Having suffered from years of back pain myself I understand how debillitating acute back pain can be. The intensity of acute back pain never really leaves you. I remember the worst time was once when I came home from martial arts training I had to crawl from the car to the house and into bed. Did I mention that I have a pretty high pain tolerance? Later that night my back went into major spasm and it felt like someone was repeatedly stabbing knives into my back. Only some significant pain killers that night and over the next few days alleviated the intensity of the pain and allowed the spasming to subside.
My own journey of searching for solutions to overcome back pain, and avoid a repeat of the above, led me to Pilates, initially as a client and eventually as an instructor and Studio Owner. So when people ask me can Pilates help alleviate back pain? I can tell you unequivocally YES. There are always some pretty important provisos in that answer, in that not all Pilates exercises are beneficial, and that not all instructors are properly trained in rehabilitation.
How do you know if your instructor is properly trained?
Well that means you need to ask some questions about the instructors own training and accreditation. In Australia if an instructor is a full member of The Pilates Alliance you can be assured that they will have completed some pretty rigorous Pilates teacher training. If they are not accredited with The Pilates Alliance they may have only completed a very short Pilates course and therefore you will get a significantly inferior service and level of knowledge.
The above means your instructor is well trained in Pilates, I think it is even better when the instructor has an additional level of training either specifically in rehabilitation or a related modality. Some examples might include Remedial Massage, Myotherapy, Exercise Physiology, Physiotherapy or Osteopathy. I have a background in Sports Massage, Shiatsu Therapy and am currently completing a Masters in Clinical Exercise (Exercise Physiology). This gives the practitioner additional diagnostic and clinical skills which translates to having a better understanding about the nature of different sources of back pain and therefore which techniques will enable more successful outcomes.
What type of Back Pain do you have?
This brings me to my next point. There are many different causes of back pain, understanding the cause of the pain is the key to understanding the most effective treatment options. The most common causes of back pain include: bulged discs, strained ligaments, strained facet joints, disc degeneration, scoliosis, stenosis, spondylosis and spondylolisthesis. However there are literally dozens of others, and then usually there is more than one problem occurring and there may a range of contributing issues which feed into one of the major causes.
When someone attends our Studio we perform an Initial Assessment with them which includes: collecting a full medical history, discussing their pathologies (if any) and goals for their sessions. Based on their pathologies (injury status) we will perform a range of special tests to help us identify the nature of the problem. We also perform a range of tests to assess things like core strength, upper body strength, lower body strength, flexibility, balance and posture. We do this to establish some initial bench marks in order to track progress but also because they can have an impact on the causation of the injury they are seeking treatment for.
It is often the case that someone attends Pilates because they have been referred by their Doctor, Osteopath, Chiropractor or Physiotherapist. In which case we may need to work in consultation with their health care provider. With more complicated or difficult to diagnose cases, medical imaging such as Xray or MRI may be required.
Not all Pilates Exercises are Beneficial!
Once the proper Assessment has taken place we will have established which movements cause pain, indicating specific causes, and therefore what exercises are suitable for the initial program. The simple fact is not all Pilates exercises are beneficial for specific injuries, and we need to perform the Initial Assessment to establish which exercises to rule in or out of your program.
Certain injuries will benefit from more flexion based movements, whereas other injuries may benefit from more extension based movements. Likewise there are a range of injuries where lateral flexion or rotation movements may be contraindicated. Sometimes lateral flexion in one direction is beneficial, but lateral flexion the opposite direction will aggravate. It may also be important initially to perform mostly closed chain movements. Unloading the spine/joints may be required, or more weight bearing might be preferable. You can see that based on the type of injury one Pilates program which is successful at alleviating the problems, might be very different from another program from a well intentioned but slightly less knowledgeable instructor which could exascerbate the problems.
So not all Pilates programs are created equal. Our aim at Living Energy Pilates & Rehabilitation is to be at the forefront of expert knowledge in both Pilates and exercise rehabilitation in order to provide the best possible service and results to our customers. If you are suffering from back pain, have a look at our Getting Started in the Studio webpage for information on the best way to commence with an individualised program to overcome your back pain.