End Back Pain with Pilates

Have you ever experienced the frustration of back pain? Back pain affects all aspects of your life. Physically, the pain wears you down and drains your energy so you can’t do the things you love. The emotional stress and anxiety leave you constantly fatigued. You can’t think straight because of worry, distraction and diminished focus.

Your life just isn’t the same when you have back pain.

Back pain is one of the most common medical problems in our modern culture and it accounts for more than $10 billion in annual costs in the US alone. It’s estimated that 4 out of 5 people will suffer from back pain in their lifetime.

Usually, your first episode of back pain resolves without much trouble - a few Advil, some rest, maybe a massage or two and you’re as good as new. But are you really “as good as new”?

You might already be aware that one episode of back pain often leads to another. And another. If this is the case, then your back is definitely not as good as new after each bout of back pain.

So how can you improve your spine health and prevent recurrent episodes of back pain?

The answer is Pilates.

Pilates is an exercise and movement discipline that incorporates strength, flexibility, balance, core control, breath and mental awareness – all the ingredients you need for a healthy back.

Joseph Pilates brought his exercise regime, called “contrology”, from Germany to the US in the 1920’s and Pilates has since been practiced by millions of people around the world. Pilates is ideally suited to correct a wide variety of pain and injury problems, as well as providing a full body workout, no matter what your ability or fitness level.

Pilates can be done on a mat, or using a variety of brilliantly designed equipment that can be arranged to either assist or challenge your movement.

What makes Pilates such a great choice for preventing and treating back pain? To understand the benefits of Pilates for back pain, it’s helpful to have some understanding of back pain’s affect on your body and mind.

Most low back pain is caused by strain on the soft tissues and structures in and around the spine - the muscles, ligaments, discs and joints. Back strain is usually caused by controllable factors like sitting or lifting incorrectly over a long period of time. Eventually, the structures of your spine break down until finally, something “gives”.

Damage to your back usually doesn't occur suddenly - although the pain might. It's a bit like getting a hole in your sock: it takes time to wear away the material of your sock. You might not notice that it’s happening until your heel is exposed.

Damage to the soft tissues of your back cause pain, inflammation and “muscle guarding” or spasm. Just like in the case of an ankle sprain, you limit your movement because of the pain.

After everything seems to be healed, you begin to return to your normal activities.

But you’re not quite normal.

What's going on? Well, there are a number of reasons why you don’t completely return to normal after a back strain. First, you’ve made adjustments in the way you move to avoid pain. These avoidance strategies have become habits, and remain with you even when the pain subsides.

If you don’t become consciously aware of these habits and do something about restoring correct movement and alignment, you’ll create further imbalance, eventually leading to more damage.

Second, in addition to developing these protective movement habits, you’ve also lost mobility, strength, and proprioception. Strength and mobility can be restored with a good training program, but what the heck is proprioception?

Proprioception is the internal ability you have to know where you are in space. There are nerve receptors, or sensors, in the joints, muscles, tendons, ligaments and other connective tissues and they are responsible for sensing where your joints are in space, giving your brain constant feedback as you move.

Even if you’ve been diligent about strengthening and range of motion exercises after your back injury, you will be prone to recurrent back problems if you haven’t retrained your proprioception. Training your proprioception connects you to your nervous system.

This training requires focusing on your inner environment. Connecting your mind and your body.

The proprioceptors in the back, which get damaged from injury, don’t reactivate unless you train them to do so. If your body and mind remain disconnected, you have little or no mechanism to avoid a vulnerable position the next time you’re putting a load on the spine: bending, lifting or playing golf. And now you’ve set yourself up for repeated, chronic lower back injuries.

Research in the last 15 years has given us guidelines about spinal stability, proprioception and movement science. It’s the inner, muscles, tendons, ligaments and other connective tissue that protects you from injury, not the large outer muscles. Another way of saying this is that specific, local stabilization is more important than global strength when it comes to keeping your spine healthy.

One of the key aspects of any back rehabilitation program is the awareness of alignment and local stabilization. Learning to be conscious of your whole body movement patterns and postures during exercise and in your daily activities will help you develop a spine-friendly environment.

Pilates, when taught with precision, inherently incorporates awareness of whole-body alignment, movement and internal and exte
al control. At first, a movement is broken down into small pieces so you can practice it correctly over and over with full attention.

Eventually, you can perform a complex movement series or activity, which you then practice until it becomes efficient and effortless. This is something called “unconscious competence”. It’s the same state that elite athletes strive for – to learn conscious control and evolve to unconscious mastery.

The bottom line is that it takes a variety of strategies to protect you from repetitive low back pain: time to allow for healing of the initial tissue and joint damage; appropriate movement to assist healing without further damage; strengthening to stabilize the spine and surrounding structures; range of motion to keep joints and tissues from getting stiff and restore full motion to all parts of the spine and extremities; proprioceptive training to maximize body-mind awareness and specific training for returning to full activities and recreation.

A good Pilates program can give you all of these things if you’re practicing mindfully and listening to your body. Under the guidance of a well-qualified Pilates teacher, you can learn how to reprogram and re-balance your body so that you are no longer putting your spine at risk.

Most Pilates programs include things you can easily do at home so you can practice consistently – the key to establishing healthy movement patterns.

How do you find a qualified Pilates teacher? As with all industries, Pilates training programs vary significantly. Some Pilates teachers claim to be “certified” after receiving just one weekend of instruction. This is completely inadequate for understanding the intricate and elegant discipline that is The Pilates Method.

The Pilates Method Alliance (www.pilatesmethodalliance.org) is the professional association for The Pilates Method, and has established certification guidelines. From their website, you can find information about Pilates guidelines and search for a qualified Pilates teacher in your area.

If you’re frustrated and fed-up with nagging back pain, you can restore your spine to health using the body-mind power of Pilates.