Pilates and Back Pain

Transcription

1 Pilates and Back Pain Katelyn Mancuso November 9 th, Course at Pilates Body and Motion

2 Abstract Rebecca came to me with the hope to strengthen her abdominals. She had never done Pilates before and the only type of physical activity she participated in was walking. She had - very little to no abdominal strength and no body- mind awareness. This was mainly due to the fact that she had her abdominal wall cut through twice. Once when she was 17 due to Crones disease, then again eight years later when she had a C- section. Because of this her abdominals were very weak and stress was put upon her back, causing back pain. She also had poor posture and a slightly kyphosis spine. My goal was to get her on a program that would start to connect her mind to her abdominals, strengthen her abdominals (especially lower abdominals), as well as straighten her posture.

3 Table of Contents 1. Cover Page 2. Abstract 3. Table of Contents 4. Diagram of Body 5. Case Study 6. How Pilates helps 7. Program Construction 8. Conclusion 9. Bibliography

4 Diagrams My work is going to focus on Rebecca s abdominals. Many people don t realize that the abdominals and pelvic floor muscles give the spine support. In order to properly support the back there needs to be enough strength in the abdominal and trunk muscles as well as the pelvic floor. This creates an 'internal corset' (Fitzpatrick, Paula). The hope is to strengthen these core muscles to help support her back and relieve her back pain. The muscles I want to strengthen are her Transverse abdominals, the deepest of all the muscles; the External and Internal Oblique s, which is the next layer up and sits right above the transverse abdominals; the Rectus abdominals, which sits in the middle and makes up the six pack; and the pelvic floor muscles. If the abdominal muscles and pelvic floor are strong and supportive then they give the spine great support (Fitzpatrick, Paula). The next page shows a diagram of the core muscles from an internal perspective and an external perspective.

5 Abdominal Muscle Diagram

6 Case Study From first glance, Rebecca seems to look healthy. She is a 42 year old woman who is of moderate weight and height. She doesn t seem to have distressingly bad posture and she carries herself as though she is not in pain. However, in reality Rebecca suffers from back pain and has had extensive surgeries and rehabilitations. These include two surgeries that cut through her rectus abdominals and pelvic floor muscles. She is a stay at home mother and has an eight year old son. Rebecca spends a great deal of time volunteering on committees where she finds herself sitting at a computer for long periods of time, planning events, and fundraisers that take a toll on her body. When I met her she was currently planning an event for Annie Wright School where she had to make hundreds of baked goods to put in gift baskets which required a lot of manual labor and hours being hunched over. The first session I spent with Rebecca I noticed she had no body- mind awareness and especially none in her abdominals. She is hoping to develop body- mind awareness, strengthen her core, and improve her posture. Therefore my work out plan for her will focus on those areas. I will put her on a regiment of basic abdominal exercises, back extension exercises, and shoulder/scapula stabilization exercises to start.

7 How Pilates Helps Rebecca s goals do not center on being the most sculpted in shape stay at home mom around, more importantly she wants to be able to live life free of pain. Pilates is great for this because she is not intimidated to come to the studio for a work out like she might be at a gym, and the low impact of Pilates is much better for her then intense cardio or weight training would be. Instead of working certain body parts in an isometric way, Pilates is working the whole body in synergy, which is how we move in our everyday lives. Most importantly Pilates requires a mind body awareness that you can take with you in your everyday motions. "The biggest benefit in my eyes would be personal awareness - - awareness of how you sit or how you stand or how you move and being able to relate those habits to the aches and pains and injuries you have or have had in the past," (Celebrity Pilates teacher Siri Dharma Galliano). This is exactly what Rebecca needs. The work she will put in at the studio to strengthen her core, back, shoulders, etc. she will take with her when she is sitting at her desk, baking, picking up her son, and just enjoying life. The number one goal Rebecca came to me for was her back pain. Pilates can help greatly with this by strengthening the core and building awareness of spinal alignment. As mentioned above posture pays a crucial roll in Pilates and this is also the case for back pain. When alignment is off, uneven stresses on the skeleton, especially the spine, are the result. Pilates exercises, done with attention to alignment, creates uniform muscle use and development which allows movement to flow through the body in a natural way (Ogle, About Pilates.com). Certain exercises such as the pelvic tilt which is where someone either tucks or

8 tilts their pelvis can cause weakness to one area of the spine and tightness to other areas. Doing simple exercises such as the pelvic tilt can bring awareness to Rebecca about how she carries herself. We can then work to correct it and develop inner strength to support the natural curves of her spin and relieve pain. In order to have good spinal alignment we need to have good core strength. Our core is not just the big surface muscles people think of when they think of getting a 6- pack. Instead the core is the deeper muscles that work to support and stabilize the back. That is why building Rebecca s core is going to be essential in relieving her back pain.

9 Program Construction My program for Rebecca would start with mat work. These are basic mat moves but will be important to build a good foundation and connect Rebecca with her body. Pelvic tilts- Help Rebecca become aware of her pelvic floor muscles. Pelvic Curl- Teach Rebecca how to move through her spine and maintain pelvic stabilization. Chest Lift- Will help Rebecca work on her abdominal strength. Chest Lift with Rotation- Help Rebecca work on her abdominal strength. Single Leg Lifts- Strengthens abdominals by avoiding hyperlordosis and to stabilize pelvic lumbar. Back Extension- Works on Rebecca s back extensors and teaches her to pull her shoulders back. Cat Stretch- Gives Rebecca a lumbar spine stretch and teaches her abdominal control. My program focuses on the above exercise so that Rebecca begins to strengthen her abdominals, back, and shoulder stabilizers. It also will enhance her mobility through her spine and teach her to stabilize her pelvis. I integrated in Reformer work after I felt like she was understanding and performer the above exercise well. I incorporated the Reformer to further her mobility and body awareness and give her a full body workout. Below is the Reformer exercise I put in her program.

10 Full Program Warm Up - Pelvic Tilts - Pelvic Curl - Chest Lift - Chest Lift with Rotation Foot Work - Parallel Heals - Parallel Toes - V Position Toes - Open V Heals - Open V Toes - Calves Abdominal Work - Single leg lifts Hip Work - Frog - Circles - Openings Stretches - Standing lunge Arm Work - Sitting arms series (with set modifier to assist in sitting up easier) Expansion Rhomboids Hug- a- Tree Salute Back Work - Basic Extension - Cat Stretch I did not include spinal articulation, full body integration 1, full body integration 2, additional leg work, or lateral flexion/rotation blocks because she is not at that fitness level yet.

11 Conclusion In conclusion, Rebecca has benefited from being on my Pilates program. Although she still has a way to go she has seen an improvement in her posture, body awareness, and back pain. She has taken what she has learned in my program and applied it to her life outside her Pilate s session. She is more aware of how her posture is when she is doing things such as baking, working on her computer, and driving her son around. She is also more aware of her pelvic floor muscles and stabilizing her pelvis which has helped relieve some of her lower back pain. Her abdominals have become stronger, and although abdominal work and awareness is still sometimes a struggle for her due to her many surgeries, she has seen an improvement from when she started. By strengthening her abdominals and back extensor muscles, working on her spinal mobility, and teaching her how to stabilize her pelvis, her back pain has decreased.

12 Bibliography Ogle, Marguerite. Pilates and Back Pain. About.com. June 13, Pain.htm The Benefits of Pilates. WebMD, Health and Fitness exercise/features/the- benefits- of- pilates?page=2 Fitzpatrick, Paula. Low Back Pain Tool Kit < back- pain- toolkit.com/index.html> Isacowitz, Rael. Mat Movement Analysis Workbook. Body Arts and Science International,