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Writer's pictureAndrew Keefe

What happens in a #Pilates for #BackPain & #Stress Session?




If you’ve been living with #ChronicLowerBackPain (CLBP) for some time and are thinking of joining my Pilates for Back Pain & Stress Class, but don’t know what to expect, or are perhaps worried you won’t be able to keep up or that it will make the pain worse. You will probably have lots of questions, so please keep reading!


Why is the class for Pilates and Stress?


CLBP have a physical purely physical cause but psychological issues like stress, anxiety, trauma or depression, can make it worse and in some cases even cause it, so my approach is to address both the physical and the psychological, in the same class.


Do I need any equipment?


I teach Mat Pilates, not Reformer so you don’t need access to a machine. All you need is a Pilates Mat and a block or cushion. We also sometimes use a Pilates Ball and a Resistance band but these are very inexpensive and I can let you know where to purchase them.


What is Pilates?


Pilates is a system of exercise developed by German physical therapist, Joseph Pilates in the 1920s, to aid the rehabilitation of wounded soldiers, athletes and professional dancers etc. It has been adapted over the years to be accessible to a very wide range of people. Most exercises are done lying on a Mat, and strengthen the whole body, but especially the core and increase bodily flexibility and control. Pilates sessions are planned and delivered according to the “Seven Principles” of Concentration, Control, Precision, Breathing, Centring (focusing on the core) & Smooth Flowing Movement. You will learn how to focus your attention on how your body feels as it moves, how to use the stabiliser muscles in your body to control the movement of your limbs, hips and spine, how to be precise in your movements, how to move with your breath and harness its power, how to focus on the “Powerhouse” of your core (the area between your hips and your ribs, with all the deep muscles which lie within it, including the Pelvic Floor Muscles, (PFMs) and The Transverse Abdominis, the TVA) and how to move smoothly, with flow and efficiency. 


What happens in the Class?


All Mat Pilates sessions begin with Set Up: We always start standing on the Mat, getting the body set, before beginning to move. You will learn about “Optimal Posture”, setting your neck, shoulders, hips, knees and ankles and engaging your core (PFMs and the TVA) and learning how to breathe “laterally” into the ribs, so that you can get the maximum advantage from your breath, even though you can’t use your diaphragm as much as usual, as your core is engaged. You learn how to achieve “Neutral Pelvis”, an essential skill for all movement in Pilates. Optimal Posture is a strong, healthy, sage position for your spine, with the spinal curves arranged to distribute and support your upper body in the most efficient manner.


After Set-Up, we start to Mobilise with a series of movements to mobilise and warm up the major joints of the body (neck, shoulders, hips, knees and ankles), loosening up and preparing the body for the main session.

Once your feeling warmed up and ready, we move onto the Main Session, a series of nine exercises from the Pilates Repertoire, mostly on the mat, either lying on your back (“supine”), on your front (“prone”) or side-lying, with some in sitting or standing positions. Pilates exercises combine use of Mobiliser muscles to move one or more limbs, with use of Stabiliser muscles to keep other areas of the body still. This usually involves keeping the Pelvis in neutral, using your core muscles, in whatever position you’re in. We always start with a basic level or “layer” of each exercise and gradually increase the difficulty by making the movement more complex, increasing Range of Motion (ROM) or the length of a hold. As ROM increases or the movement becomes more complex, the pressure on the Pelvis to move out of neutral becomes more intense, meaning the stabiliser muscles of the core need to work harder to keep it in neutral and that’s how you core gets stronger. Pilates exercises also build flexibility in all joints of the body. In this class, we focus on spinal mobility and strength through the moving spine. Exercises are followed by release stretches to relieve the tension built up in the relevant body parts and re-set before moving to the next part of the programme. Every time an exercise is presented, there is always an Alternative (a easier version) and a Progression (more challenging) and you will be encouraged to work at a level you find comfortable, with just the right level of challenge.

Pilates focuses on the core but it works the whole body as well and you’ll find your upper and lower body get a work-out too.


After the Main Session, we Cool Down, beginning to relax the body, with a series of stretches and breathing exercises, designed to stretch the muscles used in the session, either with Maintenance (returning the muscle to the length it was at the start) or Development (lengthening) stretches.


The class always finishes with 10-15 minutes of Relaxation: this is Pilates for Back Pain and Stress: We use Mindfulness, deep, Diaphragmatic Breathing, and Visualisation, to help you relax and learn to let go of worrying, stressful thoughts. Diaphragmatic Breathing calms the nervous system, signalling safety to the brain, allowing it to switch anxiety and stress signals, reducing pain as anxiety and stress make the body more sensitive to pain and reduce levels of the body’s natural pain killer, serotonin (serotonin levels go back up as anxiety lessens.) It’s always the brain’s decision whether something should hurt or not and it decides this based on sensory information it gets from the body about the condition of the area concerned and information about how stressed or calm the body and it’s general condition, so calming the body makes a real difference.


Visualisations help reduce pain by distracting the brain and helping it switch off the pain signals: one area of the brain involved in processing pain, the Posterior Parietal Lobe, is also responsible for processing visual information, but it can’t do both at the same time, so if we flood the brain with calming, soothing, healing visualisations, it stops processing pain and the pain signal gets switched off.


What do people in the group say about it?

I asked the group for feedback recently and one of the members said: “After five years of pelvic pain, all exercise was painful. Andrew’s Pilates classes are tailored for people with lower back pain. I’m in less pain now and feel stronger and more confident.”


How can I join the group and how much does it cost?

If you’d like to join the class, email me through the website and we can arrange to talk about your needs and how the class could help you. The first session is free and then £14 per session after that.

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