pilates for lower back pain...pilates for lower back pain amanda qin january 18, 2018 comprehensive...
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Pilatesforlowerbackpain
AmandaQin
January18,2018
Comprehensiveprogram2017-2018
BodyInMotion,CA
Faculty:DominiqueLesperance
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Abstract
Pilatesisagreatwaytohelpwomenprotectedandstrengthentheirbody
whiletheyarepregnant。Pilatesfocusesonposturalalignment,core
strength,andoverallmusclebalance.InthispaperI’mgoingtotalkabout
theinfluenceandchangeofpregnancyonthebody,andchangesinbody
posture.Next,I’mtalkingaboutthecauseofthelowerbackpainafterbirth
andIwillalsoincludeaconditioningprogramutilizingtheBlockSystem
fromBASI.
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Table of Contents
Abstract page2
AnatomicalDescription page4-9
Discussion page9
ConditioningProgram page10-12
Conclusion page13
Bibliography page14
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AnatomicalDescription
Pregnancy is a wonderful and wonderful experience for women. Women's bodies are
pregnant, childbirth and lactation. During pregnancy, the body of a woman is affected
by a hormone, with some major physiological changes. The most obvious change is
the growing number of babies in the womb, the increase in weight and the change in
body posture.ThefollowingtenitemsisimportantthatthePilatesinstructorand
clientareawareofthechangesoccurring.
1 musculoskeletal and changes in body posture
The spine continues to realign to maintain balance. This produces a shift in posture
with exaggerated lumbar lordosis towards late pregnancy. Increased laxity in the
ligaments, caused by an increase in relaxin, contribute to back pain and pubic
symphysis dysfunction. The pelvic bones loosen to prepare the body for labour and
birth.
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2 The Respiratory System
The respiratory rate rises to compensate for increased maternal oxygen consumption,
which is needed for the uterus, the placenta and the fetus. As a result the client may
feel out of breath.
3 cardiovascular system
As the uterus enlarges, it rises up and out of the pelvic cavity. The action displaces the
stomach, intestines, and other adjacent organs. Progesterone causes relaxation of the
lower esophageal sphincter. As a result the client may experience constipation, reflux
and heartburn.
4 changes in the breasts
Breasts may become larger and tender due to the increased levels of hormones,
estrogen and progesterone. The nipples may stick out and by the third trimester,
colostrum may start to leak.
5 urinary system
The growing uterus puts pressure on the bladder, urethra and pelvic floor muscles
which may result in the client needing to frequently urinate.
6 gastrointestinal system
As the uterus enlarges, it rises up and out of the pelvic cavity. The action displaces the
stomach, intestines, and other adjacent organs. Progesterone causes relaxation of the
lower esophageal sphincter. As a result the client may experience constipation, reflux
and heartburn.
7 endocrine system
Hormonal changes readjust the entire body system. The placenta acts as a temporary
endocrine gland during pregnancy, it produces large amounts of estrogen and
progesterone. It serves to maintain the growth of the uterus, helps to control uterine
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activity, and is responsible for many of the maternal changes in the body. Pregnant
women may feel warmer due to increased hormonal level and basal metabolic rate.
8abdomen system
During the second trimester the abdomen starts to expand and the uterus will be close
to the ribcage by the end of this trimester. The client may ache on either side as the
abdominal wall and ligaments stretch.
9 leg cramps
Caused by carrying extra weight, compression of blood vessels, excess in
phosphorous, a shortage of calcium or magnesium and an increase in pregnancy
hormones.
10 swelling
Feet and ankles may swell due to an increase in fluid.
Manyofthephysicalchangesthatcancauselowbackpainduringpregnancy,
childbirthandpostpartumperiod.Duringpregnancy,expandinguterusstretches
andweakensabdominalmusclesandaltersbodyposture,puttingstrainonthe
back.Plus,extraweightmeansmoreworkformusclesandcreasedstressedon
thejoints.Whatmore,hormonalchangesinpregnancycanloosenthejointsand
theligamentsthatattachpelvicbonestospine,whichcanmakefeellessstable
andcausepainwhenwalk,standorsitforlongperiods,rolloverinbed,getout
ofalowchairorthetub,bendorliftthings.Inadditiontothis,thereisalsothe
causeofhyperlordoticspine,diastasisrectiandimbalancemuscles(lower
crossedsyndrome)
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Hyperlordotic
Hyperlordosisofthelumbarspineisaconditionthatoccurswhenthelumbar
regionorlowerbackdramaticallycurvesinwardtothepointofcausingexcess
painorspasms.Itisacommonposturalpositioninpostpartumperiod。This
faultypostureispelvis in a fixed anterior tilt.causedbyweakabdominals,tight
hipflexors,andtightbackextensors.Tocorrecthyperlordosistheabdominals
needtobestrengthened,andthehipflexorsandlowbackextensorsneedtobe
stretched.Specificallythetransverseabdominalsandmultifidusneedtobe
strengthened.Thisposturecreatesexcesspressureonthelumbarspineandcan
causelowerbackpain.
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Diastatis Recti
DiastatisRecti,bydefinitionisphysicalseparationoftherectusabdominis
muscles.Thisisverycommonamongpregnantwomanaspregnancyapplies
pressureonthebellywhichpreventstheabdominalsfrommaintainingtheir
shape.Themainsymptomsofdiastatisrectiisprimarilytheinstabilityofthe
abdominalsalongwithbackpain,poorpostureandconstipation.bythe
occursbetweentheLineaAlbaandLineaSemilunarisintheAbdominalRaphe,
whichisthemidlinecollagenousconnectivetissue.Themainsymptomsof
diastatisrectiisprimarilytheinstabilityoftheabdominalsalongwithbackpain,
poorpostureandconstipation.
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TransverseabdominalsandMultifidu
Thetransverseabdominalsarethemusclessurroundingeithersideoftheback
belowtheobliquemuscles.Thetransverseabdominalsmusclesplayakeyrolein
stabilizationspecificallyinstabilizingthelowerbackandpelvis.TheMultifidusis
abackextensormusclerunningalongthespinethatplaysakeyrollinstabilizing
thejointswithinthespine.TogetherthetransverseabdominalsandMultifidus
helpstabilizeusthrougheverydayactivityandhelpprotectthespine.
CaseStudy:
Clientname: Susan 30yearsold
Sheisathreemonthsbaby’snewmother,becauseshetookherchildallday
alone,andsherecentlyfoundherlowerbackpain,especiallywhenshewas
holdingachild.Atthreemonthspostpartumherabdominalsarestillveryweak
andthereisanoticeableseparationoftheabdominalsandrelaxationofthe
stomachmuscles.Soherweakabdominalsarecausinglumbarhyperlordosis,her
lowerbackextensorstooverusing,leadtolowerbackpain.Shesuffered
constipationtoo,whichIthinkwascausedbytheseparationoftherectus
abdominis,andthedecreaseinabdominalpressurecouldalsoproduce
constipation.Shedoesn’thaveanytrainingbase.Hermainobjectiveistolosethe
weightthatshehasgainedfromherpregnancywhilefocusingonregainingher
abdominalstrengthandincreasinghermobility. 9
ConditioningProgram-BASIBlockSystemforSusan
BASIBLOCK Sessions 1-10 Sessions 11-20 Sessions 21+
WARMUP
RollDown
PelvicCurl
SpineTwist
Supine
RollDown
PelvicCurl
SpineTwist
Supine
ChestLift
ChestLiftw/
Rotation
RollDown
PelvicCurl
SpineTwistSupine
ChestLift
ChestLiftw/
Rotation
FOOTWORK
Reformer
ParallelHeels
ParallelToes
VPositionToes
OpenV-Heels
OpenV-Toes
CalfRaises
Prances
Reformer
ParallelHeels
ParallelToes
VPositionToes
OpenV-Heels
OpenV-Toes
CalfRaises
Prances
SingleLegHeels
SingleLegToes
Cadillac
ParallelHeels
ParallelToes
VPositionToes
OpenV-Heels
OpenV-Toes
CalfRaises
Prances
SingleLegHeels
SingleLegToes
Abdominal
work
Reformer
Hundred(heaton
themat)
WunderChair
StandingPike
SittingPike
Cadillac
BreathingWith
PushThroughtBar
Reformer
Hundred
Teaser1
HipWork
Reformer
Frog
Circles(Down,
Up)
Openings
Reformer
Circles(Down,
Up)
Extendedfrog
Extended
frog/reverse
Cadillac
Frog
Circles(Down,Up)
Walking
Bicycles
Spinal
Articulation
N/A
Reformer
BottomLift
BottomLiftw/
Extensions
Cadillac
Monkeyoriginal
Stretches
Mat
Catstretch
Reformer
StandingLunge
Reformer
kneelingLunge
Cadillac
ShoulderStretch
Fullbody
Integration
N/A
Reformer
Scooter
Cadillac
Sittingforward
ArmWork
Reformer
Armssupine
series
Reformer
Armssitting
series
Cadillac
Armsstandingseries
Chestexpansion
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ArmWork Reformer
Armssupine
series
Extension
Adduction
Circles(upand
down)
Triceps
Reformer
Armssitting
series
Chestexpansion
Biceps
Rhombids
Hug-a-tree
Salute
Cadillac
Armsstandingseries
Chestexpansion
Hug-a-tree
Circles(upand
down)
Punches
Biceps
LEGWORK
Reformer
HamstringCurl
(nostraps)
Reforfmer
SingleLeg
Skating
Cadillac
Squats
LATERAL
FLEXON/
ROTATION
Mat
Sidelift
Reformer
Mermaid
Cadillac
Butterfly
BACK
EXTENSION
Mat
Backextension
Reformer
BreastrokePrep
Reformer
PullingStraps1
PullingStraps2
Final
Assessment RollDown RollDown RollDown
Conclusion
Mothers are prone to developing muscles imbalances due to new repetitive movement
patterns and routines. Daily activities such has picking up and holding a child,
breastfeeding, and carrying a diaper bag can overload unconditioned muscles causing
stress and fatigue. There is a strong emphasis in Pilates to strive to achieve overall
balance. In doing so muscles imbalances need to be addressed, and the appropriate
muscles need to be stretched, strengthened, and conditioned. At the same time, it
needs to be established ideal posture,to reduce the pressure of the joints and bones.
Susanupon evaluation after completing her tenth session, the exaggerated curvature
of lumbar spine had slightly decreased while her pelvis appeared to be closer to a
neutral position than it had been at the beginning of the program. Her abdominal
strength was also improved. After twenty session the symptoms of the rectus
abdominis were also improved. During the training period, I paid special attention to
her rectus abdominis separation, so I did not do the chest lifting and rotation in the
first ten sessions. No trunk flexion but strengthen transverseabdominals and
multifidusco contraction and awareness , to establish trunk stabilization. Mobility in
Susan’s lumbar spine has also improved, the lower back pain is better than started.
She is motivated to continue her Pilates conditioning program, striving for ideal
alignment and a healthy spine.
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Bibliography
Pilates in Pregnancy
http://www.babycentre.co.uk/a563313/pilates-in-pregnancy
Rosecrams,Tracy.BodyChangesThroughPregnancy.WebHealthline.com,
http://www.healthline.com/health/pregnancy/body-changes-infographic
BASI.Studyguide–comprehensivecourse.CostaMesa,CA;2000-2014.
BASI.Reformer–movementanalysisworkbook.CostaMesa,CA;2000-2012.
BASI.Mat–movementanalysisworkbook.CostaMesa,CA.2000-2012.
BASI.Cadillac–movementanalysisworkbook.CostaMesa,CA.2000-2012.
BASI.WunderChair–movementanalysisworkbook.CostaMesa,CA.2000-2012.
IsacowitzR.Pilates.Champaign,IL.HumanKinetics;2006.
IsacowitzR,ClippingerK.PilatesAnatomy.Champaign,IL.HumanKinetics;2011.
PilatesJH.Returntolifethroughcontrology.Miami,FL.PilatesMethodAlliance:
Reprinted;2003.
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