Banishing Back Pain: The Power of Pilates + Physical Therapy

BANISHING BACK PAIN: THE POWER OF PILATES + PHYSICAL THERAPY

When everyday movement became unbearable for Erinn, a certified Pilates teacher with more than 600 hours of training, she turned to Kinexology and Great Falls Physical Therapy to strengthen her body and retrain basic movement patterns. In this case study, we look at the process from Erinn’s perspective, the physical therapist’s angle, and finally through the Pilates teacher’s eye to understand how a combined approach yielded a solution that worked.

Erinn’s Story

At the ripe old age of 26, I began to have lower back pain. I recall the precise moment it first happened. I bent over to pick something off the floor and experienced incredible shooting pain that radiated through my back and down my right leg. It took my breath away and I collapsed, unable to get off the floor. After several days of bedrest and muscle relaxers, I resumed life but not as normal. Every time I moved, I feared it would happen again. Household chores became difficult to complete, nightly walks were painful, and driving would cause my right foot to go numb. In other words, my active lifestyle shifted conclusively.  

For almost 8 years, I seesawed between operating at my new physical capacity or being immobile; there was little in between. After discovering Pilates, and gaining back some strength and mobility, I became a certified Pilates teacher with over 600 hours of training. But even though I was moving again, I continued to be plagued by back pain. So in 2019, I began weekly Pilates sessions with Chelsea Corley at Kinexology.  

Chelsea took a comprehensive, full-body approach by assessing my weaknesses and how those weaknesses were contributing to my back and mobility issues. We worked on those shortcomings for almost a full year and made considerable strides. But as time went on, it became clear that I needed even more help. 

“I had been teaching Erinn Pilates for about a year during which she had ongoing discomfort in her back. With her Pilates programming, I was conscious about only giving her exercises that did not irritate her back further. When lockdown hit, Erinn’s back became worse. Over time, she was experiencing numbness that extended into her toes, up her foot and eventually into her calf. The list of exercises that we could do without discomfort became smaller and smaller, so I suggested that she go see a spine specialist to figure out the structural origin of her problem. At the same time, I recommended Mary Jean at Great Falls PT for rehab.”

Chelsea Corley, Founder, Kinexology

At Chelsea’s recommendation, after the numbness in my foot returned in early 2020, I got an MRI and started weekly physical therapy sessions with Mary Jean from Great Falls Physical Therapy. Much like Chelsea, Mary Jean’s plan was to rebuild my motor pathways to regain strength and control. So with a diagnosis in hand and the right team in place, I was ready to fully commit to the recovery process. 

“Erinn was first evaluated at Great Falls Physical Therapy in June 2020. Erinn was referred by an orthopedist and Chelsea at Kinexology to our practice. She had a history of chronic lower back pain, but had a recent flare up in right lower extremity radiculopathy causing numbness and tingling in her feet. A recent MRI showed L3-S1 disc bulges and L4-5 disc herniation. At that time she wasn’t able to do her workout routine, including treadmill walking and lifting. Upon evaluation, Erinn demonstrated a significant lumbar and hip range of motion deficit as well as a decrease in hip/ core activation and stability. Our goal with Erinn was to decrease her symptoms and improve her function in her daily activities and workout routines without the need for medication or injections.”

Mary Jean Stack, Founder, Great Falls Physical Therapy

In my first PT session, we quickly learned that my tense muscles were exacerbating my lower back issues, and that to address my lower back, we had to address my upper back, hips, glutes, legs, and the biggest culprit of all in my opinion—my right and left psoas. It wasn’t long until I realized just how much my past injuries and current habits were leaving me in constant discomfort. I had to relearn the most basic and foundational movements including “tummy time” to activate my upper back. 

Mary Jean and Chelsea would regularly discuss my progress so that the PT exercises and pilates movements were uniquely aligned for me every week. And even though there were setbacks along the way, their commitment to my progress was steadfast. 

As I’m writing this, I’m entering the home stretch of PT. After a year of consistent work, I’ve made more progress than I realized was possible. I’ve learned what my body needs on a daily basis to function properly—stretching, exercises, and using a heating pad everyday are now routine. Because the structural issues still exist, I may have to redefine my new normal again in the future—but after this experience,  I am equipped with the skills to navigate future flare ups. And for that, I am forever grateful.

The Physical Therapist’s Perspective

Based on Erinn’s examination I initiated a lumbar extension physical therapy program to relieve the symptoms stemming from the disc herniation.  We also worked on promoting core stability to maintain her gains as we progressed in PT. She initially had difficulty with motor control and activation patterns which we worked on through exercise in both PT and she continued in her Pilates with Chelsea at Kinexology. Her exercises followed a developmental sequence to re-educate her muscles in non-weight bearing position, and then eventually to more functional and inreasingling difficult positions to mirror her return to weight lifting and working out. 

I spoke with Chelsea frequently--about once every two weeks or if something changed in Erinn’s presentation that required an adjustment in her Pilates routine. With the combined PT and Pilates exercise, Erinn was able to strengthen her muscles and retrain poor motor habits that had contributed to her chronic lower back pain. It was helpful for her to have the Pilates instruction outside of PT to make sure she was using the correct muscles and form to safely and effectively perform her exercises without risk of reinjury. The teachers at Kinexology are well versed in motor control and Pilates technique which ensures correct completion of Pilates exercises. This allowed her to speed the gains she was making in PT in regards to her back pain, as well allow us to address other chronic aches and pains (upper back and knee pain) that she thought would never improve. 

At this point, Erinn has made significant improvement in PT and Pilates. She no longer complains of lower back pain and has no remaining radiculopathy. In addition she notes improved function and can do her workouts and squat down to play with her puppies! We hope that as she graduates from PT she is in a much better position to continue her life without the risk for reinjury or need for medical management of her previous chronic pain/ injury. 

The Pilates Angle

Taking a team-based approach to Erinn’s recovery with collaboration between Great Falls PT and Kinexology was essential to restoring and advancing Erinn’s Pilates practice. What was so great about Erinn rehabbing at Great Falls PT was that I was able to talk to the physical therapists to check in on her progress, learn how she was advancing, and discuss both what we should avoid in Pilates and what we needed to add to her Pilates routine. The combination of the movement we were able to do in Pilates, and the treatment she was receiving at Great Falls PT, made a huge difference to her overall progress. 

Working with Great Falls Physical Therapy was seamless. Mary Jean and I would connect about once every two weeks or so to talk about what we were each working on with Erinn, what improvements we saw, but also where we still saw limitations. We were then both able to address these limitations within our own sessions. And since I knew the exercises that Erinn was supposed to be doing for physical therapy, we were able to add them into her Pilates routine to make sure she was activating the correct muscles. I was also able to adapt Pilates exercises to help target the weak points that Mary Jean found during treatment.

Evaluating Erinn’s progress from a Pilates standpoint, I could see where she had achieved increased range of motion in areas that previously caused her pain. Additionally, she was able to actually feel the muscles that Pilates exercises were targeting because the physical therapy had improved her mobility and tight muscles so that the correct movement patterns were able to fire. Erinn gained so much strength and body awareness as well. Working in tandem with Mary Jean, the short list of Pilates exercises that she could do safely, and without pain, grew week after week. As a certified Pilates instructor, Erinn had strong working knowledge of what a particular Pilates exercise was supposed look like, but after combined Pilates and physical therapy, she was finally able to execute more movements, move in more planes of motion, and perform more difficult exercises than was previously possible, making her Pilates practice truly rewarding.