Pilates & Back Pain

SSOP has recently established ‘Pilates on Macquarie’, a fully equipped pilates studio inclusive of reformer, trapeze table, barrel and wunda-chair. Pilates is a unique approach to training control of movement and postures, popular for years in the dance community, it utilises specialised apparatus to facilitate normal movement patterns.

Recently pilates has become ‘in vogue’ as a method of exercise. Physiotherapists have embraced a modified pilates approach as it offers a flexible environment to meet patient’s specific needs. Pilates has become a successful intervention with a large variety of clients of all ages with ranging diagnoses inclusive of neurological, orthopaedic (Levine, 2009), womens health (Savage AM, 2005), and for performance enhancement in sport.

General Practitioners and Physiotherapists commonly manage patients with non-specific low back pain (LBP). Recent research suggests that the patient with LBP should be classified into treatment subgroups (manual therapy, stabilisation exercises or specific exercises) for positive outcomes (Brennan et al 2006)
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It is now widely accepted that a subgroup of the LBP population suffer from altered neuromuscular control mechanisms, affecting muscular stability of the trunk. “Local mechanisms” are the deep local muscles that control intervertebral movements, namely transversus abdominus and multifidus. “Global mechanisms” such as gluteus maximus and spinal paravertebral muscles, are the muscles that control the movement of the spine generally. Effective control of both mechanisms is essential for efficient stabilisation of the spine (Richardson, Jull, Hodges 1999). At SSOP we use ‘real-time ultrasound imaging’ for assessment of activation of these muscles (Kidd et al 2002).

Research supports the effectiveness of a specific exercise approach for retraining of these mechanisms in a LBP population with spondylolysis or spondylolisthesis (O’Sullivan et al 1997). Rydeard at al, 2006 conducted a randomised controlled trial for pilates-based therapeutic exercise program for subjects with chronic LBP (> 6weeks). Findings included a reduction in functional disability and pain intensity in the pilates group versus usual care, that was maintained at 3, 6 and 12 month follow-up. The pilates intervention was 3 one-hour sessions/week over a 4 week period. Gladwell et al 2006 also found that a chronic LBP (>12 weeks) group responded to a 6 week intervention of pilates exercises, with an improvement in general health, sports function, flexibility and proprioception and a reduction in pain, as compared to no intervention.

At SSOP we have a strong commitment to evidence-based practices. Hence, with the establishment of our new pilates facility we are providing our clients with the best possible care.

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