How Pilates Can Help with Back Pain – and When to See a Physical Therapist

At Marko Physical Therapy, we’re big fans of movement as medicine — and Pilates is one of those mindful, powerful movement practices that has stood the test of time. Originally developed by Joseph Pilates, this method focuses on core strength, alignment, flexibility, and controlled breathing. It’s no surprise that many physical therapists, athletes, and individuals recovering from injury turn to Pilates for both rehabilitation and wellness.

How Pilates Helps with Back Pain

If you suffer from chronic low back pain, Pilates can be a game-changer. One of the foundational principles of Pilates is core stability — and your core is more than just your abs. It includes your deep abdominal muscles, pelvic floor, multifidus, and diaphragm, all working together to support your spine.

Here’s how Pilates can help with back pain:

We often recommend Pilates-based movement for people with:

Common Injuries in Pilates (and What to Do About Them)

Although Pilates is low-impact, improper technique or pushing too hard can lead to injury — especially for beginners or those returning after a break. At Marko Physical Therapy, we commonly treat these Pilates-related injuries:

✅ Neck Strain

Why it happens: Poor cervical alignment during abdominal exercises can lead to overuse of neck muscles instead of deep core engagement.

Try this instead: Chin Tuck with Deep Core Activation

✅ Lower Back Pain

Why it happens: Poor control of the spine during exercises like leg lifts or bridging can lead to lumbar strain or aggravate pre-existing issues.

Try this instead: Pelvic Tilt with Marching

✅ Hip Flexor Strain

Why it happens: Overuse of the hip flexors during leg-heavy movements like teasers or circles, often due to weak deep core engagement.

Try this instead: Dead Bug with Core Focus

✅ Wrist or Shoulder Pain

Why it happens: Improper weight-bearing and lack of shoulder stability during planks or other arm-supported positions.

Try this instead: Wall Scapular Push-Ups

How a Physical Therapist Can Help

If you’ve been injured during Pilates — or you’re unsure if it’s right for your condition — a physical therapist can:

Whether you’re new to Pilates or a seasoned student looking to stay injury-free, working with a physical therapist can help you move smarter — and feel stronger.

Need help with back pain or a Pilates-related injury? Reach out to Marko Physical Therapy today to schedule a consultation. Let’s keep you moving — safely and confidently.

How Pilates Helps with Back Pain

Here’s how Pilates can help with back pain:

Improves posture and spinal alignment, reducing mechanical strain

Strengthens stabilizing muscles that support your spine and pelvis

Enhances body awareness, helping you move more mindfully

Encourages mobility without overload, making it a safe option for many

We often recommend Pilates-based movement for people with:

Lumbar disc issues

Spondylolisthesis

General mechanical low back pain

Sacroiliac (SI) joint dysfunction

Postural dysfunction

Core weakness postpartum or after abdominal surgery

Common Injuries in Pilates (and What to Do About Them)

Although Pilates is low-impact, improper technique or pushing too hard can lead to injury — especially for beginners or those returning after a break. At Marko Physical Therapy, we commonly treat these Pilates-related injuries:

✅ Neck Strain

Why it happens: Poor cervical alignment during abdominal exercises can lead to overuse of neck muscles instead of deep core engagement.

Try this instead: Chin Tuck with Deep Core Activation

Lie on your back with your knees bent.

Gently tuck your chin as if nodding “yes” without lifting your head.

Engage your deep core (draw your belly button toward your spine).

Hold 5 seconds, relax. Repeat 10 times.

✅ Lower Back Pain

Why it happens: Poor control of the spine during exercises like leg lifts or bridging can lead to lumbar strain or aggravate pre-existing issues.

Try this instead: Pelvic Tilt with Marching

Lie on your back with your knees bent.

Flatten your lower back gently into the mat (posterior pelvic tilt).

While keeping your pelvis still, lift one leg into tabletop, then lower and switch.

Repeat 10 times per side.

✅ Hip Flexor Strain

Why it happens: Overuse of the hip flexors during leg-heavy movements like teasers or circles, often due to weak deep core engagement.

Try this instead: Dead Bug with Core Focus

Lie on your back with arms and legs lifted.

Flatten your lower back into the mat.

Extend the opposite arm and leg without letting your back arch.

Return and switch sides. Do 10 per side.

✅ Wrist or Shoulder Pain

Why it happens: Improper weight-bearing and lack of shoulder stability during planks or other arm-supported positions.

Try this instead: Wall Scapular Push-Ups

Stand facing a wall with arms extended.

Let your shoulder blades pinch together as your chest moves slightly forward.

Push the wall away by spreading the shoulder blades apart.

Repeat 15 times to build shoulder stability.

How a Physical Therapist Can Help

If you’ve been injured during Pilates — or you’re unsure if it’s right for your condition — a physical therapist can:

Assess your movement patterns and alignment

Teach you modifications or targeted pre-Pilates exercises

Provide manual therapy to reduce pain or tightness

Design a custom program that blends Pilates principles with your rehab goals

Whether you’re new to Pilates or a seasoned student looking to stay injury-free, working with a physical therapist can help you move smarter — and feel stronger.

Need help with back pain or a Pilates-related injury? Reach out to Marko Physical Therapy today to schedule a consultation. Let’s keep you moving — safely and confidently.

If you would like help with an exercise program to meet your needs, Marko Physical Therapy can help.

Make an appointment today with a physical therapist. We have in-person and telehealth appointments available.

Learn More: markophysicaltherapy.com

A physical therapist can help you Restore Your Body!

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