The Lower Back

Lower back pain affects most people at some time in their lives. It is thought that as many as 4 out of 5 of us will experience it to a greater or lesser extent at some point. In fact, such a large number of people need lower back pain relief that it accounts for a staggering 9% of all adult GP visits in the UK. For some of us, lower back pain is no more than a simple ache that quickly improves, for others however, it can be a much longer-term problem. 

Over the last fifteen years or so, a number of research papers have been published that show Pilates can be used effectively to help back pain. The combination of deep abdominal strengthening, postural awareness, and release and stretching exercises makes it extremely effective in both the prevention and treatment of lower back pain.

Obviously lower back pain can stem from a long list of causes: from sprains and strains to herniated discs and fracture. Less serious and most common causes include:

  • bad postural habits, such as hunching over a computer all day or carrying a heavy bag on one shoulder
  • poor posture, such as Kyphosis (rounded upper back) or Lordosis (over arched back)
  • tight or strained muscles
  • weak abdominal muscles

Fortunately, in many cases the best medicine isn’t surgery or pills, it is exercise. However if you have persistent or recurring back pain it is important that you seek the advice of your doctor before starting an exercise programme or doing any of these exercises.

Pelvic Curl Bridge

The pelvic curl is usually one of the first exercises taught to beginners of Pilates as well as being a favourite of physiotherapists. It’s a great exercise in that virtually anyone can do it. At the same time it helps us learn how to use the abdominal muscles in a way that supports and lengthens the back. 

Lie on your back in relaxation position with your knees bent and feet flat on the mat, a hip-width apart. Place your arms by your sides with the palms facing down. Relax your neck, shoulders and lower back.

Inhale to prepare, engage the core, starting with your pelvic floor muscles and then up towards your belly. Imagine that you are zipping yourself in to a pair of jeans that are too tight. Your pelvis should move into posterior tilt, so that the small of your back is now touching the ground. Exhale and slowly raise the pelvis and then the spine off the mat, one vertebra at a time.

Inhale and hold at the top. Ensure that the inner thighs are engaged, your knees should remain a hip width apart and not fall outwards. Increase the stretch of the hip flexors by pushing your knees forward a little. The pelvis should be at maximum posterior tilt and you should feel a stretch in the hip flexors.

Finally, exhale and slowly lower the trunk. Roll down one vertebra at a time, returning to the starting position.

Repeat ten times.

Single-Leg Folds

The single-leg fold is done with the spine in a neutral position. It’s another great exercise for beginners to Pilates who lack pelvic stability or core awareness. Lifting one leg when the other remains on the mat begins to challenge the core in a functional way, similar to walking. The exercise works the abdominals and hip-flexors.

Lie on your back in relaxation position with your knees bent, feet flat on the floor a hip width apart. Your arms should rest by your sides, palm down,. Ensure that your shoulders are relaxed and your pelvis in neutral.

 Engage your core but ensure that the pelvis remains in neutral. Exhale and raise one leg until the knee is above the hip joint and the thigh perpendicular to the mat.

Inhale and return to the starting position by lowering the leg to the mat.

Repeat the exercise five times with the same leg. Place the foot fully down on the mat.

Perform the same sequence with the opposite leg.

Curl up

Lower back pain can occur for any number of reasons but it is frequently caused by weak abdominal muscles. This exercise is another classic Pilates move.

Lie in Relaxation Position with your knees bent and the feet flat on the mat, a hip-width apart. Place your hands, one on top of the other, behind the head and bend your elbows so they point sideways.

Engage your core and then slowly curl the head, neck and upper torso up, so that the shoulder blades lift off the mat.  Make sure you direct your gaze to your belly button to avoid straining the neck and ensure that your lower ribs stay connected to the mat. Breathe in to the back of your ribcage and maintain the position.

Exhale to lower the head and chest back to the starting position without releasing the abdominals.

Repeat the sequence ten times.

Oblique Strengthener (or Knee Rolls with double knee fold)

This supine spine twist is great for those lacking spinal mobility but it is not an easy exercise as a reasonable amount of core strength is required. Substitute the Oblique Strengthener with feet flat on the floor if you have any concerns. As the name suggests the exercise targets the oblique muscles as well as stretching the back muscles.

Lie on your back in Relaxation Position. Breathe into prepare and engage your core, then exhale and float one leg up, breathe in then exhale and float the other leg up, so that both legs are held in the coffee table position, with your knees directly above the hip joints and the lower legs parallel to the mat. 

Put your arms out to the sides so that they are in a T position with the palms facing up and your shoulders relaxed. Ensure that your lumbar spine is pressing into the mat, by engaging your pelvic floor muscles and bringing your pubic bone towards your belly button. 

Engage your inner thighs and bring your legs together.

Exhale and rotate your pelvis to the left so that your knees  move towards the mat. 

Exhale and rotate back to centre.

Inhale and rotate the pelvis, lowering the legs to the other side.

Finally, exhale and return to centre.

Repeat the sequence five to ten times on each side.

The last of our pilates exercises for lower back pain is basic back extension. It’s a simple yet effective exercise for strengthening the often weak back extensor muscles. It also helps develop control of the core muscles. The basic back extension works the back extensors and abdominals.

Basic Back Extension – Pilates Exercises for Lower Back Pain 

Dart Prep

Lie prone with the forehead resting on the mat or if you prefer a small cushion.

Your arms should be by your sides with the palms facing inwards. Your legs should be in parallel.

Engage your core muscles, stretching your spine downwards by pulling your pubic bone towards the mat and stretching through the crown of your head  upwards.

Inhale and maintaining the stretch slowly raise your head and upper off the mat, keep your gaze downwards towards the mat.

Hold at the top for a couple of breath cycles (depending on ability).

Exhale to lower to the starting position, sequentially from bottom to top.

Repeat 5 to 10 times.

Other exercises that are excellent for the back include, Side Plank dips, Bird Dog and The Plank.

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