Spinal stenosis, says Spine Universe medical writer Kamiah A. Walker, was once called creeping paralysis, because people believed that the condition was untreatable. Spinal stenosis occurs when the spinal canal narrows and causes seemingly paralyzing back pain. Pilates, says Walker, may reduce spinal stenosis pain by lengthening and mobilizing the back muscles and strengthening the spine-stabilizing core muscles.
Cervical Spinal Stenosis
There are two types of spinal stenosis. Cervical spinal stenosis occurs in the neck area, and may cause pain in the neck, arms and shoulders, as well as the lower body. People afflicted with cervical spinal stenosis may also have a tendency to lose their balance. The Pilates supine abdominal exercise pose a significant problem, because the head and neck remain lifted from the floor for extended periods of time. Modify the exercises by using the leg movements, but keeping your head resting on the mat. If you experience lumbar pain, keep your knees slightly flexed, and avoid lowering your legs below a 45-degree angle. Make sure that your lower back stays imprinted into the floor, and rest between exercises by bending your knees and drawing them toward your chest.
Lumbar Spinal Stenosis
Lumbar spinal stenosis occurs in the first five vertebrae of the lower back, causing pain in the lumbar area and gluteal muscles. In some cases, lumbar spinal stenosis may cause numbness. Many Pilates warmup exercises mobilize your spine, and may ease the pain associated with lumbar spinal stenosis. The cat is an example. Kneel on all fours, draw your belly in, tilt your pelvis and round your upper back. Return to the starting position, but do not allow your back to arch. Perform 10 repetitions. Most lumbar stenosis patients, according to an article on the InnerIDEA website, are more comfortable with spinal flexion than extension exercise. If you want to work in the prone position, place a pillow under your pelvis.
Bridging Exercises
Bridging exercises, whether performed on the mat or equipment, teach you how to articulate each vertebra of the spine and regain spinal awareness. To perform the bridge on the mat, lie supine with your knees bent and your feet flat on the floor. Start by tilting your pubic bone toward your navel. Return to the starting position. Then, lift the pelvis and the lower back. Return to the start. Next, lift your pelvis, lower back and middle back. Return to the start, and then finally, lift each vertebra until your spine is in a bridge position with your weight on your shoulders. As you return, let each vertebra touch the mat, and make sure that your lower back touches the mat before your tailbone returns to the floor.
Equipment
Physical therapist and Pilates instructor Christine Romani-Ruby uses the Pilates combo-chair for her spinal stenosis patients. She has them stand and push the chair pedal downward as they bring their spine into forward flexion. The pedal provides resistance on the way down, but assistance as the spine returns to the starting position. This is important, explains Romani-Ruby, because the return phase of the exercise is most painful for people with spinal stenosis.
References
- SpineUniverse.com: Facts and Tips About Spinal Stenosis: Karimiah Walker
- Pilates.com; Rehab for Spinal Stenosis; Chrissy Romani-Ruby: Nov. 15, 2010
- PtProducts Online; Pilates; Christine Romani-Ruby: July 2010
- InnerIDEA: Pilates-Based Exercises for Lumbar Spinal Stenosis: March 2007
- Stott Pilates: Warm Up: The Cat Stretch
