Most doctors and physical therapists would agree that an integral component of a healthy spine is spinal stabilization exercise, however not all spinal stabilization programs accomplish the desired effect. When movement patterns are faulty, or if extensor flexor ratios are not properly balanced for instance, spinal stabilization will not be achieved. The goal of this article is to highlight the importance of stabilization exercise and to identify some important details for instructing your patients.

Stabilization exercise is a central aspect of spinal health. The role of stabilization is to:

- Increase muscle mass in core muscle groups

- Develop awareness of positioning

- Improve muscle recruitment patterns

- Create the proper technique from which all other exercises should be performed

Muscle Mass

Sad but true, all the muscles in the body atrophy without use after 25-30 years of age. The foundation of strength necessary to carry out simple activities such as lifting groceries or climbing stairs depends on the trunk muscle support. When these muscles are weak or when they are simply inactive (meaning that the muscle recruitment is deficient); the result is intervertebral compression and shearing. It is logical to conclude that the foundation of fitness is in the spine and the trunk muscles. The trunk muscles not only support spinal movement but they also initiate all limb movement when functioning properly. Trunk muscle hypertrophy is necessary for spinal health and fitness and thus is a goal in stabilization exercise.

First let’s identify the key trunk muscles that should remain fit throughout one’s lifetime. These muscles must be the target of stabilization exercise. They include the Abdominal Wall, Deeper and Intermediate Spinal Muscles, Iliopsoas, and Pelvic Floor (PF). An exercise program that addresses the strength and coordination of these core muscles is essential for protecting the spine.

Posterior Trunk Muscles:

Deep Layer:

Semispinalis Capitis, Semispinalis Thoracis, Multifidus, Transversus Abdominis, Rotatores, Interspinalis, Inferior Oblique Capitis, Intercostals, Intertransversi, Quadratus Lumborum (Much of this layer connects vertebrae to vertebrae and lies underneath the erector spinae)

Intermediate Layer:

Longisimuss Capitus, Semispinalis Capitis, Splenius, Capitis and Cervicis, Serratus Posterior Superior, Iliocostalis, Longissimus, Spinalis, Serratus Posterior Inferior, Transversus Abdominis, External Oblique, Internal Oblique

Superficial Layer:

Trapezius, Latissimus Dorsi, Infraspinatus, Teres Minor and Major, External Oblique, Internal Oblique,

Anterior Trunk Muscles:

Pectoralis Major, Pectoralis Minor, Serratus Anterior, Rectus Abdominus, External Oblique, Internal Oblique, Transversus Abdominus, Diaphragm

Muscles of the Pelvis:

Gluteus Maximus, Gluteus Medius and Gluteus Minimus, Coccygeus, Iliococcygeus, Quadratus Lumborum, Piriformis, Iliopsoas, – Iliacus, Psoas Major, Psoas Minor and the Pelvic Floor – Urethra, Vagina, Rectum.

Decreases in muscle mass and strength as well as decreases in bone mass and intervertebral disc height are often a result of aging. Often times a patient withdraws from exercise programs because their pain increases after workouts. This is the start of a cycle of deconditioning and pain whereby, the patient becomes less active and less fit. It is important that he/she be given a progressive stabilization program so that activities can resume without reinjury. For person who do not receive proper stabilization therapy, denervation of key spinal support muscles occurs and is a precursor to severe deformities and fractures of the vertebral bodies (ie: kyphosis).

Improving Proprioception

Stabilization exercise should also help the patient understand and improve spinal alignment. The three curves of the spine should be in balance for shock absorption. Most people rotate the pelvis posteriorly and flatten the lumbar and cervical curves while performing exercises. Stabilization exercise is used to reinstate these curves and develop strength to maintain proper curvature and alignment. The patient should understand that mobilization exercises can be used to increase flexibility at a joint; whereas stabilization exercise is used to strengthen the body in its correct position and co-contract the trunk muscles to build muscle fiber recruitment and endurance.

It is common that a patient will learn an exercise in the office only to repeat it at home with incorrect form. Educating the patient to “feel” a new position as correct takes time and repetition. This is why the exercises should be repeated in the office until the patient’s neuromuscular system is re-educated. Hands-on correction of minor errors is tedious but necessary. For example, pelvic stabilization is comprised of an isometric muscle contraction of the Pelvic Floor (PF) and Transversus Abdominis (TrA) while maintaining an elongated neutral spine position. Many patients will use the gluteal instead of the PF and TrA muscles and posteriorly rotate the pelvic complex thus flattening the curve of the lumbar spine. Without correction, this could further irritate soft tissues in the low back; and if repeated during weight bearing exercise may cause serious injury.

The goal of reviewing pelvic, thoracic and spine stabilization exercises is to improve the proprioception of the Spine Stabilization System and build core muscle support. Your patient will reach a point of awareness where he/she is uncomfortable in the old postures and has fully integrated new postures. At this point you can progress his/her exercises without risk of injury. Abdominal and back strengthening exercises performed correctly will help the patient feel confident to resume an active lifestyle. This is a process that varies for each individual and needs to be continuously evaluated by educated eyes.

Muscle Recruitment

The order in which the muscles “fire” to produce movement is now known to be dysfunctional in many patients with low back pain. The correct order of muscle recruitment for moving or exercising the lower and upper limbs begins with the Transversus Abdominis (TrA) followed by other trunk muscles and concluding with the limb muscles — in other words, from the center to the periphery. When a patient does not “fire” his/her muscles in the correct order, the spine is not protected from the loading produced by the movement (ie lifting). Exercise programs, such as pilates, can be designed to change dysfunctional muscle recruitment patterns (MRPs).

An important component to stabilization exercise is to analyze and develop MRPs so that they become more automatic for the patient. All exercises should begin with a contraction of the TrA and PF. These muscles have been shown in research to work together and are effective for stabilizing the pelvis and low back (Sapsford and Hodges 1999).

In pilates programs clients are taught to stabilize before each and every movement. When performed correctly, pilates workouts develop trunk muscle endurance and tone, an important factor in the prevention of low back pain.

Recent research by Paul Hodges demonstrates that the diaphragm is not only a muscle used in breathing but is also a postural stabilizer. Other research shows that the TrA, Internal Oblique (IO), and External Oblique (EO) will fire with a Forced Exhalation (also referred to as Deep Diaphragmatic Breathing); thus the breath is a key in triggering the muscles to “fire”. When teaching stabilization exercises the breathing is important in training trunk muscle recruitment.

The problem with many abdominal exercises is that they irritate soft tissue or increase compressive loading on the intervertebral discs. For example – the common sit-up often causes high levels of compression in the lumbar spine. In a study by McGill the safety of the sit-up was questioned because of the degree of tissue loading. Load predictions from this study suggest that performing sit-ups (dynamic and quasi-static) result in compression loading (>3000 Newtons) on the low back. Repetitive sit-ups at high acceleration produced extremely high inertial loads and thus are prohibitive. McGill also discovered that the straight leg sit-up does not significantly differ from the bent knee sit-ups in abdominal EMG activity or compression loading.

Create the Proper Technique

This brings me to the final point in this article — CREATE THE PROPER TECHNIQUE and REINFORCE THE CORRECT MOVEMENT PATTERN so that the patient can and will perform all exercises correctly. Obviously, we want our patients to be physically fit, but not if the exercises reinforce bad habits (movement patterns). Unfortunately, this is usually the case. How many times have you watched gym members perform abdominal curls incorrectly, (with too much momentum and pelvic movement) resulting in the compressive force of a dozen backpacks upon the low back. How many times have you seen a hamstring stretch performed as if it was a thoracic compression move? How many patients do you know who can reach overhead without moving their cervical spine out of alignment? Exercise programs should be formulated to correct faulty movement patterns and to create trunk stability, which is essential to a spinal stabilization program, and ultimately to your patients’ spinal health. Stabilization exercise supports spinal adjustments, soft tissue manipulation and muscle setting. Learning to identify the details of correct stabilization is valuable to your back care practice!

The Pilates has become a very popular form of workout inspired by many models, athletes and celebrities who promote and are actually into this form of mind- body exercise. The Pilates is developed and inspired by a prisoner of war, Joseph Pilates, during the Second World War. If you have been considering the idea of trying Pilates particularly because most of your friends may have already been into this workout, you may want to checkout the benefits of getting a Pilates workout. Here are three reasons why you must try Pilates:

Pilates can help make your body look and feel better. Many people go through exercise regimen because they want to keep their body fit and beautiful. A Pilates workout is therefore a good fitness activity as it can help make your body look better. People who have regular Pilates workouts usually have flatter stomach, a thinner waist and more slender thighs. If you want to have a great looking body, a Pilates workout is the best for you. In addition to this, a Pilates workout will not only help you in attaining the figure that you want. Pilates will actually help your body feel healthier. Many chiropractic consultants, for example, recommend their patients to undergo Pilates workouts because Pilates can strengthen the back, spine and joints of a person. People who have injuries in their limbs are also advised by their physiotherapists to undergo Pilates as this can help hasten the recovery of their patient. A Pilates workout will be best for you if you feel that you have a rigid and unhealthy body.

Pilates can help make you feel better. Pilates does not only help you have better looking body. The best thing about Pilates is that it also helps in making your feel better. A regular Pilates workout, for example, can relieve stress and even depression and anxiety. People who are stressed with their jobs would therefore benefit when they enroll in Pilates classes as this can help them feel better about themselves and allow them to have a better outlook in life.

Pilates can help you lose unnecessary fats and weight. Pilates is also beneficial for you if you want to lose those extra pounds of fats that you have in your body. The best thing about losing weight using the Pilates method is that the workout will not result in bulky and unsightly muscles that many women prefer not to have.

If you are doubtful whether you need a Pilates workout, you may want to consider the many benefits of the Pilates workout. Pilates can help make your body look better. Pilates can also help make you feel better and it can help you lose unnecessary fats and weight in your body.

I will assume that you have done Pilates class before so I imagine that you’ve used Pilates machines or other such Pilates equipment. There are a number of these machines available for the home gym. Every single Pilates machine I’ve seen, like the Pilates Reformer, is a completely self-contained workout device.

It doesn’t really matter which “brand name” of Pilates you practice, whether it’s Winsor Pilates, Malibu Pilates, or Stott Pilates, there is a pretty fair chance you’ve used one of these home machines. Perhaps you’ve even bought one for your own home gym. If you don’t have one but thought about buying one…keep on reading.

O.K., let’s get right down to it. This are my reviews of the three top selling Pilates machines available for you to purchase today. I am going to review, for your benefit, the Pilates Reformer, the Malibu Pilates Chair, and the ever popular Pilates Power Gym.

So here is the first review…the Pilates Reformer, the top dog of Pilates machines.

Pilates Reformer Review

This one is in a class by itself so the Pilates Reformer is THE best in Pilates machines, bar none. It has proven itself to consistently be the best exercise equipment of choice used by the world’s top flight Pilates instructors. I know the name sounds like some sort of torture device straight out of the Spanish Inquisition, but it is a high quality piece of equipment.

I think most people are aware that Joseph Pilates formulated the exercise system that bears his name while in a internment camp in the beginning of the 20th century. What he wanted was a complete holistic system of modern exercise. Pilates strengthens the core abdominal muscles which align and correct your postural muscles, giving you an incredible sense of health and well-being.

All you have to do is sit in the comfortable carriage of the Pilates Reformer, and using the patented pulley and spring system to push and pull your self back and forth with a progressively higher and higher level of intensity. This is a real work-out folks.

The Pilates Power Gym

If you are looking for a light weight work out machine, the Pilates Power Gym should be just the ticket. With its padded handles and straps and carbon steel structure (just like the Reformer) it’s simple and easy to operate. It’s completely adjustable for each level of fitness, including yours. At only half the size of the Pilates Reformer, the Power Gym makes sculpting and toning of you hips, calves, butt and back, not to mention firming up and adding muscle to your arms and abs, an incredibly easy process. You won’t be able to help cwatching yourself in your mirror to see a more fit and healthy new you!

Malibu Pilates Chair

As perhaps the smallest, most compact (and at under $350, the most affordable) Pilates machine, the Malibu Pilates chair is the new boy on the block. Like most every other piece of Pilates equipment you have to actually use it to make it effective for your own weight loss regimen. But the Malibu Pilates chair makes it simple to lose weight with the free wall chart and diet plan that is included with the initial purchase price. Although it might be difficult to believe that you can actually get a good work-out while sitting on your backside, I am here to let you know that this thing hands you an unparalleled workout in only half the space you might normally use.

The pilates exercise is one of the best methods to acquire improvement for physical strength, flexibility and posture. Aside from that, it can also help maintain back health as it could strengthen the spine. For this certain exercise, a machine that could serve its purpose was invented years ago and it was called as pilates exercise machine.

It is created to meet a variety of exercise performance and movements. The impressive qualities this machine has are versatility, durability and convenience. It permits anyone to create a combination of exercises based on her choices and preferences. Because of the features this equipment has, monotone experience can be avoided and one can enjoy using it. This is what it’s got that no standard exercise machine could offer.

Compared to a standard machine, the pilates exercise machine is more user-friendly and it could allow easier movements. It is also good for home-use because it is fitted for a small space in any room. The compact appearance gives it a neat presentation. It is usually composed a wheeled support, foot bars, arms and legs pulleys and jump slats.

One of the most well-known basic types of the machine is the Reformer and it can be found in almost every pilates studio out there. This type of machine has the features which could allow the exerciser to work out the different groups of muscles in his body. Reformer pilates are classified into two: the spring reformers and the gravity reformers.

Another basic type of the machine is the Cadillac. This resembles a cage but the difference is that it has no bars. Diverse exercises can be allowed as its got extra bars and straps for gripping. The springs make if flexible and one can move freely while performing. The straps can be used for the legs if the exerciser prefers to pull them down opposite the resistance being offered.

The Wunda Chair is also popular among the types of pilates exercise machine. This one looks like a bench but the difference is that it is a bit elevated. The two bars on each side of this machine are attached by springs and it could allow the individual to push on the bars while standing or sitting either on the bench or on the floor.

Aside from these equipments, barrels, exercise balls, as well as rings can also be used for pilates exercises. It is easy to acquire these equipments because they are available in any pilates studios and orders can also be made online or by phone calls. Considering them for a better figure and body fitness would not just enhance the physical condition but the mental awareness as well.