Working Your Back

Last Editorial Review: 1/30/2005

How good is Pilates?

WebMD Feature

July 31, 2000 -- I'm lying on the floor of a sunny, sparsely decorated studio in San Francisco, my spine centered along the top of a large white Styrofoam tube. Under the watchful eye of my instructor, Kim Deterline, I raise one leg at a time off the ground, all the while concentrating on keeping my stomach pulled in and my spine neither perfectly flat nor overly arched. As I struggle to stay balanced atop the tube, the muscles in my torso begin to burn and tighten.

It's not easy, and it doesn't bring the aerobic rush of a quick swim or a mind-clearing run, but I'm hoping it will benefit my back. At the ripe old age of 25, I've had two back surgeries and ingested more ibuprofen than I care to admit. So I'm always on the prowl for exercises that will strengthen my spine without causing further injury.

Pilates (pronounced pih-LAH-teez), the fitness regimen I've come to the studio to learn, promises to do just that. It's a series of slow, precise movements that target your "core muscles" -- abdominals, lower back, thighs, and buttocks. Strengthen these critical areas, devotees say, and you'll be rewarded with a leaner midsection, a healthier back, and more graceful movements.

There's little research to back up these claims, but that hasn't stopped people from flocking to Pilates classes. The regimen is one of the fastest growing trends within the fitness industry, according to Bill Howland, director of research and public relations for the International Health, Racquet, and Sportsclub Association in Boston. A recent survey by Howland's group found that 24% of health clubs nationwide now offer some Pilates-based activities. And two new books -- Brooke Siler's The Pilates Body (Bantam Doubleday Dell, 2000), and Pilates at Home, by Eleanor McKenzie (Ulysses Press, 2000) -- can teach you the moves in the comfort of your living room.

From World War I to Weekend Warriors

Though Pilates isn't exactly a household word, it's hardly new. It was developed in the early part of this century by a German gymnast named Joseph Pilates who worked as a nurse during World War I and developed a series of contraption-driven techniques to help wounded soldiers recover their range of motion. After the war, he moved to New York and began working with injured dancers and other high-performance, body-beautiful athletes. Many of the exercises are still done using the bizarre-looking equipment (think bars, pulleys, and straps) that Pilates designed. But these days more and more gyms are offering classes that require only an exercise mat to get started.

The new simplicity is only part of the appeal. For many people -- particularly aging baby boomers mindful of their increasingly creaky physiques -- Pilates serves as a kind of insurance policy. The core muscles in your back and pelvis anchor your body and help to keep your spine properly aligned as you move. If you neglect those core muscles, says Elizabeth Larkham, a spokeswoman for the American Council on Exercise and a dance medicine specialist at St. Francis Memorial Hospital in San Francisco, you're setting yourself up for injury. Take the time to work them -- by doing Pilates or other forms of exercise -- and you'll be rewarded with a stronger, sleeker, more resilient body.

Where many other forms of exercise (including the nefarious abdominal crunch) work only the superficial muscles, instructors say that the specific alignment and careful contractions required in Pilates go deeper to work muscle fibers below the surface. In another exercise called "The Hundreds," I lie flat on my back and contract my pelvic muscles, lifting my head off the floor toward my knees while keeping my arms extended downward and in front of me. As Kim counts 10 sets of 10 and reminds me to breathe, I keep my tummy tucked, my back strong and tight, and my shoulders down and relaxed. This is no standard sit-up.

Pilates Requires Patience

After my first two sessions with Kim, I noticed that my stomach muscles were sore -- but I didn't notice any changes in my back. Why not? It takes time, says Larkham. The "magic" of Pilates doesn't happen overnight. In fact, she says, it takes most novice Pilates students about six weeks of twice-weekly sessions to notice a difference in how they move and for the subtleties of their movements to become second nature.

At first, the constant thinking -- OK, pull your navel in here, keep shoulders loose and down, pelvis in neutral position, and so on -- was mentally exhausting. There's no slacking off here: My eagle-eyed instructor noticed every nuance of my muscle movement and made sure that my form was flawless.

I can tell that the moves I'm doing are more effective than the crunches I've done in the past. Mind you, I haven't yet morphed into a lithe Pilates poster child. But I'll keep working at it and look forward to trying some of the more tortuous-looking equipment at the studio.

In just a few sessions, Pilates has taught me to be more aware of my body. The other day as I sat at the computer, I caught myself pulling my navel back toward my spine and attempting to create a little smile where my paunch resides. It's this sort of heightened awareness of everyday movements that will, I hope, keep my back trouble-free. The Pilates method is getting into my system, and -- with equal parts hard work and good luck -- I'm anticipating a future that's both pain-free and spinally sound.

Elizabeth Krieger is an associate editor at WebMD.

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