Between 60% and 80% of adults will be affected with low back pain (LBP) during their lifetime. The source of pain is not well-established in the majority of individuals with back pain, and the term “nonspecific low back pain” is often used to describe this population.
The definitions of chronic LBP (CLBP) include pain duration in the posterior lumbar region for more than 12 weeks) or duration of back pain greater than 7–12 weeks). The prevalence and high relapse rates of nonspecific CLBP often cause disability, and severely affect the quality of life.
In recent years, there has been a growing number of reports on the benefits of Pilates-based exercises for LBP and research have shown that the the most effective intervention for reducing chronic lower back pain is Pilates, mind-body and core based exercises.
So what is Pilates?
The Pilates method is a concept of body and mind exercises founded by Joseph H Pilates in the early 1900s. In the development of his own method Pilates drew inspiration from yoga, martial arts, Zen meditation, ballet, as well as ancient Greek and Roman exercises.
The practices based on this method have promoted the restoration of the function of muscles involved in lumbopelvic stabilization, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles. During each exercise, specific principles of this method should be followed to restore or sustain the motor control of the lumbar spine and proper body posture.
Unique for this method are the following key principles of carrying out exercises. These principles are:
1. Centering—activation of core muscles, ‘powerhouse’: transversus abdominis, diaphragm, abdominal oblique muscles, multifidus, pelvic floor muscles, during exercise. These muscles are involved in stabilization of the lumbopelvic complex.
2. Concentration—focusing attention on proper performance of Pilates exercises.
3. Control—exercise is performed with concentration, control of movement and posture.
4. Precision—refers to paying attention to the quality of exercise technique. The exercises are performed only with a few repetitions (to 10 times) with gradual increase of difficulty and in proper breathing rhythm.
5. Breathing—exercises are carried out in breathing rhythm, as breathing promotes activation of deep trunk muscles.
6. Flow – smoothness during exercises and flowing transition between consecutive exercises.
In Pilates, emphasis is especially placed on alignment of body posture, which means adequate adjustment of the head, shoulder and pelvic girdle in neutral position with maintaining spine curvatures as well as axial position of the lower limbs and symmetrical weight-bearing of the feet in standing position.
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