‘Pilates' has recently become the latest fad in exercise among celebrities, (including the use of a large inflated ‘gym' ball) and now the general public, but Pilates exercises are far from new. Joseph Pilates' concept of exercises focused on movement control, and in 1945 he defined it as “complete coordination of mind, body and spirit.” The emphasis in Pilates is on how the body works as a whole coordinated unit, so Pilates exercises have been very popular with dancers for many years.

The six principles of Pilates are very similar to what has been taught for back patients in physical therapy clinics for spinal stabilization for decades. These will help you gain improved strength and control of your back, pelvic and abdominal muscles while you exercise to help reduce pain, and improve movement in general. Quality is always superior to quantity of exercise.

•  First, learn and maintain proper posture in all positions and activities called centering . Why? Well-aligned posture creates balance and stability, which is a necessary foundation for free and coordinated movement of the arms and legs. This is called your ‘center'. All Pilates exercises focus on strength and flexibility of the ‘center', from the lower ribs to just below the buttocks. As these are the areas affected by pain and weakness with low back injuries, selected low-level Pilates exercises are ideal for many patients with spinal pain. Progression of exercise difficulty will keep the exercise routine from being boring as strength and flexibility improve.

•  Secondly, learn to breathe correctly . Don't hold your breath while exercising, breathe fully and deeply through the nose, and out through the mouth. As you breathe in, the air flows into your back, not only by lifting your chest and ribs.

•  Concentration on exactly how and where you move, and not just waving your arms and legs around, is one of the major things that separate Pilates from many exercise forms. Concentrating on body movement at all times can be difficult at the beginning, as the body does not always do exactly as the mind tells it. Concentrating and focusing on what movements are using the muscles correctly, and what is incorrect (and changing it) while you move is what will improve your form and control by focusing on the details.

•  Pilates requires the complete control of your body by your mind. “ Ideally, our muscles should obey our will. Reasonably, our will should not be dominated by the reflex actions of our muscles.” J. Pilates. Uncontrolled automatic movements, like how most of us work out on weight machines where the movements are mindless, can actually perpetuate incorrect muscle strength imbalances. Without concentration and control, the body's stronger muscles will tend to do all the work, and stay stronger, and the weaker muscles tend to remain relatively unused and will then remain weak.

•  Precision of movement is needed while concentrating. Continuing to practice incorrectly performed exercises will not give the desired results, it will only reinforce bad habits.

•  All of the Pilates exercises and movement in general should flow, and should not be jerky like calisthenics. One exercise should be able to segue smoothly into the next exercise.

If you have back problems, Pilates exercises can be very helpful, but must be chosen and modified appropriately by properly trained personnel. Most Pilates instructors are not trained in physical therapy or injury treatment, usually only in how to teach healthy persons how to do the exercises and postural modifications. Make sure that you are exercising within your comfortable exercise limits, as even the best types of exercises may be too strenuous for any individual with a specific problem.