Principles for Prevention

Chronic Low Back Pain (CLBP) effects so many individuals. An article in USA Today in 2006 (http://www.usatoday.com/money/industries/health/2006-10-16-back-pain-usat_x.htm) stated that "Lower back pain is a condition that eight out of 10 Americans will experience at some point. And the cost is measured in more than just pain: Medical treatment of back pain is estimated to cost $25 billion annually, according to Duke University researchers. Workers compensation costs and time lost from work add another $25 billion." With so much focus on how lower health care costs and improve our health care system, perhaps we need to be focusing on prevention and non-surgical interventions.

There is no question that strengthening your core muscles can relieve CLBP and increase functionality. (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2684152, http://www.jospt.org/issues/articleID.1140,type.2/article_detail.asp) The key is performing the exercises correctly so that you are using the intended muscle(s) or muscle group(s). This means beginning your Pilates experience under the supervision of a certified Pilates instructor who is familiar with the cause of your LBP. Your instructor will guide you to the most beneficial exercises, steer you away from exercises that could aggravate your condition, and monitor your movements to ensure that you are not relying on larger, stronger muscles or falling into habitual movement patterns.

Your instructor is your guide, but it's up to you to do your homework too. Knowing and practicing the six principles of Pilates will help maximize your results and prevent injury. Here's a quick overview:

* Concentration - Joseph Pilates called his method "the thinking man's workout." Be present and aware of your body throughout your workout. Check in with your alignment and which muscles are working. Consciously recruit and relax muscles. This is how you "unlearn" old patterns and create new healthier movement patterns.

* Center - All motion begins in the center of the body and moves outward to the periphery. In other words, in order to move your foot, you must move your leg, and that begins in the large muscles of the "core" or "powerhouse."

The next two go hand-in-hand and are critical for injury prevention.

* Control - Each movement should be completed with intention and absolute control. Smaller, controlled movements are more effective than "flinging" or "hurling" your body to achieve a larger motion.

* Fluidity - Keep your motions smooth and flowing. Don't make "jerky" starts and stops. Don't flop down after holding a difficult position. Always return to your starting position slowly and with grace.

* Precision - Performing the exercises accurately ensures that we are working the intended muscle(s) and/or muscle group(s). For more advanced exercises, like inversions, precision is critical in injury prevention.

* Breath - Of course the breath oxygenates the body and removes waste, but it can also assist us in all the other principles. By engaging our deepest abdominal muscles, the transversis abdominis on our exhale, we stabilize our bodies during the most challenging points of an exercise. Our inhale can be used to stretch and open the trunk and avoid over arching or rounding our spine.

There are many resources available to learn more about these principles in detail. A wonderful book that I refer to on a regular basis is Pialtes by Rael Isacowitz (Human Kinetics, 2006)

Perhaps I will cover each principle in detail for my posts next week. hmmmmmm