What to do if your Pilates Class causes pain

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​A question came through to my Facebook page recently, after I posted a weekly Pilates exercise video (which you can watch here) and as it’s something I’ve been asked a few times before I thought I write an article about the subject.  
 
Here’s the important part of the question

​“…I have recently started (pre-lockdown) a Pilates class on the advice of my doctor, after lower back and neck pain. Unfortunately, some of the moves are causing pain. I enjoy the classes, but don’t like the pain. Should I stop doing Pilates? Or avoid the moves that are hurting?”
 
The article below should help with these points.

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​As always anything that causes pain/discomfort should result in seeking your GP advice as first point of call.

In response to the question, here are a few key points to consider. We’ll go into details below.
 
Key points to remember

1. If a movement is causing pain/discomfort, finding and addressing why is more beneficial than avoiding the move.
2. If your instructor gives you an opinion on why they think a move is causing pain/discomfort, they should be able to further back this up with clinical screens/tests (or refer to someone who will be able to).
3. Ensure you are in a suitable class with an instructor whose qualifications meet your needs.
4. Consider avoiding the move temporarily until you have addressed the cause of the discomfort.
5. Avoiding the move totally or pushing through the pain is unlikely to be an effective long-term solution.

 
Should I stop??
 
It’s worth remembering Pilates is essentially normal functional movements the body should be able to carry out. For example, Spinal flexion, rotation & extension are movements we do all the time in everyday life, so there should be no reason for these moves to cause discomfort in a class. However, if you are experiencing pain/discomfort in particular movements in the class, the main question you want to ask is why?
 
As mentioned above a good Instructor/Therapist won’t just to tell you why they think you are getting the discomfort, but will give you some clinical tests/screens to enhance/disregard this.

Beware if you ever get told its because of a “weak core” or you “need to improve flexibility”, this information isn’t anywhere near specific enough.
 
 
Should I push on through the pain? - I wouldn't recommend this approach, mainly because this hasn't identified and hasn't corrected why you may be getting the discomfort. Whats the point in doing something thats painful? 

Sometimes there are some particular movements or positions which people cannot tolerate due to certain conditions and a good instructor will be able to identify these a give alternative.
 
Make sure you in the right type of Pilates Class
 
The original Pilates (which involved the hundred, the roll up etc) was an exercise method mainly used by professional dancers and gymnasts. These days Pilates is a lot more mainstream (often recommended as a way of easing back pain). The problem is most of the people attending these days do not need to be doing the same exercises as professional dancers and gymnasts did back in the 1950s and the original exercises aren’t that suitable… especially if you have some form of pain!
 
Something else you may not know is that Pilates is an unregulated industry and these days you can have qualification courses ranging from just a weekend course up to some like the Pilates Therapy course I did, which lasted over 4 years. There’s nothing wrong with instructors who do shorter courses at all, you just need to make sure that you are in a class which is best matched for you. A general rule I give people deciding classes is:

• For back pain (or other pain) or you’ve been recommended by a healthcare advisor (physio, GP etc) select a class which is small in numbers (8 or less) and run by a qualified therapist (Pilates Therapist, Sports Therapist, Physio etc).
• If you’re an Athlete, Sports Professional, Dancer or Performer looking to improve performance consider an equipment (reformers, Cadillac’s etc) over a mat class with an instructor who has experience in working at similar levels.
• If you have no pain or discomfort and are looking for something to go alongside your weekly fitness class, consider a class at a health club which will be included with your monthly membership.

 
Hopefully this gives you a bit more information and guidance of what to do if your Pilates causes you discomfort. Should you need any further help, please feel free to leave a comment or drop me a message.

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About the author
I am a Manual Therapist covering a range of different disciplines including massage & Biomechanics. I also run small specialist Pilates classes around Corfe Mullen, Broadstone, Wareham, Wimborne & Poole. Instead of just purely rubbing the pain, I always look to see if I can find a potential cause (or causes of the pain) and then work on treating this.