Can Pilates Improve My Posture and Help Prevent Upper Back Pain?

Question: I have extremely poor posture, and according to my doctor, that's what's causing my chronic upper back pain. (He's ruled out other serious spine conditions.) I'm only 25, and I don't want to live with back pain anymore. I've heard a lot about how Pilates can help with posture. Is that true, and if so, how can it help me maintain good posture?
— Charlotte, NC
Women in a pilates class outdoorsAnswer: Your doctor's absolutely right: Extremely poor posture can be causing your chronic upper back pain. And, yes, Pilates can definitely help you maintain good posture, which in turn can help improve your back pain.

I'm glad your doctor ruled out other serious spine conditions. But first, did you get the okay from him to do Pilates or to start an exercise program? If you haven't, just mention to him that you're thinking about doing Pilates. Once he gives you the green light, you can start!

It sounds like you've done your research on Pilates. Pilates is a good exercise in general so you already know that it has multiple benefits for not only your spine but your overall health.

Some of the specific benefits Pilates offers:

  • Strengthens your core muscles (your abs)
  • Teaches you good spinal alignment
  • Helps you become more aware of your posture
  • Helps improve your flexibility

These benefits work together to prevent back pain and help you maintain good posture. Let me explain how.

Pilates is based on developing strong core muscles. In Pilates, you'll do various exercises to develop core strength. These exercises will teach you how to "lock/brace" the core and to breathe correctly. That is, you'll train your body when to contract your core muscles; you'll also learn how to release them. Contracting and releasing muscles can lead to overall core strength.

But what does having core strength mean? It means that the muscles in the trunk of your body work together to stabilize and support your spine. Strengthening these muscles can help you develop a strong core.

Also in Pilates, there is something called "active awareness" of the muscles that help maintain posture. You engage in active awareness when you do core stabilization exercises.

Once you acknowledge the importance of your core and you engage those muscles, good alignment—namely good posture—will follow.

Most people forget that the core—which is essentially the abdominal muscles and back stabilizer muscles—are separate from the diaphragm. The diaphragm is the main breathing muscle, and it's located in the middle of the core. The diaphragm expands on an inhale and shrinks on an exhale.

Paying attention to your movement and your breathing when engaging your core muscles can help you become more aware of your posture, too. For instance, you may notice that your shoulders hunch over when doing Pilates exercises. But if you draw your shoulders back and down, lengthen your spine, and engage your abs, you'll be able to breathe more deeply.

Incorporating Pilates into Your Routine
Although treating upper back pain caused by poor posture can take some time, I'm confident you will get there with some hard work and dedication.

Remember that proper posture will make Pilates—specifically core stabilization—more effective. On the other hand, poor posture can actually prevent you from having good core stabilization.

At 25 years old, it's important for you to develop healthy habits now—including having good posture and developing an exercise routine that incorporate Pilates. Carry these good habits with you throughout your life, and you will have the tools to prevent upper back pain in the future.