With an epidemic of lower back pain in the U.S., conservative treatments such as Pilates are becoming increasingly popular to help prevent and manage pain. Pilates improves the mobility of the spine by treating each vertabrae as an individual bone, emphasizing sequencing of the bones of the spine to stack on top of each other in the correct alignment. This focus on mobility, along with exercises that improve the stability of the abdominal and back muscles, works to prevent low back joint stiffness and muscle tightness. Joseph Pilates’ method, which was originally coined “Contrology”, consists of six main principles:
Centering, which focuses on the “powerhouse” as the center, involves effectively engaging your deepest abdominal muscles. The proper firing of your abdominal and spine muscles can prevent low back pain by providing increased support to the spine and by improving posture.
Concentration is essential for mind-body connection and maintaining good form. This concentration then overflows into posture at work while sitting at a desk job, or maintaining good form while lifting a box from the floor.
Control: Muscle control refers to the strength and stability that is developed from repeatedly challenging your body via exercise. Motor control refers to the refinement of the movement patterns as the connection between the brain and the muscles improve. This added control assists in improved firing of the deep low back and deep abdominal muscles during functional activities, which will prevent injury as they act as a support to the spine.
Precision is a principle that comes with time by executing the Pilates exercises in a refined manner. With effective firing of muscles, proper form, and concentration, precision is made possible. With improved precision comes improved body awareness. For instance, when lifting something, people will be precise in engaging their abdominal and deep low back muscles which will act like a girdle to the spine and therefore prevent injury.
Breath is fundamental to fuel the powerhouse. Breath provides nutrients to the muscle, increased awareness to the exercises, and helps to engage the abdominals. Inhaling is associated with extension movements of the spine, while exhaling is associated with the engagement of the abdominals during bending movements of the spine.
Flow refers to the choreography of the exercise that allows one to gracefully transition from one motion to the next. This same flow carries over to the proper body mechanics during activities of daily living to improve form and therefore reduce risk of injury to the low back.
When applied to daily activities, the Pilates principles can prevent injury by not only increasing the strength of one’s muscles, but also by improving postural awareness so the likelihood of injury is lessened. Furthermore, as people become proficient in technique, the Pilates therapeutic exercises improve the firing of the muscles that support the spine. When one has a low back injury, the firing of these muscles in inhibited. Without proper strengthening of the important muscles that support the lower back, one is at greater risk of injury and future problems.
Alyson Mackay is a Doctor of Physical Therapy at Hospital for Special Surgery Rehabilitation. She is a Pilates Method Alliance (PMA) certified Pilates Teacher.