The Spine & Pilates – Back Pain Rehabilitation

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 in conjunction with the obliques — rotates and side bends the trunk

External oblique muscles — located on the sides of the rectus abdominis, it allows the trunk to bend laterally and twist.

Internal obliques muscles — 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 strengthening the Abdominals help with back pain?

When these layers are strong, they act as a tight abdominal corset to ‘scoop’ and pull the organs inward thus closer to the spine. However when weak, 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 vulnerable and unstable. Rigidity and hyper mobility of the spine are both equal culprits that can lead to pain and injury.

Back Pain Rehabilitation

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 pulling and therefore straining the lower back. In which case, a program of stretch and abdominal strength training can be adopted. The stretching will alleviate the pain and the strength training is more maintanence and prevention.

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 end goal is for the program to be strength building dominant and the stretches more secondary. The strength building will prevent future injury or aid to a faster recovery.

Be wary when jumping into ‘core’ training, 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. True core strength training is about maintenance and longevity of the spine and not just feeling the ‘burn’ in the abdominals!

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