Recently I have been having a lot of people coming in for Pilates with various issues in their backs. These issues include Herniated Discs, Bulging Discs and Spinal Stenosis. It is important to address these issues as Pilates can be a  great alternative to surgery.

I have modified the exercises in the Sequences that we use at The Center Studio to directly address the problem. Most likely the client will not be able to perform forward flexion at the affected area of the back, and as well will not be able to do spinal sequencing (bridging or more advanced Pilates Exercises.

Before I will even do a warm up I like to review the correct way to sit and stand from a chair (leaning forward to weight the feet and letting the momentum bring the body up), as well as the correct way to lay down (the Log Roll, laying on the side and rolling onto the back.

Then in their warm-up I perform the following exercises.
Single Leg Lifts / Leg Changes
Chest Lift while maintaining a neutral pelvis
Chest Lift with Rotation - again maintaining a neutral pelvis
Possibly, depending on the client, I may do the chest lift and chest lift with rotation over the Step Barrel to facilitate ab strengthening.

Exercises I would perform include:
Foot work on the reformer, or
Foot work on the Wunda Chair
100’s prep or the 100 while holding neutral. The client will need to be strong enough to hold the legs up for the full hundred.
For Hip Work - Standing leg press on the Wunda chair - this will facilitate balance as well as engaging the muscles for Gait.
Stretching - Either standing lunge on the reformer or utilize the Ladder Barrel for Stretch - Stretching is important, but over stretching (in the case of dancers) should be avoided.
Arm work - Ped-A-Pul, Supine on the Reformer, Seated Arm Series, or Kneeling Arm series.
Here - planks are a wonderful exercise for people with back issues - once they progress doing the kneeling arm series will really help with their back issues.
Extra Leg Work - I like to do clams, or standing clams on the reformer. This is similar to a single leg skate and again here will help with gait exercises
Lateral Flexion - Side leg lifts
Back Extension - Before doing back extension on the equipment review proper mechanics of back extension by either doing back extension will standing against the wall or laying on the floor. Then progress to back extension exercises on the Wunda Chair (Basic Back Extension or Swan on the Floor, or pulling straps on the reformer will be a great way to teach upper back extension. Please note that these exercises are a progression over time and it may be a couple of months to get into a whole program.

As a teacher one must be patient with their clients and the clients must also be patient with their own progress.

I hope this is a help.