A new report by the National Institute for Health and Care Excellence (Nice) suggests that instead of taking painkillers, those with back pain should take up Pilates. Sarah Millington talks to two teachers who can vouch for this

WHEN Sarah Wilkinson sees someone slouching her heart sinks. She can’t bear watching children on iPads and as for offices with bad ergonomics – well, don’t even get her started. For Sarah, good posture equals good health. Conversely, bad posture often results in a bad back.

With an estimated one in ten people affected, back pain is now the leading cause of disability worldwide, having overtaken heart disease as the biggest persistent cause of ill health in Britain. Many sufferers turn to painkillers, with paracetamol and ibuprofen being the most common. Yet a recent study by Nice shows that these provide negligible relief, with patients often reporting little or no improvement. It warns that drugs have the potential to cause permanent damage if taken regularly and that the side effects sometimes outweigh the benefits. The report suggests that exercise like Pilates, which focuses on addressing the root cause of the problem, would be a healthier, more effective alternative.

This comes as no surprise to Sarah, 42, who runs Pilates & Beyond from a studio in Darlington. She first encountered the discipline, devised by German Joseph Pilates in the early 20th century, when she herself developed a bad back. It solved the problem – and the rest is history.

“I was in my early 20s,” she says. “I’d finished university and I started working as a medical rep, which meant that I was sitting in my car all day and in doctors’ surgeries, so basically not moving. I started getting back problems, which turned into chronic back problems, then actually discovered that I had a slight curvature of my spine. I was living in Manchester at the time and Pilates had just come to the gym I was going to. I went along to a class not really knowing what it was – I just thought, ‘I’ll give that a go’. I didn’t realise the benefits it was going to have and thank goodness I did find it.”

It took time, but Sarah found that by realigning her body to its natural position, she could alleviate the pain. She became a convert, training as an instructor, and now works with physiotherapists, chiropractors and osteopaths, helping to rid others of back problems.

Jill Robinson, of Langley Park-based Organic Pilates, had a similar experience. A fitness instructor for more than 20 years, she started doing yoga to help ease a painful hip. She progressed to Pilates – and found it ideal as both therapy and exercise. “I felt a massive improvement in my own body and I felt myself strengthen up very quickly,” says Jill, 44. “Pilates was the one thing that cut through it all. I fell in love with it then, really.”

Pilates works from the inside out, building strength in the core muscles, which then enables them to support the whole body. It relies on precision, with movements often so small as to be barely perceptible, and this is why, according to both Sarah and Jill, it should only be taught by fully qualified instructors in small classes.

“If you don’t do it correctly with a properly trained instructor, you could do a lot of damage,” says Jill. “A lot of people do it on videos and DVDs and my heart sinks. When you come to a Pilates class we’re very much obsessed with alignment and you can’t get that with a DVD. The whole point of doing exercises is doing them correctly or there’s no point in doing them at all.”

Jill works closely with physiotherapist Gordon Ellis, who formerly worked with Sunderland AFC’s first team, with Gordon diagnosing the problem and Jill devising a suitable programme. For those with back pain, it means there’s minimal risk of further damage – a potential with any form of exercise – and the maximum chance of addressing its cause.

“What we try to do is start off with one-to-ones and then get people into classes,” says Jill. “We do a beginners’ rehab class and we’re going to start back care classes, which will involve getting a full assessment from Gordon then coming to me for a four-week programme. We’re just setting them up at the moment.”

What is fundamental to Pilates is that it isn’t just a form of exercise – it’s also both a mindset and a way of life. The first step is promoting an awareness of what feels right. Correct posture flows from there.

“It works on increasing and developing your body awareness, strength and flexibility – all of which improves your posture,” says Sarah. “A lot of back problems come from incorrect posture, so it’s just working on strengthening the spine, strengthening the body as a whole; basically bringing people to where the body should be naturally.”

Jill echoes this: “It’s not just the problem that we’re working with – it’s the whole body. You work to strengthen everything and on posture and education as to how to prevent the problem happening again.

“It’s like going on a diet – we strengthen all the muscles but if you stop working them, you can go back to how you were. What you’ve got to think about is maintaining your body by doing Pilates, even if it’s just once a week. It’s a lifelong thing. Most people who have back pain understand that and they don’t want to go back to where they were before.”

For Sarah, modern, sedentary lifestyles have a lot to answer for when it comes to poor posture and consequent back problems. She often sees children with thoracic tightening (a tensing of the muscles between the neck and diaphragm) and blames hours spent on computers and iPads.

“Years and years ago, we used to move around more and now we rely on cars and computers,” she says. “The negative side is that they fix you in one place. The more you move generally, the better, but then it’s how you move as well.”

The good news is Pilates is for everyone, and it’s never too late to start. “There’s really no upper age limit,” says Sarah. “I’ve got people in their late 80s doing it. I think people have greater awareness that they have to look after their bodies. There’s no point in living to a great age if your body hasn’t developed with you. If you don’t have a strong body, you’re not going to enjoy life as much.”

“I work with so many people who say, ‘I wish I’d started this years ago’,” adds Jill. “It’s one of those things that you don’t think about when you’re young but you’ve got to preserve what you’ve got and keep working on it to keep strong. I’d like everyone to do Pilates. I think it would be amazing if it could be offered on the NHS. I think it would save a heck of a lot of money.”

W: pilatesbeyond.co.uk; facebook.com/pilatesbeyond

W: organicpilates.co.uk

Five Ways To Avoid Back Pain

1. Think about your posture. Don’t slouch – stand up straight. If you’re sitting at the computer, sit up straight.

2. Don’t sit for long periods of time. Get up and keep moving, even if it’s just for five minutes.

3. Practise Pilates with a qualified instructor in a small class.

4. Drink plenty of water to stay hydrated. One of the first places the body takes water from is the discs between the vertebrae.

5. Try to relax and stay positive. Sometimes it’s about your mindset. Breathing is massive. It’s one of the best painkillers there is.