Pilates for herniated discs

The vertebrae that form your spine are cushioned by discs. Each disc acts like a shock absorber for the surrounding vertebrae and include a tough, outer layer (annulus) that surrounds a jelly-like nucleus.

A herniated disc - sometimes called a bulged, slipped, or ruptured disc - occurs when the nucleus tears through the annulus and presses out into the spinal canal. The spinal canale is narrow and generally does not have space for spinal nerves and the displaced disc fragment. As such, herniated discs often press on spinal nerves, producing pain. This pain can become quite severe.

*American Association of Neurological Surgeons (aans.org/patients/neurosurgical-conditions-and-treatments/herniated-disc)

Herniated discs can occur anywhere along the spine, but most often occur in the lower back. You can have a herniated disc with no symptoms, but it is more common to have symptoms that affect one side of the body.

• Arm or Leg Pain - If your herniated disc is in your lower back, you'll typically feel pain in your lower back, buttocks, thigh, and calf. You might have pain in part of your foot as well. For a herniated disc in your neck, you might feel pain in your should and arm. Pain may shoot into your arm or leg when you cough, sneeze, or move into certain positions. Pain is often sharp or burning.
• Numbness or Tingling - Herniated discs often lead to radiating numbness or tingling in the body part served by the nerves being pinched by the disc herniation.
• Weakness - Muscles served by the affected nerves tend to weaken. This can lead to stumbling, drop-foot, or inability to lift or hold items.

In extreme cases, a disc herniation can lead to loss of bladder and/or bowel function. This is an emergency that requires immediate medical attention.

*Mayo Clinic (mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095)

Pilates can alleviate your pain, increase your mobility, and strengthen your core in many ways.

• Stabilize the Injured Spinal Segment - Our "core" includes many muscles across several layers that encase our entire trunk. Even if we have strong "abs," we may have weak core stabilizers along our spine. Pilates Includes many movements that target and strengthen these smaller stabilizer muscles that help take pressure off the injured disc.

• Elongate the Spine - Many Pilates exercises incorporate gentle traction. This helps increase the space between discs - which in turn frees up some area around the spinal nerves, allowing for greater movement with less pain.

• Improve Hip Dissociation - Injured discs are often the result of flexing or twisting the back beyond a normal range of motion. Some Pilates exercises help teach "hip dissociation" or moving from the hip instead of the spine.

• Increase Mobility of the Thoracic Spine - The thoracic spine can still move quite a bit with a lumbar disc herniation. Many Pilates movements help teach how to move the upper back while keeping the lumbar spine stable.

*PilatesEncyclopedia.com/blog/pilates-for-herniated-disc

Your Pilates instruction should never cause you pain. Generally, exercises that include heavy back flexion should be avoided. With that in mind, there are many Pilates exercises you can do to strengthen your core and lessen your pain.

• Dead Bug or Table Top Legs (use cushion or mat under the glutes to help tight hip flexors and hamstrings)
• Marching on Mat or Reformer
• Single Leg Stretch  (small range of motion, toes point to ceiling)
• Double Leg Stretch (small range of motions, maybe legs only with toes pointing to ceiling)
• Control Front (knees on the mat, use box to elevate the torso)
• Control Back (use the box to reduce the range of motion)
• Side Planks (keep knees down, keep elbow on the mat)
• Hinge Bridges (use box on the mat to reduce hamstring strain)
• Footwork on the Reformer or at the Barre (use lighter springs to keep low back relaxed)
• Feet In Straps on the Reformer (keep the springs light with a neutral spine)
• Clam shells and/or Fire Hydrants
• Many More!