Pilates Students' Manual

Can Pilates Help with Back Pain?

September 24, 2020 Olivia Bioni Season 2 Episode 3
Pilates Students' Manual
Can Pilates Help with Back Pain?
Show Notes Transcript Chapter Markers

Pilates can help you identify and remedy some underlying causes of back pain. Tune in to learn more about back pain and how Pilates can address it!   

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Show Notes:

Here's the American Chiropractic Association's article on back pain: *http://bit.ly/ACAbackpain*

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[00:00:00] Hello and welcome to Pilates Students' Manual, a podcast helping you get the most out of your Pilates classes. I'm Olivia and I'll be your host. Join the conversation and share your thoughts on Instagram @pilatesstudentsmanual. You can support the podcast by visiting buymeacoffee.com/OliviaPodcasts. Let's learn something new.

Hello, hello everybody. Welcome back to the podcast. Exciting news before we dive into today's episode: one thing is that the entire series of Pilates Students' Manual so [00:01:00] far is available on YouTube. The channel is Olivia Bioni Wellness, which hosts both Pilates Students' Manual and Pilates Teachers' Manual podcasts. There is a little bit of a video component that you might get a kick out of. I highly recommend that you check it out and if you are a YouTube aficionado, subscribe there as well. 

There's also a Facebook page for the podcast. So if you are on Facebook and you want some juicy Pilates goodness on your feed, be sure to like that page as well. That's searchable @pilatesstudentsmanual, or if you just search Pilates Students' Manual, it'll pop up.

Today's episode is tackling a subject that is frequently asked about both in classes and on the internet, on YouTube, anywhere there's a search engine, people are asking about Pilates and back pain. 

Just some stats about back pain from the American Chiropractic Association. [00:02:00] Worldwide, back pain is the leading cause of disability and it's the leading cause of missed work. Approximately 80% of the population in America will experience back pain symptoms at some point in their lives. Back pain is something that can affect people as young as when they're in their adolescence, or as old as when they are very elderly. Usually back pain is temporary and does go away with time, but it can also become chronic where it lasts longer than three months. And that affects about 31 million Americans nationwide, which is about 10% of the population. 

With back pain being such a huge issue that affects such a large percentage of the population, why don't we have a quick fix for it? You might be thinking, you know, well, there's painkillers. You can make that pain go away. But the tricky thing about painkillers is it's really a short term solution. It [00:03:00] doesn't solve the root cause of the pain. It just stops you from being able to feel it. 

Back pain is also really complicated. It can be caused from trauma where you're in a car accident or something happens and your spine is injured or your back muscles are injured. But back pain can also be the result of underlying issues that, when not taken care of, can result in back pain. Things like poor posture, muscle imbalances, pelvic instability, lack of core engagement, a lack of body awareness, all those things can contribute. And usually when there's one of those things, there's more than one of those things. So they could really kind of, kind of dovetail on top of each other and make it even more complex. 

Best news ever. Pilates definitely looks at all of those underlying causes and really seeks to address what's going on in those multiple facets. By focusing on [00:04:00] working from the center, building that core strength- core strength also helps with that pelvic stability- bringing that attention to balance and balancing any muscle imbalances, and then becoming more aware of where your body is in space is going to help you have better posture, which is going to eliminate that poor posture component that might be contributing to your back pain. 

It's definitely a theme in Pilates, that body awareness is something that we're really focusing on when we do Pilates. We want to be aware of where our body is in space. There's so much of a focus on your body's alignment, where your body is relative to other parts of your body, because certain alignments ease pain, increase your muscles efficiency, and also balance the load of effort. 

So if you visualize for yourself what poor posture [00:05:00] looks like. In my mind when I think of poor posture, I usually think of the head really far forward from the torso. Sometimes that's called tech neck, where you're gazing forward over your computer, over your phone for a long time, and your head is no longer in line with your shoulders, kind of ears in line with the shoulders from the side view. Your head's really far forward.

To support the now increased weight of the head because the head is further forward, your neck muscles are working overtime. Your upper spine rounds, that's that kyphotic or kind of hunch look where you're really rounded, your shoulders come forward. Your spine kind of juts back between your shoulder blades.

There's usually a tucked pelvis there because you're trying to counterbalance this weight. So you turn into like this big capital C, but there's not muscular support there. And because you're in that capital C the muscles between your shoulders and your tush are really stretched taut and [00:06:00] they'll become weak because they're constantly stretched, in this stretched position. It's not in a neutral position where they're kind of firing together. It can be overstretched. And then they feel tight, which is gonna sound crazy. 

I just saw amazing tutorial on- the Instagram handle @curlsandpilates- and she did this really great talk about how a tight muscle can be a weak muscle. And part of it when you're thinking about this bad posture is the fact that that muscle that is overstretched, in order to keep you upright, your brain tells that muscle to just get tight. And it doesn't get strong when it's tight, it's literally just tight to hold you up. And that's happening because your core support isn't there, your front body isn't helping support the weight. Your back body is trying to do it all by itself. It gets tired that can lead to back pain and your back can feel tight when really it could be overstretched and weak. 

That's kind of a complicated thing. Probably dive into that a little bit more in Teachers' Manual, but that's another thing to keep in mind for [00:07:00] back pain.

So if you think about that poor posture and that less than great alignment, certain parts of your body, like your back, like your neck, are working really, really hard, usually your quads are also overworking in that specific scenario. Those muscles are working really hard and then other muscle groups aren't working at all. As a result, that imbalance in effort can become something that triggers pain. When those muscles get so tired, and they just can't do it anymore. 

Pain is just feedback. It's your body telling you that something isn't quite right. If we change that alignment from the way you're in that poor posture into a more neutral posture, if we begin to stack the weight of the head so that it's directly above the torso, your ears are in line with your shoulders, your head gets less heavy. That's why standing up straight is easier on your spine than being at an angle or being in that excessive curve. It really is less work for your body to be in neutral. 

It might [00:08:00] feel like more work when you're getting started, but it actually becomes less work over time. By balancing the effort, by bringing you back into a better alignment, your muscles can also work efficiently, more efficiently, because they're able to do the job that they're designed to do. They don't have to pick up the slack from other muscles that aren't doing their job, if that makes sense. It becomes more of a teamwork makes the dream work situation, than one person pulling all the weight in a group project situation. 

Back pain is not just about the back. Pelvic instability, whether you're in that tucked shape that I just briefly mentioned in poor posture, or if you're in what I also call a duck butt, where you're really sticking your tailbone out behind you. If you think of wearing high heels and the way that lifting the heel, in order to compensate for that up the chain, your low back has to arch really severely.

So you're now past neutral and you're in a bit of extension but mostly localized at your lumbar spine. [00:09:00] Your tailbone juts behind you in that situation as well. Then your abdominal muscles, if you're in that position over time, without awareness about it, perhaps those abdominal muscles are getting overstretched the same way your back muscles were, right. We just flipped the curve. And now your back muscles are really shortened because they're trying to hold you while your pelvis has changed its tilt. 

Pelvic stability also tied very much to rib cage stability. Like, are your ribs really forward? In the case of a person wearing high heels, your ribs might jut forward. Your chest kind of comes forward because you have to counter balance that lift in the heels. But you can also be in that body shape without wearing heels, but that might help you think about it a bit more. 

Or by that same token, if you're in that poor posture where you're very rounded, then your rib cage, instead of being stacked above your pelvis, it would be dropping towards your spine. Your bottom rib would be pulled in instead of neutral. So either extreme, we know that our [00:10:00] body isn't really excited about extremes. So how can we bring it back to neutral? 

Bringing yourself back to neutral decompresses is the low back as much as you can be under the pressure of gravity. Whether you're super rounded or super arched in your spine, or even just a little bit, either way, it's putting stress on your low back because your back muscles are working harder than they need to. We really want to find a balance so that all of your muscles can work together.

One way to think about the body is that your muscles are like rubber bands. And if you're pulling some of them very tight, other ones that are going to have to be loose, and the goal isn't to have a body that's all loose rubber bands are all tight rubber bands, but more evenly, tight rubber bands across the body is just overall going to be a less painful, more efficient way to move.

After the break I'm going to address, in addition to Pilates for back pain, another question that comes up a [00:11:00] lot, that is can Pilates cause back pain? That's coming up next.

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[00:12:00] It's definitely possible that I'm biased because I am a Pilates teacher, but Pilates itself does not cause back pain. The underlying issues, however, that we talked about in the first part, that do contribute to back pain, like your lack of core support, lack of body awareness, poor alignment, muscular imbalances, pelvic instabiliy, all of those things are still present while you're doing Pilates.

So if you're coming to Pilates because you're having back pain and you want to not have back pain, the things that are contributing to back pain in your life, all of those things are still there when you're doing Pilates. And it might feel as if you know, I did Pilates and my back pain didn't go away.

One of my students mentioned to me that their back was hurting when they were doing abdominal exercises, maybe things like the series of five or other things where you've got like long, straight legs, [00:13:00] long arms, are usually in a chest lift. And she mentioned that her back was hurting. So if Pilates is so good for me, why does my back hurt when I'm doing these things?

Believe it or not, I know that abs series, the series of five, is all the time included in classes, is a very popular series of exercises. It's actually a pretty advanced series of exercise and a pretty high intensity version of an abdominal exercise. The fact that you're doing it in a chest lift that you've got long, straight legs and they're far away from your center point, supporting those long levers takes a lot of abdominal strength. There's also speed, there's choreography. And if you're doing it in order, if you're following like the classical traditional way of doing them, you're also doing them for a pretty long time. It's very difficult. It's a very high threshold set of exercises. 

But what, in that case, would be contributing to the back pain? Again, it's complicated. I can tell you what I know as a Pilates teacher and as someone who [00:14:00] has a body, but you can never see inside someone's body. And I can't really pinpoint and say, Oh, it's this, but here's some things that might be going on.

My idea about that particular case was that it was a combination of lack of core strength, pelvic instability, and a little bit of confusion around body awareness and body positioning that was contributing to the back pain in that scenario. Now, when I say lack of core strength, it doesn't mean that the person was weak or that, that weakness is even a bad thing.

It's just that that exercise requires such a high amount of abdominal engagement. There is a point in any exercise, whether you're an experienced Pilates student or a brand new Pilates student, that there's a threshold and your abdominals can do this much work and if you want them to do more than that, other muscles have to help. Your abdominals cannot do it by themselves, right? 

And [00:15:00] that's when your back likes to come in and help you in those exercises. So if you've ever felt kind of, I like to think of it as like a pinching sensation, usually around your bottom rib or in your low back, that usually means that your spine is arching, the same way you think about a spine arching when you wear high heels. That you're elevating your rib cage, or ribs lifting off of the mat in these, like supine exercises. And that shortening of the low back, which is a short term strategy to recruit more muscles to support you in the exercise that you're doing, those muscles again, get tired and then they can get strained and then they feel very unhappy and you'll say, Oh, my back hurts. 

Pilates can also remedy that by the more you do do it, as you become aware of your body, you know, where is my rib cage when I'm doing this? Am I unintentionally lifting my ribs to compensate for doing an exercise that my abdominals can't do on their own?

And this is in no way to create shame about it. It's just really like noticing where your body is, how your body is [00:16:00] responding to the exercise, right? So you shouldn't feel bad if you're like, Oh my gosh, lower lift too much for my abdominals. Lower lift is too much for my abdominals on some days. As you know, lower lift is a seriously difficult exercise.

But as we're doing Pilates, as we're becoming more aware of our body, the way it moves, how it compensates, kind of the habits that we have, or that we had before we started doing Pilates, and then really slowly starting to change those habits. Those are just all things to keep in mind as you're doing the exercises, because definitely when you're doing the exercises, your back shouldn't hurt. If your back starts to hurt, something's going on. We want to change something. 

When I work with someone one on one, and I want to kind of explore what their threshold is like, how much can their abdominals handle on a given day. Again, it's a moving target. I always take the intensity way down. So maybe instead of doing the series of five, I might have you lie on the mat, knees bent soles of the feet on the floor, and start [00:17:00] with, you know, your awareness of your pelvis, your awareness of your rib cage.

Can you find neutral with the ground supporting your body? Can you stay in neutral when you slide one leg long on the mat and then bend the knee, slide the foot back? Can you do that while you march? If you lift one leg at a time, can you keep your rib cage in neutral and your pelvis in neutral? And also be aware that you're in neutral because that's as important as being a neutral, is knowing when you've lost it.

Can you lift both legs into tabletop knees over hips, 90 degree bend at the knees and stay in neutral. Can you march from there? Can you add a chest lift? 

Adding a chest lift, especially when you're doing exercises like the hundred, like if you're doing single leg stretch with your legs, very low, your spine might change shape into a slight tuck or a slight imprint in order to support the long curve of your body. So it's not even that neutral is the end all be all of these exercises because depending on how you're doing the exercise, the [00:18:00] spine shape might change, but it will likely change towards an imprint instead of towards that arch, if that makes sense. 

If your spine is arching, when you're doing the ab series, you're not really doing the ab series. You're doing the back series, and your back is going to let you know about it when you're done. 

Finding the proper alignment for each exercise, finding the correct level of engagement for your muscles in each exercise is really difficult and is a long journey. It's not something that you're going to expect to come in for one class, even one private session be like, I totally get it and then be set to jet. It really is a process and it takes time. And every time you learn a new exercise or you do an exercise in a slightly different way, you're going to have to pay attention to how your body responds to it.

Your Pilates classes are a laboratory where you move slowly and you do movements often in isolation, so that you can begin to notice your body's habits, your body's movement patterns. You can address ones that aren't working for [00:19:00] you and then create new ones. The more you practice those movements, you become more aware of the way you're moving, you build strength, you get more flexible. You try out those new patterns. You try to incorporate those new patterns so that they become second nature. They become muscle memory. And then those compensation patterns become less and eventually you can eliminate them. 

The weaker muscles in your body that were not quite pulling their weight become stronger. The muscles that were being bossy and maybe taking over the job of those other muscles, they're going to learn to maybe engage a little bit less or engage, like as a team and over time with a lot of patience and a lot of hard work back pain can become a thing of the past. 

I hope you can take some time this week to take a Pilates class, notice your rib cage, notice your pelvis, notice how your back feels while you're doing those higher intensity exercises or any exercises, really, and really just pay [00:20:00] attention to your alignment. See if you can catch yourself when you come out of alignment. Maybe notice when your back wants to help. 

Again, not from a place of judgment, not from a place of shame, but just really from a place of curiosity and a place of self exploration, so that you can understand the way your body works to support you. Because even compensation patterns that when we look at we're like, you know, that's really not doing me any favors in the long run, your body is just doing its best to get you from point A to point B in the ways that it knows how. And when we do Pilates, we can learn new ways to move, and ideally we can leave that pain behind as we go forward.

Thank you so much for your question, Casey, and thank you to all my supporters on Buy Me A Coffee. I really appreciate you taking the time to visit that Buy Me A Coffee page and support the podcasts. I hope you have a great week and I'll talk to you again soon.

[00:21:00] Thanks for tuning in to this week's episode of Pilates Students' Manual, a podcast helping you get the most out of your Pilates classes. Be sure to check out the podcast Instagram @pilatesstudentsmanual and subscribe wherever you're listening. Interested in teaching Pilates too? Check out Pilates Teachers' Manual, available everywhere you listen to podcasts. I hope to see you next episode. Until next time. [00:22:00]

Stats on Back Pain
Pilates Can Help!
An Example of Poor Posture
Where Alignment Can Help
Can Pilates Hurt Your Back?
Changing Back Pain Patterns
Feel It for Yourself