For individuals wanting to try Pilates for back pain and exercise, can learning how to find their neutral spine help improve flexibility and increase the range of motion in the joints?

Pilates Neutral Spine

Pilates is a functional exercise modality emphasizing core stability, which is fundamental to developing a balanced body. The exercises strengthen the muscles, improve flexibility, and increase the range of motion in the joints. (Kloubec J. 2011) It is considered a functional fitness method because its principles work to establish more graceful, efficient movements from everyday life, such as improving posture. Pilates has shown its effectiveness in that it is often used in physical therapy and rehabilitation settings. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) However, knowing how to find the neutral spine is essential for performing various Pilates exercises correctly. (Barbosa, A. C. et al., 2018) This subtle adjustment during practice may help prevent injury and increase overall performance. A neutral spine is the natural position of the spine when all three curves:

• Cervical (neck)
• Thoracic (middle)
• Lumbar (lower)
• Are active and in healthy alignment.

This is the strongest position for the spine when standing or sitting, allowing the body to move more naturally.

Alignment

The following exercise can help find the Pilates neutral spine.

Basic Position

• Lie on the back with knees bent and feet flat on the floor.
• Ensure the legs are parallel to the hips, knees, heels, and toes.
• Let the arms rest at your sides.

Relax

• Relax the body, including the shoulders, neck, and jaw.
• Allow the back to melt into the floor.
• The rib cage will drop when the lower ribs are released to the floor.

Breathe Deep

• Inhale all the way into the body, allowing it to move into the back and sides of the rib cage and all the way to the pelvis.

Pelvic Tilt

• Exhale and use the abdominals to press the lower spine into the floor in a pelvic tuck. (Eickmeyer S. M. 2017)
• Inhale to release.
• Exhale and pull the lower spine off the floor, creating a pelvic tilt.
• Inhale to release.

Pilates exercises don’t use excess energy or tension. Proper alignment and a neutral spine position can ensure that tension is released and excess energy is not exerted. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) When performing the exercise, ensure that the shoulders, neck, and legs are relaxed and not involved in the movement.

When Exercising

Once a neutral spine is achieved, the goal is to maintain this spinal position during the exercises and when changing positions.

• Start by lifting the right leg and placing it back down without letting the hips move.
• Then, repeat the motion with the left leg.
• Engage the abdominal muscles to help stabilize the pelvis, keeping it from moving and maintaining a neutral spine.
• Repeat this process with each leg.
• Once each leg can be lifted easily, test with both legs.
• Exhale deeply and lift the legs while keeping the core and pelvis stable.
• Then, lower them back down.
• When performing this progression, there may be a want to release the abs and let the back arch.
• This will cause a tuck and tilt position away from the neutral spine position.
• If this progression is difficult, keep practicing until you can maintain a neutral spine.
• Once this basic progression feels easy, try additional progressions and positioning.

Visualization Tips

Most people have their spines in one of two positions: tucked or tilted. A neutral spine requires individuals to be in between, with the lower abdominals flat and the lower spine’s natural curve slightly off the floor. The following visualization can help establish a neutral spine.

Balanced Pelvic Placement

• Imagine a cup of water sitting on the lower abdomen, a couple of inches below the belly button.
• Allow the abdominal muscles to drop toward the spine, flattening the belly.
• You don’t want the water to spill, so the pelvis cannot be tipped forward or tucked under.

Body Scan Meditation

• Once the body is relaxed with a balanced alignment on the floor.
• Allow breathing to become deep and full and the abdominals to drop toward the floor.
• The natural neck and lower spine curves should be off the floor.
• Ensure the lower spine is not pressed into the floor, as this indicates a pelvic tilt.

If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

---

Is Motion Key to Healing?

---

References

Kloubec J. (2011). Pilates: how does it work and who needs it?. Muscles, ligaments and tendons journal, 1(2), 61–66.

Byrnes, K., Wu, P. J., & Whillier, S. (2018). Is Pilates an effective rehabilitation tool? A systematic review. Journal of bodywork and movement therapies, 22(1), 192–202. doi.org/10.1016/j.jbmt.2017.04.008

Barbosa, A. C., Vieira, E. R., Silva, A. F., Coelho, A. C., Martins, F. M., Fonseca, D. S., Barbosa, M. A., & Bordachar, D. (2018). Pilates experience vs. muscle activation during abdominal drawing-in maneuver. Journal of bodywork and movement therapies, 22(2), 467–470. doi.org/10.1016/j.jbmt.2017.05.002

Eickmeyer S. M. (2017). Anatomy and Physiology of the Pelvic Floor. Physical medicine and rehabilitation clinics of North America, 28(3), 455–460. doi.org/10.1016/j.pmr.2017.03.003