Pilates and Chronic Low Back Pain - Part IV: Progression; Segmental Motion
Pilates and Chronic Low Back Pain Part II and III discussed exercises that teach us how to dissociate movement of the spine from movement of the arms/legs: ie keep the spine “stable” while moving the arms and legs. But in real life, we also need to move our spines. In activities such as reaching, we use a combination of spine and arm movement to reach for an object. In walking, our legs propel us forward, our arms swing reciprocally and our spine and pelvis rotate. Our spines are able to bend forward and backward, side bend, rotate and do a combination of these movements. So, the next exercise progression is to begin to gain control of spinal motion. Remember that our spine is composed of 31 vertebrae stacked on top of each other. We need to be able to control these individual segments with our muscles. An example of this is a flexion exercise, where the spine curls and rolls back, controlling one vertebra at a time with assistance from the spring. It requires coordinated muscular control of the individual segments of the spine.
An example of a combined movement is this rotation in flexion. The abdominals are pulled up and in, decompressing the spine during the rotation motion. Again, the bar provides support and the frame of the equipment helps to guide the motion.