Pilates Classes Failing to Reduce Back Pain

A number of clients, from the Sevenoaks, Tonbridge and Tunbridge Wells areas, have come to me recently for one-to-one Pilates training because of long-term back problems.

Now there is nothing unusual in their seeing Pilates as a potential source of relief.

But what struck me immediately as unusual was that they all said they had been doing Pilates classes at various health clubs for five to eight years. Two clients were proud of the fact that they had reached an advanced level in their Pilates class.

Despite all those classes, and all that progress through the levels, each client voiced frustration that they still suffered recurring back pain.

Two questions put to me came to the fore:

  • I know Pilates should be good for my back so why are the issues with it not being resolved?
  • If my back pain is not receding, why am I being put into advanced classes?

My Views on Pilates Classes and the Treatment of Back Pain

Based on my experience of instructing Pilates and applying it to the treatment of back pain, I have formed my own personal views on how this should be done.

Having worked in gyms and observed Pilates classes there, I believe I understand why my clients were feeling dispirited as a result of their efforts.

Pilates in the Class Environment

The answer to the first question of why Pilates classes have not helped ease back pain is quite simple. Whilst application of core Pilates techniques should be of benefit to the majority of people, there are others with specific issues that require an entirely personalised approach with the application of remedial techniques.

At the start of each class, instructors are required—through adherence to health and safety rules—to ask their participants to inform them of any postural issues, injuries, pregnancy, illness and so on.

Consider an instructor dealing with a class of, say, 20 people. Let's assume five of whom have special requirements, which may not be an unusually high number for a class of this size.

Lack of assessment Because the class environment does not allow for a full assessment of every participant's needs, the instructor is limited to recommending the level of activity to which it is safe to perform an exercise. Level in this context usually refers to a notional measure of physical fitness.

Limited by the size of class and without the information from postural assessments, what the instructor is unlikely to be able to achieve are Pilates routines for these five people tailored to their specific needs. Indeed, the instructor may not be experienced in, or qualified to, identify special remedial needs even if there was sufficient time for proper assessments.

Lack of remedial routines On assessing my clients, it became clear why their back issues had not been resolved: their Pilates classes, focusing as they did on fitness, were not providing the necessary therapeutic effects.

Addressing the issues Each client is different. Each back is different. Thus the nature and cause of any pain is particular to the individual. Therefore it is vital to me to gather the knowledge gained by completing a thorough personal assessment combined with feedback from liaising with any physiotherapist, osteopath or remedial massage practitioner who may be involved.

I can then specify a Pilates programme designed to rebalance the body by stretching tight and short muscles, by encouraging to relax those muscles that have become hypertonic (rigid muscle tone hampering proper movement), and by increasing endurance in core muscles that have become weakened.

Class Emphasis on Advancing Levels

The answer to the second question about why clients were attending advanced classes, appeared to be down to the fact that at their health clubs it was sometimes left up to participants to decide for themselves which level of Pilates classes they attend.

Who is to judge This is worrying to me. It is very easy to cheat on Pilates exercises and there is no way in which an instructor, with 20 participants in their class, is going to be able to judge that each person is carrying out the exercise properly and fully.

Continue with your classes For my clients who chose to continue their group classes, I advised on proper technique and made them aware of which class exercises were unsuitable for them. I am pleased to report these clients now say that they benefit far more from their classes than they had been in the past and that their backs are now on the mend.