Why the best approach to back pain may not be choosing one over the other.
If you have ever experienced back pain, you will know how quickly it can hit you and how it can completely affects the way you live.
You might wake up one morning and suddenly find it difficult to put your shoes on. Sitting through a day at work becomes uncomfortable. You stop going to the gym because you are worried you might make things worse. Or perhaps your back has been doing this for years, it improves, you forget about it, and then something seemingly insignificant brings the pain back again.
When people come to us with these experiences, one of the questions we often get asked is:
“What treatments or exercise should I be doing? Should I be doing Pilates or do I need physiotherapy?”
After decades of working and specialising with people with back pain, our answer is rarely as simple as choosing one treatment, therapy or rehabilitation exercise program over the other.
The first thing we want to understand is you, your symptoms and your lifestyle.
These details matter because the place where you feel pain does not always tell us the whole story about why you are experiencing it.
Someone who spends ten hours a day sitting at a computer may need something very different from someone returning to exercise after an injury.
A person who has gradually become weaker and less mobile over several years presents a very different picture from someone experiencing sudden pain, neurological symptoms or pain following trauma.
And then there are the people we see who tell us, “My scans and doctors say everything is fine, but my back still hurts.”
Their pain is real too.
This is where our holistic and integrative approach becomes particularly important.
We don’t want to look only at your back. We want to understand how you as a person is functioning your movement, strength, mobility, breathing, previous injuries, daily habits, stress, recovery and, where relevant, your nervous system.
Sometimes our professional opinion is very clear: We want to assess you first.
Depending on your answers to these questions, we may recommend that you are first assessed by our Director, Natalia Laing, who specialises in disc injuries and spinal rehabilitation, or by our Holistic Physiotherapist, Aline Tisato.
Where we feel further investigation is appropriate, we may also recommend consulting your doctor or another healthcare specialist for additional assessment or imaging, such as X-rays or scans.
This allows us to build a more complete clinical picture and determine the safest and most appropriate approach for your treatment and rehabilitation.
At other times, what becomes clear is that your body simply needs to move.
It may be that years of postural habits, repetitive movement patterns or exercising without the right technique have gradually contributed to the problem. In these circumstances, Clinical Pilates is an extremely valuable part of the rehabilitation process.
With the right assessment and individually adapted exercises, we can help the body become stronger, restore mobility and coordination, and gradually rebuild confidence in movements that may have become uncomfortable or even frightening.
And quite often, we use both approaches.
Physiotherapy and Pilates are not competing treatments. In our clinic they can work together each playing a different role in helping the body recover, rebuild and move well again.
As professionals we use both to help rehabilitate, take you out of pain, build the strength, and give you back movement and your physical capability.
So if you are wondering whether Pilates or physiotherapy is better for your back pain, our starting point would be slightly different.
Before deciding on the treatment, let’s first understand the person, your back and what tools we are going to need to care for you.
Back pain is extraordinarily common, and when we look at the way many of us now live and work, that is perhaps not surprising.
Our bodies are designed to move, yet a large part of our modern life involves doing exactly the opposite.
We sit to work. We sit in meetings. We sit in cars, on trains and on planes. We come home after a long day and sit again. Even people who exercise regularly may spend eight or ten hours relatively inactive before trying to compensate with an hour at the gym.
Over time, this can change the way our bodies move.
We may lose mobility through the hips and spine, we lose our physical conditioning, or gradually lose strength in muscles that once worked naturally throughout the day. Then, when we suddenly ask more of the body like a new exercise program, a long flight, moving furniture, gardening for an afternoon, lifting something awkwardly or doing much more than usual because our situation demands it. and you expect your body to just comply, but the body may struggle with a demand it is no longer accustomed to.
But this doesn’t mean that sitting is inherently “bad”, or that there is one perfect posture we should all be trying to maintain, but you need to move.
The human body isn’t designed to stay in one position.
It needs variety.
We need to bend, rotate, reach, walk, squat, extend, carry and change position throughout the day.
Back pain rarely arrives in a body without a history.
An old ankle injury may have changed the way you walk. A previous knee or hip problem may have altered how you distribute load. Abdominal surgery can affect the way you move and recruit muscles. Years of repetitive work or sport can create their own adaptations.
Sometimes these changes are subtle enough that we don’t notice them until another part of the body begins to complain.
This is one of the reasons we look beyond the painful area when someone comes to us with back pain.
Where you feel the pain is important, but so is what is happening above it, below it and throughout the rest of the body.
This is something we believe deserves much more attention when discussing persistent back pain.
Most of us recognise what happens physically when we are stressed. Our shoulders rise. Our jaw tightens. Our breathing changes. We sleep differently. Muscles that should relax remain tense.
When this continues for weeks or months, the nervous system can become increasingly protective and our experience of discomfort and pain can change.
This does not mean that back pain is “all in your head”. Pain is real. But pain is influenced by far more than muscles, joints and what appears on an X-ray or MRI.
Sleep, stress, recovery, fear of movement, previous experiences of pain and our overall physical and emotional state can all form part of the picture.
Age can also bring changes to our joints, discs, muscles and connective tissues. But we are cautious about automatically attributing back pain to ageing. Changes seen on scans are not always the explanation for someone’s symptoms, and getting older does not mean we should accept becoming progressively weaker, stiffer or afraid to move.
This is why, in our professional experience, you can’t reduce back pain to one simple explanation:
Bad posture, weak core, aging or sitting too much…
Any of these factors may be relevant, but none tells us enough about you as a person.
Your body is considerably more complex than that.
And understanding that complexity is exactly why, before deciding whether someone needs Pilates, physiotherapy, rehabilitation or a combination of all, we first need to understand what is contributing to your pain.
Most episodes of back pain are not caused by serious disease. However, there are certain symptoms that should not simply be treated with massage, physiotherapy or exercise without appropriate medical assessment.
Please seek prompt medical advice if back pain is associated with:
Sudden bladder or bowel dysfunction, saddle numbness or significant/progressive leg weakness can require urgent medical assessment and should not wait for a routine physiotherapy appointment.
Knowing when not to treat is just as important as knowing how to treat. This is also an essential part of responsible integrative healthcare.
Once we have a clear understanding of what may be contributing to your back pain, physiotherapy gives us the opportunity to begin working with those findings.
And this is where we believe an important distinction needs to be made.
Of course, when you are in pain, relief matters. If you cannot sleep comfortably, sit through a working day, bend down to put on your shoes or move without apprehension, helping to settle those symptoms is an important part of the process.
But our objective is also to understand what we can change to help your body function better.
Our practitioner Aline Tisato’s approach to physiotherapy is holistic, which means treatment is adapted to what she finds during your assessment rather than following a standard “back pain protocol”.
For one person, significant muscular tension and restricted mobility may be dominating the picture.
Another may need to restore movement following an injury. Someone else may have good mobility but lack the strength or physical capacity to tolerate the demands of their work, sport or daily life.
There are also people whose back pain cannot be fully understood without considering previous injuries or surgery.
An old injury may have changed the way the body moves. Scar tissue following abdominal, pelvic or other surgery can sometimes affect the mobility and function of surrounding tissues. Breathing patterns, prolonged muscular guarding and the way someone has adapted to pain can also become relevant.
This is why two people arriving at SAB with what they both call “lower back pain” may receive very different treatment.
Depending on what your body needs, Aline may draw upon a combination of approaches.
Manual and acupressure therapy may be used to work with areas of muscular or fascial restriction and help restore comfortable movement.
Mobility and therapeutic exercise can begin reintroducing movements that have become limited while progressively restoring strength, control and function.
Movement and postural education can help identify everyday habits that may be contributing to symptoms, not by attempting to force the body into one “perfect” posture, but by helping you find more efficient ways to move, work and change position throughout your day.
Where appropriate, acupuncture may be incorporated as part of treatment to support pain management and reduce muscular tension.
Aline may also use breathing and Qi Gong techniques, particularly when someone is holding considerable tension or has become fearful and guarded in their movement.
And this last point is important.
When your back has hurt repeatedly, you naturally begin protecting it.
You might stop bending forward. You brace before picking something up. You avoid twisting. You stop exercising. Perhaps you have been told that a particular movement is “bad for your back”, so you become increasingly cautious about doing it.
Initially, some protection may be entirely appropriate.
But when that protection continues long after it is needed, the body can become progressively less mobile, less conditioned and less confident with movement.
This is where physiotherapy can help someone safely begin trusting movement again.
Rather than immediately pushing through pain or avoiding movement altogether, we can gradually explore what the body can tolerate and build from there.
For some people, this also means considering the nervous system.
Persistent pain can leave the body in a more protective state. Stress, poor sleep and inadequate recovery may further influence muscular tension and pain sensitivity. Techniques that encourage slower breathing, relaxation and greater awareness of the body can therefore sometimes sit alongside the physical rehabilitation process.
This does not replace strengthening or movement.
It can help create the conditions in which movement becomes easier to reintroduce.
We are particularly likely to recommend physiotherapy as your first step if you have:
But physiotherapy does not necessarily need to be where the journey ends. In many cases, there comes a point when the emphasis needs to shift.
The pain may have settled. Mobility may be improving. The body is moving more comfortably.
Now we want to progressively build the strength, control and physical capacity that allows those improvements to carry over into everyday life.
This is where Pilates can become an integral part of the treatment and rehabilitation process, either alongside physiotherapy or as a specialised treatment approach in its own right.
At Studio Australia Barcelona, we don’t see Pilates simply as exercise that you progress to once physiotherapy has finished.
This is particularly important when we are working with disc herniations, previous spinal injuries, recurring back problems or people who need to rebuild their bodies after a period of pain or reduced movement.
Our Director, Natalia Laing, has spent decades working with the body through Pilates and specialises in disc injury and spinal rehabilitation.
Natalia also brings a very personal understanding to this work.
Living with her own complex spinal injury and diagnosis has given her first-hand experience of long-term back management and rehabilitation, an experience that, alongside the years of professional practice, continues to shape the way she works with clients experiencing spinal and disc-related conditions.
Her approach is therefore very different from joining a general Pilates class and following a standard sequence of exercises with a Pilates teacher. She is a specialist and Pilates Master and her starting point is always the person’s diagnosis, history and current pain levels.
One of the most common pieces of advice given to people with back pain is:
“You need to strengthen your core.”
Core strength may certainly form part of rehabilitation, but in our experience, treating back pain, particularly where there is a disc herniation or previous spinal injury, requires a much more individualised approach.
Natalia first considers what we already know.
From there, she looks at how the whole body is functioning around that diagnosis.
These details help determine not simply what exercises someone should do, but which movements are appropriate at that particular stage of their rehabilitation.
History is equally important.
A previous injury, disc herniation, spinal condition, surgery or years of compensating for pain can gradually change the way someone moves. Muscles may begin doing jobs they were never intended to dominate. Other muscles may become less active. Certain movements may become restricted or avoided altogether.
By the time someone comes to us, therefore, the original diagnosis may be only one part of what we need to address.
The body may have spent months, or sometimes years, adapting around pain.
This is also why two people can arrive at Studio Australia Barcelona with the same diagnosis on an MRI and require completely different Pilates treatment programs.
Their diagnosis may share a name, but their symptoms, history, movement patterns, physical capacity and response to pain can be entirely different.
We don’t treat an MRI. We treat the person living with the condition and the body that has adapted around it.
Depending on what Natalia identifies during your assessment, the initial objective may be very different from what people traditionally imagine Pilates to be.
We may first need to restore movement to areas that have become stiff or guarded.
We may need to improve spinal and hip mobility, while teaching other areas of the body to provide greater support.
We may need to re-establish muscular control and coordination, particularly where pain or injury has changed normal movement patterns.
We may progressively work on strength and stability, not only through the abdominal muscles but through the back, pelvis, hips, gluteals, legs and upper body.
Breathing is also an integral part of Pilates. Learning to breathe effectively while moving can influence trunk control, ribcage mobility, muscular tension and the way someone uses their body during exercise.
And importantly, every exercise can be modified.
The Reformer and other Pilates apparatus give Natalia the ability to use springs for assistance as well as resistance. This means movement can be supported when necessary and then progressively challenged as the person’s strength, mobility and confidence improve.
The objective is not to see how difficult we can make an exercise.
It is to determine what movement your body needs and how we can use Pilates to provide it safely and progressively.
This is an area where we believe experience matters enormously.
Being diagnosed with a disc herniation can be frightening. People are sometimes shown an MRI, told they have a “bulging” or “slipped” disc and understandably become worried about bending, twisting, lifting or exercising.
For some, the response is to stop moving almost completely.
But a diagnosis does not tell us everything about how that individual is functioning, and rehabilitation needs to take into account their symptoms, clinical findings, medical advice and physical presentation.
Natalia can use carefully selected and adapted movements to gradually restore mobility, muscular support, coordination and confidence.
In the early stages, this may look nothing like the Pilates workout you see on social media.
Movements may be small. Resistance may be light. Certain positions or exercises may initially be avoided or modified. Progression is determined by how the individual responds rather than by a predetermined program.
As the body becomes more capable, the exercises evolve with it.
The same principle applies when rehabilitating previous spinal injuries. We work within the appropriate medical and clinical parameters while progressively helping the person regain as much comfortable, confident movement and physical capacity as possible.
One of the greatest challenges we see with longstanding back pain isn’t always physical weakness.
It is loss of trust in the body.
After several painful episodes, people begin anticipating pain before it happens.
They bend differently. They brace unnecessarily. They stop lifting things. They avoid certain exercises. They may become nervous about travelling, gardening, playing sport or even picking something up from the floor.
Over time, the world of movements that feel “safe” becomes smaller.
Clinical Pilates gives us an opportunity to reverse that process gradually.
Under Natalia’s supervision, movements can be reintroduced in a controlled environment. The person begins discovering what they can do rather than constantly focusing on what they believe they cannot.
She will also teach you how to understand and manage your injury, giving you practical strategies to care for your body and respond appropriately should you experience a recurrence or acute flare-up in the future.
This progressive return to movement can be just as important as building strength.
Following an appropriate assessment, Pilates may be recommended as your primary treatment or rehabilitation approach if you are experiencing:
There will also be circumstances where Natalia believes physiotherapy should form part of the treatment, just as there are times when Aline may feel a physiotherapy client would benefit from working with Natalia.
We work as a team.
And this is where having both disciplines within the same practice becomes particularly valuable.
The answer is not necessarily one or the other.
Back pain is personal. Your diagnosis, injury history, current symptoms, movement patterns, lifestyle and even the way your body has adapted to pain over time all influence what you may need to recover.
At Studio Australia Barcelona, our approach is to understand first and treat second. For some people, that means beginning with physiotherapy.
For others, specialised Clinical Pilates with Natalia may be the most appropriate treatment from the outset.
And sometimes, the best approach is to bring the two together, alongside other integrative therapies when they can add value to your recovery.
Most importantly, we want you to understand your back rather than become afraid of it. Our aim is not only to help reduce pain, but to give you the movement, strength, knowledge and confidence to manage your body well, including knowing what to do if your symptoms return.
If you are living with back pain and you’re unsure where to start, you don’t need to make that decision alone.
Book a complimentary 15-minute consultation with Studio Australia Barcelona. Tell us what has been happening, what you have already tried and how your back pain is affecting your life, and we can help guide you towards the most appropriate next step.
Your back doesn’t simply need a treatment. It needs the right treatment for you.
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Why the best approach to back pain may not be choosing one over the other.
If you have ever experienced back pain, you will know how quickly it can hit you and how it can completely affects the way you live.
You might wake up one morning and suddenly find it difficult to put your shoes on. Sitting through a day at work becomes uncomfortable. You stop going to the gym because you are worried you might make things worse. Or perhaps your back has been doing this for years, it improves, you forget about it, and then something seemingly insignificant brings the pain back again.
When people come to us with these experiences, one of the questions we often get asked is:
“What treatments or exercise should I be doing? Should I be doing Pilates or do I need physiotherapy?”
After decades of working and specialising with people with back pain, our answer is rarely as simple as choosing one treatment, therapy or rehabilitation exercise program over the other.
The first thing we want to understand is you, your symptoms and your lifestyle.
These details matter because the place where you feel pain does not always tell us the whole story about why you are experiencing it.
Someone who spends ten hours a day sitting at a computer may need something very different from someone returning to exercise after an injury.
A person who has gradually become weaker and less mobile over several years presents a very different picture from someone experiencing sudden pain, neurological symptoms or pain following trauma.
And then there are the people we see who tell us, “My scans and doctors say everything is fine, but my back still hurts.”
Their pain is real too.
This is where our holistic and integrative approach becomes particularly important.
We don’t want to look only at your back. We want to understand how you as a person is functioning your movement, strength, mobility, breathing, previous injuries, daily habits, stress, recovery and, where relevant, your nervous system.
Sometimes our professional opinion is very clear: We want to assess you first.
Depending on your answers to these questions, we may recommend that you are first assessed by our Director, Natalia Laing, who specialises in disc injuries and spinal rehabilitation, or by our Holistic Physiotherapist, Aline Tisato.
Where we feel further investigation is appropriate, we may also recommend consulting your doctor or another healthcare specialist for additional assessment or imaging, such as X-rays or scans.
This allows us to build a more complete clinical picture and determine the safest and most appropriate approach for your treatment and rehabilitation.
At other times, what becomes clear is that your body simply needs to move.
It may be that years of postural habits, repetitive movement patterns or exercising without the right technique have gradually contributed to the problem. In these circumstances, Clinical Pilates is an extremely valuable part of the rehabilitation process.
With the right assessment and individually adapted exercises, we can help the body become stronger, restore mobility and coordination, and gradually rebuild confidence in movements that may have become uncomfortable or even frightening.
And quite often, we use both approaches.
Physiotherapy and Pilates are not competing treatments. In our clinic they can work together each playing a different role in helping the body recover, rebuild and move well again.
As professionals we use both to help rehabilitate, take you out of pain, build the strength, and give you back movement and your physical capability.
So if you are wondering whether Pilates or physiotherapy is better for your back pain, our starting point would be slightly different.
Before deciding on the treatment, let’s first understand the person, your back and what tools we are going to need to care for you.
Back pain is extraordinarily common, and when we look at the way many of us now live and work, that is perhaps not surprising.
Our bodies are designed to move, yet a large part of our modern life involves doing exactly the opposite.
We sit to work. We sit in meetings. We sit in cars, on trains and on planes. We come home after a long day and sit again. Even people who exercise regularly may spend eight or ten hours relatively inactive before trying to compensate with an hour at the gym.
Over time, this can change the way our bodies move.
We may lose mobility through the hips and spine, we lose our physical conditioning, or gradually lose strength in muscles that once worked naturally throughout the day. Then, when we suddenly ask more of the body like a new exercise program, a long flight, moving furniture, gardening for an afternoon, lifting something awkwardly or doing much more than usual because our situation demands it. and you expect your body to just comply, but the body may struggle with a demand it is no longer accustomed to.
But this doesn’t mean that sitting is inherently “bad”, or that there is one perfect posture we should all be trying to maintain, but you need to move.
The human body isn’t designed to stay in one position.
It needs variety.
We need to bend, rotate, reach, walk, squat, extend, carry and change position throughout the day.
Back pain rarely arrives in a body without a history.
An old ankle injury may have changed the way you walk. A previous knee or hip problem may have altered how you distribute load. Abdominal surgery can affect the way you move and recruit muscles. Years of repetitive work or sport can create their own adaptations.
Sometimes these changes are subtle enough that we don’t notice them until another part of the body begins to complain.
This is one of the reasons we look beyond the painful area when someone comes to us with back pain.
Where you feel the pain is important, but so is what is happening above it, below it and throughout the rest of the body.
This is something we believe deserves much more attention when discussing persistent back pain.
Most of us recognise what happens physically when we are stressed. Our shoulders rise. Our jaw tightens. Our breathing changes. We sleep differently. Muscles that should relax remain tense.
When this continues for weeks or months, the nervous system can become increasingly protective and our experience of discomfort and pain can change.
This does not mean that back pain is “all in your head”. Pain is real. But pain is influenced by far more than muscles, joints and what appears on an X-ray or MRI.
Sleep, stress, recovery, fear of movement, previous experiences of pain and our overall physical and emotional state can all form part of the picture.
Age can also bring changes to our joints, discs, muscles and connective tissues. But we are cautious about automatically attributing back pain to ageing. Changes seen on scans are not always the explanation for someone’s symptoms, and getting older does not mean we should accept becoming progressively weaker, stiffer or afraid to move.
This is why, in our professional experience, you can’t reduce back pain to one simple explanation:
Bad posture, weak core, aging or sitting too much…
Any of these factors may be relevant, but none tells us enough about you as a person.
Your body is considerably more complex than that.
And understanding that complexity is exactly why, before deciding whether someone needs Pilates, physiotherapy, rehabilitation or a combination of all, we first need to understand what is contributing to your pain.
Most episodes of back pain are not caused by serious disease. However, there are certain symptoms that should not simply be treated with massage, physiotherapy or exercise without appropriate medical assessment.
Please seek prompt medical advice if back pain is associated with:
Sudden bladder or bowel dysfunction, saddle numbness or significant/progressive leg weakness can require urgent medical assessment and should not wait for a routine physiotherapy appointment.
Knowing when not to treat is just as important as knowing how to treat. This is also an essential part of responsible integrative healthcare.
Once we have a clear understanding of what may be contributing to your back pain, physiotherapy gives us the opportunity to begin working with those findings.
And this is where we believe an important distinction needs to be made.
Of course, when you are in pain, relief matters. If you cannot sleep comfortably, sit through a working day, bend down to put on your shoes or move without apprehension, helping to settle those symptoms is an important part of the process.
But our objective is also to understand what we can change to help your body function better.
Our practitioner Aline Tisato’s approach to physiotherapy is holistic, which means treatment is adapted to what she finds during your assessment rather than following a standard “back pain protocol”.
For one person, significant muscular tension and restricted mobility may be dominating the picture.
Another may need to restore movement following an injury. Someone else may have good mobility but lack the strength or physical capacity to tolerate the demands of their work, sport or daily life.
There are also people whose back pain cannot be fully understood without considering previous injuries or surgery.
An old injury may have changed the way the body moves. Scar tissue following abdominal, pelvic or other surgery can sometimes affect the mobility and function of surrounding tissues. Breathing patterns, prolonged muscular guarding and the way someone has adapted to pain can also become relevant.
This is why two people arriving at SAB with what they both call “lower back pain” may receive very different treatment.
Depending on what your body needs, Aline may draw upon a combination of approaches.
Manual and acupressure therapy may be used to work with areas of muscular or fascial restriction and help restore comfortable movement.
Mobility and therapeutic exercise can begin reintroducing movements that have become limited while progressively restoring strength, control and function.
Movement and postural education can help identify everyday habits that may be contributing to symptoms, not by attempting to force the body into one “perfect” posture, but by helping you find more efficient ways to move, work and change position throughout your day.
Where appropriate, acupuncture may be incorporated as part of treatment to support pain management and reduce muscular tension.
Aline may also use breathing and Qi Gong techniques, particularly when someone is holding considerable tension or has become fearful and guarded in their movement.
And this last point is important.
When your back has hurt repeatedly, you naturally begin protecting it.
You might stop bending forward. You brace before picking something up. You avoid twisting. You stop exercising. Perhaps you have been told that a particular movement is “bad for your back”, so you become increasingly cautious about doing it.
Initially, some protection may be entirely appropriate.
But when that protection continues long after it is needed, the body can become progressively less mobile, less conditioned and less confident with movement.
This is where physiotherapy can help someone safely begin trusting movement again.
Rather than immediately pushing through pain or avoiding movement altogether, we can gradually explore what the body can tolerate and build from there.
For some people, this also means considering the nervous system.
Persistent pain can leave the body in a more protective state. Stress, poor sleep and inadequate recovery may further influence muscular tension and pain sensitivity. Techniques that encourage slower breathing, relaxation and greater awareness of the body can therefore sometimes sit alongside the physical rehabilitation process.
This does not replace strengthening or movement.
It can help create the conditions in which movement becomes easier to reintroduce.
We are particularly likely to recommend physiotherapy as your first step if you have:
But physiotherapy does not necessarily need to be where the journey ends. In many cases, there comes a point when the emphasis needs to shift.
The pain may have settled. Mobility may be improving. The body is moving more comfortably.
Now we want to progressively build the strength, control and physical capacity that allows those improvements to carry over into everyday life.
This is where Pilates can become an integral part of the treatment and rehabilitation process, either alongside physiotherapy or as a specialised treatment approach in its own right.
At Studio Australia Barcelona, we don’t see Pilates simply as exercise that you progress to once physiotherapy has finished.
This is particularly important when we are working with disc herniations, previous spinal injuries, recurring back problems or people who need to rebuild their bodies after a period of pain or reduced movement.
Our Director, Natalia Laing, has spent decades working with the body through Pilates and specialises in disc injury and spinal rehabilitation.
Natalia also brings a very personal understanding to this work.
Living with her own complex spinal injury and diagnosis has given her first-hand experience of long-term back management and rehabilitation, an experience that, alongside the years of professional practice, continues to shape the way she works with clients experiencing spinal and disc-related conditions.
Her approach is therefore very different from joining a general Pilates class and following a standard sequence of exercises with a Pilates teacher. She is a specialist and Pilates Master and her starting point is always the person’s diagnosis, history and current pain levels.
One of the most common pieces of advice given to people with back pain is:
“You need to strengthen your core.”
Core strength may certainly form part of rehabilitation, but in our experience, treating back pain, particularly where there is a disc herniation or previous spinal injury, requires a much more individualised approach.
Natalia first considers what we already know.
From there, she looks at how the whole body is functioning around that diagnosis.
These details help determine not simply what exercises someone should do, but which movements are appropriate at that particular stage of their rehabilitation.
History is equally important.
A previous injury, disc herniation, spinal condition, surgery or years of compensating for pain can gradually change the way someone moves. Muscles may begin doing jobs they were never intended to dominate. Other muscles may become less active. Certain movements may become restricted or avoided altogether.
By the time someone comes to us, therefore, the original diagnosis may be only one part of what we need to address.
The body may have spent months, or sometimes years, adapting around pain.
This is also why two people can arrive at Studio Australia Barcelona with the same diagnosis on an MRI and require completely different Pilates treatment programs.
Their diagnosis may share a name, but their symptoms, history, movement patterns, physical capacity and response to pain can be entirely different.
We don’t treat an MRI. We treat the person living with the condition and the body that has adapted around it.
Depending on what Natalia identifies during your assessment, the initial objective may be very different from what people traditionally imagine Pilates to be.
We may first need to restore movement to areas that have become stiff or guarded.
We may need to improve spinal and hip mobility, while teaching other areas of the body to provide greater support.
We may need to re-establish muscular control and coordination, particularly where pain or injury has changed normal movement patterns.
We may progressively work on strength and stability, not only through the abdominal muscles but through the back, pelvis, hips, gluteals, legs and upper body.
Breathing is also an integral part of Pilates. Learning to breathe effectively while moving can influence trunk control, ribcage mobility, muscular tension and the way someone uses their body during exercise.
And importantly, every exercise can be modified.
The Reformer and other Pilates apparatus give Natalia the ability to use springs for assistance as well as resistance. This means movement can be supported when necessary and then progressively challenged as the person’s strength, mobility and confidence improve.
The objective is not to see how difficult we can make an exercise.
It is to determine what movement your body needs and how we can use Pilates to provide it safely and progressively.
This is an area where we believe experience matters enormously.
Being diagnosed with a disc herniation can be frightening. People are sometimes shown an MRI, told they have a “bulging” or “slipped” disc and understandably become worried about bending, twisting, lifting or exercising.
For some, the response is to stop moving almost completely.
But a diagnosis does not tell us everything about how that individual is functioning, and rehabilitation needs to take into account their symptoms, clinical findings, medical advice and physical presentation.
Natalia can use carefully selected and adapted movements to gradually restore mobility, muscular support, coordination and confidence.
In the early stages, this may look nothing like the Pilates workout you see on social media.
Movements may be small. Resistance may be light. Certain positions or exercises may initially be avoided or modified. Progression is determined by how the individual responds rather than by a predetermined program.
As the body becomes more capable, the exercises evolve with it.
The same principle applies when rehabilitating previous spinal injuries. We work within the appropriate medical and clinical parameters while progressively helping the person regain as much comfortable, confident movement and physical capacity as possible.
One of the greatest challenges we see with longstanding back pain isn’t always physical weakness.
It is loss of trust in the body.
After several painful episodes, people begin anticipating pain before it happens.
They bend differently. They brace unnecessarily. They stop lifting things. They avoid certain exercises. They may become nervous about travelling, gardening, playing sport or even picking something up from the floor.
Over time, the world of movements that feel “safe” becomes smaller.
Clinical Pilates gives us an opportunity to reverse that process gradually.
Under Natalia’s supervision, movements can be reintroduced in a controlled environment. The person begins discovering what they can do rather than constantly focusing on what they believe they cannot.
She will also teach you how to understand and manage your injury, giving you practical strategies to care for your body and respond appropriately should you experience a recurrence or acute flare-up in the future.
This progressive return to movement can be just as important as building strength.
Following an appropriate assessment, Pilates may be recommended as your primary treatment or rehabilitation approach if you are experiencing:
There will also be circumstances where Natalia believes physiotherapy should form part of the treatment, just as there are times when Aline may feel a physiotherapy client would benefit from working with Natalia.
We work as a team.
And this is where having both disciplines within the same practice becomes particularly valuable.
The answer is not necessarily one or the other.
Back pain is personal. Your diagnosis, injury history, current symptoms, movement patterns, lifestyle and even the way your body has adapted to pain over time all influence what you may need to recover.
At Studio Australia Barcelona, our approach is to understand first and treat second. For some people, that means beginning with physiotherapy.
For others, specialised Clinical Pilates with Natalia may be the most appropriate treatment from the outset.
And sometimes, the best approach is to bring the two together, alongside other integrative therapies when they can add value to your recovery.
Most importantly, we want you to understand your back rather than become afraid of it. Our aim is not only to help reduce pain, but to give you the movement, strength, knowledge and confidence to manage your body well, including knowing what to do if your symptoms return.
If you are living with back pain and you’re unsure where to start, you don’t need to make that decision alone.
Book a complimentary 15-minute consultation with Studio Australia Barcelona. Tell us what has been happening, what you have already tried and how your back pain is affecting your life, and we can help guide you towards the most appropriate next step.
Your back doesn’t simply need a treatment. It needs the right treatment for you.
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