Pilates is the safest, most effective form of exercise you could choose to keep fit (advanced flows have cardiovascular benefits), healthy (many health benefits, including prevention of back problems) and in great shape (toned body and you can burn 7 to 8 calories a minute with advanced Pilates), but are there any safety issues we should consider whilst practicing, other than the obvious ones or performing the exercises with control and engaging the core to protect the back? 

There are the obvious ones:- 

• Check with your GP before starting a new fitness regime
• Don’t exercise if you feel unwell
• Perfect your technique before moving up a level
• Do not drink alcohol or eat prior to exercising
• STOP if you feel pain or become dizzy
• Have your back problems or injuries treated before commencing a Pilates programme. 

However, there are two other major areas requiring careful consideration once you reach an intermediate and advanced level.

Hip Flexors (Iliopsoas) 

These cross the hip joint at the front of the leg and as the name suggests, are responsible for flexion – reducing the angle at the front of the hip, for example, when you walk upstairs and lift the leg to step up.  As you move up the levels of Pilates, you may start to feel these, together with the quadriceps – the big muscles running down the front of the thigh – becoming tight and quite sore.  Even the roll up (this weeks featured video and also on youtube: http://www.youtube.com/watch?v=dGg2X4kYos0)  can cause problems, especially if you are not using your abdominal muscles effectively.  Certainly the 100, the Teaser and Hip Circles will all overwork this area and tight hip flexors can lead to lower back problems. 

Never move up a level until your abdominal muscles are strong enough to do the work and take the pressure off other areas of the body.  Check that you are fully engaging the core, maintaining neutral position and stable pelvis to care for the lower back, too.  Lengthen through the legs and turn them out to engage the adductor muscles and reduce the pressure, even bend the knees a little. 

Pilates is a very safe form of exercise but the hip flexors (iliopsaos) and the neck are vulnerable areas

Neck 

The further up the spine you go, the smaller the vertebrae become because they do not have to support so much weight.  It is therefore understandable that the neck is vulnerable during exercises where we come up into a shoulder stand position.  Even at a relatively basic level, you will be performing Roll Back or Rolling like a Ball.  This should be performed with great control to prevent yourself from rolling right back onto your head and thereby putting undue strain on the neck.  More of a problem is the Roll Over (this weeks featured video and also on youtube: http://www.youtube.com/watch?v=dGg2X4kYos0) and Jack-Knife.  Both should be avoided if you have kind of neck problem and you should always allow the chin to relax to the chest rather than looking up and pushing the back of the head into the floor.  Scissors and Bicycle, whilst not particularly difficult exercises, can also put a strain on your neck: it is all about control and if you start to lose your balance, you will end up taking it in the neck. 

The head is quite heavy, too, and many people find raising the head and shoulders during core strength exercise is very stressful for the neck: build up slowly, check that you are not straining forward with the head and ensure that you are using your abdominal muscles, not your neck.

So you see the importance of walking before you can run?  By the time you attempt the intermediate/advanced versions of these exercises, your body will be well prepared and no problems should be encountered.

I’m out every day with my dogs and I prefer to run, but on days when I am walking for whatever reason, I’ve noticed a dull ache in my lower back from time to time.  I started to observe HOW I was walking and realised that I was leaning forward, almost pulling myself along and my core muscles were doing very little.  One area of the back that can cause problems is where the sacrum (between the lumbar and tailbone) meets the ilia (the pelvis).  If you feel around for those two dimples in the lower back, you are just about in the right place.  Something that may surprise you then is that walking can be the root of this problem.  Walking is very good for you, but be sure to check your technique and posture:  get it wrong and it could be very bad for you! 

Many people walk almost dragging their legs from behind rather than pushing them forward.  The pelvis is tilted forward and the body leans forward, as if walking into a strong wind.  The prime movers are the hip flexors and because the pelvis is not in a neutral position, the core muscles won’t be doing their job of stabilising the pelvis.  When you are walking correctly, you should stand tall, engage your core, tuck the tailbone if you are prone to letting your bottom stick out behind you, shoulders back and look straight ahead, not down.  You will feel the glutes (major muscles in your bottom) and hamstrings (back of thigh) working, the hip flexors and quads (front of thigh) being stretched in opposition, but your back should feel fine.  Take smaller steps, rolling through the foot from heel to toe, to prevent any possible twisting of the pelvis and always, always check your core contraction. 

Walking is a great form of exercise, but take care of your technique in order to avoid back ache

Even if you don’t have an SI problem, does this all sound familiar?  Legs feeling heavy after a while, head down?  Try this drill and feel the difference:- 

1. Start by stretching out the hip flexor and quads:  if your balance isn’t good, hold on to something.  The banister would be a good place as you need the stairs for the next stage.  Lift one foot up behind, grab the foot with the hand and bring your thighs together, knee pointing towards the floor.  As you press your foot back into your hand, tuck the tailbone under and feel the stretch right across the front of the hip and down the front of the thigh.  Repeat on the other side.
2. Stand on the bottom stair, side on with one foot on and the other dangling whilst you hold onto the banister.  Keep the hips level but swing the free leg back and forth.  Use the core muscles to prevent the hips twisting.  Repeat on the other side.  The free pendulum-like motion of the leg without the muscles gripping is how the leg should feel during the swing phase of walking.
3. Now step down and give it a go: stand tall and start walking remembering your posture and trying not to stride out.  Notice the difference.   

Apart from a reduction in any back pain you may have had, you will get much more out of your walking than just a cardiovascular workout: you’ll feel muscles you never knew you had!

Many people come to class complaining of discomfort or pain in their legs, thinking that they have pulled or strained a muscle and are surprised to learn that it may well be a back problem which is causing referred pain.  Most of us have either had sciatica or understand the idea that it is something to do with the back, not a pulled muscle in the buttock.  With a herniated disc, for example, this pain can travel right the way down the back of the leg and originates from the bulging disc irritating the sciatic nerve.  The same is true of other nerves: there are nerves all over the body and depending on which one is being irritated will depend on the area you will feel this referred pain. 

Spinal Cord and Nerves 

The spinal cord comes from the brain and is housed by the spinal canal which helps protect this delicate organ, together with the cerebral spinal fluid.  The nerves branch off the cord and exit through the foramen, gaps at the side of each vertebra, making their way to parts of the body and organs, transmitting information to and from the brain.  The cord and brain make up the central nervous system, whilst the nerves connecting the cord to the body make up the peripheral nervous system.  The nervous system is responsible for all movement, function and sensation of the body.  The spinal cord ends roughly around the first couple of lumbar vertebrae and the rest of the nerves hang down in a bundle, like a horse’s tail (cauda equina).  Each  nerve has a protective sheath around it, extending just beyond the spine, but any changes in the facet joint or the disc can cause contact, causing the nerve to become inflamed.  This causes pain, for example, sciatica. 

The Torso Muscles 

In Pilates, these muscles are sometimes referred to as the corset muscles because this is exactly the way in which they act, running vertically, laterally and diagonally.  Without these muscles, the spine would collapse in a heap.  Research is ongoing as to how best to exercise these muscles, but one thing everyone agrees on is the importance of strengthening them and keeping them strong.  The major muscles involved make up what is known as the core:-

Avoid back problems: Pilates will create a girdle of strength by toning the core & torso muscles

• Rectus Abdominus:  These are the “six pack” muscles, clearly visible in mostly male athletes, running down the centre of the body from breast bone to pubic bone.  They can separate during pregnancy.  A good example of a Pilates exercise to strengthen them would be the roll up.  Their role is to support the spine when flexing (bending)
• Obliques:  These muscles wrap themselves diagonally around the body – external around the ribs, internal roughly from hip to pubic bone.  The side planks work these muscles very effectively in Pilates.  They offer support when rotating (twisting).
• Transversus Abdominus (TA):  The deepest layer of muscle, offering stability to the spine, a bit like a weight belt and running laterally.  In Pilates, these are referred to as the core muscles and great emphasis is placed on strengthening these muscles – 100, single leg stretch, front plank – and using them in our daily lives.
• Pelvic Floor:  Running like a hammock from the pubic bone to the tail bone, strong pelvic floor muscles keep the uterus, intestines and bladder in place.  They work with the TA and MS in a co-contraction to support the pelvis and spine.  Pelvic floor and exercises
• Multifidus Spinae (MS):  The most important of the spinal muscles, a deep layer running either side of the spine and very much in control during bending, almost pulling each vertebra back up and restacking.  Works very closely with transversus. 

Strong abdominal muscles, together with a co-contraction with the back muscles work to keep the spine upright.  A strong contraction during bending offers the lumbar area good support (a bit like filling up a space as you suck back the abdomen) and allows the ligaments to do their job in stabilising the spine.   During bending, it is essential that the muscles of the torso, including the back muscles, are contracted first to stabilise the spine and control the movement.    

So you see, it is essential to strengthen the torso muscles and use them during movement to avoid back problems.  Poor posture and a sedentary lifestyle have contributed to a breakdown in the corset muscles and this is often the first stage of a back problem.  The featured video (also here http://www.youtube.com/watch?v=eZOOHQzos8s) this week shows the Twister which targets all the core muscles, but if you haven’t done Pilates before, please do not attempt it.  Download the Beginners Pilates course and learn safely from the very beginning.

For years I thought I had a stiff back.  I lived with low level back ache and referred aches and pains through my legs, occasionally seeing the physio if the symptoms became acute, usually after exertion of some kind: continuous bending and twisting to pick up leaves, lifting boxes and twisting when we moved house.  Generally, I’m not particularly mobile and certainly not hypermobile: in fact, I thought I had the opposite problem and spent more time stretching and loosening up with yoga.  Then the clicking started!

Mobility needs to be counterbalanced with strength and flexibility

Since teaching Pilates, I have been surprised at how many people come to see me on the advice of their therapist to address the problems of hypermobility.  A few have had operations to correct the problem in situations where they have suffered multiple dislocations, normally of the shoulder and a couple have had back operations to fuse the vertebrae.

Whether unstable in some areas of the spine or hypermobile, the course of action is the same: start creating stability by strengthening the supporting muscles.  Our Featured Pilates Video this week concentrates on the core muscles and some of the other abdominal and back muscles.  Repeat every other day, if not daily, and after a couple of weeks you will start to notice the difference.  If you have never done Pilates before, please make sure you are familiar with neutral position and thoracic breathing.  This is explained in this video: http://www.youtube.com/watch?v=SRFGOveevEw

Supporting articles: http://vitalflow.tv/2009/11/hypermobility-the-unstable-spine/  and  http://vitalflow.tv/2009/11/dealing-with-an-unstablehypermobile-spine/

Start a Pilates course today: click on DOWNLOADS and see the selection.

Hypermobility and an unstable spine need to be stabilised by strengthening the supporting muscles to prevent injuries and pain such as sciatica.  In the previous article I explained the role of the spinal stabilisers: discs, ligaments and muscles.  This article aims to discover the reasons for the instability, the symptoms and the treatment. 

Causes 

• A trauma of some kind which can cause the bones to shift out of normal alignment.
• A congenital condition such as a scoliosis (lateral abnormal curve of the spine) which will put increased stress on one side of the spine.
• Herniated discs or degenerative disc disease where the discs shrink and breakdown – the discs help keep the spine together but keep the bones apart.
• Weak core muscles: when your core muscles contract, they create IAP (intra abdominal pressure) which has a supporting, stiffening effect on the spine.
• Stretched ligaments: this can happen during pregnancy when relaxin is released to allow the pelvis to open up for the birth.  Ligaments can also be the culprit for dancers and gymnasts because of the positions they need to achieve are beyond the normal range of motion. 
• Osteoporosis weakens the bones and can cause them to move out of line.
• Being unfit: carrying excessive weight, lack of fitness and muscle tone will all contribute to the problem. 

Symptoms 

• Pain from muscle spasm and pinched nerves.  Sciatica is a common symptom.  Most of the time the back aches if kept in one position for too long and most people live with low level pain until one day they do something strenuous which causes sudden slippage and severe pain.
• Clicking: whilst normally painless, this is a sign that the bones aren’t realigning as they should in a smooth gliding motion.
• Dislocation: I’ve had several clients whose shoulders dislocate very easily, a couple having had surgery to prevent it from happening.

Diagnosis 

Hypermobility is quite easy to spot: apart from the ability to do the splits or get a leg around their neck, their knees and elbows look as though they are bending backwards.  Their posture is generally out of line, too.  The funny thing is that the back feels stiff rather than too loose.   The stiffness is caused by the muscles tightening up in an attempt to stabilise the spine, making diagnosis difficult. 

An unstable or hypermobile spine needs to be stabilised by increasing the strength of the supporting muscles

Treatment 

• Pilates: First and foremost, before the problem becomes acute, the core and torso muscles need to be strengthened.  Pilates is all about creating the correct balance of strength, mobility and flexibility on both sides of the body, all within a normal range.  At the risk of upsetting people, I would advise against yoga: even the majority of the strength postures (eg, Warrior II, Trikonasana, Parsvakonasana) require abduction to a degree beyond the normal range for most and are likely to stretch the ligaments.  Get strong first.  This week’s featured video will teach you some key exercises you can perform every day.  When it is no longer available on site, you can find it on Youtube: http://www.youtube.com/watch?v=gidd5tHE9ho
• Diagnosis:  See a specialist – osteopath, physiotherapist, chiropractor – to get a correct diagnosis, especially if you are in pain.  You may need some treatment. 
• Discs: Although age will bring about a certain amount of degeneration, certain easy exercises can help plump them up, eg, cat stretch, where you move your spine from arching to sinking on all fours.  This helps draw in fluids and keep the discs healthy.
• Water:  Keep your body well hydrated.
• Diet:  If you carry excess weight, lose it and ensure that your diet is packed with nutritious ingredients: if you put good quality fuel into your body, you will get a higher level of performance.
• Surgery: A last resort, but help is at hand if absolutely necessary having exhausted every other form of aid.  The vertebrae are fused together which obviously creates stability but at the same time, reduces mobility to nil.

It wasn’t until I started teaching Pilates and yoga that I came across hypermobility.  In the days of high impact aerobics, step, legs/bums/tums, gym and sports, the opposite was far more likely.  People would leave my classes before the final stretch because they found it boring!  But being too mobile is just as much of a problem leading to dislocations and instability in the spine, leading to back problems.   This post gives an overview of what exactly is involved in stabilising the spine.

The Spine

The spine is an amazing structure, made up of 24 vertebrae, each one joined to another by the facet joints, allowing for movement in every direction, some more limited than others.  It houses the spinal cord which transfers information to every part of the body from the brain, such as when and how to move, sensation, etc, and basically, holds the body upright.  The discs keep them together, but also prevent them from moving apart.  Ligaments and muscles also keep the spine stable and supported.

Spinal Ligaments 

The ligaments are like a support system, guiding and restraining the movement of the spine.  The ligamentum flavum is short and thick and covers the front of the facet joint, where the spinal cord runs through.  The multifidus muscle covers the back of the facet joint and you will hear quite a lot about this muscle in Pilates as it is one of the core muscles.  Together they control the movement of each segment, offering stability to the spine, especially during movement. 

There are a couple more important ligaments that need to be mentioned: the interspinous ligament and the supraspinous ligament, which provide stability particularly during lifting.  The former sits between the tails of the vertebrae and the latter runs from tip to tip, together preventing the pulling apart of the vertebrae.

The anterior and posterior longitudinal ligaments run down the front and back of the front part of the vertebrae, the bit that resembles a cotton reel with the discs between.  They prevent the spine from curving in or out too much. 

Finally, the ilio-lumbar ligament act as a kind of anchor, holding the base of the spine, the sacrum and the pelvis together. 

Muscles supporting the Spine 

The discs, ligaments and muscles help maintain stability of the spine

I’ve already mentioned the multifidus and this, together with the other core muscles (transversus abdominis, obliques, pelvic floor) have a huge role in maintaining the stability of the spine.  There is no doubt these days that core strength is essential for the health of your back.  Nothing works the core muscles better than Pilates, but Pilates isn’t just about the core.  All the other torso muscles get a good workout too, creating a girdle of strength, leading to a stable spine.  Rectus abdominis (6 pack muscles), trapezius and latissimus dorsi, amongst others, also play an important role. 

Movement of the Spine

The movement of each vertebra compared to the one above and the one below is fairly modest.  However, put each small movement together and you have an amazing range of motion in all directions.  The vertebrae move by twisting, tipping and sliding, sliding being the most restricted.  It is the sliding motion that prepares each joint for movement:  too small a range and the segment is stiff; too wide a range and the segment becomes unstable.  The vertebrae move around on the discs which keep it all together, along with the ligaments and the other muscles of the torso.  These discs are responsible for around 30% of the control during a forward bend; the facet joints and ligaments take just over 50% of the control; muscles do the rest. 

Causes of Hypermobility 

Some people are just more mobile than others: some of us would never have made it as a gymnast/dancer, no matter how young we started or how long we trained.  But for many it is a case of stretched ligaments, weak muscles and a breakdown in the discs.  

My next post will explore in more detail the causes of hypermobility and the best treatment.  Next week’s featured video is aimed at strengthening the muscles to help address this problem.

The first things you learn when you enrol on a Pilates course are:-

Don't attempt a Pilates exercise until you know your neutral position, can engage your core muscles and can breathe laterally

• how to find your neutral position,
• where your core muscles are and how to engage them,
• thoracic/lateral breathing and
• pelvic/shoulder stability. 

You need this knowledge to make your practise safe and effective.

Now with so many Pilates video clips popping up all over the internet, anyone can have a go at a Pilates exercise – even the most advanced versions – without knowing the basics.   With this in mind, the featured video this week is a beginners guide to the fundamentals so that you can safely try each new exercise every week.   To get the most out of this, practise several times, particularly the alternate leg lift exercise to start strengthening the core.

The featured videos change every week but this is available on youtube: http://www.youtube.com/watch?v=SRFGOveevEw

For further information, read these articles: http://vitalflow.tv/2009/09/core-muscles-core-stability/ ; http://vitalflow.tv/2009/09/correct-breathing-for-pilates/

Once you’ve got the hang of it, why not embark on the Beginners Course and change your body?  These Pilates video downloads can be stored on your laptop/PC or stored on your iphone or MP3 player.

A great golfer requires consistency and accuracy.  My husband has managed to reduce his golf handicap by 4 strokes over the past year.  His secret?  Better preparation.  I had been nagging him for ages to at least do some Pilates stretches before leaving the house, not least because he was complaining of lower back pain and what sounded like tennis elbow to me.   A year on he always stretches before going out and also does a workout I prepared for him to help reduce injuries and improve his game!

He is in good company: many of the worlds top golf pros use Pilates as part of their training regime, for example, Tiger Woods, Annika Sorenstam, David Duval, Rocco Mediate to name but a few.  But why?

Pilates will improve your game and reduce the risk of injury

Top 10 Benefits of Pilates for Golfers

1. Focus:  Golf requires a high level of focus and in order to perform Pilates safely and efficiently, focus is absolutely essential.  With regular Pilates practise your levels of concentration will improve dramatically.
2. Stability:  Pilates will strengthen the core muscles which will offer stability to the spine, one of the most common sites for injury.  The negative effects of a golf swing on an unstable spine are obvious. 
3. Mobility:  Freedom of movement through the spine and into the hips and shoulders will enable the golfer to achieve full range throughout the swing and reduce the risk of injury.  It will be difficult to follow the ball if your neck is tense and stiff.
4. Strength:  You will increase strength throughout your body and added to core strength, this will increase power which, coupled with the benefits of mobility, will increase drive length.
5. Balance:  Swinging a club from one side to the other requires balance to enable you to make your shot precise.  Balance also refers to the correction of muscle imbalances created by a one sided game such as golf: both side of the body are worked during your practise.
6. Functional:  Pilates is a whole body workout meaning that each exercise uses multiple muscle groups rather than isolating one group at a time.  This ability is a crucial component of all sports, especially golf.
7. Posture:  “…incorrect stance and faulty posture greatly affect the success of the entire swing.” (Ben Hogan)  Correct posture places minimal stress on the joints and eases the strain on your back, thereby reducing the risk of injury.
8. Flexibility:  The obvious point here is that unless you are a pro and have a caddy you are bending down regularly to pick up your ball.  Tight hamstrings, for example, will mean that your back constantly takes the strain.  Your back will also come under pressure if the back of your legs are tight every time you address the ball: you will find it difficult to keep your back straight when you bend at the hips.
9. Breathing:  There are several benefits to breathing efficiently, not least because you will walk several miles during a game of golf and you need to get the oxygen circulating to the muscles.  It also has a calming effect as well as helping maintain a flow throughout your game.  Pilates breathing (lateral) will make it easier for you to engage the deep postural muscles.
10. Stamina:  Regular Pilates will improve your stamina, essential if you are to maintain a gentle contraction of the core muscles and play for 3 1/2 or 4 hours. 

This week’s free video (sidebar right) will mobilise your spine and if this is all you do before you go to play, you will be doing yourself a favour.  The two exercises are both advanced (watch your wrists) so start off with one of each and build to 10.  They will greatly strengthen the torso muscles.  Best place to start?  Download the Beginner and Improver courses.  Specific golf Downloads will be available shortly: Golf Warm Up and Golf Workout.

Pilates is now the exercise of choice with many people on account of the impressive benefits to be gained.  Below are the top 10 benefits you can expect from your regular practise, in no particular order!

(1)  Re-educate and realign your body to prevent imbalances.  This is particularly useful for sportsmen, for example.  If you think of a tennis player constantly hitting the ball using the same arm or a golfer always swinging from the same side.

(2)  Make you more body-aware and co-ordinated.  Pilates improves your proprioception skills, the way your body moves in space.  Particularly useful if you are working by yourself.

(3)  Create or improve space between vertebrae to minimise pressure on discs and nerves.  There is no question that Pilates will prevent back problems or teach you to manage them.

(4)  Improve core muscles and back strength to help support the spine and maintain good posture.  Many of us have posture that is far from ideal.

(5)  Strengthen all muscles so that the whole body can work together rather than one area becoming overloaded.

(6)  Improve flexibility and mobility so that the body can move freely, without putting undue strain on the back.

One of the benefits of Pilates is increased mobility and flexibility

(7)  Teach you to breath correctly and fully so that plenty of oxygen reaches every part of the body, especially the spine.   Try observing the way in which you breathe normally and you will see how inefficient it is.

(8)  Give you that feel-good factor and relax your body and mind.   Pilates is a form or meditation, allowing you to forget all your troubles and draw your focus of attention to your body – at least for a little while.

(9)  Improve pelvic floor tone, reducing incontinence problems.  A huge problem and not just for women!

(10) Flatten abdomen.  There is no other exercise that flattens the lower abdomen – believe me, I’ve tried it all.

Consistency is the key and our Pilates video downloads are the ideal way to always have your workout at hand.

The human spine is an upright bendy column made up of 7 cervical vertebrae forming the neck, 12 thoracic vertebrae forming the middle back and 5 lumbar vertebrae forming the lower back. These 24 vertebrae sit on a triangular bone called the sacrum to which your pelvis is attached at the sacro-iliac joint. The coccyx (tailbone) is the last bit of the spine.

The spine is a complex structure

Vertebrae 

The vertebrae are like a series of building blocks, one stacked on top of another.  There are 5 lumbar making up the lower back.  The bottom lumbar vertebra (L5) sits on the sacrum, making up the lumbo-sacral joint, one of the most common sites for lower back problems and the most compressed area. 

Structure of a Vertebra

Each vertebra has a front and a back: the front is like a cotton reel, narrowing in the middle and flaring at the top and bottom to help take the strain.  There are discs between each vertebra to prevent them from grinding against each other and to act as shock absorbers (L5 having the fattest disc).  These discs are pretty tough with a nucleus of fluid.  They also suck in water to keep hydrated so that they won’t get squashed flat.  One of the main ways in which the discs draw in fluid is by movement – the more varied, the better, hence the importance of Pilates to keep your back healthy and prevent problems in the future or prevent a return of an old problem.  Not only do the discs keep the vertebrae apart, but their role is also to keep them together. 

The back part of each vertebra has a more complex role:  each one has a couple of facet joints which hook each vertebra together to keep it in place, guides the movement of the spine and also houses the spinal cord.  This area of the vertebra takes very little weight in a healthy spine.  However, in cases where the discs have narrowed, it is forced to take much more, which is extremely damaging.  The knobbly bits of the spine which protrude quite clearly through the skin are called the spinous process and allow for the attachment of the muscles which make the spine move.

The front of the vertebra is made up of a layer of hard bone, but inside it looks more like a sponge with a rich supply of  blood: as the discs don’t have their own blood supply, they can take nutrients from here.  This structure also helps reduce the strain, dispersing the force.  The sponge like structure allows the bones to be strong but light.

The Function of the Spine

• allow movement – forward, backwards, side to side and twisting
• provide a support structure
• carry heavy loads
• protect the spinal cord

The vertebrae get bigger the further down the spine we go, designed to take the full weight of the body. The spine rises from the pelvis in an “S” shape, curving in at the neck, out at the thoracic area and in at the lumber. The curves hold the spine upright, arching back and forth over the centre of gravity in order to balance the top-heavy torso over the narrow base of the hips. There are discs between each vertebra, allowing movement between the vertebrae and acting like shock absorbers. Although there is little movement between each vertebral joint, when they all work together the combined range of movement is fairly large. Each vertebra is joined to its neighbour by facet joints. The spinal cord, about the thickness of a finger, runs from the brain through the spine to the end of the thoracic area, with the nerves exiting each vertebra.

How Pilates can help

For your back to be healthy, you need to maintain good posture: ear, shoulder, waist, hip/thigh joint, knee and ankle all lined up, keeping the natural curves of the spine. It is widely acknowledged that stiffness in any part of the spine will have an effect in another part, so keeping the spine (and all other joints) mobile is vital. Imbalances in the muscles will play their part, too: if you have tight hamstrings and bend over, your back will take the strain; if your abdominal muscles are weak, you will increase the lumber curve, putting a great deal of stress on the lower back. The core muscles need to be kept in great condition, so if you haven’t already done so, make Pilates a part of your life.