Does Pilates Help Low Back Pain?

by Paul Meripol

I originally came to Pilates hoping for a solution for chronic low back pain. And it has helped immensely.

Yet for a long time, despite good instruction, some exercises – especially certain back extension movements – made the pain worse and not better. The problem was not the exercises, it was how I was doing them.

The key to safe and successful back extension, especially for sufferers of lower back pain, is in the abdominals!

Proper abdominal engagement while performing back extension protects the low back, and helps put the work where we want it - in the mid back.

Once I learned this lesson, I was able to perform virtually any back extension exercise safely.

Here’s a simple back extension exercise example with principles that can be applied to any others you perform:

  • Lie on your stomach on a mat or carpet. Your nose is resting lightly on the mat, the back of your neck is long, and your arms are along your sides with your palms against your hips and your fingers reaching down towards your knees.
  • Stretch your legs away from you. I like to lightly engage my glutes and hamstrings as I do this.
  • Here’s the key to the exercise: along with that engagement of your glutes and hamstrings, lift your belly button up off the floor toward your spine. By doing this you engage your deep abdominals.
  • You should feel your pubic bone pressing into the floor.
  • Now keep that tummy pulled up tight as you lift your head and chest off the mat. Don’t overextend your neck.
  • Keep looking down at the floor. Think of a turtle reaching its head and neck out of its shell.
  • Your goal here is to strive for length from top of head to toes. Don’t worry about how high you lift. That is definitely secondary.
  • You want to feel your back is hinging in the middle, behind the ribs.
  • If you feel you are hinging in the low back, or you feel any discomfort in the low back then come back down and recommit to your abdominal engagement before you try it again.

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