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Pilates for Back Pain


To get the best results, it is always essential to have an accurate understanding of the condition we are working with and, as a result, an accurate diagnosis of the back pain must be made. To have back pain diagnosed accurately, it is often worthwhile excluding other causes of back pain that can result in a similar presentation of back pain for example, an unaligned pelvis or issues with gait. 

Otherwise, you could waste a lot of money on the wrong form of exercise for your back. Pilates does not help all types of back pain, no matter what you are told. To get your back pain assessed accurately, you must first see a therapist who is able to properly diagnose the problem and has received adequate training in the correct testing procedures for back pain and its various forms. 

Seeing a lesser qualified therapist could result in wasting lots of money on pilates sessions that will not help you back at all. Just because back pain does not get better with the conventional treatment, it does not mean it would respond to Pilates. Taking a thorough medical history and screening testing allows the GP, Osteopath, or Physiotherapist to diagnose the condition in relation to the results of these tests. If issues were to be seen relating to disc issues then an MRI referral may be suggested to rule anything out in this instance. A series of exercises will be conducted as well to check range of motion and how this is affecting low back pain. This will help to advise the types of pilates exercises that will be most beneficial for the condition being experienced.

Pilates for Back Pain

Pilates has been shown clinically to significantly reduce the effects of muscular-skeletal back pain resulting in better mechanical functioning. However, if the Pilates is not prescribed in the right dose, i.e. exercises, it will result in detrimental effects on the spine and pelvis.

Smaller group sessions of Pilates and intimate rehab sessions lead to much better results as the one to one attention clients receive results in a better understanding of the intricate nature of this form of rehabilitation. Pilates classes often use exercise equipment such as foam rollers, mats, and pieces of equipment like the reformer and cadillac.One-to-one sessions over a period of 4 weeks are suggested in order to help build confidence in movement and help with adherence to correct alignment in all planes of movement. 

Back pain must be taken seriously and messing about with it is not acceptable and can delay the healing process. Getting a prompt diagnosis, accurate exercise prescription, and a long-term management program are vital for the health of your back. 

Why does Pilates Benefit Back Pain?

The reason why Pilates benefits back pain is partly due to the concept of core stability. Core stability is described in many ways but the most accurate description of core stability comes from the book concepts of fitness and wellness- a comprehensive lifestyle approach:

Core Stability; Strength of muscles which demonstrate optimal firing patterns and tension-generating capabilities to ‘brace’ the trunk in anticipation of and during the movement of the head, arms, or legs.

This all sounds rather complex I know, but it’s simple really. The core is like a sling of muscles that wraps around your midsection, the fibres lying in different directions allowing a widespread but even increase in the intraabdominal pressure.

This results in a pressure like an effect which helps support the spinal load, much like the pressure in a bicycle pump going outwards when the piston is depressed and the air inside is squashed inwards by the pump walls and downwards by the pump itself. Luckily you have your pelvic floor to stop pressure escaping from the base region, unlike the bicycle pump. 

Core Strength and Back Pain

Core strength is thus important for lower back pain as it reduces the impact of increased pressure or load through the spine and discs, thus reducing the mechanical burden of the load by spreading the forces around and not through the other weight-bearing structures in the back. Essentially, core strength keeps your spine aligned and spreads weight around other joints so that all pressure isn’t directly impacting on the lower back muscles and lumbar spine itself. This is why neutral pelvic positioning is so important for back pain as it takes the pressure away from the lower back and disperses it evenly elsewhere i.e. the pelvis in this case. 

However, it is never as simple as this. There are many theories to date that try to explain the effect of spinal stabilisation through the effect of core stability strength. As you can imagine it is only certain types of back pain, which are the result of a failure of this mechanism, which will respond to Pilates-type exercises. So proper screening is vital.

Core strength vs biomechanical accuracy of movement in Pilates

As important as it is, core strength improvements are not the only part of this equation. Bad backs often result from improper movement mechanics. By having a thorough understanding of the human anatomy, physiological makeup, and biomechanical functioning we are able to screen which movements are faulty and address these as causative agents in the genesis of back pain. A gait scan is perfect to address these issues as it will give an understanding of any other areas in the body that are affecting the lower back.

Without doing this, other methods of stabilisation such as Pilates alone cannot address the underlying root causes of the issues faced by those suffering from back pain. Functional rehabilitation allows quicker integration back into day-to-day life, this may incorporate movements which you carry out on a daily basis and can also include a release of certain tight muscles that can refer to back pain.


It is so important to understand the nature of your back pain before undertaking exercise. It is possible to waste large amounts of money on a regular basis doing exercise that actually may be detrimental to your improvement. Make sure you look for serious qualifications and experience in those teaching you, as well as an understanding of your condition.

Classes should be small and you should receive good attention during these to make sure you are doing things correctly. To Find out more about how we do Pilates and Rehabilitation then use the link.

If you have a bad back and are thinking of seeing someone then you can read about our Osteopathy and Physiotherapy services also.

For more information about Pilates and Back Pain

If you would like additional information about Back pain and Pilates or to discuss how we may be able to help with your back injuries and issues, please contact us using the form below and we will get back to you as soon as possible.

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