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What is Spinal Stenosis and how can Pilates help

Spinal stenosis is a narrowing of the space around the spinal cord and nerve roots that branch off your spinal cord within the spine. When this happens, the spinal cord or nerves can become irritated, compressed or pinched, which can lead to back pain.

Stenosis can occur anywhere along the spine but often occurs in the lower back (lumbar canal stenosis).

One of the main symptoms of lumbar stenosis is lower back pain, it’s sometimes described as a dull ache or it can feel like an electric-shock or burning sensation.

The pain can come and go depending on the time of day, the movements being performed or the length of time in a particular position or movement. Often the pain can feel worse when standing for long periods of time, walking or walking downhill.

There can be sciatic pain that begins in the glutes and travels down the leg, possibly down into the foot. The legs can feel heavy, which may lead to cramping in one or both legs. There can be numbness or tingling ie pins and needles in the glutes, leg or foot. Sometimes weakness in the leg or foot can be felt.

I have treated clients over the years for spinal stenosis using Pilates and corrective exercise strategies to help release the areas of the spine where the stenosis is, stabilise and build strength.

One of the first things I’ll do is assess a clients movement followed by their breathing, from there I'll then correct any imbalances within their breathing/intrinsic core system which often involves bringing more movement to the diaphragm (the main muscle involved in breathing and building abdominal pressure), as well as stretching / strengthening the muscles surrounding the diaphragm so that spinal stability and core function improves.

The spine is often restricted around the area of the stenosis and as the spine moves it loses its ability to load share which places further stress throughout. I’ve found decompressing the spine helps, starting with movements that allow the spine to lengthen and release - using spring work on the trapeze table is really beneficial for this as well as mat based exercises with me adding extra traction. I’ll also incorporate movements to strengthen the core, spine and align the pelvis and legs, slowly working towards movements using resistance on the reformer as well as body weight exercises in various positions that are tolerated and don’t cause further back pain.

Time, consistency and going slowly is so important, repeating movements each week until the spine adapts, gradually adding in more complex movements and exercises when ready helps build a solid foundation for core and spinal strength. The main goal is to help my clients move better in everyday life so that they don’t feel restricted and in pain, this will give them more confidence in their body and their recovery.

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