Pilates and Low Back Pain


Ahhh, tricked ya!  You thought I was going to give you the secret to living pain free in one little article!…. Sounds ludicrous when you put it like that – I mean, if it was that simple, wouldn’t the whole world be pain free?

Okay, okay …  so this is a half rant and half explanation!  How many times do you hear that Pilates can fix your back pain?  There’s articles in pretty much every fitness magazine, every Health section of the weekend paper and fitness websites the world over telling us how core exercise help alleviate back pain.  Some even give you 8 to 10 pilates moves to strengthen your “core” and reduce your pain.

I’m here to tell you that Pilates can and does alleviate your back pain, your aches and pains, rehab your injuries and so many other wonderful things.  It does – I can personally vouch for that fact myself.  But folks, it’s much more complicated than just doing the exercises in these articles, and more complicated than just starting Pilates classes!  And here’s why…

  • Low Back Pain should not be “generalised” – it’s very individual
  • Are you doing the exercises outlined in those articles properly?
  • All Pilates Instructors are not created equal
  • The different types of Pilates
  • Understanding what “the core” is and then knowing how to use it properly

General pilates classes will help alleviate most general low back pain and most general aches and pains caused by lack of movement and a weak core.  But the devil is in the detail …. not all Pilates instructors are created equal, and not all Pilates exercises are great for every person.  It depends on why you’re suffering low back pain in the first place.  And there’s too many reasons why you might be suffering low back pain to even hazard a guess or take a stab in the dark.

Low Back Pain should not be “generalised” – it’s very individual

Low back pain can be present for a number of reasons:

  • weak deep core muscles (well, derrr);
  • injury;
  • bad postural habits (including sitting too much);
  • tight leg muscles / tight back muscles;
  • scoliosis;
  • pelvic instability;
  • abdominal muscle separation;
  • weak or over-active pelvic floor;
  • breathing issues;
  • basic muscular imbalances;

…. I can go on and on and on here!  Suffice to say some are simple movement fixes, others are far more complicated requiring individualised attention and a diagnosis from an Allied Health Professional such as an Osteo or Physio.   There’s no cookie cutter solution, no one size fits all plan here.  Soooooo, you need to understand WHY you have low back pain and then do what is appropriate for YOUR issue.

Are you doing the exercises outlined in those articles properly?

Sure, you can read the “how to” description and do the exercises seen in the article you just read, but how do you know if you’re really doing it properly?  You may in fact do more harm than good by relying on your own (perhaps limited) knowledge of anatomy and ability to interpret the instructions.  So, how do you know you’re even performing the exercises as they were intended to be performed, with the same intent and muscular activation attached thereto?

All Pilates Instructors are not created equal

You could try signing up for classes at your local gym to see how you go, but gym instructors/PTs have trained as Personal Trainers and Pilates Instructors have trained as… Pilates Instructors.   And then you can have Clinically trained Pilates Instructors who are trained to work with injuries and issues and Fitness Pilates Instructors who are trained to give you a great group Pilates exercise class.  There’s a big difference in the training each receive in their different modules.   There are weekend courses for Pilates meant as an add on for people who are already Personal Trainers/Gym Instructors and Pilates courses which take years!  You’re absolutely allowed to ask what type of training and certifications your Gym/Pilates Instructor has received and their experience.

The different types of Pilates

Some Pilates Instructors are trained and certified to teach what is commonly referred to as “Fitness Pilates”.  Fitness Pilates concentrates on group class application where each participant is expected to be a healthy body with no issues.  Some Pilates certifications teach the classical method meant for smaller groups, and others are heavily geared towards the clinical application of Pilates exercises to assist with injury rehab and pain issues.   Group classes don’t teach the client as much detail or body specific training as private Pilates tuition does and this comes down to pricing and costs.  In my personal view, every single person should start Pilates with at least 3 private sessions before moving into group, just to begin to wrap their mind around the principles and understand their own individual movement hiccups…. But that’s in a perfect Pilates world.

If you’re a fit and healthy body, you might find the clinical application of Pilates to be a little boring, and if you’re someone with an injury you might find Fitness Pilates to be too strong for you when you first start.  Simply, all Pilates is not the same and it helps to know what style of Pilates is going to suit you.  Not every person with low back pain should be in a Fitness Pilates setting, but some certainly can.  It depends on the reason for your low back pain.  BUT every single person needs to understand and be able to perform appropriate deep core activation… IT’S THE ENTIRE BASIS OF PILATES!  So if you’re not getting that where you’re going, how do you know you’re doing Pilates and not just an exercise class on Pilates equipment?

Understanding what “the core” is and then knowing how to use it properly

In addition to all of the above, the “core” is a tricky concept – it’s not just the much sought after  6 pack.  In fact, a very strong 6 pack can quite often be the ‘cause’ of low back pain, but that’s a whole other article!  The “core” includes multiple different muscles wrapping from the pubic bone and pelvis all the way up and under the ribcage front to back.  These muscles work WITH or AGAINST each other to provide stability through movement.  Many times, core strength and control is taught with rigidity which can often lead to low back pain in itself.  Developing an understanding in your own body that you can create stability without the need for rigidity is a difficult concept to learn and more difficult to put into play in your own body.  It takes time to learn.  Given the time needed to learn correctly, it is a concept or skill that can be overlooked in large, fast group classes where the emphasis is on giving a great workout rather than teaching great movement patterning … which brings us back to the different types of Pilates.

As a Pilates Instructor, if you teach a purely technical class designed to educate your clients on how to use their machine (and by that I mean their body), participants sometimes complain of it being too slow or too boring.  As a society, we are encouraged to seek the burn, push the body to breaking point, fast and hard, if you can “walk” out of the class afterwards then you didn’t work hard enough.  As Pilates instructors, we need to find a balance between the two.  We want to instruct and teach you, while keeping you challenged enough to get you to return….it is after all a business … but that my friends is the sign of a good instructor.

Basically, you have to be able to perform the basics really well before moving into intermediate and advanced classes, you need to understand the principles, know how to engage your muscles correctly and at the appropriate level and time, understand and have the control to make adjustments as you move through the flow of an exercise and finally, understand what the instructor is telling you to do.  Don’t be in a hurry – good things come to those who wait, and the good news (or bad news depending on how you view it) is that Pilates just gets harder and harder the better you become at it!

So, if you want to do Pilates to alleviate your low back pain, find out why you have it in the first place and then seek out an appropriate form of Pilates.  If you’re after a recommendation, give us a call, we have some amazing people we work with.


Julie Ojeda

Pilates Nation

Julie is a fully certified STOTT PILATES® instructor and holds Cert IV Allied Health Assistant; Cert IV Fitness and has completed numerous additional courses in Pilates for Injuries & Special Populations,  Athletic Conditioning, Pilates for Children & Adolescents, Pilates for Pre & Post Natal Clients


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