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Pilates is a type of low impact strengthening which is based on movement with control.
Low back pain is often caused by structural imbalances in the body. Poor core strength, pelvic instability, muscle imbalances, poor posture and lack of body awareness are all factors which overload joints, discs and muscles of the lower back. Pilates helps in improving these imbalances by improving overall posture and quality of movement.
According to a small, randomised, controlled study published in the Journal of Orthopaedic & Sports Physical Therapy, participants who practiced Pilates over a four week period experienced more relief from their symptoms than those who went through typical treatment programs.
All pilates exercises are performed in a neutral spinal position. Neutral spine is the position in which our core stability muscles function best and also the position in which there is the least amount of loading and tension on the structures of our spine. Our core muscles include our deep abdominal muscles, pelvic floor, deep neck muscles, scapular muscles and gluts. All of these muscles play a role in segmental control and stability of our body. Increased awareness of this position is very important in those with lower back pain.
Abdominal core muscles are the deepest layer of abdominal muscles. Core muscles stabilise each segment of our spine and transfer force from one segment to another. Strength of this muscle group is extremely important in the prevention and treatment of lower back pain. Studies have shown that individuals who have been experiencing low back pain for a prolonged period of time have decreased ability to activate these core muscles and the timing of the activation is often delayed. This in turn means that the segmental support required to stabilise the spine as we move is diminished. This then causes our larger muscles e.g. erector spinae, rectus abdominus, quadrates lumborum to do more work and therefore become overactive and tight. This whole process sets up an unfavourable loading pattern on our spine, which must be retrained in order to decrease pain.
By improving strength, postural asymmetries can be corrected, reducing wear and tear on joints and discs of the spine which has come on from uneven stresses on the spine. Increased awareness of posture and the neutral spine position helps patients change bad movement habits which have been overloading and stressing the spine.