Pain During Pilates? Why It Happens and What to Do
- Sheela Cheong
- 2 days ago
- 11 min read
Pilates should challenge you. It should not consistently hurt.
If you regularly experience neck pain during The Hundreds, lower-back pain during feet in straps, hip flexor pain during core work, or aching shoulders after hands in straps, it is worth paying attention to what is happening rather than assuming that you need to push through it.
There is also an important difference between muscle soreness and pain. Delayed onset muscle soreness (DOMS) usually develops 12–24 hours after unfamiliar or strenuous exercise and is often strongest between 24 and 72 hours later. Pain that appears during an exercise is different.
A useful place to start is with your core.
First: what does “core” actually mean?
Your core is not simply your abdominal muscles or your six-pack.
Think of it as the group of muscles around your abdomen, back and pelvis that work together to support and control your spine and pelvis while your arms and legs move.
You do not need to feel a dramatic squeeze to know that your core is working. In fact, if you are new to Pilates and genuinely cannot tell whether your core is doing anything, that is useful information in itself.
A well-organised movement should give you some sense that your middle is supporting the movement, rather than your neck, hip flexors or lower back taking over.
A quick check: do your arms or legs suddenly feel heavy?
This is one of the simplest things to notice during Pilates.
If your arms or legs suddenly feel very heavy during core work, stop and check what has changed.
Two common possibilities are:
Your core is not yet strong enough to support the weight of your limbs in that position.
Your spine has moved into extension — meaning your lower back has started to arch — so the weight of your legs is being transferred into the muscles around your lower back.
This is particularly common when both legs are lifted into tabletop or moved away from the body.
Think about leverage
This comes down partly to simple physics.
A short lever means the weight is closer to the body, so it is easier to control.
A long lever means the weight is further away, so the demand is greater.
For example, a bent knee held close to your body is a shorter lever. A straight leg extended away from you is a longer lever.
That is why bending the knees, bringing the legs closer, reducing the range or working one leg at a time can make a core exercise more manageable.
The question is not:
“Can I complete the hardest version?”
It is:
“Can my core control the weight and leverage of my arms and legs in this position?”
Common Pilates Exercises That Can Cause Pain
1. The Hundreds
Common pain location
Neck
Front of the shoulders
Upper back
Lower back
Why it may happen
The Hundreds combines a sustained abdominal position, breathing and repeated arm movement.
If the head and upper body are lifted for longer than you can comfortably control, the neck muscles may start doing too much work.
If the legs are held very low, the demand on the core also increases. As fatigue develops, the lower back may begin to arch and take on more of the load.
How to modify it
Rest your head and upper body on the mat.
Keep the legs higher.
Bend the knees.
Use fewer arm pumps (or skip them).
Take a break before your neck or lower back starts compensating.
What to notice
You should feel that your core is supporting the position.
If your neck becomes progressively tighter while your abdominal work becomes less noticeable, the exercise needs to be modified.
2. Shoulder Bridge
Common pain location
Neck
Shoulders
Lower back
Hamstrings
Why it may happen
Your head and neck should remain supported by the mat during a standard bridge.
Neck discomfort can occur if you lift or turn your head, push too much weight through the shoulders, or move beyond the range you can control.
Lower-back discomfort may occur when the movement becomes more of a backbend than a controlled lift of the pelvis.
How to modify it
Keep the back of your head resting on the mat.
Bodyweight should be distributed between lower body and the back of the shoulders - not head.
Focus on lifting the pelvis vs pushing the ribs upwards.
Visualise tailbone pointing to ceiling vs floor.
Slow the movement down.
Reduce the range if your lower back starts to compress or grip.
What to notice
The movement should be driven primarily by the hips and legs, with the core helping to control the position.
Your neck should not feel as though it is carrying your body weight.
3. Feet in Straps
Common pain location
Lower back
Hip flexors
Inner thighs
Hamstrings
Why it may happen
The straps support the legs, but your core still has to control your pelvis and spine while your legs move.
As the legs move further away from the body, the leverage increases. If you cannot maintain control, your pelvis may move or your lower back may arch.
This is one reason that a movement can feel comfortable at one range but uncomfortable a few centimetres further.
How to modify it
Reduce the range of movement.
Keep the legs higher.
Bend the knees slightly.
Try a different spring tension.
Pause between movements.
What to notice
Your legs should be moving without pulling your pelvis and lower back out of position.
If your lower back starts gripping or arching as the legs move, slow down and reduce your range of movement.
4. Tabletop Legs and Supine Core Work
Common pain location
Lower back
Hip flexors
Front of the thighs
Why it may happen
Holding both legs in tabletop creates a significant demand on the core.
If the core cannot maintain the position, the lower back may begin to arch. At the same time, the hip flexors may become increasingly dominant because they are working to hold the legs.
This is not necessarily a question of having “weak abs”. The position may simply be too demanding at that particular range, duration or stage of training.
How to modify it
Keep one foot on the floor (knee bent).
Lie near a wall and gently rest your toepads on the wall (heels off). This keeps you in tabletop but with the option for support when you need.
Alternate the legs.
Bring the knees closer towards the chest.
Reduce the range of movement.
What to notice
You do not need to force your lower back flat against the mat.
Instead, notice whether you can control your pelvis and spine without pain or excessive gripping.
5. Roll-Up
Common pain location
Neck
Upper back
Lower back
Hip flexors
Why it may happen
The Roll-Up requires considerable control as you move from lying down to sitting and back again.
If you cannot yet control the movement through the full range, momentum may take over. The hip flexors may also become very prominent as they help move the body.
How to modify it
Bend the knees.
Use your hands behind your thighs for assistance.
Begin with the upper body elevated (e.g. on Bosu ball).
My favourite: Do a Roll-DOWN instead (start seated upright and roll down to supine).
What to notice
You should not have to throw your head forward or pull yourself up with momentum to complete the exercise.
A smaller, controlled movement is more useful than forcing the full version.
6. Seated Hands in Straps
Common pain location
Neck
Top of the shoulders
Between the shoulder blades
Lower back
Why it may happen
The arms are moving, but the rest of the body is working too.
Your core and back muscles should keep your pelvis and spine stable while the arms move.
The muscles around your shoulder blades and upper back help control the movement of the arms.
If that support is not happening effectively, the neck and upper shoulders may start doing too much work.
You may end up compensating by leaning foreward/backwards or arching your spine to create the movement.
How to modify it
Reduce the range of the arm movement rather than simply reducing the spring resistance.
Slow the movement down and pay attention to what is happening around your shoulder blades and upper back.
Practise the arm movement with very light weights, or without resistance, to understand the movement without the straps.
What to notice
The important thing to remember is that stability is active work. Just because your spine and pelvis are not moving does not mean they are doing nothing. Your arms should be able to move while your centre remains steady and your neck stays relatively quiet.
If you mainly feel the exercise in your neck and shoulders, rather than through your upper back and around your centre, something about the movement may need to change.
7. Plank / Long Stretch
Common pain location
Lower back
Wrists
Shoulders
Why it may happen
Lower back: the lumbar spine collapses into extension when the core is not providing enough support.
Wrists: the hands are bearing your body weight, which can be uncomfortable if wrist mobility or load tolerance is limited.
Shoulders: the shoulders fatigue quickly when they are supporting too much of the body's weight without enough control around the shoulder blades and core.
A plank is not simply about holding yourself up. Your core needs to keep the spine organised while the arms and legs support your body weight.
Wrist vs forearm plank
Hands: requires more wrist extension and places more load through the hands and wrists.
Forearms: removes most of the wrist demand and can be more comfortable for people with wrist pain.
Forearms are not automatically easier for everyone — the position changes the demands on the shoulders and core.
How to modify it
Wrist pain: move from hands to forearms.
Still too demanding: place the knees on the floor while maintaining the same spinal alignment.
Need more support: practise against a wall, keeping the body in a straight line.
Ready for more: move the feet further from the wall to increase the load.
Wall becomes easy: progress to a stable countertop or table surface before returning to the floor.
Shift weight slightly backwards so that core/lower body are bearing the bulk of your weight.
What to notice
Your lower back should not sag towards the floor as you fatigue. Keep the spine long and the core active, rather than trying simply to hold the position for as long as possible. If you cannot maintain the position, change the angle or reduce the load before your form starts to collapse.
8. Swan / Spinal Extension
First: what does “extension” mean?
Extension is when the spine curves backwards, opening the front of the body. In Swan, the movement should be distributed through the spine rather than concentrated in the lower back.
The goal of the exercise is to strengthen the back muscles, not to create maximum distance between your torso and the floor.
Common pain location
Lower back
Neck
Shoulders
Why it may happen
The movement is initiated from the lower back instead of gradually through the upper and middle spine.
The glutes and thighs are not providing a strong enough base.
The head is jerked back, putting excessive movement into the neck.
The hands are used to push the chest higher, the elbows lock and the shoulders hike towards the ears.
Trying to create a very large chest lift can cause compression in the lumbar spine.
How to modify it
Keep the feet hip-width apart to create more space in the lower back.
Focus on strong glutes and length through the lumbar spine rather than trying to lift the chest as high as possible.
Practise a smaller range of extension if you feel the movement concentrating in your lower back or neck.
Keep the hands light and avoid pushing into the mat to increase the height of the pose.
What to notice
The movement should gradually travel from the head and neck through the upper and middle back, rather than hinging at the lower back. You should feel the back of the body working, particularly the glutes and back muscles, while the lumbar spine remains long.
A useful check is to briefly lift the palms away from the mat. If your neck tightens, shoulders hike towards your ears, or lower back compresses, you are likely relying on compensation to create more height.
Pain After Pilates: Is It Normal?
Not every ache after exercise means that something has gone wrong.
Muscle soreness
DOMS is common after unfamiliar or more demanding exercise.
It usually:
appears later rather than during the exercise
develops within about 12–24 hours
is often strongest between 24–72 hours
feels like general muscle soreness or tenderness
gradually settles
That is different from pain that appears while you are actually performing the exercise.
Pain deserves more attention when:
it appears during a particular exercise
it is sharp, catching or shooting
it feels like joint pain rather than muscular effort
it gets worse as you continue
the same pain happens every time you perform the movement
it persists after the session or keeps returning
you experience numbness, tingling or unusual weakness
You do not need to diagnose yourself.
But you also do not need to assume that pain is something you should tolerate because the exercise is supposed to be challenging.
The Exercise May Not Be the Problem
A Pilates exercise is not automatically right or wrong for a particular person.
What matters is whether the exercise, the way it is being performed and the current load match your body's capacity.
That can change depending on:
strength
mobility
coordination
fatigue
previous injury
resistance
range of movement
leverage
breathing
how much you have already done that day
The same exercise can feel completely different from one person to another.
That is why simply being told to “engage your core” does not always solve the problem.
Sometimes the range needs to change.
Sometimes the resistance needs to change.
Sometimes the exercise needs to be simplified.
Sometimes a different exercise needs to come first.
And sometimes your body needs a different kind of session that day.
Pain Is Information
This is where movement education matters.
If an exercise is supposed to train your core but your neck is doing most of the work... If a bridge repeatedly produces lower-back discomfort...
If your shoulders ache after every seated arm exercise...
All of these are telling us something.
The answer is not necessarily to stop Pilates.
It may be to change how the movement is organised, reduce the load, change the range, or use a different exercise until you have the strength and coordination to return to it.
Pilates can be useful for people with low-back pain, and research supports exercise-based approaches including Pilates for improving pain and function.
But Pilates is not a magic solution, nor is there evidence that one particular Pilates exercise or method is universally best.
Exercise selection still needs to be appropriate to the individual.
The exercise should work for your body. Your body should not have to fight its way through the exercise.
If Pilates Keeps Hurting
If you repeatedly experience neck pain, lower-back pain, hip discomfort or other symptoms during Pilates, another generic class may not be what you need.
Sometimes the more useful step is to look closely at how you are moving.
In my private Pain & Recovery sessions, I work with people experiencing pain, discomfort or uncertainty during Pilates, yoga, strength training or everyday movement.
The focus is not on pushing through pain or repeating an exercise until you somehow become better at tolerating it.
We look at what is happening, modify the movement, and gradually rebuild the strength, coordination and confidence needed to move well.
Your Pilates practice should help you understand your body better — not leave you wondering why the same thing hurts every time you do it.
This article is educational and is not a diagnosis or substitute for medical assessment. New, severe, unexplained or persistent pain, particularly when accompanied by significant weakness, numbness, neurological symptoms, trauma or loss of function, should be assessed by an appropriately qualified healthcare professional.
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