Back Care Basics: The Pilates System of Postural Health

At Holly's Pilates Village, we work with many people who are recovering from injury and illness. Undoubtedly, the most common ailments stem from back pain.

From bulging discs and back spasms to more serious structural problems such as scoliosis, spondylolisthesis, and spinal fusion, our clients turn to Pilates for help mobilizing and strengthening the muscles that support the back. Often, people come to the studio after spending many months or even years seeking treatments from a range of medical specialists, including neurologists, orthopedic surgeons, and physical therapists.

To be clear, Pilates teachers are not physicians. Nor do we make diagnoses and assign "treatment plans." Rather, we are functional movement specialists who search for imbalances in the body's muscle mechanics and use the comprehensive exercises that Joseph Pilates developed to help people achieve healthy movement and fitness.

It can be a complicated process. Consider the findings from Cathryn Jakobson Ramin's excellent book, Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery. In it, Ramin describe an odyssey to heal her chronic back pain, including undergoing spinal surgery and a vast array of treatments and rehabilitation methods. During her six-year investigation, she also exposed a much bigger problem—Americans spend more than $100 billion a year on back care treatments, which are often ineffective and sometimes harmful.

"In a world that is increasingly virtual and screen-based, the musculoskeletal system suffers," she writes. "Today the average U.S. adults spends almost nine hours a day in a seated position: watching television, working at a computer, or driving a car. As a result, the gluteal and postural muscles, essential for supporting the spine, rest idly and grow lax.

"Too much sitting and too little exercise make for a potent combination. The way that most people arrange themselves in chairs—with curved spine, collapsed pelvis, jutting chin, and slumped shoulders—overworks ligaments and joints, and restricts the oxygen supply to spinal nerves and discs. When circulation is inadequate, muscles turn to fatty tissue, resulting in weakness and deconditioning."

How can Pilates help reverse the course? It starts with mobilization, creating suppleness in the spine through proper articulation. Next, Pilates teaches that healthy mobilization requires strong stabilization, a balance between the intrinsic muscles that are opposing larger muscle groups and good alignment when the body bends, extends, and rotates. Finally, Pilates focuses on strength and stamina. Through regular and precise practice of the Pilates repertoire, we gain greater physical conditioning by exerting more energy to challenge stability through a wider range of movements.

In Sitting Kills, Moving Heals, Dr. Joan Vernikos shares the story of how Joseph Pilates applied his exercise techniques to wounded soldiers lying in bed during World War I. "The purpose was to teach them to exercise their trunk muscles in order to remain in good shape. Many of these men could not stand up to use their own body weight, nor were they able to lift weights, but they could contract their trunk muscles. This conditioning regimen, although it bypassed working against gravity, also helped them improve their posture and muscle strength when they got out of bed. Strong abdominal muscles are crucial for a healthy back."

Maureen W. has experienced the Pilates difference in her body. When she first came to Holly's Pilates Village in May 2017, Maureen had so much back pain stemming from severe scoliosis that she often had to use a wheelchair to get around. A surgeon was recommending spinal fusion, but Maureen wanted another option, so she turned to Pilates. Working diligently three times a week, first in private sessions with Pilates teachers Molly Mitchell and Teresa Willis and now in group classes with Molly and Dawn Adcock and Jessica Goldstein, Maureen has learned how to mobilize, stabilize, and strengthen all of her major muscle groups with no residual pain.

During a recent visit to an orthopedic surgeon she has consulted for more than 20 years, Maureen was delighted when he told her that he had never seen her in better shape. Her wrote her a prescription for continued health: "Keep doing Pilates."