Effective Pilates Exercises for Imperfect Backs

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Effective Pilates Exercises for Imperfect Backs

By CarolAnn, MS, CPT, NPCT

Back pain and discomfort are common issues for many people, often caused by poor posture, prolonged sitting, lack of movement, injuries, or chronic conditions. Pilates, with its focus on core stability, alignment, and controlled movement, offers an effective way to alleviate and prevent back issues. When working with clients who have “imperfect” backs—whether they have scoliosis, disc issues, or general stiffness—tailoring exercises to their needs is crucial. Let’s explore some effective Pilates exercises that can help improve strength, mobility, and relieve pain for those with back issues.

Structure of the Back

The back supports the body’s weight and allows for flexible movement while protecting vital organs and nerve structures. It comprises the spine, nerves, as well as several different muscle groups.

  • Spine: The spine is composed of 33 bones called vertebrae, which stack together to form the spinal canal. This protects the spinal cord inside. The spine is divided into 5 sections:
    • The Cervical Spine (7)
    • The Thoracic Spine (12)
    • The Lumbar Spine (5)
    • The Sacrum (5)
    • The Coccyx (4)
    • The Spinal Cord: The spinal cord runs from the neck down to the lower back. It consists of nerves that carry messages to and from the brain.
    • Muscles
      • Superficial/Extrinsic Muscles:  Allow movement for the limbs
        • trapezius
        • latissimus dorsi
        • levator scapulae
        • rhomboids
  • Intermediate: Connect to the ribs and support respiration.
    • serratus posterior inferior
    • serratus posterior superior
  • Intrinsic: Allow for movements such as rotation and bending
    • the iliocostalis
    • the longissimus
    • the spinalis
    • the semispinalis
    • the multifidus
    • the rotators

Common Back Conditions

Osteoporosis

A condition wherein the bones lose their density and become more fragile. This can cause the bones to fracture more easily.

Avoid spinal flexion, rotation and side bending. Focus on extension exercises.

Osteoarthritis

The cartilage that cushions bones wear down, causing the bones to rub against each other.

Avoid high impact activities.

Intervertebral Disk Degeneration

A decrease in cushioning between the vertebra with age that can cause pain.

Avoid high impact activities.

Herniated Disk

Occurs when some of the nucleus encased in the disk pushes out through a tear in the annulus. A herniated disk is sometimes called a slipped disk or a ruptured disk.

Avoid all exercises that cause pain or feel as though they are making the pain worse.

Sciatica

Compression of the sciatic nerve, or the spinal nerve root, can cause back pain, numbness, tingling and can radiate to the buttocks and legs.

Avoid any position or exercises that increase pain

or radicular symptoms.

Spinal Stenosis

A narrowing of the spinal canal that puts pressure on the spinal cord and nerve roots.

Avoid excessive extension (prone positions and

prolonged standing positions).  Use seated, quadruped and side-lying positions.

Spondylolisthesis and Spondylolysis

Spondylolysis is a stress fracture in the lower back. If left untreated, spondylolysis can progress to spondylolisthesis, a condition in which a vertebra, weakened by fracture, slips out of alignment with the rest of the spine.

Avoid extension and prolonged standing. Focus on flexion exercises.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Common Misalignments

  • Flat Back: The normal curve of your lower spine loses some of its curvature. Your lower back looks straight, and you stoop forward.
  • Military Back: The upper back is straight, and the lower back is arched, with the chest thrust forward and the pelvis tilted forward.
  • Forward Head: The head is positioned with your ears in front of the vertical midline of your body.
  • Sway Back: Lordosis or hyperlordosis, is when your hips and pelvis tilt forward, in front of your body’s midline.
  • Kyphotic: An exaggerated curvature of your upper back (the thoracic spine) where the shoulders are rounded forward. It’s also called hunchback.

 
Key Considerations for "Imperfect" Backs

For individuals with back pain, it's important to modify Pilates exercises to avoid aggravating existing issues. Here are a few key points to consider:

  • Avoid Overextension: Exercises that require extreme back extension can put excessive strain on the lumbar spine. Modify or limit these movements as needed.
  • Focus on Core Engagement: The deep core muscles provide support for the spine. Prioritize exercises that strengthen the transverse abdominis and pelvic floor.
  • Move Mindfully: Slow, controlled movements reduce the risk of injury and allow you to focus on proper alignment.

Key Benefits of Pilates for Back Health

Pilates strengthens the deep core muscles, which support the spine, promotes better posture, and enhances flexibility and mobility in the spine. By focusing on controlled, precise movements, clients learn how to stabilize and move their spine in a healthier way. It's essential to keep in mind that not all Pilates exercises are appropriate for every back condition. Pilates instructors must assess each individual to modify movements as needed. The following exercises can be particularly beneficial for individuals with back pain.

1. Pelvic Tilts: Pelvic tilts are a gentle way to warm up the spine and engage the core without putting stress on the back. This exercise helps in improving the mobility of the lower back and can be done lying down or seated.

  • Lie on your back with knees bent, feet flat on the mat, and arms by your sides.
  • Inhale, and as you exhale, press your lower back into the mat by tilting your pelvis.
  • Inhale again as you release the tilt and return to a neutral spine position.
  • Repeat 8-10 times.

2. Bridging: Bridging strengthens the glutes and lower back muscles while also promoting spinal articulation. It's a great exercise for addressing lower back discomfort and improving core strength.

  • Begin by lying on your back with your knees bent and feet flat on the mat, hip-width apart.
  • Inhale to prepare, and as you exhale, engage your glutes and lift your hips off the mat.
  • Keep lifting the pelvis until your body forms a straight line from your shoulders to your knees.
  • Inhale at the top, and exhale as you lower the pelvis back to the mat with control, articulating through the spine.
  • Repeat for 8-12 repetitions.

3. Chest Lifts: For individuals with poor posture or rounded shoulders, chest lifts are helpful in strengthening the abdominals while improving proper spinal alignment.

  • Lie on your back with your knees bent and feet on the mat.
  • Place your hands behind your head with your elbows wide.
  • Inhale to prepare, and as you exhale, engage your abdominals and lift your head, neck, and shoulders off the mat in a controlled manner.
  • Inhale to hold, and exhale as you lower down.
  • Focus on not straining the neck and keeping the movement smooth.
  • Repeat 8-10 times.

4. Spine Stretch Forward: This exercise stretches the entire back, especially the lumbar spine. It promotes mobility and can be a gentle way to relieve tension and tightness in the lower back.

  • Sit tall on the mat with legs extended hip-width apart and feet flexed.
  • Extend your arms in front of you at shoulder height.
  • Inhale to lengthen your spine, and as you exhale, begin to articulate forward through your spine, reaching toward your toes while maintaining a rounded back.
  • Inhale to return to a seated position, stacking each vertebra one at a time.
  • Repeat 6-8 times, focusing on a smooth articulation of the spine.

5. Swimming: For those with back stiffness or muscle imbalances, Swimming is an excellent Pilates exercise for strengthening the back muscles without overloading the spine. It also improves posture and overall body coordination.

  • Lie in a prone position (faced down) with your arms extended in front of you and legs straight.
  • Lift your head, arms, and legs off the mat slightly.
  • Begin a fluttering motion with opposite arm and leg (right arm with left leg, left arm with right leg), simulating a swimming movement.
  • Keep your core engaged and squeeze the glutes to avoid straining the lower back.
  • Continue for 10-15 seconds, rest, and repeat 2-3 times.

6. Bird Dog: Strengthens the muscles of the lower back and core while promoting balance.

  • Place yourself on the mat on all fours (hands and knees).
  • Extend one arm forward and the opposite leg back.
  • Hold briefly, then switch sides.
  • Repeat 5 times to each side.

7. Knee Folds: Stabilizes the core and improves lower back stability.

  • Lie on your back with knees bent and feet flat on the floor shoulder-width apart.
  • Lift one leg to tabletop, lower it back down, and switch legs.
  • Alternate legs without letting your pelvis shift.
  • Repeat 5 times on each side.

8. Mermaid Stretch: Stretches the side of the body and can help release tension in the lower back.

  • Sit with legs bent to one side.
  • Reach the opposite arm overhead and stretch sideways.
  • Return and counter stretch to the other side.
  • Repeat 5 times and then switch the legs and bend to the opposite side.

 
Expand your teaching expertise with the FiTOUR® Primary, Advanced, and Reformer Pilates courses that provide tools necessary to create safe and effective programming for imperfect backs. With the growing needs of your clients, specialty education is imperative to service those needs.

CarolAnn has been a certified fitness professional with a master’s degree in Exercise Science and Health Promotion for over 30 years, has been a FiTOUR® ProTrainer for over 25 years, and has authored 18 FiTOUR® courses including the Yoga, Pilates, Primary Aqua, and Primary Indoor Cycling Primary.  CarolAnn is a Club Pilates Corporate Master Trainer and Lead Instructor for the Club Pilates studio in Athens, GA where CarolAnn specializes in movement for everyBODY.