Ouchhhh....it's Stenosis

Spinal stenosis is a PAINFUL disease of the elderly. It involves narrowing of the bony spinal canal, commonly due to arthritis. It causes irritation to the nerve passing through the spinal canal. Thus creating paing that may radiates down the back of the legs. This pain is worsen with walking, as the patient holds his spine in an extended position, and this further decrease the size of the spinal canal. Hence patients with spinal stenosis will notice improvement of their symptoms in a flexed position, as this position "open" up the spinal canal.

An eye doctor asked if Pilates can help her cousin who is suffering from stenosis. In my opinion, if her cousin prefer to manage her condition without spinal surgery (pdf) (removing some posterior bony tissue of the spine), physical therapy including in the form of Pilates should help alleviate her pain. This is because Pilates has plenty movements that flex the spine so it will be an excellent therapy to reduce the symptoms of spinal stenosis and curb its progression.

Contrary to slipped (herniated) disc (which can be treated by physical therapists with lots of spinal extension exercises that decompress disc space), patients with spinal stenosis may benefit from flexion exercises, such as assisted roll-up, roll-up, rolling, seal, roll-over, spine stretch and so on. However instructors need to take note that the patient's range of motion will be reduced and has to avoid extension exercises such as prone press up, swan dive, single & double leg kicks which will only intensify the problem by futher decreasing the size of the spinal canal. That's why it is always essential to advise your clients who suffer from moderate to severe back pain to consult medical professionals (if they haven't done so!!) to obtain a proper diagnosis before prescribing them a suitable exercise program.

Hope you can share your teaching experience in the comment portion if you have previously trained clients with spinal stenosis. I think it would be fun to discuss and explore how we can better train clients with special conditions.