What causes some people to experience neck pain or tension when practising Pilates?

Pain and tension in the neck and shoulders can often be experienced by Pilates beginners.  Although the strength of the muscles in the neck is a consideration* when tension occurs, the most likely culprit is weak abdominals, weak back muscles and poor alignment.  When the neck and shoulders are not properly supported in an exercise they take on too much of the work.  When the abdominals and the muscles in the back create correct alignment, the stability that this provides in the torso allows the neck to feel free and the head supported.

Bearing this in mind, there are three points to discuss which are all relevant and important for progressing your Pilates practice:

1. Your neck requires support from strong abdominals

2. Your neck requires support from strong upper back muscles

3. Your neck requires support from good spinal alignment and mobility.

Developing Abdominal Strength

Many Pilates exercises involve lying on the back, flexing the upper spine and lifting the neck and shoulders away from the mat.  When curling up or rolling down to the mat your abdominals have to be strong enough to support your upper body and resist the pull of gravity.  If you abdominals are not taking on the bulk of the work, the neck muscles will certainly take the tension instead.

For many people neck and shoulder tension are often chronic habits; meaning the muscles of the neck and shoulders are used constantly even when not needed (one example is subconsciously in breathing).   It is important that increased awareness is brought to this (which Pilates teaches), notice it and learn to ‘let go’, it’s time to retrain your body to put the effort where it belongs, in the abs!  The correct sequencing of muscle engagement will help with this.  Developing core abdominal strength will allow the abdominal muscles to relieve extra pressure on the neck muscles.  The first thing you have to learn is how to engage your abdominals correctly, only then will forward flexion exercises for the upper torso help to build the strength required in the abdominals.  As soon as you feel neck pain or tension, it is a good idea to stop, re-engage and start again.  Quality of engagement is much more important than quantity of repetitions.  Over time, your Pilates instructor will be able to modify exercises for you to help build the strength required to free your neck.

Developing Upper Back Strength

When our back extensor muscles don’t work for us, we can often experience tension in the neck and shoulders.  Upper back extension exercises such as Breast Stroke Preps, Swan Dive and Swimming can help develop the strength required to support the neck.  To protect your neck when practicing extension exercises, you must engage your abdominals and use the back muscles to extend the upper torso and support the head instead of lifting the head and shoulders independently.  It is also important to keep your head in line with your spine by reaching the crown of your head and tips of your ears away from your shoulders.

Modifications you might be given in back extension exercises are:

Smaller range of movement.

Reduction of the endurance phase of an exercise (hold time).

Stopping when you don’t have the core support you need to continue.

Good alignment required to support the neck

Keep your head in line with your spine!  Breaking alignment by over extending or over flexing the neck can easily result in neck pain or tension.

Your neck should hold its natural curve with your head balanced directly above your shoulders when sitting, lying and standing. In some cases, a small pillow or pad should be used when lying on your back to put your head and neck in a comfortable position.

Whenever you lift your head and upper body from the mat, lengthen the back of your neck and nod your head forward without jamming the chin into the chest. There should be enough room to fit your fist between your chin and chest. Once your head is in proper position and your shoulder blades are stabilised, the upper torso can be lifted by contracting the abs and sliding your rib cage toward your pelvis. When lying on your stomach and lifting the upper torso, pay particular attention to maintaining an even line from the upper back to the neck.  Avoid lifting the head too high and crunching up the back of the neck.

Over time, most people develop the strength in their abdominals and back, as well as the awareness of their alignment which results in reduced neck tension and in many cases completely eliminates it.