10 Pilates Moves to Alleviate Back Pain: Don’t Do These…

by | Nov 3, 2014 | Alleviating Pain & Chronic Health Problems, Back Pain, Pilates, Pilates Exercises, Techniques & Teaching Tips | 2 comments

Why these 10 Pilates Moves to Alleviate Back Pain, just might make your back feel worse instead of better…

10 Pilates Moves to Alleviate Back PainI recently read an article from ACE: 10 Pilates Moves to Alleviate Back Pain and I so vehemently disagree with the exercises and information in this article that I have to share my thoughts.

Here’s the short version of what I’m thinking about this article:  10 Pilates Moves to Alleviate Back Pain if executed well because you really understand Pilates and don’t have any back problems to start with!

Now if you want a few more details about this, keep reading.  I’m on a rant and this is a longer than usual post, but if you have chronic back pain and want to use Pilates as a method to help, the info below will be worth your time to read more.

I love that Pilates is a hot topic to help people alleviate back pain, but it really bothers me to read articles like the recent post from ACE Fitness, which starts by saying that, “Many people with chronic back pain have felt their aches diminish with regular Pilates sessions.”  Yes, I agree.  Then the article goes on to say, “While equipment-based Reformer sessions can be costly and group mat classes may not target your specific needs, many Pilates exercises can help realign your movement patterns to prevent and lessen common back pain.” And then there’s more… “Here are 10 moves that, when practiced regularly, can help improve posture and strengthen the support structures that take pressure off the lower back.”

Sigh… as a fitness professional who has been in the health and wellness industry for forty years, and more specifically focused on Pilates and functional movement training for the past twenty years. It frightens me to see this article and think that people with chronic back pain are reading this and thinking, “Great, I don’t need to invest in Pilates equipment training, OR find a well-qualified Pilates teacher to help me, and why bother with group mat classes, I can just do these 10 exercises on my own and my back pain will go away!” AUUGHGHHHH!

Here’s why if you chose to follow the advice from the ACE article, 10 Pilates Moves to Alleviate Back Pain, your risk of further injury is imminent:

  1. Pilates is a system. Ideally, to truly maximize the whole-body health benefits from the system, you “work” the system. You cannot just pick and choose a couple of exercises and say “voila” these will cure you. Half the system is the work on the Pilates Reformer and other Pilates equipment. The other half of the system is the series of Matwork exercises.
  1. In reality, Pilates Matwork is the most difficult part of the system, because you have to have enough core support, and proper body mechanics to AVOID back strain and injury. (This is where the Pilates equipment exercises come in to play, and why working with a well-qualified Pilates professional matters.) Using the Pilates equipment provides support while the right muscles are getting stronger so you do not feel pain, or strain in your neck or back while moving your spine, arms, or legs for ANY exercise.
  1. There are many different reasons for chronic back pain… Have you experienced a sudden injury, or has your back pain slowly crept in due to repetitive strain, poor posture, or muscle imbalance. The type of back pain problem matters for exercise selection. (bulging disc, degenerative disc disease, spinal stenosis, spondylolisthesis, SI joint instability, scoliosis, sciatic pain, just to name a few…) There is not a one-exercise-fits-all solution. And Not every Pilates exercise is for every person. A qualified teacher will be able to evaluate your health history, posture, and movement habits, before “picking” exercises to be sure that the Pilates exercises in your program are the safest ones possible to get started, and then work with you to progress as you get stronger.
  1. If you are investing in pain pills or steroid injections to “mask” the problem, why not instead put your money to work and invest in better health, by teaming up with an expert to identify your posture and alignment issues, as well as strengths and muscle imbalances, to get the right exercises in your workout program to really make a difference? Long-term, pain meds aren’t going to solve the problem, and while surgery might be an option, it’s going to create a lot of additional compensation issues. Getting the right balance of strength and flexibility can go a long way to alleviating chronic back pain, and that is one of the great benefits of working the Pilates system.
  1. The more correctly you find and use the right muscles (for any exercise) the better benefits you will get from your efforts. If nobody is helping you find and fix your compensation patterns, you may find yourself in more pain, rather than less from the 10 recommended Pilates exercises in the ACE article. NONE of the exercises in the ACE article would be a starting point for me if I was working with a client with chronic back pain! In my professional opinion, doing these exercises as listed would only exacerbate back pain problems.
  1. Going to a Pilates Mat class (or group equipment class) with back pain, and not informing your instructor of your issues is a recipe for disaster! I would recommend Private one-on-one training if you have any pain, health, or medical issues, until you are stable, and confident with your modifications or personalized versions of exercises, or your private training instructor has told you that you’re ready to hop back into group classes. Be smart and stay safe!

Let’s do a quick breakdown of each of the ACE article exercises so you can better understand WHY these are not a good starting point for you if you’re looking for Pilates moves to alleviate back pain.

ACE Article: 10 Pilates Moves for Chronic Back Pain (and why these exercises are potentially dangerous for you to do, as a starting point, or home-workout program if you have back pain.)
Click the link above to read the ACE article, see the photos and descriptions for the exercises they recommend.  See my notes below as to why you shouldn’t put these 10 exercises in your home exercise program if you have back pain.

The Standing Roll-up

A great beginner exercises ON THE WALL for healthy backs. (ACE article states it’s more advanced on the wall…wrong info.) BUT most clients with chronic back pain have very tight hamstrings, a weak core, and poor hip mechanics and no idea how to segmentally articulate the spine. In addition, hanging forward in this position places more stress on the low back, especially if you do not have the core support to bend you forward and roll you back up.

The Floor Roll-up

A classical Pilates Matwork exercise that for many avid Pilates students is very challenging to do correctly! If you have back pain, this exercise is another one that can place additional unnecessary strain on the low back. Again, with a weak core, tight hamstrings, and poor hip mechanics, the chances of this helping your back feel better are minimal, the chances of it aggravating your back pain, 95-100%.

There are much safer exercise options you could learn to modify the Roll-up, and get all of the right parts of your body stronger and more flexible so that you might be able to add this exercise to your workout program in the future. (But it depends on what’s really going on with your back.)

IF on the outside chance, this exercise is appropriate for you, keep in mind that the most difficult place to execute it is on the floor. There are versions on the Pilates Reformer (“Chuck wagon”) and on the Pilates Trapeze Table (The Roll Down Bar and the Push Through) that provide support and assistance to improve articulation, strength, and mobility, and modified versions for Mat and with the Pilates Spine Corrector that would be a safer starting point than the full Roll-up.

Roll Like a Ball

AaaaKKK! Really? What’s demonstrated in the photo would be a good exercise. Lie on your back, breathe, and hug both knees to your chest, actively pulling the low abs up in and back to the mat. But if you actually follow the directions and do the Rolling Like a Ball exercise, well ..just DON’T!

This exercise is actually IMPACT on your spine. For a healthy back, you need a well-padded mat to roll on to help protect the spine. (There is NO mat in the photo!)

If you have back issues, chances are you’re going to thud, not roll, or pull with your arms, throw your head and get whiplash, or kick with your knees and feet in an attempt to roll which negates finding the support you really need for a good ball shape. Round things roll… if your low back is tight, and your low abs are weak, (and chances are this is the case which is a contributing factor to your back pain…) most of your round at the moment is in the upper back and shoulders. This lack of balance for a rounded C-Curve of the spine is typical for all new Pilates students, even if they have a healthy back. There are so many great fundamental prep exercises, and Reformer exercises (as well as Pilates Cadillac, Chair, and Barrel exercises) that can assist with finding proper support for a good C-Curve. But for some back issues, this rolling exercise should NEVER be in your workout!


Ok, first of all it’s called the Hundred, or 100 (not plural.) Lots of controversy in the Pilates community on the spine position for this exercise. There is a classical Pilates version with a scooped pelvis to keep the lower back firmly anchored to the mat, and a more contemporary version with the pelvis in a more “neutral” position.

I happen to prefer the classical Pilates scoop, because if you’re attempting to curl the head and shoulders up, but holding the pelvis and lumbar in a slight arch, there is a lot more stress and strain on the low back. And in fact for most people, the back muscles will probably be working harder than the front of the belly.  Yes, core support involves both the abs and the back muscles; it’s about finding the proper balance.

I also find the Tips for this exercise in the ACE article not very helpful. The Hundred exercise will be easier if the knees stay bent, and is more difficult with straight legs. The brain has enough to think about without bending and straightening the knees on every breath. If you decide to follow this tip, I’d straighten the legs on the inhale and bend them on the exhale.

Ideally on the Hundred, the legs are held up at eye-level, that’s about 3-4 inches up off the floor. If you’re experiencing back pain, lifting your legs up at all, may be too much for your back and has the potential to make your pain worse.

Want a safer version to get started, keep your knees bent and BOTH feet on the floor. (Pilates Reformer and Cadillac exercises working against the resistance of the springs play a very helpful role in helping improve stability for the low back and pelvis while you learn to extend your legs and hold them up (without stressing out your back.)

Bridge Roll-Ups

This one I’m ok with. However, my experience with clients doing bridging exercises is that if clients experience back pain, they usually lift right up into the pain, and don’t know how to find the right support to get the exercise out of their back pain point.

Yes this is a great back strengthening exercise, works to open the hip flexors and strengthen the hamstrings, as well as articulate the spine, but only if done correctly. Finding the right firing pattern to activate the pelvic floor, and lengthen out towards the knees as you lift, will make this a much more successful (and pain-free) exercise. If it hurts, you’re not doing it correctly, don’t push through the pain!


In 20 years teaching Pilates, going through 3 different Pilates teacher training programs, and attending hundreds of continuing education workshops, I have never learned “Superman” as a Pilates exercise.

I’ve seen this exercise, I’ve done it… but I don’t consider it Pilates. And in fact when I watch people at the gym do their Superman back strengtheners, I worry… because for most people ALL the lifting is coming from the lumbar spine. The low back is doing ALL the work, rather than distributing the work evenly throughout the entire spine.

There are better (and safer) posterior chain exercises for hip extension and improving back strength.

Personally, my go-to exercises for back and hip strengthening are with the Pilates Spine Corrector where you can start with your legs below horizontal and lift up in line with your body – it takes the stress out of your back while you’re getting stronger. If you’re interested in learning more, you’ll find my favorite Pilates Spine Corrector exercises in the book A Barrel of Fun.)


Swimming is an intermediate Pilates Mat exercise. However, just like the Superman, if you don’t know how to distribute the work correctly through the whole back, this is not going to be a happy back exercise. It would be much better to get started with a version of this on the Pilates Spine Corrector / Arc Barrel. Or begin doing the arms and legs separately and work up to the full exercise.

Proper leg and hip mechanics play a vital role in supporting the low back to lift the leg. Lying on your stomach can be a nice way to find the stability of your pelvis, and proper movement of the leg from the hip. Learn more about this in my E-course: 6 Simple Training Tips for Functional Movement at the Hips.

Dead Bug

Well my version of Dead Bug is a little different than this. But in looking at the photo and description, and knowing that these exercises are targeted to people with back pain, I’m frightened.

It’s a great exercise IF you have a strong back and core… But with everything up in the air, and arms and legs moving away from center, there’s a really great chance that you’re going to arch your back every time a leg lowers or arm goes over head. And this is only going to make your back pain worse…

Which is why Pilates equipment is so important!  With the springs, straps, foot bar, boxes, you can do versions of this movement with more assistance and support, until you are strong enough to do it on your own.

I can’t think of a single client with back pain that I’ve worked with in the past 20 years who could lie on their back and float one knee up to their chest and all the way down to the floor with the other leg in the air as a starting exercise for their workout program Even with one foot flat on the floor, it can be a challenge, and for most clients getting started I’ve propped their feet up on a box or chair to limit the range of motion to stay out of trouble for their lower backs. Be careful, if you can’t support in all the right places, you’re going to feel this in your back in a bad way.


Oh MY, I just read the directions for this, and it’s for the ROCKING SWAN! EEEKKKKK! My healthy back clients do a slower (non-rocking) version of this for a long time before I introduce the rock. If you are reading the ACE Article and are considering this exercise DON”T ROCK!

Looking at the photo, the model has pushed up into the lifted upper body position with her arms, rather than really articulating and activating the upper spine to balance the lift through the whole back. If you can’t do a well-articulated lift lengthening your spine to lift from the back of your t-shirt to your waist lifting slowly and lowering yourself back down to flat on the mat using your back muscles more than your arms. DON’T ROCK!

There are many subtle details to getting the support, length, and mobility of the spine for this exercise. Done well, it should not hurt your back. (Although I have to tell you that personally, I do have lower back issues. Back bending is not ideal for my spine, and when I do it incorrectly, it always puts my back out!) Form and finding the right muscle support matters for every exercise you choose to do.

When your back no longer hurts, it might be OK for you to progress to a Rocking Swan, and maybe even the advanced version where the arms are over head while you rock. But as a beginning exercise for someone with chronic back pain – NO!

Single-Leg Split

The directions for this don’t match the photo… And if you have chronic back pain, having all your limbs up in the air means zero stability for your back. If you don’t have the flexibility to curl your head and neck up to the bottom of your shoulder blades, you’re weak link to stay lifted might be neck strain.

If you have difficulty with the Dead Bug exercise that’s on this list, with a bent leg, doing a straight-legged exercise is only going to be harder, and more stressful on your back. If you’ve got very tight hamstrings, there’s a chance you’re going to tuck your hips, or hike a hip to lift your leg up. And even worse, without good core support, as one straight leg lowers away from the body, your back will arch, and create more strain on your low back.

Modify it to get started. Keep one knee bent and foot flat on the mat. Grab the lifted leg with both hands, and pull your abs in to gently pull the straight leg up towards you. Set the lifted leg down BEFORE lifting the other leg to help support your back and keep your hips still.

And if you’re hamstrings are too tight for you to grab 1 straight leg, there’s a real justifiable reason for your chronic back pain. Flexibility is your friend, more hamstring and calf stretching (done flat on your back to start) can be a very nice addition to your training plan.

In conclusion:

I am passionate about the power of Pilates to help improve whole-body health. Whether you are one-hundred percent healthy, or struggling with chronic back pain, Pilates training can be a great addition to your weekly workout routine. But specifically which exercises you do, as well as how well you are executing them will make a huge difference, and directly relates to whether the exercises will help you get and stay healthy, or create more pain and additional problems. It’s nice to be independent with your workouts, and ideally you shouldn’t have to be tied to your Pilates teacher for life! (Although if you have a teacher you love, they should always be able to challenge you and help you grow and improve your form and function.)

It’s best to get with a qualified professional whose opinions you trust. Use your resources, and get hands-on help to sort thru any aches, pains, or injuries you are experiencing. Even reading my opinions about the exercises from the ACE Article, while insightful to justify why I don’t think you should consider the exercises they recommend if you have chronic back pain, my article still doesn’t provide you with a clear action plan. (a few suggestions to make some of the exercises safer maybe, but that’s it.)

Each of us is a unique individual with unique needs, movement patterns, and habits that have contributed to our current health status. It is NOT OK to live with chronic back pain, medication is only going to mask the problems, but getting the right exercises into your weekly workout plan can be an effective tool to help you take control of your life, and your health. You have to do the work, but the rewards are huge!

Now go and find an expert you trust to help you get the right back care exercises into your workout program on your road to recovery.

Aliesa George: Over the past three decades, Aliesa George has helped assist people with their personal health journeys by sharing, teaching, and developing Pilates, Foot Fitness, and other Mind-Body programs.


  1. Nicole LaBonde

    Great post! Thank you for articulating so many of my feelings!

    • Aliesa George

      Hi Nicole, You’re welcome! I spent a few days stewing on this and decided I just had to voice my thoughts. Nice to know I’m not alone.


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