But true Pilates technique goes by some very specific principles, making it an effective choice for back pain sufferers. If you encounter, for example, a teacher who encourages you to "push" your way through an exercise, you have found someone who does not know how to apply Pilates to back problems. Pilates exercises emphasize the eccentric muscle contraction, and involves much more pulling than pushing. When the abdominals and other core muscles are accessed, which requires establishing your body position with ideal alignment, eccentric contraction can help build a very strong, stable, yet flexible trunk. (Eccentric muscle work results in more strength development than its opposite - called concentric muscle contraction.) This is just one example.
Certainly there are many excellent certification programs for Pilates teachers. These programs may come in different flavors, for example, one might place an emphasis on achieving super fitness while another may focus the curriculum on how to work with surgical and chiropractic patients, and common posture problems.
Unfortunately, though, some certifications programs are quick, superficial teacher producing mills that have stripped the method of its back enhancing ways of working. In doing so, they reduce Pilates to just another form of exercise - one that cannot be trusted to safely or effectively address spinal pain. So, to keep your back and neck safe while doing Pilates, it is very important to first look around for an instructor and studio that would make a good fit for you. It can't hurt to ask pointed questions of your potential instructor.
In 2005, the Pilates Method Alliance initiated a certification exam for Pilates teachers. The exam is designed to show that a Pilates instructor has the equivalent of at least a 450 hour teacher training program under their belt. But this does not mean that a Pilates instructor who has taken and passed the exam has also completed a teacher training program. The training requirements for those who take the exam need include only one of the following:
- Prior certification from at least one fitness organization such as the American Council of Exercise (ACE) or the American College of Sports Medicine (ACSM)
- Six months of full time work as a Pilates instructor in the last year
- Completion of 200 hours of teacher training.
OR
OR
Just prior to the rollout of the exam, the Pilates Method Alliance estimated that only one-quarter of all 13,000 Pilates instructors in the U.S. were adequately trained for the job.
A lack of instructor skill and/or experience is of particular concern to Pilates participants with back or neck pain, because of the vulnerability to additional injury.
Sources:
Cotton, R., ed., Personal Trainer Manual. American Council on Exercise. Second Edition. 1997. San Diego.
Baechle, T., ed. Essentials of Strength Training and Conditioning. National Strength and Conditioning Association. Human Kinetics. 1994. Champaign, Ill.
Upcoming Pilates Certification Will Help Protect Consumers. Pilates Method Alliance. Jan 25, 2005.

