As a pilates instructor, I've worked with countless clients who come to the studio for one main reason- low back pain. In many cases, the pain has been apparently inexplicable. Its not uncommon for a new client to come in, say they have "tried everything" or "seen everyone", and yet their pain persists. While pilates is not usually considered a last resort, many clients come in because they feel like they might as well give pilates a try, because nothing else has seemed to work.
And, in most cases, I am happy to say that I have seen pilates work in helping people conquer their low back pain. And now, a study in the Journal of Orthopaedic and Sports Physical Therapy shows just that- practicing pilates on pilates equipment is effective in helping people conquer non-specific low back pain.
The study used pilates as a theraputic exercise approach for chronic, low back pain sufferers who were not diagnosed with a specific condition that was obviously causing their pain, such as stenosis, scoliosis, broken bones, etc.
The study states, "Thirty-nine physically active subjects between 20 and 55 years old with chronic LBP were randomly assigned to 1 of 2 groups. The specific-exercise-training group participated in a 4-week program consisting of training on specialized (Pilates) exercise equipment, while the control group received the usual care, defined as consultation with a physician and other specialists and healthcare professionals, as necessary. Treatment sessions were designed to train the activation of specific muscles thought to stabilize the lumbar-pelvic region."
The study continued with a 3, 6, and 12 month follow-up with all participants. The study then found that, "There was a significantly lower level of functional disability...and average pain intensity... in the specific-exercise-training group than in the control group following the treatment intervention period."
The fact is, every body has a dominant side of the body (which is not, as one may expect, always the side that we write with). Usually, not only is there a more dominant side, but there are also all kinds of little imbalances running throughout the body. On top of that, some people are "over achievers" or "over-doers"- people who always try to do as much as possible in one day, work as hard as they can to accomplish things, ignore emotional and physical stress and just continue pushing on. It may sound narrow minded and unfounded, but its true- that is what I have seen and I can admit that I am one of those people, too!! It took me many years to understand that one cause of my aches and pains was that I tend to over-do everything. And its this kind of person who comes in with inexplicable low back pain.
So why does pilates work? I'll use the example of the type of person I described above. Using the pilates equipment is especially key in relieving low back pain. It is very obvious when, on the equipment, one side of the body is working harder than the other to complete an exercise.
For example doing Frogs with the leg springs on a pilates tower, if one leg is pushing or pulling harder than the other, the heels do not stay together and the client cannot steady the springs. From the eye of the instructor, it is also obvious if the client is trying to "bear down" into the low back in an effort to do the Frog movements, rather than working in neutral pelvis and initiating the Frogs properly from the core and the mid-line. Observing an exercise like this is very telling of how a client moves throughout their day. They may subconsciously "bear down" into their low back to push through the days activities. One part of the body may be overworking to complete the days activities. Using the springs on the pilates equipment is very telling of what is going on, not just in the moment, but also outside the studio and in the client's daily life.
So, one way pilates works is that, with the helpful eye of the instructor, clients can retrain their bodies how to move symmetrically and in balance. They learn that less is truly more. They realize that they have been "down" in their low backs, instead of "in and up", as pilates teaches.
Retraining the body how to move properly is not a quick experience. It can take time and patience, and a lot of mental effort. But, it is worth it in the end, and the best part is, pilates is actually fun and doesn't get boring!
I'm not, and the study is not, saying that pilates replaces seeing a medical professional or physical therapist. In this blog, I have never discouraged anyone from seeking as much help and advice from any type of professional they choose. And, the type of person I described above is only one example, one type of person who can find help with pilates. There are all kinds of reasons for low back pain, and all kinds of ways that pilates can help. This study shows that pilates does work. So, if you feel as though you have tried everything and just want to live pain free, why not just try pilates at a pilates studio, on the equipment, with a certified instructor who has worked with clients who have low back pain? If nothing else, pilates may just be a stop along the way on your endless journey in gaining knowledge about your own body.