16 replies to this topic

[reb]

Since I discovered pilates ten years ago (I have been teaching for seven years), I have not had any back pain other than mild pregnancy related sciatic discomfort. I somehow that I was "above" having back problems because I have a strong powerhouse and knew how to protect my back when performing sports or other activities. But here I am with a "bad" lower back since the end of december. So was I foolish or arrogant or both? Not sure how the pain started. I had a fairly serious knee injury in September which could have led to the problems. Then in trying to remedy another problem (I suspect a tendinitis of the popliteus but don't have a definite diagnosis), my physio corrected my pelvic imbalance. He may actually have caused the back problem - he is a student of ostepathy but has not finished his studies). At any rate when I went to see a certified osteopath, by pelvis was seriously off so he obviously did not fix it. After two visits to the osteopath, my back is better but not 100 percent. I have another visit scheduled in two weeks. Am I wrong to be embarrassed about this (as a teacher)?

[nikki]

Could be that your physio corrected it but it went back out of place anyway... I had SI issues for years where my pelvis was off (one ilium was nutated)... lax ligaments, tight muscles pulled it out of place. When my popliteus was inflamed one one side I began compensating on another, resulting in glutes that were hard as a rock, creating tension in the sacroiliac ligaments, pulling the sacrum out of place and allowing the ilium to slip... sometimes it took multiple visits to "fix" everything by a wonderfully skilled chiropractor. Periodic massage and yoga helps keep it under control now. I'm sure mine will slip up again in the future.

No need to be embarrassed - what it comes down to is that Pilates, while wonderful, is not a cure-all.

[reb]

Thanks for your response, Nikki. Interesting that you had an inflamed popliteus, too. Doesn't seem from my research that they are too common. I actually do not have a certain diagnosis although I have mentioned the problem to my general doctor and that one that I saw for my knee accident. I will eventually consult a specialist but am a bit tired of seeing knee doctors, osteos, physios, etc. How long did it take for your popliteus to heal. When I have my leg in flexion more than 90 degrees for more than a few minutes, I cannot stand on that leg for a few seconds subsequently although the sensation goes away pretty quickly. I can also definitely feel it when I squat down on my heels with my feet raised, say to tie a kid's shoelace. But other than that it is fine. Running doesn't hurt it, nor does the elliptical machine and actually it doesn't bother me during flexion, just after. I suspect I got it by overzealous riding of a stationary bike. Does that sound similar to what you had.

I know that pilates doesn't make me superwoman but I have had people raise eyebrows and express surprise that my back is bothering me.

[Carole Amend]

Hi reb,
I think that a host of emotions might be appropriate to this issue, however, I think it’s only appropriate for you to be the judge and decide how to allow that emotion to work for you. Thanks for sharing your feelings and writing in about this important topic!

It’s important to note that, previously, you might have had an unleveled pelvis and not been in pain. And there are people walking around with level pelvises who are in excruciating pain. Alignment gives us clues into pain, however, it is NOT a guaranteed indicator. Pain is a tremendously complex issue, and neuroscience isn't included in the curriculum for pilates instructors.

From your original question, my train of thought went to: Do you think only pilates instructors get a "raised-eyebrow" response...or do other practitioners get one as well?

(The topic seemed to be heading in a different direction, so I edited to put the rest of what I wrote, and more on biopsychosocial models, on my PCDB blog, Pilates & Pain..?)

Edited by Carole Amend, 17 February 2012 - 01:06 AM.

[taowave]

Since I discovered pilates ten years ago (I have been teaching for seven years), I have not had any back pain other than mild pregnancy related sciatic discomfort. I somehow that I was "above" having back problems because I have a strong powerhouse and knew how to protect my back when performing sports or other activities. But here I am with a "bad" lower back since the end of december. So was I foolish or arrogant or both? Not sure how the pain started. I had a fairly serious knee injury in September which could have led to the problems. Then in trying to remedy another problem (I suspect a tendinitis of the popliteus but don't have a definite diagnosis), my physio corrected my pelvic imbalance. He may actually have caused the back problem - he is a student of ostepathy but has not finished his studies). At any rate when I went to see a certified osteopath, by pelvis was seriously off so he obviously did not fix it. After two visits to the osteopath, my back is better but not 100 percent. I have another visit scheduled in two weeks. Am I wrong to be embarrassed about this (as a teacher)?

Dear Reb,
As I do not know you and am only going by what you said,I will have to vote
1) very foolish:)
2)and not arrogant,but overly optomistic/confident

If i was you brother/friend and you told me you were going to a student of osteopathy,I would look at you like you had two heads.Do you remember the old Bell motorcycle helmet ads? If you have a 10 dollar head,buy a 10 dollar helmet:) That should do it for the foolish part.

When you say you have a bad back,could you be a bit more specific?
I ask as I have a herniated disc,and I fully realise,that I am one explosive movement/compressive force/exuberance in flexion away from being frozen in pain.So,in my case,I had no choice(my decision) but to give up Brazilian jiu jutsu,and I havent kicked a heavy bag in 7 years.I am painfully aware that I have to squat with relatively light loads,and I have to avoid excessive flexion with my legs together.And I always warm up extensively,preferably with an exercise bike,versa climber etc..

I NEVER let anyone touch me when I go into a stretch,and I have had to make adjustments to what I have been taught

I wouldnt be embarrased at all.I would take a step back and keep mental/written notes of how you feel and the activities you participated in.



I assume you have had MRI's of your back and am aware of what the issue is.I ask as I too went to an osteo,and he would only prescribe an Xray which showed no damage.A doctor friend of mine asked if I was nuts,and said you MUST get an MRI.The osteo initially was against it,but mysteriously changed his stance when I informed him I would pay for it myself,but I would seek any and all legal remedies if I found out there was a herniation.Needless to say,I got the MRI,there was a herniation and he had egg all over his face.

On another note, I am not mistaken,you have recently begun practicing yoga????

Any correlation between the pain and Yoga?

There is an awful lot of deep flexion and extension as well as balancing on one leg(pelvic tilting)

T

[reb]

I was going to a physio as prescribed by a doctor following a silly accident that caused me to dislocate my kneecap. The physio is also a student of osteopathy. I mentioned to him a nagging discomfort behind my leg that actually predated the knee injury but that i took for a hamstring inflammation but that i now think is a tendinitis of the popliteus and that's when hé said that the pelvis was off. Since i trusted him with my knee, I let him do his thing. Shortly thereafter, i started having pain (spasms) in my left lumbar region. I went to an osteopath who, by the way, are not MDs here but have i think also seven years of education. She said that I had a block caused by stress and that i should be better after her manipulations. When there was no change, i went again to see her again (two weeks ago). Apparently, sometimes it can take several visits. I had no experience with osteopaths, but here everyone goes and seem to find immediate relief so I was optimistic. I have not yet had either an x-ray nor an MRI because my general Doctor prescribed neither. Plus, i was really sick of seeing doctors about my knee and i don't have much time. But i will if the problem persists. The spasms are gone after the second visit, but the back feels stiff and sensitive. Yoga seems to help but i may hold off for a while. The problem predates my return to yoga after the knee problem. So you can see, i am a bit of a mess physically, what with the kneecap and the popliteus and the back. I tend not to go very often to doctors. They are much les s receptive

[reb]

Oops. Got cut off. .,, then in the US. I have another appointment with the osteo in two weeks and if it does not clear up, i will ask my doc to prescribe an x-ray and perhaps an MRI.

[taowave]

I was going to a physio as prescribed by a doctor following a silly accident that caused me to dislocate my kneecap. The physio is also a student of osteopathy. I mentioned to him a nagging discomfort behind my leg that actually predated the knee injury but that i took for a hamstring inflammation but that i now think is a tendinitis of the popliteus and that's when hé said that the pelvis was off. Since i trusted him with my knee, I let him do his thing. Shortly thereafter, i started having pain (spasms) in my left lumbar region. I went to an osteopath who, by the way, are not MDs here but have i think also seven years of education. She said that I had a block caused by stress and that i should be better after her manipulations. When there was no change, i went again to see her again (two weeks ago). Apparently, sometimes it can take several visits. I had no experience with osteopaths, but here everyone goes and seem to find immediate relief so I was optimistic. I have not yet had either an x-ray nor an MRI because my general Doctor prescribed neither. Plus, i was really sick of seeing doctors about my knee and i don't have much time. But i will if the problem persists. The spasms are gone after the second visit, but the back feels stiff and sensitive. Yoga seems to help but i may hold off for a while. The problem predates my return to yoga after the knee problem. So you can see, i am a bit of a mess physically, what with the kneecap and the popliteus and the back. I tend not to go very often to doctors. They are much les s receptive

Hi R,
In the states,osteopaths are recognised as Physicians and I believe have much of the training and MD has.They are often general practitioners.If it makes you feel any better,if a herniaiton is detected Pilates type rehab is often the cure.I find nothing better than intermediate mat or reformer.

A block of what??

Sounds like we are heading towards TCM,meridians and energy blocks...Have you monitored your chi:)

[reb]

I guess she was referring to a muscle sprain. Nothing New Age, just me giving you a poor translation from the French word "blocage". The French say that "ils ont bloqué leur dos" and thé translation is fine if you are referring o a door and not a back. Seems that I've been here too long

[Carole Amend]

reb, fyi: I edited my previous response, since the discussion seemed to be heading in a different direction.

[reb]

Thanks for sharing your insights, Carole. Love the blog, by the way!

[Geniusall]

Hi Reb, thanks for this topic....when I first started teaching pilates, I too, thought I should never experience back pain or alignment issues for that matter, but was soon humbled by arrogance....I now know those experiences actually pushed me into understanding Pilates is not a panacea and also with my personality "type" i was overworking in my pilates practice.....I also learned, as Carole has so beautifully stated, it is an individual experience....I have a client with severe scoliosis and she feels no back pain....and another who has very mild functional scoliosis and is often in pain...so how can that be? It can only be that the physical characteristics are not they only way we feel pain.....I am trying to completely view the video Carole recommended, but am experiencing issues with my computer, but the bit I saw has been very helpful.....

Edited by Geniusall, 17 February 2012 - 06:50 AM.

[Carole Amend]

Thanks for sharing your insights, Carole. Love the blog, by the way!

It's an important question that you asked and I answered from my perspective, as I heard it, which is all any of us can do.

Pilates instructors have an opportunity to learn more about the full scope of our practice....which, yes, includes understanding back pain!
There's a gap between the medical model and what the public now thinks "pilates" is, and Pilates Professionals are in a unique position to fill that niche by learning more about the body and teaching.
For me, further study has given me confidence that bodies, minds, and hearts can fully heal through practicing and studying the work of J.H.Pilates (and I am neither arrogant nor foolish).

Thanks for the feedback on the blog, reb...that's wonderful to hear. : )

Deborah, Lee...you "get" me (and yes, Lee, you're right--I am embarrassed :/ ). : ) Thank goodness for this board!

Edited by Carole Amend, 18 February 2012 - 06:26 AM.

[taowave]

Carole,i just may "make your day"(you know the reference:) in march as i return from my travels and back to the east coast om 3/5 -3/7.

Where is this workshop?

[Carole Amend]

carole,i just may "make your day"(you know the reference:) in march as i return from my travels and back to the east coast om 3/5 -3/7.
Where is this workshop?

(Please do go ahead! : ) and then, I'll make yours!)
March 3 & 4 Topton, PA. (It will be in LA soon)
There is a discussion in the Announcements Forum about it (see link in my signature below).
Here's the Bodies Mind Program of Study™ facebook page link to the agenda.
Or, go to my about.me page, for all my links, listed on the bottom of my profile page.
Many thanks for the interest : )

[circlesquare]

You were optimistic about avoiding back injury. Not sure it is something you need to hide from your clients. I actually don't trust people who have never experienced injury. It's just hard to believe them or that they can empathize with the patient. One of my teachers had a shoulder injury and occassionally mentions it. It doesn't seem to impact the students perception of her. Actually, it may be what motivates her to help us strengthen our shoulder girdle and middle/upper back with a lot of different exercises including using therabands (it's not a classical pilates method studio). Maybe your students will relate to you more or you can use it as an opportunity to help them with back issues better. Trying to find the brighter side of the situation.

I would think that as a teacher, all you can do is set a good example for your students by taking care of your pain and joints and maybe trying to find the exact cause of the pain. Even though many treatments are similar for different origins of low back pain (muscle relaxers, disc decompression, core strengthening and safer movement patterns/posture, anti-inflamatories, icing) - the exact cause found with an MRI could give you more power to choose appropriate treatments rather than guessing what might work. I also wonder if your knee injury maybe caused (or is causing) you to alter your gait and walk with impaired movement which could cause pain.

I recently found the exact cause of my back pain. I'm "young" and do not know how I developed the injuries - but it feels really good now to know what bones, discs, and nerves are involved and what to watch out for in the future. It gives me more confidence to discuss the pain or limitations with an instructor whereas before, I was just saying what I thought it was and what the xrays had shown - which was not the whole picture.

In addition to pilates, there are other treatments to add in to manage the pain and hopefully keep it away for long periods of time. The Esther Gokhale Method focuses on sitting, walking, and standing posture improvement to decrease back pain. You may be interested in it - many of the concepts are in-line with Pilates' teachings. You might also try a chiropractor for adjustments - I've never seen an osteopath so I don't know what kind of adjusting they do. I also really like working out on the CoreAlign which is a therapy based piece of equipment sold by Balanced Body. It's not pilates but it focuses on even recruitment of both sides of the body (you mentioned your pelvis was mis-aligned) and works the whole body. If you have access to one of these in a rehab place or studio, I encourage anyone to try it. I think I'm going to make use of a new physio prescription to see what those practitioners have to offer too. They may see things I can work on that neither the pilates instructors nor I have caught. I'm not so optimistic about PT - but will give it a try and find someone who knows pilates.

Last comments - I'm surprised you were given an adjustment without an x-ray! That can be dangerous and most chiropractors require it before treating you. And, yes, many adjustments are needed when you come to a clinic in pain. Sometimes if feels like they are over selling you - 3 times a week for a couple weeks and then once a week for a month or two - and finally, they recommend monthly adjustments as maintenance. The "stress block" hopefully was meant as structural stress on joints that could be decompressed and realigned temporarily with a spinal adjustment. Otherwise, I agree with another post that it sounds a bit mystical and non-scientific.
Good luck. It can take time to sort things out with the back.

[reb]

Thanks. My back is actually much better. I had a second visit to the osteopath who told me that i kept rotating my pelvis. I think it was a natural tendency since I was younger, then exacerbated from carrying my kids and my récent knee injury. Since then, i have paid more attention to placement in my everyday activities plus started using the reformer again. So far, so good. Knock on wood and i'm keeping my fingers crossed instead of my pelvis.