From a physiotherapy perspective, neck and back pain are probably some of the most common complaints that stem from trunk and core weakness. So I’ve teed up my favourite YouTube videos from my channel to walk you through several Reformer Pilates exercises for lower back pain, from beginner to advanced.

Pilates on the Reformer is a great low-impact alternative that I’ve found to be incredibly effective at addressing strength and range of motion imbalances. To be more specific, the following videos are aimed at improving deep core activation, lumbar flexion, thoracic mobility, and posterior chain and anterior chain strength.

It’s no secret that Pilates can help manage lower back pain or discomfort. But I’ll be the first to admit that sometimes Mat Pilates exercises can get a little stale. If you’re looking for an injection of something new and fresh, consider using a Pilates Reformer as another option for your clients.

Not sure about how to use a Reformer? Grab my free Safety and Set-up Guide.

Want to learn more about how to start using a Reformer with your rehab clients? Check out my one-hour mini course with my most frequently used exercises.

Core Warm Up with a Pilates Reformer

Starting any session with waking up the core is never a bad idea. So to save time from moving between the Mat and Reformer here are a few you can do in Footwork position.  These exercises are great before moving onto any of the following videos. 

This video includes: 

• Footwork with Twist/Rotation +/- Bridge (Leg press with trunk rotation)
• Pelvic rocking with zipper on exhale (Pelvic and lumbar AROM through flexion/extension)
• Lumbar side flexion (Crook lying AROM)
• Knee Drops and Arm Raises (TA activation in crook lying)
• Toe Taps, Leg Extensions/Circles (Higher level TA activation in crook lying)
• Hip Rolls (Articulated bridge)

Beginner Lower Back Pain Exercises

A few very gentle mobility and ROM exercises for people new to Reformer Pilates. This is a great place to start for someone brand new to this apparatus.  For anyone practicing the Mckenzie Method, Knee Stretches can be performed with slight extension if the client is able to control their spinal support and alignment.  There is some overlap in the exercises from the Core Warm-up, but that’s because this set of exercises was designed to stand alone.  Remember to keep things pain-free with lighter spring resistance if necessary.  

This video includes: 

• Mermaid with Twist (Side sitting with hip IR/ER and lumbar and thoracic rotation)
• Knee Drops and Arm Drops (TA activation in crook lying)
• Hip Rolls (lumbar spinal articulation into flexion with hip extension)
• Knee Stretches with Round Back (Lumbar flexion/extension AROM, +/- hip extension) 

Chronic Lower Back Pain Exercises

Chronic low back pain (LBP) can lead to a lot of persistent changes in the core muscles and lumbar spine.  Pain is often a very strong influence on altering movement patterns.   Even if it has been years or decades since they herniated a disc, I still see things like poor posture, weak core strength, and reduced range of motion.  Try these exercises with clients who are not in an acute episode, and are ready to get reacquainted with their back muscles, deep core stabilzers, and balance.  

This video includes:

• Teaser Prep (lumbar flexion and deep core stability)
• Stomach Massage with Forward Fold or Rotation (Hamstring stretching, posterior chain stretching, spinal rotation)
• Side Splits Cross Touch (Sustained hip abduction with forward bend)

Beginner Core and Oblique Strength Exercises

Things get a bit more interesting with this kneeling exercise series.  I’m adding a lot more oblique strengthening to help support the spine.  It can be easy to overlook the obliques when the focus is often on spinal extension or flexion in the lumbar region.  I find that kneeling helps isolate the trunk through these rotational movements.

This video includes: 

• Arm Rotation in half kneeling (Diagonal patterns with single strap)
• Back Hand with Rotation in half kneeling (Diagonal patterns with single strap)
• Open Elbows with single strap in tall kneeling (Short lever back fly) 
• Open Arms with Long lever back fly with single strap (T and Y arms)
• Star Prep (Kneeling side plank with twist

Intermediate Side flexion/Oblique Stretching and Strengthening Exercises

Ready to layer on some eccentric obliques? Look no further. A few of my favourite feel-good Pilates exercises for those that are more comfortable with the Reformer machine.   These dynamic stretches wake up trunk muscles to help improve mobility and strength through a greater range of motion. Make sure to move slowly to get the most out of the eccentric work.

This video includes: 

• Half kneeling Side bend (Resisted side flexion with arm overhead)
• Short Box Mermaid with pole (Side flexion in side sitting)
• Plank with pike and twist (Dynamic plank with trunk rotation)

Advanced Exercises for Chronic Lower Back Pain

Chronic back pain does not discriminate and can effect even high level athletes.  So what do you do when you need something higher level yet still therapeutic? Using Reformer Pilates is such a great way to increase strength and flexibility but still keep things challenging.  These exercises target both the posterior and anterior chains with supported spinal flexion. 

*Please note it is strongly recommended that you have completed an Advanced Reformer Pilates instructor training before attempting these exercises.  Check out my online Advanced Reformer Course for clinicians if you’re interested in a thorough and safe way to learn these challenging yet fun exercises. 

This video includes: 

• Back Rowing Straight Back 
• Advanced Long Spine (NOT for individuals with osteoporosis)
• Tendon Stretch

If you’re interested in learning how to make Reformer Pilates a part of your skill set, Check out my online Reformer courses made specifically for rehab professionals.