Lifestyle Physical Therapy is the top rated new physical therapy clinic in New York City. At Lifestyle Physical Therapy, we believe that high quality, one-on-one, comprehensive care is not only possible, but necessary for a long, happy and healthy life.

Pilates and Chronic Low Back Pain - Part III: Progression of Pilates Exercises

Pilates and Chronic Low Back Pain Part II discussed the initial Pilates and Physical Therapy exercise approach to chronic low back pain – these exercises teach you submaximal activation of the deepest core muscles that stabilize your back and teach you how to separate or dissociate movement of your extremities from movement of your spine.  The next progression is to do similar exercises but with less support for your spine.

Lying on your side is still supportive but less of your trunk is in contact with the mat.  As well, in this position, you tend to “sag” into the mat at your waist because your shoulders and pelvis are wider than your waist.  This requires you to use your core muscles to maintain the alignment of your spine.  An example of an exercise in this position is side lying leg springs.  In this position you submaximally engage your core muscles and move your leg in the leg spring, moving only the hip joint while keeping the spine and pelvis stable.  Once again, we may start with smaller range of motion and progress only when you have gained enough core control to work into larger ranges of motion.

Other examples are the all 4’s position (on hands and knees), sitting and standing.  In these positions, the spine is no longer supported on the mat so you have to maintain the core control “in space”.  Sitting and standing are challenging because you have to stabilize the spinal alignment against the downward force of gravity.


1.        Bruno P. The use of "stabilization exercises" to affect neuromuscular control in the lumbopelvic region: a narrative review. The Journal Of The Canadian Chiropractic Association [serial online]. June 2014;58(2):119-130. Available from: MEDLINE, Ipswich, MA. Accessed October 8, 2015.

2.        Jull G, Richardson C. Motor control problems in patients with spinal pain: a new direction for therapeutic exercise. Journal Of Manipulative And Physiological Therapeutics [serial online]. February 2000;23(2):115-117. Available from: MEDLINE, Ipswich, MA. Accessed October 8, 2015.

3.        Rydeard R, Leger A, Smith D. Pilates-based therapeutic exercise: effect on subjects with nonspecific chronic low back pain and functional disability: a randomized controlled trial. The Journal Of Orthopaedic And Sports Physical Therapy [serial online]. July 2006;36(7):472-484.

Matt Seltzer