Regular stretching, strengthening and low-impact exercises, especially Pilates, can help reduce chronic or acute back pain for many people. Most significantly, exercising and resting with your back in a neutral position can keep your spine healthy, explains Ronald Tolchin , D.O., medical director of Miami Neuroscience Institute ’s Spine Center .
Dr. Tolchin refers to spine care as the “three P’s: Pilates, Plank and Pillow.”
“First, I’d like to start with Pilates,” says Dr. Tolchin. “This is a form of exercise that places the spine in neutral. What that means is not too much flexion and not too much extension, and then Pilates begins to strengthen the core muscles in that position.”
Watch now: Ronald Tolchin, D.O., medical director of Miami Neuroscience Institute’s Spine Center, explains the importance of following the “3 P’s.”
Planking is an exercise that is growing in popularity for developing core muscles, including the abdominals. It’s not just about getting those sought-after “six pack abs.” Strengthening core muscles can contribute to improved spine health, better protecting amateur athletes or weekend warriors from lumbar stress fractures or other serious back injuries. “By maintaining your body in the chest down position while on your elbows, you’re strengthening your abdominal muscles and your deep back and pelvic muscles at the same time,” Dr. Tolchin said.
The third “P” is Pillow, which comes as a bit of a surprise to most patients consulting with spine specialists.
“It’s important to maintain that spine in a neutral position while you’re in bed,” explains Dr. Tolchin. “So, if you sleep on your side, put a pillow between your knees. If you sleep on your back, put a pillow or two under your knees. If you sleep on your stomach, put a little pillow under your abdomen and pelvis.”
Here are more details from Dr. Tolchin on the three P’s.
No. 1: Pilates
The Pilates Method was developed by Joseph Pilates during the 1920s. This is a form of exercise that places the spine in neutral mechanics without adding more stress such as when flexing or extending. These exercises are designed to strengthen the core muscles which stabilize the spine.
Pilates emphasizes low-impact flexibility, muscular strength and endurance. It focuses on proper postural alignment, core strength and muscle balance. It relaxes muscles which are tense and strengthens those that are weak. This can be achieved through the use of an exercise mat or a machine with pulleys and springs called a Pilates Reformer.
No. 2: Plank
This can be done on a flat surface. You start in the prone position. Keeping the spine straight, you then come up on your elbows. From there, try to hold this position for as long as you can while contracting your abdominal muscles. Initially, you may only be able to hold it for 15 to 30 seconds. However, with time that should improve, and you may be able to hold this position for a minute or two.
For a better challenge, you can do a walking plank and come up from your elbows to your hands with outstretched arms. This will help build up the muscles around your spine, including deep-core muscles, your pelvic girdle muscles, and your abdominal muscles. Ultimately, this will empower the muscles to take over for your spine and take some of the stress off your vertebral bodies and discs.
No. 3: Pillow.
A pillow under the knees will relax the iliopsoas muscles, which are the primary hip flexors, and thereby relax the back and support the natural curve of your spine. Many times, tight iliopsoas muscles contribute to reflexive low back pain. If you are a side sleeper, a firm pillow between your knees will prevent your upper leg from pulling your spine into rotation and out of alignment, and reduce stress on your hips and lower back. It will keep your hips, pelvis, and spine in better alignment.
A pillow under your head should support the natural curve of your neck. If you sleep on your stomach, placing a small pillow under your abdomen or pelvis can help reduce the stress to your spine. You should use a small flat pillow under your head and neck to reduce neck strain. A pillow that is too high can cause muscle strain on your neck, upper back and shoulders.