Anastasis Tzanis
Is Reformer Pilates good for Lower Back Pain?
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Epidemic as Lower Back Pain might be, it is in 90% of cases treatable even if the symptoms are chronic. Those using Reformer Pilates for Lower Back Pain not only recover faster but reduce their chances for a relapse.
In this article I am providing a reformer pilates roadmap for those suffering with Lower Back Pain (LBP), depending on the severity of the symptoms. Avoiding common mistakes in lower back pain rehab is equally important of course.
Severe lower back pain
Those dealing with severe LBP are often restricted in performing many moves and experience intense pain, for prolonged periods of time, triggered by a variety of events (including long walks, lying down in the same position for more than 2 hours). The pain may wake them up in the middle of the night and pain killers often become part of their ‘diet’ so to speak.
There are 2 categories of severe LBP: sudden / acute and dull / chronic.
a. Acute LBP
Those experiencing acute LBP need to waste no time and consult a physician. A word of caution:
Be prepared to hear: ‘There is nothing wrong with you.’ Or ‘It’s in your head. Just get some rest and you will be fine.’ Which translate to: ‘With the means I have available and my current knowledge I cannot help you. Consult someone else.’
Please read the text above x2. What should you do if there is no explanation to your symptoms?
1 Continue to monitor the symptoms as this will help future physicians and therapists to advise you accordingly.
2 Proceed with the plan provided below.
b. Chronic LBP
Chronic intense lower back pain is common especially among the elder population and in particular women. It is not uncommon, when following the right protocol, for symptoms to reside substantially, lower:
If you have been living with the pain for years, you shouldn’t expect the recovery to be overnight. A recovery period of approximately 1-2 months, for every year you have lived with the symptoms is a reasonable expectation.
During this phase the goals ⚽️ are to:
1 Recover and perform regularly all physical movements that do not trigger the lower back
2 Improve strength in all muscles that work synergistically with the lower back and abdomen
3 Start challenge the mid-section progressively and only when appropriate. This often involves exercises that are not typically classified as core exercises (ie. Carries).
Hamstrings & gentle ankle stretches
Articulated upper back
Dissociate hips & abdominals
Rectus abdominis
Moderate lower back pain
Pain will be triggered in individuals suffering from moderate LBP, when performing specific activities. In men these activities are: seating for long periods of time (ie. when driving or during flights), after doing manual work of moderate intensity. Women’s lower back might be triggered before their period, when standing for long periods (ie. when cooking or visiting galleries).
Both men and women in this category are less likely to experience LBP while walking.
During this phase the goals ⚽️ are to:
1 Strengthen the muscles that work synergistically with the lower back.
2 Improve spine stability with abdominal inner unit work
3 Perform low intensity plyometric training (both bilateral and unilateral)
Strengthen glutes
Strengthen the inner unit
Intermediate rectus abdominal exercises
Introductory obliques
Hamstring work
Occasional LBP
Occasional discomfort in the lower back is unfortunately not rare. It is often attributed to age, over or under training, the weather, the planets, … but whatever the reason lower back sensitivity is an amber flag and if ignored it can escalate or cause issues in the knees or ankles. Lower back sensitivity is likely to cause involuntary adaptations in how many movements are performed, including squatting, walking, running and a few lifts.
During this phase the goals ⚽️ are to perform:
1 Compound movements
2 Supersets of lower back and ab exercises
3 Plyometric training
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Compound movements:
Leg flexibility & core
Shoulders & core
Intermediate oblique
Supersets of abdominal work including isometric holds , spine flexion
Upper back stability
FAQ
How do you stretch your lower back with Pilates Reformer?
You can stretch your lower back by bringing your spine into flexion. These exercises can provide temporarily relief from lower back pain but should be treated as palliative work and not treatment.
Is Reformer Pilates good for herniated disc?
The reformer pilates is a low impact form of resistance training and thus can help those suffering from herniated disc to maintain muscle tone without loading their joints to the point of discomfort.
Herniated disc can cause different degrees of pain, from severe to just an occasional discomfort. The protocols above can be used but the exercise selection has to be personalised to the individual’s limitations.
What causes lower back pain in females?
Women with low levels of oestrogen [ref], progesterone or testosterone [ref] are more prone to experience pain. In one study the peak of progesterone during the 2nd phase of the menstrual cycle was associated with a 25.6% reduction in pain severity [ref].
Those suspecting hormonal imbalances can perform a hormonal test such as the Dutch one, to confirm if the problem exists.
which exercises to avoid with lower back pain
As a rule of thumb you should refrain from the exercises that intensify the pain you experienced prior, as well as those that you feel you have no control in their execution.
Depending on the level of severity and the nature of the pain (ie. neurological, muscular, fascial) two individuals with lower back pain may have to avoid different exercises.
Conclusion
LFor those that have access to a reformer machine and suffer from lower back pain, practicing on the reformer x2-5 times per week is a non-brainer. Make sure the challenge of the class matches your current needs and over time you increase the difficulty as you progressively get stronger.
References
Chen, Q., Zhang, W., Sadana, N., & Chen, X. (2021). Estrogen receptors in pain modulation: cellular signaling. Biology of sex Differences, 12, 1-10.
Schertzinger, M., Wesson-Sides, K., Parkitny, L., & Younger, J. (2018). Daily fluctuations of progesterone and testosterone are associated with fibromyalgia pain severity. The journal of pain, 19(4), 410-417.
Vincent, K., & Tracey, I. (2008). Hormones and their interaction with the pain experience. Reviews in pain, 2(2), 20-24.