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:
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.
Make an appointment today with a physical therapist. We have in-person and telehealth appointments available.
A physical therapist can help you Restore Your Body!
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