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PILATESFORBULGINGDISCSINLUMBARSPINE

ACASESTUDY

KristinaDavoyanJuly16,2016BodyArtsandScienceInternationalComprehensiveTeacherTrainingProgram2015TheWoodlands,TX

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CONTENTS

RESEARCHSUMMARY.............................................................................................................................................................3

ANATOMICALDESCRIPTION ...............................................................................................................................................4

CASESTUDY.................................................................................................................................................................................6

BASIPILATESCONDITIONINGPROGRAM .....................................................................................................................7

CONCLUSION ............................................................................................................................................................................ 10

REFERENCES ............................................................................................................................................................................ 11

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RESEARCHSUMMARY

Bulging discs is a common diagnosis where one of the intervertebral discs, which cushions the bones in

the spine, weakens and loses its shape. Bulging discs can press against the nerve causing chronical pain

and other symptoms.

The subject of this case study is a 30 year old female, a mother of three small children, who has been

diagnosed with bulging discs in her lumbar spine. An eight week program that consisted of sixteen 50

minute private Pilates session program has been designed. This program was created not only to help her

to decrease pain in her low back but also to build both strength of her core and overall flexibility of her

body.

Upon completion of this program client felt a significant relieve in her low back pain and demonstrated

vastly improved body strength.

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ANATOMICALDESCRIPTION

Lumbar spine is located in the lower part of the spine. It is designed to be extremely strong to protect

highly sensitive spinal cord and spinal nerve roots and at the same time it is highly flexible, provides

mobility in many different planes and helps support the weight of the body. Lumbar spine consists of 5

movable vertebrae numbered L1-L5 (as shown in the figure above), starting at the top. Each vertebra is

stacked on top of the other and between each vertebra is a gel-like cushion called an intervertebral disc.

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The discs help to absorb pressure, distribute stress, and keep the vertebrae from grinding against each

other (spine-health.com)

Bulging discs occur when the disc extends from its natural space. The disc presses against the nerve

which causes radiating pain.

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CASESTUDY

Marie is a 30 year old stay at home mother of three small children. Prior to becoming a stay at home mom

she had a desk job and was in a sitting position for several hours each day. She had inactive lifestyle, no

exercising and minimum walking. She started feeling pain in her low back but didn’t take it seriously up

until her first pregnancy. One day when she bended down to pick up her child she felt a spasmatic pain in

her low back and couldn’t extend back up. Marie went to a chiropractor thinking it will take couple of

sessions to get back to her normal lifestyle. Chiropractor refused to proceed with any procedures until he

has a clear picture of what’s going on with her low back. He ordered Marie an MRI which revealed that

she had bulging disc at her L3-L4 and L4-L5.

At that time chiropractor recommended her manual therapy and low impact workouts avoiding flexion of

her spine in order to build strength of her core. Since Marie at that time insisted on a ‘quick fix’ he

recommended her to consult with the physician and receive steroid injections to relieve pain temporarily.

After a sorrow research on steroid injections Marie decide to proceed with the manual therapy. She was

very consistent with her appointments and several sessions later she felt relieved and decided to research

workout routine that will suit her body and her life style. She has chosen yoga over other types of

exercises thinking it will help her to meet her needs. Since it was a group session with 10-15 other people

in the class, where workout routine wasn’t adjusted to her particular needs after few classes she started

feeling worse. Marie kept researching workouts that might be a better suit for her body and decided to try

a private Pilates session.

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BASIPILATESCONDITIONINGPROGRAM

Pilates instructor has thoroughly reviewed the history of Marie’s medical recommendations as well as

workout programs that she tried before. To avoid flexion of the spine was the only mandatory physical

limitation. Significant concern for the instructor was the Marie’s constant fear of pain. The goal was to

slowly overcome her fear. Marie had hard time relaxing her body, especially her neck muscles since she

believed that might protect her from the low back pain.

Instructor has created an eight week program that introduced Marie to the motions which were completely

new to her. The goal at this point was to relieve pain, start building core strength and last but not the least

renew Marie’s confidence and trust in the abilities of her own body.

Weeks 1-4 Weeks 5-8

Warm up Pelvic Curl Leg Lifts Leg Changes Chest Lift

Pelvic Curl Leg Lifts Leg Changes Spine Twist

Foot work Reformer: Heels, toes, small v, wide v heels, wide v toes, calf raises, prances, single leg heels, single leg toes.

Cadillac: Parallel heels, parallel toes, v toes, open v heels, open v toes, calf raises, prances, single leg heel. Single leg toes.

Abdominal work Arc: Chest Lift Reach Overhead stretch

Reformer: Hundred Prep Hundred Coordination

Hip work Reformer:

Frog, circles (down & up), openings

Cadillac:

Frog, Circles (down & up), walking, bicycles.

Spinal Articulation None None

Stretches Arc:

Shoulder stretch lying side

Pole: Shoulder stretch, overhead stretch, side stretch,

spine twist. (sitting on a ball)

FBI I Knee Stretch (Flat back) Bridging (Front Support)

Arm work Reformer :

Supine series-extension, adduction, up &down

circles, triceps.

Cadillac:

Arm Standing Series-chest expansion, hug-a-tree, circles

up &down, punches, biceps, butterfly.

FBI II None None

Additional legs Circle: ankles, below knee, above knee Circle: ankle, below knee, above knee

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Lateral Flexion Chair: Side Stretch Cadillac: Side Lift

Back Extension Swan Prep (w/circle) Swimming

Warm up: Basic Warm Up has helped client to get to know her body and get into positions with

proper alignment recruiting abdominal muscles.

Foot work: Foot Work has helped with the proper alignment of feet, spine, and pelvis with the

engagement of hamstrings and abdominals.

Abdominal work: Abdominal Work on arc has help to properly engage abdominals with the

minimum impact on low back. When client has learned proper engagement of the abdominals

Reformer abdominal work has been introduced.

Hip Work: Hip Work has helped to properly maintain pelvic lumbar stabilization while

controlling the straps/springs.

Stretches: Arc Stretches have helped to stretch and control at the same time with the recruitment

of the abdominal muscles. Pole stretches sitting on a fitness ball combined stretches while

balancing on a ball with the proper trunk stabilization.

FBII: Flat Back Knee Stretch has helped to recruit abdominal muscles and back extensors while

maintaining a neutral spine position.

Arm Work: Arm Work Supine has helped to maintain neutral position of the spine and abdominal

engagement while legs are in table top position while Cadillac Arm Standing Series has required

stabilization of the trunk with the proper alignment of the body.

FB2 II None

Lateral Flexion: Chair Side Stretch has helped to build strength in oblique and abdominal areas

while stretching and maintaining pelvic stabilization. Cadillac Side Lifts was a next step when

client has learned more control of her body.

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Back Extension: Swan Prep (w/circle) has helped to build back extensor as well as shoulder

strength with the recruitment of the abdominals. Swimming on the mat has been introduced as a

next step where stability and control are required.

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CONCLUSION

After a few private sessions Marie has felt significant decrease of pain in her low back. Ability to catch up

with slowly but constantly increasing complexity of the exercises led Marie to a renewed trust in her body

strength. Her fear of pain has reduced tremendously. She became stronger and more confident person.

Marie feels that she made a right choice by choosing Pilates as her workout regimen. She is also satisfied

by the ability to control her back pain and the fact that currently no medical treatments are required to

address her back issues. She also shared that physically she feels much better while doing every day

chores and taking care of her family. Marie continues regular (twice a week) Pilates sessions.

Based on the facts presented above, it is clear that Pilates regimen created based on the needs of the

particular client has delivered strong visible results.

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REFERENCES

Websites

“What's a Herniated Disc, Pinched Nerve, Bulging Disc...?”, http://www.spine-health.com/

“Types of Bulging Discs”, https://northamericanspine.com/

“Bulging Disc”, https://www.depuysynthes.com