Pain in the back (specifically, tension-related pain) is most often caused by an overuse of back muscles compensating for other deep core muscles (usually the abdominals). The system of movements (habits) that you employ every day (standing, sitting in the car, or even running several miles daily) may seem perfectly normal but if your back likes to compensate for your abdominals, tension will build in the back from chronic overuse. Pilates helps break this system by balancing muscles groups and bringing them in concert with each other to strengthen, stretch and invigorate your body. The total body workout of Pilates brings breathing, flexibility and strengthening alongside each other and trains more efficient patterns of movement, which alleviate tension and pain.
Let’s take this a little deeper into the anatomy behind tension-related back pain. Ideally, your “inner unit” deep core muscles (the transverse abdominis, posterior fibers of the internal oblique, diaphram, pelvic floor muscles, multifidus, and lumbar portion of the longissimus and iliocostalis) are equally strong and mobile and work together to create stability in your spine. Your “outer unit” core muscles, those slightly more external and peripheral core muscles (external oblique, internal oblique, erector spinae, latissimus dorsi, gluteal muscles, quadratus lumborum, adductors and hamstrings) help with movement and greater stability. When there is a weak link in either of these packs, there is compensation. Something has to do the work. Overtime, this pattern of compensation can lead to chronic tension and pain. In the case of tension-related low back pain, it is often the deepest abdominal muscle, the transverse abdominis, that is underworking, and the low back extensors, like the erector spinae, that are chronically tense from doing too much of the work to keep the body upright.
The following three exercises are recommended if you have tension-related back pain and wish to strengthen the deeper core muscles, namely the abdominals in this case. If you suspect you have a more serious issue (herniated disc, stenosis, osteoporosis, etc.), consult your physician and, if allowed, seek a knowledgeable Pilates instructor for private instruction. If you have an achy low back and you sit slouched all day, you likely have fatty low back muscles and thus, the focus would be on strengthening them, in concert with whole body movements, of course. If you have scars on your abdominals, this will impact your ability to access and strengthen your abdominals. Consider booking a session with a Neurokinetic Therapy-certified practitioner (who has a license to touch) to help you clear compensation patterns before you begin movement. If you have any degree of scoliosis or chronic tension that will not subside with Pilates or yoga or other whole body movement, try Biosomatic movement, Hanna Somatics or Feldenkrais to unravel patterns of tension.
Most Basic: Knee-Folds
Prep: Lie on your back with your knees bent and feet flat. Arms long by your side.
Exercise: Draw your navel to your spine. Imagine a pulley between your low abdominals (the space just inside your hip bones) and your right knee. On an inhale, bring your right leg up to “table-top,” where your knee is just over your hip and your shin is parallel to the floor. On an exhale, lower the foot back to the ground. Repeat on the other side. 8-10 sets.
Basic: Toe Touches
Prep: Lie on your back with your knees bent and feet flat. Arms long by your side. Draw your navel to your spine. On an inhale, bring your right knee up to table-top. On an exhale, bring your left leg up to table top.
Exercise: Take a breath in. On an exhale, touch one toe to the ground and bring it back up to table top. Repeat on the other side. 8-10 sets. Remember to go slowly and keep your navel to your spine. Even imagine drawing the navel in and UP, all the way through the top of your head.
*Want a challenge? Do this same exercise on a long foam roller with your palms on the mat for support.
Basic/Intermediate: Single-Leg Stretch
Prep: Lie on your back. Draw your navel to your spine. On an inhale, bring your right knee into your chest and then your left knee into your chest. On an exhale, curl your head and shoulders up off the ground. Gaze just above your knees and slide your ribcage toward your pelvis.
Exercise: Inhale, hug your right knee into your chest and extend the left leg up to the ceiling (for more of a challenge- out to the diagonal). Exhale, switch legs. Do 8 sets. Breathe deeply, in through the nose and out through either the nose or the mouth. Move slowly and with control.
*Want a challenge? Reach your arms long by your side, an inch off the mat.
*Need more neck support? Keep your head down or prop it up on a rolled up towel. Or, and slightly more challenging, bring your hands behind the head, one on top of the other, let your head relax into your hands and slide your ribcage toward your pelvis to lift the head and shoulders.