Research and Evidence for Pilates and Back Pain

Spinal pain is extremely common with many causes. There is a lifetime prevalence of 35-40% for neck pain, 11-15% for Thoracic (mid back) pain, 60-80% for low back pain and 15% for pelvic pain.

When someone experiences an episode of back pain the stabilising muscles of the spine weaken and become inhibited as a result of the pain. This weakening can leave the spine very vulnerable to further injury and episodes of pain.

60-80% of adults in the general population will suffer with low back pain

60-80% of adults in the general population will suffer with low back pain (LBP). Most will suffer recurrence of pain episode within a 12 month period. These recurrent episodes of pain can continue for many years. Several studies have demonstrated a delayed activation of the deep abdominal and back muscles and increased activity of the superficial trunk muscles with people with recurrent episodes of back pain.

Studies into individuals with recurrent LBP have identified an impairment in the control of the deep trunk muscles (i.e. transverse abdominus and multifidus). These muscles are responsible for the stability of the spine. Almost acting like scaffolding for the spine. It is thought this impairment happens fairly quickly as a result of pain. The muscles become inhibited because of the pain. Your body will then try and compensate and overuse other non-stabilising muscles which will lead to further muscle imbalance and pain. Tight overactive muscles happen as a result of another muscle not working as it should.

A researcher called Panjabi proposed a mechanism for the development and recurrence of spinal pain. Changes in recruitment of specific deep spinal muscles thought to be responsible for the control of spinal stability have been reported in people with spinal pain. The onset of activity of the deep abdominal muscles, transverse abdominus, is delayed in people with recurrent episodes of LBP. Muscle wasting has also been identified in the multifidus muscles after episodes of pain.

One study demonstrated this delay in activation of the transverse abdominus with individuals with LBP. The study which used EMG electrodes on the transverse abdominus and the deltoid (shoulder) muscle during arm swing movements found a difference between the healthy back group and the back pain group. In the subjects with healthy backs the transverse abdominus activated before the arm even moved. This means the brain is very clever at preparing the spine for movement by activating the deep stabilising muscles of the spine to protect it. The subjects with the history of back pain had a delay in the activation of the transverse abdominus as the arm moved making the spine vulnerable to simple movements.

As a physiotherapist I regularly assess patients for movement dysfunctions and come across very common patterns of movement dysfunction that can be restored with my method of clinical Pilates.

'I have had many patients visit my clinic with an acute onset of recurrent back pain from picking up a pencil or reaching for the light switch. All simple movements and all as a result of this of the lack of protection around the spine from the stabilising muscles. There is also further evidence of decreased cross sectional area and increased fatigability, and a suggestion of increased intramuscular fat in the paraspinal muscles of individuals with LBP.'
Lyndsay Hirst,
Creator of Your Pilates Physio

How our exercise programme works is it retrains these spinal stabilising muscles and corrects common movement dysfunctions. Lyndsay teaches you in the sessions how to activate the stabilising muscles then challenges you with an exercise, therefore teaching these stabilising muscles to stabilise the spine with movement and allow you to learn normal movement patterns. You will build on this strength each time you workout. This type of exercise has been proven to reduce pain and stop recurrent episodes of pain.

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