Are Pilates Instructors Capable Of Rehabilitating Back Pain?

Pilates is generally a good exercise method for those who suffer from back pain. Pilates focuses on core strength, stability and spine range of motion, all those areas which need the most improvements by back pain sufferers. However, all those improvements are up to the particular Pilates Instructor. When rehabilitating back pain clients the most important thing is to have an experienced and knowledgeable instructor. Pilates instructor needs to know much more than just Pilates specific exercises. And while Physical Therapists and Physicians recommend Pilates for back pain, the problem is that they don’t often know what kind of exercise Pilates really is, what kind of education Pilates instructors go through and how ready and knowledgeable they are teaching Pilates for those who has fragile spine and chronic back pain.

Many, even comprehensive, Pilates programs do not give enough tools and knowledge for the instructor to teach people with back pain. As both a Physical Therapist and certified Pilates instructor myself, I’m puzzled how openly and confidently many Pilates instructors market their services and teach people with back pain without any anatomy or back pain education in addition to their basic Pilates Instructor certification program. Many comprehensive Pilates teaching programs are just “certification businesses”, and there is a lot of competition in the marketplace where those certification programs don’t have any real, verifiable requirements to people who want to start Pilates education, so basically anybody can become a Pilates instructor. Most programs also lack any knowledge about anatomy, musculoskeletal disorders and body’s, especially spine’s, biomechanics. A basic Pilates instructor is not meant to be a therapist, and it’s definitely not enough to know just how many vertebras there are on the spine or knowing wide Pilates repertoire and how to cue them verbally. In my professional opinion, a skilled Pilates instructor has to understand in details how the spine is moving and how exactly it should move, what muscles the client should contract or not contract, and most importantly know all contraindicated exercises and how to properly modify Pilates movements individually based on the need and condition of back pain of the client.

Every back pain is different, so should the Pilates program be. There are no “one size fits all” Pilates exercises for back pain. Designing the Pilates exercise regimen should always aim at underlying problems. These problems are usually a poor posture, weak deep abdominal and back muscles, tight low back, hamstrings or hip flexor muscles, and limited spine range of motion. Pilates gives a wonderful toolset to improve all of those elements – but only if the Pilates instructor knows how to use those tools safely, correctly and efficiently. It’s important to notice that if Pilates exercises are taught unprofessionally, they may cause more problems or even re-injuries. Pilates instructor should never teach fitness and back pain clients similarly. Instructors have to be very cautious, especially when teaching clients who have osteopenia, osteoporosis, osteoarthritis, spinal stenosis, spondylolisthesis, spondylolysis, herniated disc or bulging disc.

In Pilates market the competition is hard these days and it’s getting even harder. Many studios have financial problems and some studios even have more instructors than clients. Consequently, there are many Pilates instructors who claim to be specialized in post-rehab and rehab without any education (except certified Pilates instructor), so be cautious when choosing a studio or instructor to rehabilitate your back pain – always ask for instructor‘s education, credentials and real experience. Also, never go overcrowded mat class or your fitness centers mat class with back pain. Many mat Pilates instructors get their certifications through a short, one weekend course or, even worse, by internet. Pilates for back pain should always be individual, one-on-one private session. Check always instructor’s background and previous client referrals too. Many instructors might have a story about their own back pain and injury and how the Pilates “saved their lives”. Good for them, but while not only being subjective, own experience does not necessary mean that they are capable of rehabilitating others back pain. In my opinion, much more education is needed in this area anyway.

I’m very positive that Pilates is a wonderful movement therapy and treatment to rehabilitate back pain. However, quality and education are the key to choosing the right Pilates instructor and studio. Try to find a well educated instructor who understands your specific needs and conditions. When you find a good one to work with, you will be surprised about the results – and that will be priceless!

Tuula Niskanen has college degrees of Physical Therapy and Physical Education. She holds advanced certifications in Spinal Stabilization Training, Golf Conditioning and Comprehensive Pilates Teaching. She offers private and semi-private Pilates classes with reformer and other equipment at California Pilates Center studio in Carlsbad, CA. More about Tuula’s Pilates services at PilatesWise website http://www.pilateswise.com .





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