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It is no secret that Pilates is great for back pain management, maintaining spine health and prevention of back injuries.

Why? Because Pilates is all about stabilising and strengthening the trunk to support the spine. We refer to this as strengthening the ‘Powerhouse’.

The Powerhouse is composed of muscles in the trunk & pelvic stabilisers. The Abdominals (upper and lower), lower back make up the trunk, and the hips and gluts make up the pelvic stabilisers. Pilates differs from most core training regimes as it anchors the spine while maintaining the strength, suppleness, flexibility and stabilises the pelvis in motion.

We often over simplify when referring to the abdominals, dividing them into two components — upper and lower. But if we were to be more precise — the abdominals are made up of 4 layers. All of which adds to the integrity and strength powerhouse, thus spine.

Clarification of the abdominals layers;

Rectus abdominis — the most superficial muscular layer. Often referred to as the ‘six-pack’ muscles. Its main function is to move the trunk between the ribcage and pelvis.

Transverse abdominis — the deepest muscular layer and stabiliser. This layer works to maintain abdominal pressure, and with co-ordination with the obliques rotates and side bend the trunk

External oblique muscles — located on the sides of the rectus abdominis, it allows the trunk to bend laterally and twist. When bending one side contracts and the other stretches ie. the right contracts to bend to the right as the left stretches. But when twisting the contraction is oppositional ie. when twisting to right, its the left oblique that contracts

Internal obliques muscles — sits at the base of the trunk in-between the hip bones, also responsible for twisting action. They work in conjunction with the opposing external obliques, as you twist to the right — the right internal oblique contracts with the left external oblique

So how does Pilates help with back pain?

When these layers are strong, they act as a tight abdominal corset scooping/pulling the organs inward and closer to the spine. If these layers are weak, the abdominal corset is ineffective and the organs distend and pulls on the spine. As it pulls, it compresses parts of the spinal column.

By keeping these layers strong with the organs ‘scooped’ in — it helps lengthen and support vertebral column in its verticality. Thereby giving the vertebral discs that act as shock absorbers more space to move effectively.

These days spinal injuries such as tears, bulges or herniations are due to compression between the vertebrae of the spine. It is important to note without abdominal strength to support the flexibility, the spine is hyper mobile and unstable. Note in both instances of rigidity and hyper mobility of the spine are both equal culprits to compressing the spine that can lead to pain and injury.

Treatment for Back Pain

Unless you have a structural reason (normally from injury) for back pain ie. Herniated, disc bulge — instances of unexplained twinges can be symptomatic of tight muscles that are pulling and straining the lower back. In which case, a program of stretch and abdominal strength training can be adopted. The stretching will alleviate the pain.

If the back pain is from injury — wait till the inflammation is over, and start with a gentle program of stretch and slowly increase the intensity of abdominal strength building. The goal is for the program be dominated with strength building and the stretches are incorporated in the exercises. The strength building will prevent future injury.

True core strength work should enable strength and flexibility in the spine and stabilise the pelvis. It should promote good posture and muscle integrity throughout the body to support, maintain and protect the spine in its full range of motion ie. flexion, extension, lateral bending and torsions.