Low back pain and pilates
Posted by Eamonn Brady on
Sinead Brogan is a Chartered Physiotherapist and runs FlexPhysio Physiotherapy Clinic at Whelehans Pharmacy, Pearse St, Mullingar. To book an appointment or ask a question call Sinead at 083 1722171
Low back pain is a common problem associated with significant negative effects, physically, emotionally and socially on an individual’s life. The majority of low back pain (LBP) cases are diagnosed as non-specific low back pain, meaning there is no known cause for the pain. Acute non-specific low back pain (ANSLBP) is defined as pain lasting less than 4 weeks duration, while chronic non-specific low back pain (CNSLBP) refers to pain persisting for longer than three months duration.
There are a range of evidence based therapeutic interventions designed for the management of low back pain. Among these, exercise therapy has continuously been associated with positive outcomes for those suffering from this condition. Exercise therapy may be provided as a single treatment, although in most cases exercise is recommended as part of a more comprehensive multi-modal rehabilitation plan.
Pilates, a ‘core’ based strengthening form of exercise, is an increasingly common exercise regime, recommended for those with LBP. The original concept of pilates was developed by Joseph Pilates in the 1920’s and was traditionally recognised as a comprehensive mind–body conditioning method, with the main goals of efficient movements, core stability and enhanced performance (Akuthota and Nadler, 2004). In recent years, it has been adapted, modified and simplified to specifically target the issue of lower back pain. The goal of pilates training for LBP is to improve general body flexibility and movement, core strength and posture, using breathing techniques to facilitate muscle activation.
LBP is often linked to weakness of the stabilising muscles of the spine, pelvis and trunk, such as the transversus abdominis (TA), multifidus (MF), diaphragm and pelvic floor. The main focus of therapeutic based pilates training is to assist in strengthening these muscles and hence, increase the support around the lower back, minimize pain and improve function.
A key component of any low back pain rehabilitation program is promoting everyday functional movements and mobility. Pain is associated with fear of movement and can lead to limited activity (e.g walking, bending, and sitting). These protective habits can result in muscles becoming taut and tight and joints become stiff, thus leading to a vicious cycle of pain. Pilates encourages mobility of the spine, hips, pelvis and shoulders. This facilitates normal patterns of movement, which promotes improved function and a decrease in pain.
Sustained poor postures such as slumping on a couch or bending over a computer can place a considerable stretching force on the joints of the spine, resulting in acheyness and pain around the back. Often, learning how to correct poor posture can alleviate this type of pain. Pilates focuses on how the body is positioned and controlled and encourages ‘good’ postures and activity tolerance. This can help alleviate stress on the spine, thus having a positive impact on pain.
Hamstring tightness and decreased low back flexibility have been highlighted as risk factors for low back pain (Phrompaet et al., 2011). Pilates exercises encourage a combination of static and dynamic stretching, pushing the muscles to an end of range of tightness rather than discomfort. The response of contractile tissues to stretch is improved muscle length, which allows a more efficient pattern of movement and reduces stress on stiff muscles and joints.
What does pilates entail?
Pilates exercises are primarily floor based. Some exercises are also performed in standing, which have the added advantage of training balance and proprioception (the body’s ability to sense joint position). Resistance equipment such as fitness circles or therabands are commonly incorporated with the exercise to provide more of a challenge to the core muscles.
The key principles of pilates include:
- Centering - this movement encourages drawing the navel to the spine and involves co-contraction of all the abdominal and buttock muscles, and tilting of the pelvis in a posterior direction.
- Control - managing posture and movement during the exercise.
- Concentration – attention required to perform the exercise.
- Breathing – co-ordination of inhaling and exhaling throughout the movement for increased contraction of the stabilising spinal muscles.
Who can do it?
Pilates is suitable for men, women, sports people and teenagers. It is recommended for those with back pain, but also for those are who are in sustained positions for long periods of time – such as standing, sitting and bending. Pilates can also be undertaken as a pre-emptive strength and conditioning program and has the added benefits of toning the abdominal, buttocks and legs.
*** For those with low back pain, an initial screening with a Chartered Physiotherapist is recommended before commencing Pilates.
Pilates class in Mullingar
Want to get toned, stretched and strong? Sinead Brogan runs Pilates classes in Loman’s Clubhouse, Delvin Road, Mullingar regularly throughout the year. Classes fill up soon so book early. Men and women welcome! Contact Sinead on 083 1722171 or email@example.com to book or for more information.
Physiotherapy service in Whelehans
Chartered Physiotherapist Sinead Brogan MISCP runs FlexPhysio Physiotherapy Service in the therapy rooms at Whelehans Pharmacy in Mullingar. Sinead has an Honours Physiotherapy degree and has experience working in Midland Regional Hospital Mullingar and private practice in New Zealand, Australia and Ireland, treating a wide variety of musculoskeletal issues including acute and chronic sports injuries, repetitive strain and postural problems, spinal dysfunctions and pregnancy related issues. Sinead has also completed a Masters in Neuromuscular Physiotherapy in UCD. Sinead is interested in sports injuries, having worked with many Gaelic and rugby teams providing pitch-side cover. Sinead is a Stott Pilates instructor and teaches pre and post-partum pregnancy, beginners and intermediate Pilate’s classes. She is also a Trigger Point Dry Needling practitioner and uses this technique with great results. Reduced physiotherapy rates for over 60’s and affiliated sport clubs. Contact Sinead at 083 1722171 or firstname.lastname@example.org to book.
FlexPhysio Physiotherapy service at Whelehans Pharmacy, 38 Pearse St, Mullingar (Opposite the Greville Arms Hotel). Book by calling Sinead at 083 1722171