexion is the movement of the spine that most damages the structures of the spine; especially the intervertebral discs and the ligaments of the back. If you feel uncomfortable when doing flexion exercises; don't do them! Instead, do all the exercises that don't bother your back, and come back to the others when you have more strength.

To avoid loaded flexion, use proper body mechanics when bending over and lifting:

Keep a Neutral Spine. You can just think of keeping the spine straight. Don't round the back forward (flexion)

Bend your knees; and if you're lifting something, use your leg muscles not your back!

Keep your Abdominal Scoop by pulling your navel in toward your spine. Doing so helps support the back.

Being your own guide

A well-known doctor named Robin McKenzie wrote a book called Treat Your Own Back, which revolutionized the way the rehabilitation profession viewed back pain. Basically, the book describes a program where you experiment and find out what movements exacerbate your back pain, and what movements and positions alleviate your back pain. Then you do the things that make you feel better. It sounds so fabulously simple and it works. You can follow the same principles when doing Pilates.

When trying a new exercise, see if the movement makes your back pain worse or better. Use this information to heal yourself. For instance, if you find that flexion (rounding the spine forward), like in Spine Stretch Forward, makes your back feel great, then you can proceed with all the flexion exercises with a fair bit of confidence. In that case, exercises that do the opposite movement, extension (arching the back), as in the Rising Swan, may make your back hurt. If this is so, avoid all exercises that extend the back. The act of twisting may be the source of the problem, or it could be twisting in just one direction. Take note of what hurts and apply this information to your workout.

When you're in pain, you must be very mindful when trying out new exercises. Talk to your doctor first to make sure you don't have any serious injury, and then go to a trained Pilates instructor if you are worried about hurting yourself.