Back Pain and Pilates

CHRONIC back pain is one of the most common reasons people come to Pilates. From over use injuries, to car accidents, muscle imbalance or just poor posture, Pilates can really help to alleviate pain and manage the condition long term. But just why is Pilates good for back pain and when pain strikes during or after a class what is your body telling you.

Let’s start with the whole ‘Pilates is good for backs’ thing. Well in my experience of teaching, yes it is, but perhaps not just for the most obvious reason Pilates is known for, core strength. And – forgive me for being outspoken here – but not all Pilates classes will work for you. If you’re attending a class expecting to come out with burning abs and nothing else, well then I’m afraid your instructor has done you something of a dis-service.

Core Strength

Have you ever been told that you have a bad back, therefore you have a weak core? I’m afraid it’s not that simple. For a start, for me, your core is the broad spectrum term I’d use to describe your entire torso and your butt. Shoulder girdle, pelvic girdle, spine, abdominals, pelvic floor, gluteals, hip flexors all have a major part to play in your core control. If you were weak in all these areas, you’d probably struggle to stand up! Also, I’ve seen many clients referred to me with back pain from a physio who have excellent core awareness. It is far more likely that you have an imbalance somewhere in your torso, which could have started anywhere (that car accident, wearing high heels, marathon running, a sprained ankle, pregnancy) and which is aggravating your back pain.


Before you run away, despondent, there are many good reasons why Pilates can help with a sore back. Yes, core activation and strength has a part to play but balance and movement are just as important. And this is where the type of class you attend is so important and why an ‘abs dominant’ class isn’t really going to do you any favours.

Whilst there is no evidence to support the assumption that good posture will alleviate back pain, there is plenty of evidence to support the notion that movement is key to long term health and pain management. If your joints and your spine can move freely, through all their designed ranges of motion,  it is unlikely that you will experience chronic pain. Not sure about this? When did you last twist your ankle, strain your neck or pull your back? Were you able to move that joint freely whilst in pain or during your recovery? Or did you find the pain was worse at a certain movement point? Injury along with poor posture, repetitive sports like running, chronic illnesses like asthma and pregnancy can all make your joints seize up – and if you don’t manage them with movement, this can become permanent.

In a Pilates class we move. In my Pilates classes we move your body through all its planes of movement and we move your joints through all their ranges of motion. Sometimes the ‘slow’ bits can feel a bit .. well slow! But they are all part of the process.


The other really important factor for back health is balance. If you have super tight hip flexors from years of triathlon training or years of wearing high heels (NOTE: if you are very comfortable in high heels this is probably you) you will probably have muscle weaknesses elsewhere which are pulling you out of ‘happy back’ posture. Again, your spine gets stuck and those dominant muscles will just keep screaming at you until you get a little action into those weak and weedy ones. This is why I am very particular about glutes and shoulder girdles in my classes. For me (and to most of the fitness industry), the ability to squat and do a push up with good form are fundamental to a strong, fit body, that moves well.

This means (unfortunately) that those exercises you really hate are the ones you need to make your best friends and those you love, well it’s great to love them but pay heed to what your body is telling you.


Pain During Class

So we’re back to pain during class. Firstly, never exercise through pain. It’s one of those absolutes. Pain is your body telling you something. It’s quite possible that in the context of a Pilates class is telling you that a) you’re working too hard or you’ve done enough of that exercises; b) you’ve lost form (or never had it); c) you’re not quite in the right position; or d) your tight and strong muscles are screaming at you and doing all the work you’re trying to undo!

So listen to the pain. Then stop. You might need to find a different position. You might find that on that day your body isn’t responding well (tiredness, time of the month or a bloated tummy can all affect core control and movement). Talk to your instructor. Stretch. Go gently and focus more on movement than keeping up with your neighbour. Remember, there are very few Pilates participants who are good at everything, we all have favourite exercises and tricky ones. Work at the level that suits you and your body.


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