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Pilates

Pilates for neck pain: a 20-minute head-supported class

This class follows the easiest (level 1) Pilates programmes used in neck pain trials, with your head supported throughout: a folded towel under your head when you lie on your back, and your forehead on a towel when you're face down. It adds the neck and shoulder-blade strengthening that has the best evidence for long-lasting neck pain. Keep pain at 5 out of 10 or less during the class, and your neck should be no worse the next morning. Leave out any move that sends pain, tingling or numbness down your arm.

20 minBeginner15 movesA wallAbs · Neck · Hip flexors · Glutes · Back · Shoulders
Follow along: a timer, a cue and the next move, one step at a time.

Lying, head on a folded towel

  1. Lateral breathing (Pilates breathing)5 breaths
    Beginner · Abs · 3D demoKnees bent. Let your ribs widen to the sides; shoulders and jaw softHarder: Roll-up (Pilates)
  2. Lying chin tuck5 gentle holds of up to 10 s
    Beginner · Neck · 3D demoA small nod, as if saying yes; your head stays resting. Jaw and throat relaxedHarder: Chin tuck
  3. Knee fold5 each side
    Beginner · Abs, Hip flexors · 3D demoLift one knee to a tabletop and lower it, pelvis level, head downEasier: Supine heel slideHarder: Dead bug heel taps
  4. Supine heel slide8 each side
    Beginner · Hip flexors, Hamstrings, Quads · 3D demoSlide the heel away and back, pelvis stillHarder: Hip windshield wipers
  5. Dead bug heel taps5 each side
    Beginner · Abs, Hip flexors · 3D demoKnees in a tabletop, head down; tap one heel down with your back stillEasier: Bent-knee fall-outHarder: Forearm plank
  6. Pelvic tilt into bridge6 to 8 slow reps
    Beginner · Glutes, Abs, Hamstrings · 3D demoWeight on your shoulder blades, not your neck; look at the ceiling and don't turn your headHarder: Glute bridge

On your side, then face down

  1. Side-lying open book6 each side
    Beginner · Back, Chest, Shoulders · 3D demoHead on a pillow; let your head turn with your arm only as far as is comfortableHarder: Thoracic rotation
  2. Swan (Pilates swan dive)5 small lifts
    Intermediate · Back, Glutes, Triceps · 3D demoForehead on the towel to start. Slide your shoulder blades back, then lift your head and chest a little, looking at the matEasier: Mermaid (Pilates seated side bend)Harder: Double-leg kick (Pilates double kick)
  3. Prone Y-T-W raises5 of each shape
    Beginner · Back, Shoulders, Neck · 3D demoForehead on the towel, thumbs up, shoulders away from your earsEasier: Wall angelHarder: Bent-over reverse fly

On all fours

  1. Cat-cow6 slow waves
    Beginner · Back, Abs · 3D demoLet your head follow your spine; keep the neck part of the movement smallHarder: Half lord of the fishes (Ardha Matsyendrasana)
  2. Bird dog, one limb at a time5 each arm and leg
    Beginner · Abs, Back, Glutes · 3D demoLook at the floor just ahead of your hands; neck longEasier: Side-lying tummy draw-inHarder: Bird dog

Sitting tall on a chair

  1. Neck CARs (controlled articular rotations)3 turns, 3 tilts and 3 nods
    Beginner · Neck · 3D demoSeparate movements, not circles: turn and hold for 2 seconds, tilt and hold for 2 seconds, nod down and up, only as far as is comfortableHarder: Rabbit pose (Sasangasana)
  2. Thoracic rotation6 each side
    Beginner · 3D demoHips still; turn from your ribcage, not your neckEasier: Side-lying open bookHarder: World's greatest stretch

Standing at a wall

  1. Wall angel6 to 8 slow slides
    Beginner · Back, Shoulders · 3D demoBack of your head toward the wall only if it reaches comfortably; don't force itEasier: Table slide (seated forward reach)Harder: Prone Y-T-W raises
  2. Breath reach5 breaths
    Beginner · 3D demoArms float up as you breathe in and down as you breathe out; breathe out for longerHarder: Slow breathing (6 breaths a minute)

Tips

  • Pain up to 5 out of 10 is OK during the class; if it goes higher, do fewer repetitions, move more slowly or rest longer. Your neck should be no worse the next morning.
  • Two or three times a week is a good start: the trials ran for 6 to 12 weeks.
  • If a move sends pain, tingling or numbness down your arm, make it smaller or leave it out.
  • When your neck has settled, add the chest lift with your hands supporting your head, and the hundred with your head down.
  • Felt a pop in your neck, then a new headache? Stop and get it checked the same day.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

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Questions people ask

How long does the pilates for neck pain: a 20-minute head-supported class take?

About 20 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: A wall. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 7 of its 15 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.