In the UK today (1st April 2015) a study into the use of Paracetamol for the treatment of back pain has made the national headlines.

As a Pilates instructor who has worked with hundreds of people with back pain over the last 12 years, my ears pricked up when I heard this on the lunchtime news.  A quick Google search brought up this article on the BBC website which nicely summarises the findings.  However, I know that the media like to pick and choose the juicy bits of information from research papers so I headed over to the British Medical Journal website where whole report is published.  These are the key points:

The objective of the study was to “investigate the efficacy and safety of paracetamol (acetaminophen) in the management of spinal pain and osteoarthritis of the hip or knee”.

The authors pulled together reports from 13 separate trials: 10 trials (3541 patients) looked specifically at the efficacy of paracetamol for people with osteoarthritis of the knee or hip, 3 trials (1825 patients) focused on people with low back pain.   They did not identify any trials in people with neck pain.

When tested against a placebo for low back pain, the researchers found that paracetamol had no effect on pain intensity or quality of life.  With regard to hip or knee osteoarthritis, they found that there was a “significant small effect favouring paracetamol for pain” and “a significant but small benefit of paracetamol was found for short term reduction in disability”.  The research also revealed that “participants taking paracetamol are nearly four times more likely to have abnormal results on liver function tests than participants taking placebo”.

The implications of this study are huge.  It is estimated that 26 million people in the UK suffer with back pain every year and if you visit your doctor to get help with your back problems, s/he will more than likely recommend that you take paracetamol as per the NICE (National Institute for Health and Care Excellence) guidelines.   However, according to the BBC, the NHS is now going to review their guidelines.

What if you are one of the 26 million back pain suffers?  Firstly, you MUST speak to your doctor before stopping or changing your medication.

And there are many positive steps that you can take to ease the pain such as exercising regularly, reducing your stress levels and adopting a healthy lifestyle.

I’m really interested to hear from you about how you manage your back pain.  Do you regularly take pain killers? What have you found works for you?  Please comment below or email me: core.pilates@virginmedia.com.

People attend Pilates classes for many different reasons. Maybe it was a friend who recommended it, perhaps an osteopath suggested you needed to strengthen your core or maybe you were looking for a class to ease some general aches and pains and improve your posture. Whatever your reason, you want to notice and feel the benefits so here are my top tips to get the most out of your weekly class:

Practice in Comfort

What you wear to a Pilates class can help or hinder your practice. Stretchy, non-bulky clothing is a must so no combat style shorts or anything with a hood! I’m not suggesting you go and blow a fortune in Lululemon (although that can be an enjoyable experience too!) but some soft, flexible clothing will allow you to move freely through the hips, knees and shoulders.

A yoga mat may be OK for a while but it’s worth remembering that Yoga and Pilates are two very different disciplines. A yoga mat needs to be thin and sticky so that you can maintain good stability in balance poses, however a Pilates mat needs to be thicker to cushion your joints and spine. I recommend getting a mat that is at least 14mm thick but not too soft – a squidgy surface will affect your ability to maintain good alignment.

Use a Head Support Wisely

This is really important because if you get it wrong you will throw your spine out of alignment before you even begin exercising.

If, when lying in the supine position, you feel like your head is dropping back and your chin is lifting towards the ceiling, first try a gentle ‘nod’ of the head to bring your chin towards your chest.  You should feel the back of your neck lengthen and this may be enough to correct your alignment (A).  If, however, your neck is still extended (B), place a folded towel or cushion under your head to raise it slightly and then ‘nod’ again to lengthen the neck.

Using a towel unnecessarily and lifting the head too high will result in neck flexion (C) and the feeling that your chin is being jammed in to your chest which is not good alignment either so if you’re unsure ask your instructor to check your alignment.

Lift Yourself off the Floor for Seated Work

If we take the Spine Twist as an example, we ideally want the spine and pelvis to be as close to neutral as possible (A). However, if you have tight back muscles or hamstrings you may find that your seated posture is far from ideal (B).  Sit in front of a mirror and check your posture – if your spine is rounded (flexed) and your pelvis is tilted back then try sitting on a cushion. By raising your body just a few inches off the floor you will find it much easier to lengthen your spine and correct your pelvic tilt and therefore benefit more from the exercise, the main focus of which is thoracic mobility.

Make the Mind/Body Connection

Pilates is regularly promoted as a ‘Mind Body’ class and the connection between your mind and body really is crucial while performing the exercises.  If you allow your mind to wander and simply ‘go through the motions’ you are really missing out.  Aim to keep your mind focussed on the movement you are performing.  Pay attention to your alignment and notice how your body responds as you execute the exercise.  If you’re tired you may need to simplify the movement or, alternatively, you may feel ready to challenge yourself and increase the intensity. But don’t expect your body to respond in exactly the same way, week after week. The better you get at maintaining the mind/body connection, the more you will understand your body.

Let the Movements Flow

I know it’s frustrating when there’s one particular move that is proving to be tricky and you feel that you’re not progressing. The temptation is to use more force or try and muscle your way through the movement.   STOP!

Your deep core muscles are designed for endurance not sudden bursts of power or strength so if you’re straining and twisting to sit up from the floor in a Roll Up, for example, not only are you straining and twisting your body, but you’re also relying too much on the stronger, superficial muscles for the movement. When you attend a Pilates class it’s not about keeping up with the other people in the room. Work at a level that is right for YOU. Remember, we all have postural and muscle imbalances that make some exercises more challenging than others.

 If you’re Unsure, Ask

Perhaps there is a particular exercise that you’re struggling with, maybe you’re not sure where you should be ‘feeling’ another exercise. Whatever it is then please ask your instructor. We love to share our knowledge and help our class members get the most from their practice.

I hope this helps you get the most from your Pilates class – please post in the comments below if you have any questions.