Pilates for Back Pain

What Is the Core?

PilatesImage by jo-h via Flickr

OK, core training is everywhere! Core fitness, core exercise machines, core, core, core! So I wondered what people thought their core muscles were.

In an inexact survey of guests and friends I was dismayed to learn that most people think that core = abdominals only. WRONG! The core muscles are the abs, back, butt, and inner thigh muscles, all of which must be strong and balanced.

Now Joseph Pilates knew that when he developed Contrology (now known as Pilates) in the early 20th century, using exercises that strengthened what he called the Powerhouse of butt, abs, back, and inner thighs. For him this whole center had to work for the body to be strong.

In a recent NY Times article, Is Your Ab Workout Hurting Your Back?, back exercise research guru Stuart McGill lays this out very clearly.

"The “core” remains a somewhat nebulous concept; but most researchers consider it the corset of muscles and connective tissue that encircle and hold the spine in place. If your core is stable, your spine remains upright while your body swivels around it. But, McGill says, the muscles forming the core must be balanced to allow the spine to bear large loads. If you concentrate on strengthening only one set of muscles within the core, you can destabilize your spine by pulling it out of alignment. Think of the spine as a fishing rod supported by muscular guy wires. If all of the wires are tensed equally, the rod stays straight. “If you pull the wires closer to the spine,” McGill says, as you do when you pull in your stomach while trying to isolate the transversus abdominis, “what happens?” The rod buckles. So, too, he said, can your spine if you overly focus on the deep abdominal muscles. “In research at our lab,” he went on to say, “the amount of load that the spine can bear without injury was greatly reduced when subjects pulled in their belly buttons” during crunches and other exercises.

Instead, he suggests, a core exercise program should emphasize all of the major muscles that girdle the spine, including but not concentrating on the abs."

Says McGill, “I see too many people who have six-pack abs and a ruined back.”

Cellist Conquers Back Pain With Pilates

In 2005 60 year old Anne McCafferty, a cellist with the Indianapolis Symphony Orchestra, started having screaming back pain with pain down her legs. She had compressed 4 lumbar discs, causing nerve impingement. "People don't think of musicians as athletes, but in many ways, we are. Cellists tend to be prone to back problems because of the posture of sitting, and we don't have much flexibility of movement once the instrument is in front of us. Most of us sit toward the front of the chair, without back support."

After three months of physical therapy McCafferty started walking and taking Pilates mat and reformer sessions, a total of twice a week, to help relieve the pain.

"I've never been very athletic, but I find Pilates is crucial for me, as it enables me to do my job without pain. I'm in my 37th season and I want to be a lifelong cellist. If I live a long time, I also want to be able to stay in good shape. I'm highly motivated because it's changed my physical health."

Rehab Pilates

Yesterday I taught a Rehab Pilates session to a Japanese journalist who told me that Rehab exercise and Pilates were not linked in Japanese culture. You go to a Pilates teacher for exercise, and a physician for any kind of Rehab exercises.

Now this is appropriate in acute injury cases, but when you are dealing with imbalances from an injury 20 years ago that still cause problems the physician usually shrugs her shoulders. This is where a Rehab-focused Pilates session can come in handy.

In a 60-90 minute session I can assess the imbalances and offer an exercise program to help strengthen what is weak and stretch what is tight, leading to better muscle balance and function. Email me for more information.

Lower Back Pain Pilates Audio

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Pilates Teacher and writer Ann Samoilov has tested my Lower Back Pain Mp3 and here are her unedited comments:

I just did Lynda Lippin's Lower Back Pain audio workout. Now, I do not
have any known issues with my back and I don't suffer from any chronic
pain. However, I will say that I do have hip tightness and random
pain caused by liftiing my toddler incorrectly.

I finished this guided exercise sequence much more open and looser in
my hips--especially the outer hips and also where I experienced
sciatica pain during pregnancy.

I highly recommend this audio program to anyone who has minimal or
continuous back pain. My own mother is struggling with some lower
back issues and I won't hesitate to recommend she try this!

The sequence of exercises has all the qualities of a solid pilates
principles workout--easy to follow, well-paced and above all safe.
Lynda has the ability to be very specific without overwhelming the
listening with anatomical jargon. She says just enough and a little
bit more to get you feeling what you should be feeling.

I can't wait to hear Lynda's next program and hope she considers doing
a series for prenatal women.

Thanks Ann! I will work on the prenatal as well as one for osteoporosis.

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Pilates, MS, Neck Pain

Hi Lynda,

I am 46 y.o. woman with kyphosis and scoliosis for many years. Never have really done something about it. Recently I have been diagnosed with MS, mitral valve prolapse, carpal tunnel syndrome. I must also add that I have anemia since childhood and I am in menopause since 38 y.o. I had a pregnancy at my 35 and my daughter has been born when I was 36. The indication to send me to the doctor's were strong vertigo that completely threw me down. I do Pilates (BASI) for 6 months now and have seen a lot of improvement. However, sometimes during workout (when I try to maintain my position in abdominals and/or roll ups and leg stretch), I feel like my head is going to explode. What can I change to avoid that? It makes me stop the exercise and really don't want to start over.

Thanks in advance,


Dear Sophia,

Your story is so inspiring! Congratulations on finding Pilates and following an exercise path which will help you tremendously going forward.

Regarding your neck/head tension, it doesn't surprise me at all that head up positions hurt you with your history of kyphosis and MS. I suggest avoiding the position all together, using pillows or towels when needed, and work instead on stretching your chest and shoulders in extension.

Let me know if you have more questions.



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Scoliosis & Pilates

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In my years of teaching Pilates I have worked with many many clients with scoliosis. Some had full spinal fusions with Harrington rods, and some just managed on their own. Some where professional dancers and athletes who really had to work on their back and core strength in oredr to continue working, and then I also had just regular folks who discovered that Pilates kept them fit, safe, and in less pain.

Curves, Twists and Bends: A Practical Guide to Pilates for Scoliosis is a short introduction to Pilates/pre-Pilates exercises geared to non-exercisers with scoliosis. It is written by a scoliosis patient and her Pilates teacher, the UK based Alan Herdman. While very clear, basic, and simple, the exercises in this book are easy to grasp and easy to perform. They may be small and low impact, but will impact your body in a profound way, especially if you tend to shy away from exercise.

Note that this book is not a comprehensive guide to Pilates for scoliosis. It does not address more advanced Pilates mat and equipment exercises, and is not necessarily geared towards athletes and teacher/trainers. However, if you want a good understanding of scoliosis, it's physical and psychological effects on the individual, and a good quick basic self care program, this book provides all that and more.

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