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The Lumbo-Pelvic Rhythm
For many years now, I have taught Back Care Pilates to hundreds of people in the Aberystwyth area, alongside providing Level 4 Exercise Practitioners courses for Fitness Instructors. These courses have all been based around peer-research reviewed literature and uses exercises taken from a wide range of suggested interventions – but more often bracketed under “Pilates” as this is what is often recommended by doctors and physios once you have finished your 6-week physio intervention.
I have also had a bad back myself - many years ago playing squash (!) and it is one of the reasons that got me interested in doing this type of work to help rehabilitate your back. I can remember the excruciating pain, and not being able to do the simple things like put your socks on or sit on the toilet. I was teaching around 14 classes a week at the time, and noticed within a month of injury how my class numbers had dwindled due to my inability to move with my normal energy - it made me realise the importance not only to my own health, but also how important your spine was in movement.
Although I was a Pilates teacher at the time, I had not paid it much attention until that point. I then did more work looking at the specific exercises to help my back and then developed a love and fascination with how movement can help - rather than the out-dated advice of rest and stillness. I initially did my own research, but then became involved with more educational aspects and worked on developing courses with Fitness Wales and sitting on the Welsh Government body for Back Pain and teaching the NERS instructors on adaptations to exercise - because many of the co-morbidities come about because of back issues - where not being able to move well restricts you looking after your health. Lack of mobility leading to obesity, Type 2 Diabetes, increased blood pressure and cardiometabolic syndrome.
Despite being pain free for decades now, I have not forgotten the pain and disability of my back issue. It has made me very empathetic and sympathetic to anyone in the same position - but also confident and positive about how exercise can be of great value - not only in reliving the pain, but also reducing the incidences of it reoccurring, and recovering quicker from any relapse. There is a wealth of research that demonstrates the value of controlled exercise to alleviate lower back pain – and much of this focuses on what is called the “lumbo-pelvic” area, and more importantly, the “rhythm” of this system.
When we think of rhythm, we think of dance, or moving with some style, fluidity, and comfort of being within our own body – and the Lumbopelvic rhythm is the same. It looks at how the balance of the front, back and sides of the body work together to stabilise the spine and pelvis and relive the pressure on the lower back. This kind of exercise is achievable for many - and essential for all. Having a strong back makes life so much easier, from the walk you walk, pick things up, carry, do tasks, sit still and sleep well. I know, from my experience, that people find Pilates to be the fundamental change that helped their backs get better.
Here are some of the key thoughts and exercises you can do to help.
Tip #1 - Keep Active to Keep Moving
Keeping active is key to a quicker recovery - although in the acute phases, exercise has not been shown to be helpful, moving slowly, stretching, deep breathing and massaging your muscles can help to speed up your return to normal life. Rest might be needed initially, but moving will help blood flow through the muscle, helping it to keep warm, improve repair and help alleviate tension. Always check with your Dr if you are not sure, or want to confirm the exact injury. Much of this information is for general lower back pain.
Tip #2 - What stretches help?
A stretch will help to ease the tension in a tight muscles. Decide how often you think you will remember to do this - and stick at it. Ideally, daily, with short held stretches (6-10seconds) or moving stretches to start to ease the tightness.
"Exercise is helpful to regain normal activities to those with chronic back pain"
Spine, 2000
Tip #3 - What I do to help chronic back pain
There are different phases to think about - so to begin with, learn to do some deep breathing exercise to help manage pain, then include some stretching of the tight muscles. But - once you are pain free, don't forget about your back. Think WHY did your back flare up and invest in your body with exercises designed to help improve both strength and flexibility of your body.
The exercises I find really make a difference all lie around the hip area - or lumbo pelvic area. Think about strengthening the hip muscles, with bridge exercises, rear leg lifts and the clam. Then work on the core, so that you back takes less strain, with Single Leg Stretch, Dead Bug, modified plank and Side Lying. Work on your upper body too, to improve posture and reduce strain on the spinal column - use light weights or bodyweight - The Dart, Back Extension, Press Up, Lateral Raise, modified back rows etc. Improved posture also improve your gait, and this is linked to reducing lower back pain and falls. And Finally, don't forget about the important side stabilisers, and use Torpedo, leg kicks, hip hitches and side circles.
All of the exercises benefit from mobility movements between the workouts, so hip rolls, cat/camel, single leg pull, etc
There is no "one way fits all" and you need to think about where your imbalances are - maybe your right side is stronger, maybe you sit at an angle, think about these things. Do you find that your back gets stiff after sitting for a while, then simple things like a morning and lunchtime walk will do you the world of good - both for your back and your mental health. Catastrophising and depression are linked to chronic back pain - but being outside and walking daily can help your to manage your thoughts and mood.
"Pilates intervention in patients with chronic non-specific low back pain is effective in the management of disability, pain and kinesiophobia"
Clinical Rehab, 2018
Feel free to include personal details and examples. The more relatable you or your website is, the more you connect with your readers.
Tip #4 - Mix up routine
Try different ways of doing your activity and break up your day with exercise and stretch. Do something different each day - maybe long walk one day, concentrated stretch another day and conditioning work another. Know your back. When are you feeling most vulnerable? In the morning, after work? Long car journey? Don't wait for these to come to you - head them off with a plan of action.
There are many ways to follow exercise - online, in person, or think about what works for you. Being still in not one of them, ignoring issues is not one of them. Invest the time in helping yourself to a strong, fit and health back.
Tip #5 - Be responsible, be thoughtful
Understanding that most back pain will resolve itself in the long term is always helpful - please see your GP if you have severe pain or long standing issues, but for everyday back aches, getting older pain, or just being inactive, moving works. Do little, do it often, go to class, get advice, keep moving. I teach classes in the Aberystwyth area that you can find on my web page, and have an online workout "Café" that has exercises suitable to help. Please get in touch if you want to know more, or download this document with some simple exercises to follow - please be cautious and careful, and ask for more information if you are not sure.
Finally...
After teaching for many years and many people, I can say that even one session of Pilates can make a difference - and regular sessions keep your back moving, mobile and pain free. I never have to advertise my class, as people walk in, they get better and think that the issue has gone away, only to realise it was the regular Pilates that made a difference. Then I get people making the weekly regular trip as they know it works. My classes are used as a referral from physios and other professionals as a way of keeping on top of your back pain. You might make the effort to see a physio, but you also need to make the effort to stay on top of the issue too - investing your time in looking after your back always pays dividends x
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