PHYSIO
Home > Blog > Spinal Physio & Clinical Pilates > Clinical Pilates: Doing more for low back pains than ‘core stability'
Pilates has been used by many to prescribe “core stability" for low
back pain. Specifically, this approach promotes core muscle contraction
and maintain it while lmovements are performed. Recently, there is a
growing mass of research showing that this approach is not beneficial.
Clinically, encouraging these heightened contractions and rigid postures
can reinforce unhealthy beliefs around movement, and perpetuate pain.
(Nijs et al., 2013).
Over the years, with new emerging evidence on back pain, Physiotherapy
and Clinical Pilates has evolved to move beyond this stability approach.
In particular, Clinical Pilates explores movement rather than promote
rigidity. Instead of focusing on isolated contractions, it concentrates
on factors (evidenced based) contributing to pain.
Below listed are a
few areas in which Clinical Pilates can be helpful to people with low
back pain.
Body Awareness
Altered body schema has been observed in people with low back pain
(Mosely, 2008) such as lack of awareness of body position with movement.
Performing movements with tools such as mirrors for visual feedback can
help reconnect body with movement and improve co-ordination.
De-threateningc Movement
Evidence has shown that one's pain experience can be linked to tissues
perceiving danger during movement (Mosely & Flor, 2012). Meaning, if
you subconsciously fear movement will hurt, it can amplify pain,
whether there is any damage occurring or not.
Therefore clinical pilates
can be used to explore safe movements initially before progressing
movements back towards the perceived "harmful" direction
(De-threatening).
Tissue loading
Tissue loading with exercise can have an several positive effects.
Firstly, loading muscles, tendons and joints around a painful area can
initiate a neurophysiological response to reduce pain similiar to manual
therapy.
Secondly, loading can initiate tissue repair, strength and
conditioning in muscle, tendon, cartilage and bone. This is done through
a process called mechanotransduction (Khan & Scott, 2009), where
unhealthy weaker cells are replaced with healthy stronger cells.
In summary, discouraging rigidity and being liberal with movement is
good for low backs. As always, chatting to your Physiotherapist about
the benefits of an exercise programe for your problem is the best place
to start.
References
Khan K. M., & Scott A. (2009). Mechanotherapy: how physical
therapists’ prescription of exercise promotes tissue repair. British
Journal of Sports Medicine, 43, 247-251.
Mosely G. L. (2008). I can’t find it! Distorted body image and tactile
dysfunction in patients with chronic back pain. Pain, 140, 239-243.
Mosely G. L., & Flor H. (2012). Targeting cortical representation in
the treatment of chronic pain: a review. Neurorehabilitation &
Neural Repair, 26(6), 646-652.
Nijs J., Roussel N., Paul van Wilgen C., Koke A., & Smeets R.
(2013). Thinking beyond muscles and joints: therapists’ and patients’
attitudes and beliefs regarding chronic musculoskeletal pain are key to
applying effective treatment. Manual Therapy, 18, 96-102.
Smith B. E., Littlewood C., & May S. (2014). An update for
stabilisation exercises for low back pain: a systematic review with
meta-analysis. BMC Musculoskeletal Disorders, 15, 416-437
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TAMPINES
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Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.
HAND THERAPY & CUSTOMIZED SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to
Commonly treated hand pain injuries includes
REFORMER CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.
It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
TRADITIONAL CHINESE MEDICINE (TCM)
DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY
Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired, tight and tense muscles to accelerate recovery and shorten downtime / recovery period required.
It also prevents muscles from scar tissue micro-tears (and potential ruptures), and increases muscle performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.
Read the benefits of regular deep tissue release therapy here.
ALTERNATIVE THERAPIES
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.
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