Pilates for back pain: how it can help and where to start

Long sitting keeps the body in one position. The muscles around the spine work all the time at a low load, while the abdominal and glute muscles often "switch off". Add rounded shoulders, a head pushed forward and shallow breathing. The result can be tension in the neck, between the shoulder blades and in the lower back.

There is no single cause of back pain. It can be linked to posture, lack of movement or stress, but also to an injury or an illness. That is why this article does not diagnose. If the pain is severe, sudden, spreads into the leg or comes with numbness, see a doctor first.

Pilates is a system of exercises that combines movement with breathing, control and attention. Many people feel that regular classes help them sense their body better and sit and stand in a more comfortable way. We do not promise to "cure" your back, but Pilates can support things that matter for the spine:

• Deep muscles (the centre of the body). Exercises teach the muscles that stabilise the spine and pelvis, not only the ones on the surface.
• Posture awareness. Slow, precise movements help you notice how you sit and stand and where you hold tension.
• Mobility. Gentle lengthening and rotations help restore freedom of movement in the spine, hips and shoulders.
• Breathing. Calm, deep breathing helps relax the neck and ribs. Many people notice they feel calmer after class.
• Strength without overload. On the reformer the springs can make an exercise easier and support the movement, or make it harder, so the resistance can be matched to you.

The reformer is a moving platform on a frame, connected to springs. At Las Pilates we train on BASI Systems equipment. For people with a tense back it has several advantages:

• Support. Many exercises are done lying down, so the spine is unloaded and you can focus on the movement.
• Matched resistance. The instructor chooses the springs for you and changes them during class if something is too hard or too easy.
• Clear feedback. The movement of the platform shows when the body tilts to one side and helps you set it up symmetrically.

You can read more about the equipment in the article What is Pilates?.

These are examples, not a training plan. Do them slowly, within a range that does not hurt, and stop if pain appears.

• Pelvic movements lying down. Lie on your back, bend your knees, rest your feet on the floor. On the exhale gently draw in the lower abdomen and tilt the pelvis slightly, on the inhale return. 8–10 repetitions.
• Breathing into the sides of the ribs. Sitting, place your hands on the sides of your ribcage. Inhale through the nose so that the ribs widen to the sides, exhale slowly through the mouth. 5 calm breaths.
• Cat stretch. On hands and knees, round and lengthen your back in turn, in the rhythm of your breath. 8 repetitions.

Regular classes with an instructor help you refine the technique, because someone sees your movement and corrects the alignment. That is why these three exercises are not a replacement for classes.

Classes once or twice a week are a lot, but you spend the rest of the time at work and at home. A few simple changes help your back between classes:

• Change position. Stand up, walk around the room, stretch. The body likes variety, not one "perfect" position.
• Set up your workstation. Screen at eye level, feet on the floor, elbows relaxed. If possible, check your setup with an ergonomics person at work.
• Breathe consciously. Several times a day, stop for 3 calm breaths into the sides of your ribs. It can be the simplest way to relax the shoulders.
• Look after sleep and stress. Mental tension often shows up in the neck and back. Movement that calms you is a good ally here.

Pilates classes teach these habits in practice. The instructor pays attention to the position of the pelvis, ribs and shoulders, and you take that with you into everyday life.

Pilates is a gentle form of movement, but not every back pain calls for exercise. Contact a doctor before you start classes when:

• the pain appeared suddenly, after an injury or a fall,
• the pain spreads to the leg or arm, or comes with numbness, weakness or tingling,
• the pain gets worse at night or does not go away with rest,
• other worrying symptoms appear, such as fever.

If you have a diagnosis, such as a herniated disc, osteoporosis or scoliosis, ask your doctor or physiotherapist which movements to avoid and tell your instructor. Private sessions leave the most room to match the programme to your situation. You can read more about this format on the page private Pilates sessions in Warsaw.

In your first class the instructor will ask about the place and nature of the pain, when it gets worse and about earlier injuries. You do not have to prove anything or push yourself. Exercises start with simple basics: breathing, pelvis position and calm movements in a small range. If something feels unpleasant, let us know and we will change the exercise or the spring setting. Mild muscle tiredness the next day is common and usually passes within 1–2 days. Back pain is not a "normal effect of exercise", so always report it.

• People who work sitting down and want to move consciously and look after the neck, shoulders and lower back.
• People 55+ who want to keep fitness and independence. The pace is calm and exercises are matched to your abilities.
• People after injuries, in private sessions, after consulting a doctor or physiotherapist, when a programme matched to a specific situation is needed.
• Beginners. You do not need fitness or experience, you just need to come.

For people 55+ we have prepared a separate article: Pilates for seniors.

During pregnancy exercises are adapted to the trimester and how you feel, and it is worth having the approval of your doctor or midwife before you start. Read more in the article Pilates during pregnancy.

The studio is in Mokotów, Warsaw, at ul. Dywizjonu AK „Jeleń” 7A/U8. Group classes are held in groups of up to 4 people, so the instructor sees every person, corrects the alignment and chooses the spring resistance. If you prefer to work one-on-one you can choose private sessions, and if you want to train with someone close to you, a duo class. Our instructors are certified. Before the first exercise they ask about how you feel, pain and injuries so they can match the movement to you. Classes last about 55 minutes, and you train in comfortable clothes and non-slip socks.

There is free parking for clients on the estate. You can find details and the course of your first visit in the article First Pilates class: what to bring and what to expect.

You can start at any age and at any level. Check the class schedule and book through Fitssey, or have a look at the pricing to choose the format that suits you. If you have questions about back pain, write to us at studio@las-pilates.pl before your first class.