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Neck Pain During Pilates: Practical tips on how you can help (Part TWO - Arm Back Connection)

Do your clients experience Neck Pain during Pilates exercises? 

Neck pain during Pilates exercises can be a common complaint. From basic abdominal exercises through to upright exercises, there are some common reasons for clients experiencing tension in their neck. 

In my previous blog (Part 1), we looked at: Head Position, Abdominal Strength & Trunk Flexion and how they can be the cause of neck pain during exercise. This included tips on what you can do to alleviate and assist movement to reduce pain. 

Now we will look at Part 2: Are the arms connected to the back muscles? 

This is when the ‘shoulders down’ cue isn’t helping! Not because they can’t hear you, but because they are not sure how. They have likely been using their upper traps, neck and shoulders to do many things. Perhaps engaging the upper back muscles to use their arms is not familiar to them.

How do you know if someone’s arms are not connected to their back? Here are some tell-tale signs they are not: 

Their shoulders are hunched up

Yep, they are all up in their upper traps, levator scapulae, with shoulders up around their ears. We want to work our arms from the muscles that stabilise the scapulae: The lower trapezius, the Latissimus Dorsi, and the Serratus Anterior. Yes, sure the upper traps will also be working! But we want to recruit some of those larger muscles further down the back that will help to keep the entire shoulder complex strong for years to come. 

They may complain of tension in their upper traps

(the area between their neck and shoulder)

Because….they are overusing their upper traps!!! They may have rounded shoulders and a stooped posture. This posture places the upper trapezius on a stretch. Then often to help ease tension, this population are given…Upper trapezius stretches!!!! They don’t need more stretching, but strengthening to keep their traps strong, which will improve their posture and keep their shoulders strong. 

They often cannot keep their ‘shoulders down’ no matter how many times you cue this.

…because they are not connecting to the muscles mentioned above, as well as the rotator cuff muscles, the rhomboids, etc. You may often see shoulders up when arms are being used or lifted. Or perhaps they are reaching through the chest and pectorals. This tells me they are working in their shoulders and neck, not their upper back and core. 

They have limited mobility in their spine.

If the spine is stiff, the shoulders are used to take on the movement so people feel like they are working deeper, further, reaching more. I see this in things like Push through on the Push Through Bar, or Spine stretch Forward, Saw, The Hundred on the mat. If the spine is not able to stretch forward, the shoulders go up, and the arms reach forward and it gives the feeling like they are getting further forward and deepening. 

They don’t use their upper back to support themselves in supine

Those who are working inversions (with their hips up in the air), or even positions such as bridge, need to have a strong upper back to create their upper ‘tripod’ for stability. This consists of the area between the back of the head, and the area across the shoulders, along with the arms pressing down on the mat. This area, as well as the deep core, needs to be strong and stable to take the weight of the body, otherwise, they risk placing too much pressure on the neck. 

Here are some tips on how I help my clients work the connection between their arms & back: 

  • Try some exercises to 'pre-activate' this area of the upper back. I love to press a soft Pilates ball or Pilates Magic Circle into the side of my hip with my hand in standing. I think about squeezing the area under the armpit. I also employ this idea on the Cadillac for the arm springs. 

  • Ask your client to imagine the shoulder blades wrapping around the ribcage with any forward-reaching movements. This will get them to engage the serratus anterior to help stabilise the scapula on the ribcage. 

  • Rather than 'shoulders down', cue keeping the collarbones wide. This will instantly place the shoulders down their backs and keep the upper back nice and wide. It also helps to prevent the movement coming from the pectorals only. 

I hope this blog has given you some helpful ideas and advice in helping to reduce neck/shoulder pain in your clients during Pilates!

Get expert advice from a healthcare professional who understands Pilates.  

Schedule a consultation with Sonia, an experienced Pilates Instructor and Registered Physiotherapist, to delve deeper into your questions, and get the answers you are looking for.

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