How to Overcome Neck Pain and Upper Back Soreness in Pilates

Alignment, Strong Abs, and Back Muscles Support the Neck

Young woman in sportswear with neck pain. You may also like:
Marcela Barsse/E+/Getty Images

A sore neck, neck pain, and tension in the neck and shoulders are not uncommon complaints for Pilates beginners. They may wonder if there are neck strengthening exercises that can help them get past the sore neck stage. While the strength of an individual's neck muscles can be a factor, a weak neck is often not the main cause of neck pain in Pilates.

When the neck and shoulders are not properly supported in an exercise, they take on too much of the work. Weak abdominal muscles, weak back muscles, and poor alignment are likely culprits. The abdominals, back, and alignment must work together to create the stability in the trunk that frees the neck.

If you have constant or worsening back and neck pain, work with a health care provider to look for potential causes and find relief.

Strengthen the Ab Muscles

In Pilates, many exercises (such as chest lift, the hundred, and roll up), require laying on your back, lifting your head away from and returning it to the mat. When you come up or roll down, your abdominal muscles have to be really strong to support your upper body in resisting the pull of gravity.

If the abdominal muscles aren't doing a lot of the work, the neck muscles tense, taking on more effort than they should. Further, if the neck muscles are weak and can't support the head and neck, which can lead to muscle strain and misalignment of the vertebrae.

How to Develop Abdominal Strength

Two related practices will help you develop the strength and coordination you need for your abdominal and neck muscles to work together to support your head. First, neck and shoulder tension are often chronic habits. We use these muscles even when we don't need to. The cure for that can be as simple as increased awareness.

Notice, let go, and put the effort where it belongs, in the abs. Second, the neck muscles are going to get work, but you do have to develop the core abdominal strength that will allow the abdominal muscles to relieve extra pressure on the neck muscles.

Pilates exercises are all about creating strong abdominal muscles and overall core strength. The first thing you need to know is how to pull your abdominal muscles correctly because this is almost always the supportive move that happens before anything else. Once you have that, we use a lot of forward bending (flexion) exercises to focus on increasing abdominal muscle strength.

Practice using your abs to support your neck with these exercises:

Strengthen the Back Muscles

Your abdominal and back muscles work together to support your spine and neck. When you aim for a long spine, you need the support of back extensor muscles. If those don't work, you will feel extra tension in the shoulders and neck. This can happen with exercises that are forward-bending, back-bending, or in neutral spine, but you may feel more pain in exercises where you are lying face down and lifting the upper body away from the mat.

To strengthen the back extensor muscles, try back-bending exercises like swan, dart, swimming, and double leg kick (more advanced). To protect your neck when you do back extension exercises, engage your abs and focus on using your back muscles to lift and support your upper body and head instead of lifting with the neck and shoulders.

To modify back extension exercises, use a smaller range of motion, reduce time you hold an exercise, and stop when you don't have the core support you need to continue.

Holding the arms up adds extra weight and difficulty. For example, swimming is harder than half swan because the arms are extended. If you have neck pain, try keeping your arms by your sides or using them for light support.

Practice Good Alignment

Your head and neck should be aligned as natural extensions of your spine. Breaking the line at the neck is one of the easiest ways to wreck an exercise and get neck pain. This can look like a back tilt of the head during back extensions, jamming the chin too far down in forward bends, or tilting too far to the side in sideways exercises.

When the spine is in its natural, neutral position, the ears should be right in line with the shoulders. When you change that alignment to do forward-bending exercises like wall roll down or the hundred, the head needs to do a little nod forward to remain in line with the intention to curve the spine.

In back-bending exercises, extend the neck as part of the line of the long spine. People often have the urge to look up when doing extension exercises like swimming or even single leg kick. Instead, think of energy extending out the top of your head so that the sense of length through the spine helps lift you.

Practice keeping your head in line with your spine when you do these exercises:

Protect Your Neck With Modifications

Making sure that your abs and back are strong and your abs are working throughout an exercise is very important. But if you are experiencing neck pain, you might also need to modify your exercises as you build strength and release neck and shoulder tension.

  • Don't keep your head up for long. As soon as the neck muscles take over, put your head down and come up again, engaging the abs for the lift.
  • If you are rolling down, stop when the neck and shoulders get tense. Back off a bit, then try again, keeping your abs working this time. You might not roll down all the way; just move to your limit and back off. You will get stronger and go further with practice.
  • Place your hands behind your head for light support (elbows out).
  • When the legs are outstretched, raise them or bend them to tabletop position to take strain off the abs until they get stronger.

There are more ways to modify exercises to help relieve stress on the neck. If you are having neck pain when you do Pilates or after, work with a Pilates instructor who can help you with your particular movement patterns.

Was this page helpful?
Article Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Su JG, Won SJ, Gak H. Effect of craniocervical posture on abdominal muscle activitiesJ Phys Ther Sci. 2016;28(2):654-657. doi:10.1589/jpts.28.654

  2. Lee DK, Moon DC, Hong KH. Effect of neck flexion restriction on sternocleidomastoid and abdominal muscle activity during curl-up exercisesJ Phys Ther Sci. 2016;28(1):90-92. doi:10.1589/jpts.28.90

  3. Vinstrup J, Sundstrup E, Brandt M, Jakobsen MD, Calatayud J, Andersen LL. Core muscle activity, exercise preference, and perceived exertion during core exercise with elastic resistance versus machineScientifica (Cairo). 2015;2015:403068. doi:10.1155/2015/403068

  4. Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitance L. The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic reviewJ Back Musculoskelet Rehabil. 2017;30(6):1149–1169. doi:10.3233/BMR-169615

  5. Nightingale RW, McElhaney JH, Richardson WJ, Myers BS. Dynamic responses of the head and cervical spine to axial impact loading. J Biomech. 1996;29(3):307-18. doi:10.1016/0021-9290(95)00056-9

  6. Mortensen P, Larsen AI, Zebis MK, Pedersen MT, Sjøgaard G, Andersen LL. Lasting effects of workplace strength training for neck/shoulder/arm pain among laboratory technicians: Natural experiment with 3-year follow-upBiomed Res Int. 2014;2014:845851. doi:10.1155/2014/845851