Thu04242014

Your Health

Proper program can help manage back pain


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A program designed by a therapist or Pilates instructor can help manage back pain through strengthening muscles that act as an internal bracing system around the spine. Kim Gladfelter

When it comes to pain, Pilates has your back.

That’s because a Pilates-based program designed by a physical therapist or Pilates instructor can turn back pain into a thing of the past by teaching you how to recruit your muscles appropriately to produce efficient, pain-free movement.

Research shows that people with back pain do not effectively use their deep abdominal and back muscles, which are imperative to recovery. These muscles act as an internal bracing system to protect the spine.

The pain cycle makes it difficult to use these muscles without proper guidance to avoid common compensation strategies. Often, the same exercises can make you better or worse, depending on your form. Guidance with a Pilates approach can enhance your body awareness to successfully use the correct muscles.

The Pilates method is successful in helping manage back pain because strengthening the core to stabilize the spine is essential to controlling the pain.

The first step is to learn how to use the core muscles that brace the spine. Although it may sound simple, many people have difficulty appropriately engaging these muscles. However, this alone will not suffice. The focus on increasing hip-joint mobility and hip/leg muscle flexibility must be addressed as well. Pilates integrates all of these needs simultaneously.

As we age, flexibility and joint mobility decrease, causing a problem for the low back. The body automatically uses a strategy to take the path of least resistance to move, prompting the body subconsciously to search for ways to get around the tightness in the hips and legs. This can produce a less than optimal distribution of movement that results in too much movement hinging in the low back to make up for the stiffness. This condition usually occurs without people even realizing it.

If you are experiencing back pain, you may need to avoid exercises that push the spine into extremes of bending forward or arching backward. Combined movements of bending forward with side bending or twisting the spine may also need to be avoided. A Pilates instructor and/or physical therapist skilled in rehab will be able to determine which movements are appropriate for the spine.

Pilates exercises should be both mentally and physically challenging, but not so difficult that you compensate with the wrong muscles. If an exercise causes pain, stop and inform the instructor so that you can request a modification. The exercise may be too difficult, or you may need further guidance to maintain proper form.

As you fine-tune your form and control, you will increase the benefits and results of your program. You cannot do Pilates correctly without becoming extremely aware of your alignment and flow of movement. Individuals with back pain may benefit from several one-on-one Pilates sessions with a qualified Pilates instructor. The time and effort devoted to learning the exercise correctly is worth the investment.

After many years of incorporating Pilates into physical therapy and post-rehabilitation exercise, I am still amazed to see how many people eliminate their pain simply by learning to engage their core muscles correctly with a solid Pilates program. Pilates gives you the control to manage your pain without feeling the need to rely on long-term medication to control the symptoms.

Kim Gladfelter is a physical therapist and Pilates instructor at PhysioFit Physical Therapy and Wellness in Los Altos. For more information, call 947-8500 or visit physiofitpt.com.

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