Is this you?

If you suffer from lower back pain, you are not alone. Roughly 84% of individuals will experience an episode of lower back pain at some point in their lifetime. A staggering 60 to 80% of people with lower back pain still report pain or disability a year after its initial onset. Additionally, a recent, population-based study showed that a five-fold increase in the prevalence of lower back pain has occurred over a 15-year period.[1] 

Do you have any of these risk factors?

Males are more likely than females to suffer from lower back pain, though pregnancy is also a risk factor. Other factors that may increase one's likelihood of lower back pain include having: a family history of back pain, a previous back injury, previous surgery, existing spine problems, poor posture, and a sedentary lifestyle. Being overweight, smoking, or being under stress are also contributing factors.

How Pilates can help you!

It should go without saying that surgery is a very last-ditch resort option to treat lower back pain. Luckily, there are various treatment options to effectively manage back pain, both non-specific (general stiffness and occasional flare-ups of more acute pain) as well as specific pain of a known origin. These treatments include manual therapy (manipulation or mobilization), exercises that promote centralization (i.e., the movement of extremities toward the center of the body), stabilization exercises, and mechanical traction. The Pilates method, in a classical or physical therapy environment, can effectively incorporate these treatment options to manage a host of lower back pain diagnoses. 

Pilates effectively treats lower back pain by restoring motor control of deep and local muscles in the abdomen and spine while strengthening the hips, buttocks, and pelvic floor. Specific Pilates exercises decompress or mobilize nerves, restore alignment, and promote effective movement patterns.

The Exercises 

1. Modified Hundred 

What it’s good for – The Hundred challenges lumbo-pelvic control while incorporating a specific breathing pattern in order to circulate blood and warm up the body for the exercises to follow.

Why it works – The Hundred works the deep and local muscles of the abdomen and spine while encouraging costal breathing (i.e., back breathing) while deemphasizing belly breathing. The latter breathing pattern is common in individuals with chronic low back pain. 

Reps – Inhale for five counts and exhale for five counts, reaching forward, for 100 counts. One full set is plenty.

2. Roll Down

What it’s good for – The roll down stretches and strengthens the spine by articulating the vertebrae while working the powerhouse.

Why it works – The roll down facilitates segmental motion of the spine and dissociation of the pelvis from the rib cage.

Reps – Complete five repetitions. 

3. Shoulder Bridge

What it’s good for – The shoulder bridge works the powerhouse, thighs, and back of the legs.

Why it works – The shoulder bridge works by restoring segmental motion of the spine as well as motor control. In addition, it facilitates gluteal activation and endurance.

Reps – Complete five repetitions. If after a few weeks you feel like you’re ready to progress this exercise to the full roll up check out this video – Progression link to full roll up on website (anchor tag?)

4. Side Kicks

What it’s good for – The side kick series works the inner and outer thighs while increasing strength and mobility in the hip joint.

Why it works – Side kicks challenge as well as activate the gluteus medius (i.e., the muscle on the outside of the hip). The rotatory control of the pelvis is also challenged, which fosters motor control. This exercise is indicated in individuals with sacroiliac joint dysfunctions and an insufficient gluteus medius.

Reps – For the first exercise (point up and flex down) do 10 repetitions. For the second exercise (pulsing the leg with a flex in the foot) complete 10 pulses at the different levels. Complete five repetitions on each leg for the clam.

5. Piriformis Stretch

What it’s good for – The stretch elongates the piriformis muscle, which in many cases in a source of buttock pain and/or sciatic like symptoms. 

Why it works – Due to its anatomy, the piriformis muscle can clamp down on the sciatic nerve when it goes into spasms or when it is tight, thus producing buttock and/or nerve symptoms extending into the leg; e.g., tingling or pain. The piriformis often goes into spasms during episodes of limboscacral or scacroliliac dysfunction. The stretch can help relieve compression of the sciatic nerve as well as tension in the buttock. 

Reps – Start with a 5 second hold on progress to 20 seconds for 5 – 10 repetitions.  

[1] (Freburger JK, Holmes GM, Agans RP. et al. The rising prevalence of chronic low back pain. Arch Intern Med. 2009; 169(3): 251-8).