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Suffering from low back pain?

DSC_0269Find out why here.

Roughly 31 million Americans are suffering from low back pain (LBP) (American Chiropractic Association [ACA], 2011). LBP is one of the leading causes of missed work, and it costs Americans almost 50 billion dollars annually (ACA, 2011). This is not a small problem. Chronic LBP can have a multitude of causes, but it has been shown that improper firing patterns of the pelvic floor, transverse abdominis, and lumbar multifidus are associated with LBP (Gladwell, Head, Haggar, & Beneke, 2006; Keisel, Underwood, Mattacola, Nitz, & Malone, 2007; Lee, 2011; O’Sullivan & Beales, 2007). These improper firing patterns lead to weakness and instability of the lumbosacral spine, which in turn leads to dysfunction, injury, and pain (Ferreira, Ferreira, Maher, Herbert & Refshauge, 2006; Keisel et al., 2007; Mohseni-Bandpei, Rahmani, Behtash, & Karimloo, 2011). Pilates has been shown to reduce symptoms of LBP (Gladwell et al., 2006; Lim, Poh, Low, & Wong, 2011; Taylor, Hay-Smith, & Dean, 2011).

Ever since its inception in the 1920s, the Pilates Method has been rooted in six basic principles: proper breathing, concentration, centering, control, precision, and fluidity of movement. All of the aforementioned principles are believed to improve alignment, flexibility, strength, balance, and mind-body awareness (Culligan et al., 2010; Swann, 2009). “Until the mid-1980s the PME [Pilates Method of exercise] was known and practiced almost exclusively by dancers. By the 1990s, this method had increased in popularity outside the world of dance” (Cruz-Ferreira, Fernandes, Laranjo, Bernardo, & Silva, 2011, p. 2076). Today the Pilates Method has grown to an estimated 3.5 billion dollar industry (IBISworld, 2012).
Through the years, the Pilates Method has stayed rooted in its six basic principles; however, it has grown in many different directions due to its hasty proliferation. It has been adjusted based on clinical research and taught in physical therapy clinics; and it has been diluted, added to other forms of exercise, and taught by group exercise instructors (Cruz-Ferreira et al., 2011; Lim et al., 2011). Pilates teacher-training programs can range anywhere from 2 days to 2 years in length (Pilates Method Alliance, 2012). The Pilates Method Alliance (2012), an international not-for-profit organization, recognizes 52 different teacher-training programs in the United States. Undoubtedly, each program has its own focus based on the instructor and the chosen curriculum. However, regardless of the training program, most Pilates instructors teach a variation of the Pilates “scoop”—an abdominal drawing-in maneuver (ADIM) (Selby & Herdman, 1999; Ungaro, 2002). This ADIM has stayed firmly rooted in the Pilates principle of centering throughout the years, and it too has its own variations.

The Pilates ADIM that will be discussed herein is called cocontraction. It is the simultaneous isometric contraction of the pelvic floor, transverse abdominis, and multifidus. This maneuver was based on the Integrated Model of Function created by Dianne Lee and Andry Vleeming (“Sacroiliac Joint,” n.d.). Select Pilates practitioners and physical therapists, in what will be referred to here as orthopedic Pilates (OP), have integrated cocontraction into the Pilates Method. It is used to initiate and guide every movement that is performed during an OP session. This isometric contraction is carried out through the eccentric and concentric movements of the spine and extremities during each OP exercise further stabilizing the spine and truly strengthening the core. Cocontraction during OP training creates a simultaneous firing of the pelvic floor, transverse abdominis, and lumbar multifidus which helps to stabilize the spine and prevent or reverse low back pain (Curnow, Cobbin, Wyndham, & Choy 2008; Gladwell et al., 2006; Lee, 2011; Lim et al., 2011; Taylor et al. 2011).

 

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May 20, 2012 | Articles | Comments Off on Suffering from low back pain?

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