What's the Consensus on Pilates and Low Back Pain?

Is there a consensus among physical therapists about the use and perceived effectiveness of Pilates exercise for low back pain? 30 Australian physiotherapists experienced with Pilates exercise were surveyed and asked about Pilates as an indication for low back pain. The results were published in Physical Therapy. Consensus at 100% was reached for benefits, indications, and precautions of Pilates exercise, and only 50-56% for risks and contraindications, respectively. Therapists agreed on indications such as maladaptive movement patterns, poor body awareness, poor flexibility, decreased lumbar spine mobility, poor breathing and postural control.

The contraindications that were agreed on (but not as strong an agreement as the indications) included pre-eclampsia and unstable fractures. Agreement was reached that participation in Pilates exercise requires caution in the presence of unstable spondylolisthesis or significant lower extremity radiculopathy. The contraindications that were no agreed upon included cancer, severe osteoporosis, significant hypertension, and yellow psychosocial flags.

The physiotherapists did all agree that Pilates may help patients who have chronic low back pain by increasing function and confidence with movement, exercise, and activities, and additionally, that body awareness, postural control, and movement patterns may improve. Potential adverse events that may occur following Pilates exercise (and that were agreed upon) included aggravation of low back pain, or increased muscle tension. In relation to other potential risks of participating in Pilates exercise, inadequate training of instructors and inappropriate exercise prescription was listed. If you would like to learn more about Pilates exercise prescription for specific women’s health issues such as pelvic floor dysfunction, peripartum issues, and perimenopausal issues such as osteoporosis, check out the Institute’s new course on Pilates.