Why Does Pilates Hurt Sometimes
You’re engaging your core, holding great posture, and moving with precision—but instead of feeling strong and energized after class, you’re battling tightness, aches, or even sharp pain. What gives?
Pilates is amazing for core strength and mobility, and absolutely supports people with chronic pain. But when pain creeps in, it can feel like something’s gone wrong.
Recently, I’ve had a bunch of patients come into my clinic with neck, back, and hip pain, and through the initial chat and treatment we’ve traced it back to Pilates. If you’ve ever walked out of class thinking, “Why does my back/ neck/ hip hurt after Pilates?” – you’re not alone.
Pain isn’t a sign that you need to quit Pilates—it’s your body’s way of asking for a new approach.
It was my intention to write a simple blog about the basics of movement, common symptoms, and give you some tips, but things got out of hand and now I have 3 articles.
In this blog we’ll chat about:
✅ Pilates basics
✅ The muscles on the front of your body (the front line)
✅ Spinal movement
✅ and how it all relates to your practice.
So all in all, really nerdy stuff. Let’s dive in!
A quick recap of what Pilates is:
At its core (pun intended), Pilates is about stability and control. Pilates is “a mind-body exercise that requires core stability, strength, and flexibility, and attention to muscle control, posture, and breathing” (Here). Essentially it is based on 50 exercises that emphasize control, alignment, and core engagement. When I think of Pilates, I think of core work.
What’s the front line and why does it matter?
The front line is a series of interconnected structures that includes fascia, and muscles that help support your posture and balance, while also creating movement.
The idea of grouping tracts of muscles and fascia was popularized by Tom Myers. In his book Anatomy Trains he describes the front line in 3 layers: the Functional Front Line, the Superficial Front Line, and the Deep Front Line. As is apparent by their names each group of muscles is slightly different and has slightly different functions.
The Functional Front Line
Muscles: Pectoralis major, external oblique, rectus abdominis, adductor longus
Function: Connects the upper and lower body through diagonal patterns, it powers movements like lunging, twisting, and reaching. It’s also functional (whoa!) by supporting your gait.
The Superficial Front Line
Muscles: Sternocleidomastoid, sternal fascia, rectus abdominis, rectus femoris (quads), anterior lower leg muscles
Function: To Balance our posture, and allows quick for flexion movements.
The Deep Front Line
Muscles: Suprahyoids, infrahyoids, longus colli, thoracic fascia, scalenes, diaphragm, psoas, pelvic floor, pectineus, adductors
Function: Acts as our myofascial "core," and beautifully connects your breathing with your walking. It supports your arches, hips, and deep stability.
These front lines connect the entire length of the front of your body, from your feet to your head. And they all basically do the same thing – create flexion—bringing the head, chest, pelvis, and legs closer together.
Why it matters
The front line gets a lot of action in work outs, and in our daily lives, like when we are sitting. Now don’t get me wrong! Flexion isn’t inherently bad. The problem comes when we can’t fully move out of this position. This can happen when you don’t counterbalance flexion movements and then pair that with our modern life (read: sitting all day).
What does this mean for your Pilates practice? When one part of the Front Line is overactive or restricted, it creates compensation patterns that can lead to discomfort and altered movement patterns. If the superficial line engages too quickly it may make some exercises feel extra challenging or lead to neck or low back pain. If the deep front line isn’t activating fully you may feel unstable, or your body will compensate by using other muscles (like the superficial line), which, again, can lead to pain.
Flexion and the spine.
Let’s deep dive into movement of the spine.
A major component of Pilates is spinal flexion—think roll-downs, crunches, and teaser variations.
At a very focal level, when we bend forward we are bringing the front of our vertebrae together. Here is a picture to help situate you.
This image shows the vertebrae (bones) and the invertebral disc, on top of these structures you have stabilizing ligaments and intricate muscles (not shown in the picture). These muscles and ligaments are sensitive to the movement, and the action of our spinal joints. When a joint stops moving in one or more directions our body registers this and sends a signal to our brains. We interpret that signal as pain.
A really good example of spinal flexion that may lead to pain is if you have difficulty maintaining a neutral spine, or get back pain from forcing your back into a neutral position. This could indicate that your front line is overactive and has lost the ability to move out of a flexion position.
When we overuse flexion without balancing it out with mobility and extension, the result is pain.
In Pilates the goal is to strengthen the deep front line, AKA your deep core, but if you jump into advanced moves too soon your superficial muscles take over. Superficial muscles are bigger and easier to activate than their smaller deeper companions, but are not stabilizing. So it is super important to take training at your own pace, and not rush yourself.
In the next post, I’ll chat about how muscles, fascia, and nerves interact to produce pain when there are imbalances in your body.
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Myers, T. W., & Hillman, S. K. (2004). Anatomy trains. Primal Pictures Limited.
Wells, C., Kolt, G. S., & Bialocerkowski, A. (2012). Defining Pilates exercise: a systematic review. Complementary therapies in medicine, 20(4), 253-262. https://doi.org/10.1016/j.ctim.2012.02.005
Have questions about muscles, spinal mechanics, and pain?
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