Treating your neck pain with Pilates

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P ain in the neck is a common problem amongst the adult population for a variety of reasons. A forward head position which is “normal” in today’s tech-crazy world, plus the element of stress which is often carried around in elevated shoulders keeps the muscles in the neck constantly pulled upwards. Compounded by improper bag carrying practices and poor sleeping patterns these disorders can have you waking up feeling like a wreck!

Fortunately, Pilates has been reviewed as an indisputable movement therapy for the position of the head and a rehabilitation tool in a wide range of conditions in the neck and shoulders. The desired outcome of reducing pain and disability has been documented in an extensive study by Scollay in 2016 using equipment Pilates exercises, with 24 subjects ages 18-58.

Findings have proven that, for the vast majority of neck problems, Pilates helps to strengthen and stabilise the core and the area around the problem site, whether the source of the pain is coming from bone or disk or nerve impingement. Having a core that supports the entire body will facilitate better movement patterning and thereby reduce the load on the neck. With new-found core strength, practising better postural habits becomes easier and you can train your head back into right positioning through mindful practice.


Cueing yourself back into right posture

The best way to distinguish postural sabotage is to stand with your back up against a wall, bringing the heels within four to five inches of the baseboard depending on the space available to your body’s shape and size. With the back of the head in line with the back of the shoulders, this one mental cue returns the head directly over the shoulders.

From there, the attention to shoulder placement should be right over the rib cage, lining up the ribcage with the pelvis you become aware of the discrepancies in how you might stand if you were not propped up by the wall. Feeling where you place the weight over your feet is also noteworthy, because it can clue you in to how much you push the pelvis forward over your toes or less centred over the arch of the foot.

Positioning the pelvis in line with the heels and pulling up from the arches is a good way to start the stacking of the spine in a neutral position from the ground up. What is always surprising is how the neck is directly affected by the way you stand up on your feet, as the body lines up like a game of Jenga to balance itself.

Pilates can be done either with specialised equipment or as a floor-based exercise on a mat, but be cautious when choosing the classes that you attend, as the instructor training makes all the difference to your safety and potential harm that can be done by bad form, training imbalances, and improper exercise selection relative to your condition.

Every exercise counts with neck pain. Pilates instructors should hold a certification from a governing body such as the Pilates Method Alliance (PMA) or a printed document on display from an affiliated reputable Pilates movement education course which is registered with the PMA.

One of my favourite Pilates mat exercises is the Dart. It is done by lying on the floor facing downwards, arms pulled back in line with the body and the focus is placed on pulling the crown of the head away from the shoulder girdle. It is important to focus on the lifting of the head in moderation depending on your pain level and condition, but the quality of this movement actually comes from the belly, legs and glutes.

Directing the source of the power to the centre of the body by zipping the legs together evens out the load over the length of the spine, creating a chin effect of strength to smaller untapped muscles. With the lift happening only in the upper thoracic region, it also helps to strengthen the neck extensors, upper back, and creates a muscle memory pattern that has the arms pulled behind the shoulders, opening tight chest muscles, and creating the effect of length in the arms, pulling the shoulders down away from the ears.

Pilates is useful for improving physical function and should be used as a tool for developing the body uniformly and restoring physical vitality promoting ongoing health of the spine, but should not replace specific rehabilitative therapies for distinct conditions. After all, a Pilates instructor is not necessarily an expert in rehabilitation and an expert in rehabilitation is not necessarily a Pilates expert either. Beginning to bring mindful awareness to all of your activities goes a long way in the long-term outcome, even a squat with poor head positioning can deteriorate all of your efforts at corrective therapies. So always remember to use your core.

With a shift in modern health care moving towards patient-centred active management compared to the previous passive health care model, which by comparison drove the cost of health sky-high, the demand for physical exercises in a health care system is amplified by the need to lower the financial burden of postural defects, and the resulting musculoskeletal disorders that come with it.

Think of the amount of time we spend slumped and fast-forward 20 years to imagine what your spine will become, then apply the cost to the care of a spine that is deformed, not to mention the physical cost to the quality of life. This is the year to take back control over the life of your spine, your mind and your body.


Everything is a resource

Pilates training focuses on the small muscles which support the body to stretch upward, while delivering awareness to breathing, improving all repetitive movement that you do during daily living. Assuming an upright and balanced position in the spine begins to happen unconsciously, and that is when you are really transformed in your new habit. As a result, your ageing process is slowed down, as the whole body operates synergistically. You have an opportunity to reconnect to this intention at any time, once you become aware of your holding patterns and the thoughts behind them. And, if you forget yourself, remember your core…it’s always holding you.


Selena DeLeon has been a personal and group fitness trainer for 16 years. She has a Pilates studio in Kingston called Core Fitness, where she helps people to move and live better. Its website is

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