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Pilates For Low Back Pain
Low back pain (LBP) is a growing issue in today's world. It can come from a variety of factors such as sitting or standing for long periods of time. Unfortunately, most of the population has a desk job where they're sitting and staring at a computer all day. You don't typically see someone sitting up straight with a neutral spine. They are typically hunched over with their shoulders protracted or they are slouched back in their chair. This positioning causes poor posture and weakens muscles that are needed to be strong for a healthy back. Sitting with poor posture is the most common cause of low back pain. Having a flat back like me or having too much of an arch in your back can be a cause of low back pain.
Most of the time, people struggle to activate their deep core muscles such as their transverse abdominis and multifidi. The transverse abdominals are the deepest of the abdominal muscles and they wrap around your spine for protection and stability. When these muscles fail to fire, your body then compensates in other areas such as non-stabilizing muscles which cause muscle imbalance. This can lead to the pain that you feel in the low back. Each muscle has a specific purpose so when certain muscles aren't working properly, it will cause tight, overactive muscles and lead to an imbalance.
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The picture above illustrates the different core muscles in the body. As you can see, the transverse abdominis is the deepest of the muscles.
Pilates focuses on training the core muscles and emphasizes proper alignment of the body's posture meaning adequate adjustments of the head, shoulders, and pelvic girdle in a neutral position. Often times, people will have to re-train their muscles to function properly in order to alleviate some of the pain they feel due to muscle imbalance.
Pilates is not well know throughout. Some people perceive Pilates as one thing when it's really something else. However, it is such a wonderful form of exercise that helps with countless things like LBP, digestive issues, flexibility, strength, balance, posture, and much more. I found a list of what Pilates is and what it is not written by a woman named Robin Long who is a comprehensively trained Pilates instructor.
What Pilates IS:
- a form of exercises invented by Joseph Pilates, originally used to rehabilitate soldiers, later used to train dancers, and eventually spread to the general public due to the effectiveness of the method
- exercise that focuses on developing a balanced body through strength, flexibility and awareness
- focused on core training with the understanding that all parts of the body influence the core
- effective in treating back pain, recovering from injury and reducing stress and anxiety
- mind/body exercise
- good for bone health and modifiable for osteoporosis
- focused on precise movements in an effort to maximize efficiency and avoid unnecessary fatigue
- easily modifiable for all abilities and needs
- one of the most popular and steadily growing exercises methods out there
What Pilates IS NOT:
- mindless exercise or a way to “zone out”
- focused on going harder to get stronger
- easy
- only for women
- only for your abs
- about doing 100 reps, squeezing your muscles harder or working to exhaustion
- a fad
Information from "The Balanced Life" by Robin Long
The more you learn about Pilates, you will begin to understand just how much more there is to know. Even if you have been practicing Pilates for a while, it is always good to go back to the basics. Basic Pilates movements is the perfect way to begin the process of re-training muscles and fixing posture and back pain.
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The image above illustrates the difference in good and bad posture. As you see above, image F is a great way to sit for neutral spine. However, most people tend to sit hunched over like in image E. The goal for starting over or re-training your muscles is to have a nice neutral spine with the natural curvature of the spine like image C.
To begin this re-training process, you start with the most needed muscle activation, the transverse abdominis. Think of the transverse abdominis as a corset. Those muscles wrap everything around like a corset and they support the spine and organs.
To feel the transverse abdominis: Lie on your back with a neutral spine. Place your fingers right below your hip bones, inhale, and as you exhale act as your going to laugh. You can even say "Ha!" as you exhale to really feel the muscles. Repeating this movement is a great way to begin the re-training process. This repetitive movement is known as doing transverse pulses.
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Now let's go into some exercises that can help with low back pain or even help prevent it from happening.
Table Top with Lower and Lift of One Leg:
Lay supine (on your back) on a mat. Find your neutral spine with the natural curves and lift one leg at a time into a table top position. With plantar flexed feet, lower the right leg down, reaching your toes down to the floor. Lift that leg back into table top and lower the left leg. You should feel this in your lower abdominal area and your transverse abdominis. This movement activates the transverse abdominis and glutes so you should not feel this in your lower back. If you need to, you can support your low back by placing your hands slightly under your lower hips. However, we want to work away from that by building that strength in the transverse abdominis. Repeat this movement 3 times on each side.
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Table top: Double Leg Lower and Lift
This is essentially the same movement we just did except we're changing the degree of challenge. Begin by lowering and lifting both legs at the same time while keeping your knees bent. This movement may need less range of motion. For example, you may not lower your legs as far down to the ground. Less range of motion can help with control of the movement and will help keep the specific muscles activated that we need. Repeat this movement 6 times.
Now, hug your knees into your chest to release your lower back and feel a nice stretch here. Next we will go into frogs.
Frogs: 90 degrees or 45 degrees
For this exercise, you will stay in the same position but place your feet together, knees bent with external rotation. Keeping your feet together, press out to either a 45 degree angle or press up to a 90 degree angle. Changing the positioning of the feet can activate different muscles. Repeat this movement 6 times.
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Single Leg Stretch:
Lay supine on the mat with legs flat out to 90 degrees. Find your neutral spine. Inhale to prep and exhale as you draw your right leg in to your chest placing your right hand on the outside of your ankle and your left hand on the inside at the bottom of your knee. Inhale and exhale as you switch to your left leg placing your left hand on the outside of your ankle and your right hand on the inside of the bottom of your knee. Repeat this movement on each side 3 times.
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Bird Dog:
For this exercise, begin in a 4 point kneeling position with a neutral spine. As you lift the right leg out to a 90 degree angle straight behind you, lift the opposite arm (the left arm) straight out in front of you at the same time. Lower your arm and leg at the same time and lift the opposite arm and leg so lift your left leg and right arm at the same time. Repeat this 3 times on each side as a fluid motion.
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Bridging:
When bridging, you need to activate your transverse abdominis and your glutes first. Activating these muscles helps lift you up and to take the strain out of your low back. Placing a squishy ball between the thighs can help get the activation you're looking for.
Lay supine on the mat with arms pressed into the mat. Bend at the knees keeping firm pressure through the feet on the mat, activate your transverse abdominis and glutes and hinge up with your hips. To lower back down, think of lengthening through the spine and lowering your tailbone first. This is a hinge movement. Repeat this movement 6 times.
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Every moment of our life can be the beginning of great things- Joseph Pilates
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