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  • Writer's pictureMary Stocker

Pilates for Low Back Pain

It is estimated that 80% of people will have an episode of low back pain at some point in their lives. Over the 16 years that I have been a physical therapist, the pattern that has led people to seek treatment for their back pain is very similar in most patients. First, you have what you’ll describe as a “tweak” of your back, or maybe just a “pulled muscle”, but the pain will subside over the next day or two with a hot pack and some over the counter medications. The next time it happens, it may take longer to subside, but you’ll still come out of it without going to the doctor, or seeking any further treatment. By the time patients generally go to the doctor with their low back pain, it has become a chronic issue, and the spinal stabilizer muscles (deep) have shut down quite a bit, and are no longer doing their job, so that they larger mobilizer muscles (superficial) have to take over, thus leading to pain and dysfunction. Researchers have found that for successful treatment of mechanical low back pain, the patient must train segmental stability, which means that you have to specifically target the individual spinal segments with strength training. While most traditional exercise systems have some form of “core stabilization”, Pilates has specific exercises that focus on spinal articulation, which allows the patient to achieve segmental strengthening to help alleviate pain and dysfunction. The body must be stabile before it can be mobile, so without specific training to activate the deeper stabilizer muscles, the superficial mobilizer muscles will continue to attempt to stabilize and mobilize, which is what causes the cycle of pain. Traditional gym exercises and machines focus on the larger/superficial muscles, or what I like to call the “mirror muscles” because you can look in the mirror and see your progress (think biceps, triceps, 6-pack abs). What most people don’t know is that if you train your smaller/deeper muscles, your “mirror muscles” can get even stronger and you can prevent injury at the same time! Training smaller muscles is done with different types of exercises (controlled movements) and with lighter weight to facilitate the endurance of these muscles, as they are working to hold us up non-stop. Pilates is a great adjunct to any type of other activities that you may already be doing so that you can get even better results!


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