Pilates Exercises for Your Back Pain

The Pilates exercises in this set are frequently recommended to help prevent and decrease back pain, including low back pain. They strengthen core support for the back, teach good alignment, and provide gentle stretches for tight back muscles.

If you currently have back pain, consult with your healthcare practitioner before undertaking any exercise program. You should also note:

• If you are new to Pilates or your back is fragile at the moment, you might be better served to work with the fundamental Pilates exercises first.
• Breathe! Deep breathing activates the supportive core muscles of your trunk (among many other benefits, like keeping you alive).
• Your abdominal and back muscles are mutually supportive. You will want to support your back by engaging your abs during these exercises.
• Keep your neck long and your shoulders down and away from your ears, like a giraffe.
• Be attentive to symmetry and balance. In most cases, you will want your shoulders even and your hips to be even.
• Do these exercises mindfully. Go slow, be gentle, and don't do anything that hurts.

How Pilates Can Help Back Pain

Let's get started!

Pelvic Tilt to Pelvic Curl

Pelvic tilt is taught to almost everyone who has back pain, especially low back pain. It teaches us to use our abdominal muscles in a way that supports and lengthens the lower back. Here we start with pelvic tilt, and for those who feel comfortable, move to a spinal articulation with pelvic curl.

1. Lie on your back with your knees bent and your feet flat on the floor. Your feet, ankles, and knees are aligned and hip-distance apart. This exercise starts in neutral spine. In neutral spine, the natural curves of the spine are present, so the lower back is not pressed into the mat.
2. Inhale.
3. Exhale: Do a pelvic tilt by engaging your abdominal muscles, pulling them in so that your belly button moves down toward your spine. Let that action continue so that the spine lengthens and the abs press the lower spine into the floor. In the pelvic tilt position, your back is very long against the floor, and the pelvis is tilted so that the pubic bone is a little higher than the hip bones.
4. Inhale to release back to the floor, or go on to pelvic curl.
5. Inhale: Press down through your feet allowing the tailbone to begin to curl up toward the ceiling. The hips rise, then the lower spine, and, finally, the middle spine.
6. Come to rest on your shoulders at the level of your shoulder blades, with a nice straight line from your hips to your shoulders. Do not arch beyond this point. Support this movement with your abdominals and hamstrings.
7. Exhale: As you let your breath go, use abdominal control to roll your spine back down to the floor. Begin with the upper back and work your way down, vertebrae by vertebrae, until the lower spine settles to the floor.
8. Inhale: Release to neutral spine.

Repeat this exercise 3 to 5 times.

Chest Lift

One of the common causes of back pain is not weak back muscles, but weak abdominal muscles. Chest lift is a great ab strengthener.

Do this exercise with care. Your hands give some support to the back of your head, but the work needs to come from the abs—not from momentum or pulling your head up. If you get neck pain, stop and go on to the next exercise.

1. Lie on your back with your knees bent, feet flat on the floor. Legs and feet are parallel, lined up so that your hip, knee, and ankle are in one line, and the toes are pointing directly away from you.
2. You are in neutral spine position with the natural curve of the lower spine creating a slight lift off the mat.
3. Keep your shoulders down as you bring your hands behind your head with the fingertips touching. Your hands will give light support to the base of your skull, but your elbows will stay open throughout the exercise.
4. Inhale.
5. Exhale: Slowly pull your belly button down toward your spine and keep going, allowing your spine to lengthen out along the mat. Simultaneously, tilt your chin slightly down and slowly lift the upper spine off the mat until the base of the scapula is just brushing the mat.
6. There is a deepening feeling under the bottom ribs as you lift.
7. Remember, the work is in your abs, which are in a deep concave position. Your neck and shoulders stay relaxed, and the movement does not create tension in the legs.
8. Pause at the top and inhale. Draw the abdominals in deeper.
9. Exhale: Keep the abdominals drawn in as you slowly lower back to the mat.
10. Inhale.
11. Repeat 6 to 8 times.

Swan Prep

Swan prep strengthens the back extensors, the muscles the hold us upright. These muscles are often weak and over-stretched in people who have back pain.

Develop this exercise slowly. You might not come up as high as our model. That's okay. Just a few inches to start is fine.

1. Lie on the mat face down.
2. Keep your arms close to your body as you bend your elbows to bring your hands under your shoulders. Shoulders should be away from the ears.
3. The legs are usually together, but it is acceptable to do this exercise with the legs shoulder-width apart.
4. Engage your abdominal muscles, lifting your belly button up away from the mat. The abdominals remain lifted throughout the exercise.
5. Inhale: Lengthen your spine, sending energy through the top of your head as you press your forearms and hands into the mat to support a long upward arc the upper body. You might come up just a few inches.
6. Keep your neck long. Don't make a crease by tilting your head back.
7. Protect your low back by sending your tailbone down toward the mat.
8. Exhale: Keep your abdominals lifted as you release the arc, lengthening your spine as your torso returns to the mat in a sequential way: low-belly, mid-belly, low ribs and so on.
9. Repeat 3 to 5 times.

Child's Pose

Child's pose is an easy and restful stretch for the back.

1. Start by kneeling on your mat with your butt on your heels.
2. With your toes together, open your knees to at least hip distance apart.
3. Lean forward and drape your body over your thighs so that your forehead rests on the floor.
4. Reach your arms out in front of you. Alternately, you can leave your arms along your sides. Try both and see which feels best to you.
5. Breathe deeply and relax. Release any tension you might be feeling on your lower back, neck, or hips. Give this exercise time to work. It can take a few minutes to allow your body to relax into the stretch.

Kneeling Arm and Leg Reach

This exercise teaches core stability—something very important for those suffering from back pain.

1. Start on your hands and knees.
2. Your hands are directly under your shoulders, and your knees are directly under your hips. Make your legs and feet parallel and hip distance apart.
3. Your back is in a neutral spine position (allowing the natural curves) and supported by your abdominal muscles which are pulled in. Don't let your back sag or arch up.
4. Your neck is treated as a long extension of your spine. So your face is parallel to the floor, gaze down.
5. This exercise requires shoulder stability. Take a moment to slide your scapula (wing bones) down your back so that your shoulders are away from your ears, your chest is open, and your scapulae are settled on your back, not poking up.
6. Inhale: Extend your right arm straight in front of you and your left leg straight behind you at the same time. Your arm and leg will be parallel to the floor.
7. Balance. Hold one to three breaths.
8. Exhale: Return to hands and knees.
9. Inhale: Extend your left arm straight in front of you and your right leg straight behind you at the same time.

Cat-Cow

Cat-cow moves between a backstretch and a back extension exercise. It promotes flexibility in the spine. Many people use it as a warm-up exercise.

1. Begin on your hands and knees. Your hands are directly under your shoulders, and your knees are directly under your hips. Your toes can be curled under if that is comfortable.
2. Engage your abdominal muscles to support your spine so that you have a straight line from your ear to your hip.
3. Inhale. Then, on your exhale, pull your abdominal muscles in and up as you arch your back way up like a stretching cat. At the same time, let your head and tailbone drop down toward the floor.
4. Take the stretch further by imagining that you are bringing your head and tailbone together as if you were going to make a big circle of your body.
5. From cat pose, use an inhale to reverse the curve of the spine. Your tailbone moves up, and your chest moves forward and up. Your neck moves as a long extension of your spine. Don't let your head fall back.
6. Support this move with your abdominals. This is a lengthening exercise for the spine. Please don't collapse like an old horse!

Repeat the exercise, going from cat to cow and back, slowly, with the breath, at least two more times.

Swimming

Swimming takes the strength of the back extension work a little further than swan prep did. It strengthens the back, but you must keep a long spine and use abdominal support for it to work.

1. Lie on your stomach with the legs straight and together.
2. Keeping your shoulder blades settled in your back and your shoulders away from your ears, stretch your arms straight overhead.
3. Pull your abs in so that you lift your belly button up away from the floor.
4. Reaching out from your center, extend your arms and legs so far in opposite directions that they naturally come up off the floor.
5. At the same time, get so much length in your spine that your head moves up off the mat as an extension of the reach of your spine. Keep your face down toward the mat—don't crease your neck.
6. Protect your lower back by anchoring your pubic bone to the floor.
7. Continue to reach your arms and legs out very long from your center as you alternate lifting right arm/left leg, then left arm/right leg, pumping them up and down in small pulses.
8. Bonus challenge: Coordinate your breath with the movement so that you are breathing in for a count of 5 kicks, and out for a count of 5.
9. Do 2 or 3 cycles of 5 counts—moving and breathing in, and 5 counts moving and breathing out.

Spine Stretch

Spine stretch is a good stretch for both the back and the hamstring. But it also teaches you to support and control that stretch by using your abdominal muscles.

1. Sit up tall on your sit bones.
2. Your legs are straight in front of you about shoulder width apart. Your knees face the ceiling, and your feet are flexed.
3. If your hamstrings are tight you can sit on a small pillow or a folded towel. You can also bend your knees slightly.
4. Reach the top of your head to the sky but let your shoulders stay relaxed.
5. Inhale and extend your arms out in front of you, shoulder height.
6. Alternatively, you can place the fingertips on the floor in front of you between your legs.
7. Exhale as you lengthen your spine to curve forward. You are going for a deep c-curve. Don't collapse. Let your abdominal muscles support you in an up-and-over move.
8. Reach your fingers toward your toes.
9. Inhale and reach a little further as you enjoy the fullness of your stretch.
10. Exhale and initiate your return by using the lower abdominals to bring your pelvis upright. Roll your spine up to sitting.

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