Neck or spine pain has been at the pinnacle of conditions causing great disability worldwide for over 20 years. All experts recommend exercise as the first line of treatment, and the Pilates method is one of the best implantation options for these patients. “Research shows that in cases of neck or spine pain, we find some common musculoskeletal disorders such as respiratory distress, atrophy or changes in the activation timing of certain muscles during movement, postural changes, decreased muscle resistance, etc. Therefore, it is important to lead an active lifestyle that helps our body to be ready for daily needs, ”says Pablo Vera, physiotherapist of the Commission for Therapeutic Exercises of the Professional College of Physiotherapists of the Community of Madrid.
Pilates, says this physiotherapy expert, “with a lot of exercise designed to improve spinal stability and mobility, it is one of the best ways to control these movements and promote effective and efficient models. In addition, it is ideal for teaching us about different body movements and thus remembering many of the ideas that worked in class throughout the day. »
David Lorenzo, physical education instructor and Pilates teacher, explains that this method is based on the mobility and strength of the spine, as well as the center of the body. Such an important role is given to the spine and muscles of the regions of which it is composed that Joseph Pilates, the creator of the method that bears his name, mentions in his book that “the only proof of the greatest you is not how you think or feel, but how flexible your spine throughout your life. ” This German athlete has developed a training method aimed at offering those who practice it the flexibility of their back, proper alignment and an increase in their strength throughout life, in order to avoid all those pains that arise from prolonged lack of movement.
Pilates exercises are best for the neck and spine
According to Vera, “First, it is necessary to make a good differential diagnosis, which will help to learn more about the possible cause of this change, which causes pain in the neck or spine, since the choice of exercises will depend on this. The more information, the better the decision-making about their development and adaptation will be. ” However, the physiotherapist quotes, on the general level that we will work on:
• Improving the stability of the lower back. Exercises with which we work to maintain the normal curvature of the lower back while moving the legs, arms, or upper spine. The famous shoulder bridge exercise will be included here.
• Improved mobility of the spine, especially in the back. This may include an exercise known as a “cat” and / or an exercise that improves the rotation of that area of the body, such as “archer.” »
• Improving cervical stability by helping to activate the stabilizing muscles by performing a movement called flexion or extension of the cervix before following that area.
• Improving the dynamic stability of the blade. Hand exercises to help improve muscle control between the trunk and this limb.
For his part, Lorenzo stresses that, in general, individualization is key in these cases. Different exercises can be recommended for each person, depending mainly on the ability of movement of each column, as well as his needs.
However, it should be remembered that the method revolves around the movement of the spine (which includes the cervical region and therefore the neck). Thus, it would be convenient to talk about pilates exercises for the purpose of moving and strengthening the spine. You need to know that this structure moves in four great patterns of movement (flexion, extension, lateral flexion, and rotation), so it would be recommended that the column moves in all of these ranges for a Pilates session. Following this line of work, exercises that involve these movements can be:
- One hundred for back flexion.
- Shoulder bridge for lumbar flexion.
- Corkscrew for lower back rotation.
- Spinal rotation for spinal rotation.
- Swan Dive for spinal expansion.
- Mermaid for side flexion.
The originally mentioned exercises require prior preparation, good coordination and some knowledge of the method. Therefore, below, Lorenzo includes a practical proposal with spinal mobility exercises based on the mentioned exercises. “This sequence can be about 10 minutes long, making it easy and quick to do, it moves the spine in different ranges, it’s safe and suitable for everyone.”
If the patient has neck pain, can they do Pilates?
According to Vera, “you can and should train, but you will need to make changes to your work program. An example is not starting an exercise when the cervical spine is exposed to excessive strain or pressure, such as lifting your head off the ground while lying on your back. We could do many exercises in other positions, for example, sitting, lying on our stomach, on our side … In addition, it is important, as far as possible, that the pain does not appear during exercise, or at least that it does not get worse after 24 hours class “.
Lorenzo warns that a student who has a pain in his neck over time must find out what is happening to him. To do this, he must be diagnosed by medical professionals. Once you receive confirmation from your doctor or physical therapist that you can practice Pilates normally, the teacher must ensure that the student is doing safe exercise. In addition, it will be important for you to know what the injury is and, if possible, read about possible recommendations given by your doctor to avoid harmful exercise, personalize your practice and ask how you feel during it.
Can I do Pilates with dizziness due to a cervical problem?
Having vertigo doesn’t make it impossible to practice Pilates, Lorenzo says, stressing that consulting with a professional is key. “This dizziness can be caused by problems in the inner ear, nervous system, visual system, increasing age, loss of muscle tone, or even multicusability . Once the lineage is known, the teacher will be responsible for doing safe exercises that do not impair or endanger the student’s health. ”
No problem adapting exercises for a patient with vertigo, Vera says. In these cases, “prefers to work in remote areas (hips, pelvis, scapula and shoulder), as well as combine certain exercises in the cervical region. Changes can be made by working longer while sitting or using a wedge when we lie down when symptoms appear. The main goal will be to improve response and muscle tone. This should provide an improvement in the patient’s symptoms and improve functionality over several days. »
Is this method recommended for a herniated disc?
“In general, in conditions where low back pain is present as symptoms, including hernia, bulging, sciatica, etc., experts confirm that exercise is the first recommended line of treatment. Therefore, Pilates, understood as controlled exercise and measured by trained professionals, would be an excellent option for these cases. This is where the role of the physiotherapist comes into play, who, depending on the pathology and the patient’s clinic, will set goals and select the most appropriate exercises at the time. ” , Says Vera.
In the case of a hernia, it will be necessary to be more specific and delve into whether it is posterior, lateral or anterior, as this information is important when doing lumbar mobility exercises. If it is posterior and lateral (most often), bending and lumbar rotation exercises should be avoided in the first stage in loading positions.
Lorenzo emphasizes the same idea: “As a rule, all hernias, as well as their possible side effects, are improved by safe and progressive physical activity and will never do so at rest or a sedentary lifestyle.”
What if you suffer from sciatica? Are there any precautions to take into account?
Same as above, always adding the pain variable. That is, seeing that it does not increase during exercise or for 24 hours after.
Will Pilates be contraindicated in other cases?
Exercise is the best medicine, and one of the benefits of the Pilates method is that exercise can be tailored for all types of patients. Teenagers, middle-aged people and seniors will find suitable options in these exercises to develop and improve their physical and mental condition. In this regard, Vera says that “there are several cases where movement is contraindicated, given that there are many different modifications in the application of their exercises. Only when the area requires immobilization due to trauma, as can occur after a fracture or dislocation, can determine the effectiveness of some exercises. However, being a global method, we can always do something from a distance. If I have shoulder problems, I can always continue doing trunk or leg exercises while waiting for the upper limb to recover. ”
It is very important to know the starting state in order to start this exercise, and therefore many times the sessions are conducted individually to learn the simplest exercises before moving on to the small group sessions.
According to Lorenzo, the practice of Pilates should not be contraindicated for almost anyone. “There are actually scientific studies that analyze the impact of this method on various special populations: people with parkinsonism, herniated discs, arthritis, fibromyalgia, osteoporosis, elderly cancer survivors … However, there can be very specific cases where the practice of Pilates not recommended, such as, for example, in people with morbid obesity, heart disease, poor healing of some wounds, risky pregnancy, etc. However, it is important that if a person suffers from a specific pathology, consult a doctor if it is it is possible to practice this method. ”
For his part, this physical educator remembers that the teacher must intimately know the method and exercises in order to avoid those that can cause problems in these niches of the population. It would be convenient to work individually if a person suffers from some more complex special pathology, and, of course, if necessary, to contact the medical professionals who treat him.
Tips for choosing a Pilates class
The student is responsible for the quality of the Pilates they receive. To this end, Lorenzo offers a series of tips for choosing to practice this method:
- Choose a study in which practice is personalized or in small groups (six or seven people would be ideal), as supervised practice is key to achieving learning goals the safe way.
- If possible, the study should include devices or machines belonging to the method. They will help the student progress through the training, offer assistance (or challenge, if necessary) to understand the exercises and train more fully.
- Be consistent and persistent in your practice as this is a training method and not physiotherapy or other specific treatments.
- Constant self-assessment of the development of activities. Asking questions about your progress can be one way to achieve this goal. For example, am I achieving my goals? Do I feel like my physical condition is improving or staying healthy through practice? Can I gain strength and flexibility, do what I couldn’t before? Am I progressing in learning? Am I learning to move and train my body? Will I notice that there is planning in the classes?