By: Ashley deLalla, DPT, PMA®-CPT

Have you heard that Pilates can increase core strength or ease back pain? What exactly does that mean, and how do the principles of Pilates work? Additionally, how can core strengthening improve your sports performance?

Joseph Pilates developed exercises that have helped soldiers get in shape and stay protected from disease and kept dancers on the performance stage through injury-prevention training. His basic principles of precision, centering, and control, now known as the Pilates method, allow people to better understand their own bodies and enhance their health and well-being.

In order to understand how Pilates can help back pain, one must understand the body’s “powerhouse.” At the center of our body is the “powerhouse,” which consists of four sides. The core muscles (transverse abdominus, obliques, and rectus abdominus) make up one side; the multifidi and back extensor muscles back up another side; the diaphragm, which we use to breathe, makes up the third side; and the pelvic floor muscles make up the fourth side. When properly functioning together, these deep muscles allow our bodies to gain stability and move more effortlessly. When these muscles are injured or hurt, the body’s balance can be affected causing muscles on one side more to do more work than the other three sides, resulting in an increased risk of injury and pain.

To illustrate the basic principles of a Pilates, let’s break down the basic Pilates bridge exercise:

1. The first principle is breathing. In any Pilates exercise your breathing (inhalation and exhalation) assists or challenges your movement. In the Pilates bridge, you start on the floor, lying on your back with your knees bend. You inhale to prepare, then exhale as you roll up your spine until your hips are lifted off the floor and you are resting on your shoulder blades. You then inhale at the top position and exhale as you return to the starting position – moving your spine back to the floor, one vertebrae at a time. Breathing not only helps with control of the movement, but the exhale helps with spine flexion, allowing for improved core control. Proper breathing can help athletes run faster and for longer, reduce anxiety on the field, and control specific sport-specific movements.
2. The next principle is axial elongation and core control. By drawing your belly button in toward your spine as you roll up to your Pilates bridge, you are contracting your core muscles which adds to your powerhouse stability. Prior to starting this movement, you will align your back to the floor in a neutral position to facilitate proper core strengthening.
3. Spine articulation or segmental movement, a third guiding principle, is achieved as you move each vertebrae off the floor, one at a time, to start your Pilates bridge, and then set each vertebrae back on the floor, one at a time, to return to the starting position. Visualization of a string of pearls can be used to lift each joint off the floor and gently set it back down. For athletes, this type of segmental movement can assist with mobility and movement control, especially with back-arching moves.
4. The fourth guiding principle of the Pilates bridge is the position of the head, neck, and shoulders. To begin a bridge, you must ensure correct alignment of the head and proper neck stability. The example of holding an orange under the chin illustrates a proper chin tuck to align the vertebrae in the neck, stabilize the head for the exercise, and ensure that you don’t “crunch” your neck joints. This alignment will help prevent injury. Proper shoulder blade stability with shoulder alignment ensures that you are still working on your posture while lying on your back.
5. Weight bearing through the legs as you perform the Pilates bridge is yet another guiding principle. To start, your knees are bent with your feet flat on the floor, hip distance apart. By pressing your heels down as you exhale, lifting each vertebrae up in to the bridge, you are placing weight through your heels. This works on your proprioception, or body awareness in space. With this movement, your joints are sending signals to your brain that can translate into a decreased risk of injury and improved function on the field.
6. The final guiding principle is movement integration. When putting all the movements of this exercise together, you are allowing your body to move with control. Translating these movements to the field, with a stronger “powerhouse,” can lead to increased performance in any sport.

Cross training is important in any sporting activity, especially for injury prevention and recovery after injury. Through these principles, Pilates can help athletes recover from injury and perform better on the field. By focusing on core stability with movement, Pilates helps to create long lean muscles, increased stability and movement control that can benefit athletes of all ages in a wide-variety of sports.

CHKD provides Pilates mat classes to athletes and children of all ages. Go to CHKD.org/SPAclasses to find a class near you.

About CHKD Sports Medicine

CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in physical therapy and injury prevention programs for active children and teens. Our team is composed of pediatric orthopedic surgeons, sports medicine specialists, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists.