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Should I see a physical therapist first before starting Pilates for chronic back pain?

Q: I'd like to try doing some Pilates exercise for a chronic back problem I have. Do I need to see a Physical Therapist? Or can I just take a regular Pilates class?

A: Many people with varying backgrounds and training are offering Pilates exercise programs. In other words, not all Pilates programs are equal. The program may need to be specifically designed for anyone with a back injury or other problem. Early studies show that a supervised Pilates program works well to reduce pain and improve function for low back pain patients.

A Physical Therapist (PT) will assess your posture and breath control. These two factors are key to correctly performing Pilates exercises. The PT will also check your muscle strength, flexibility, and endurance. All of this information is needed to prescribe a Pilates program that will help restore motor control needed for spinal stability.

Once you get started in a Pilates program that is safe and effective, then you can transition to a class for the general public. Knowing what works best for your situation will help you to adapt Pilates exercises provided by any other trained teacher.

Rochenda Rydeard, PT, MSc, et al. Pilates-Based Therapeutic Exercise: Effect on Subjects with Nonspecific Chronic Low Back Pain and Functional Disability: A Randomized Controlled Trial. In Spine. July 2006. Vol. 36. No. 7. Pp. 472-484.