Shae Spine Rehabilitation (3)

Pilates is terrific exercise

As a physiotherapist if there was an exercise class that I feel everyone could benefit from I would say Pilates.

The Pilates concept was developed in the early 1900s by Joseph Pilates. He believed that injuries were caused by imbalances in the body and poor patterns of movement. He observed that when a person had weakness or pain, they overcompensated and overdeveloped another area to achieve a certain movement. This in turn, can result in further pain and injury. Pilates is an excellent way of strengthening, increasing spinal mobility, stretching and improving general function and wellbeing by concentrating on correct movement patterns.

Pilates is very much focused on core control. “Core” is a term that gets thrown around quite often in gyms and on social media.

What exactly is our core? Our core is made up of transverse abdominis (TA), multifidus and pelvic floor musculature. TA is our deepest musculature layer around our trunk, wrapping around our belly like a corset. Multifidus sits at the back of our spine, close to the midline. The pelvic floor is a hammock of muscles that sit underneath our genital region. When these muscles are activated they provide a strong cylinder-like support system for our spine and pelvis.

Activating your core is very different to what you would expect. When asking people to switch on their core often I see maximal bracing or “flexing” around the trunk. Correct core activation actually only requires a 30 per cent contraction. Activate now, reading this. Imagine you have a belt around your belly and you want to tighten the belt, but only up to the 3rd notch. Now think about holding in a wee or gas. Can you feel the subtle tightening of your core?

Real-time ultrasound can be conducted by a physiotherapist and is a way of visualising if you are activating your core correctly. 65% of people incorrectly activate their pelvic floor. Women especially tend to bare down on their pelvic floor which can lead to weakness and incontinence issues if not addressed. Poor core control can also be a cause of low back pain, or disc injury when lifting. Research shows that people with ongoing low back pain can benefit from two supervised Pilates sessions per week of 30-60 minute duration.

If you are new to Pilates I would start with a Pilates assessment with your physiotherapist. Learn some of the exercises in a one on one setting, eventually building into a class. Pilates is quickly becoming part of the elite training world. Take a look at the AFL for example. If you have ever thought about trying Pilates, do it. The benefits are profound.