Not All Pilates Exercises Are Good for Your Back — And That’s Okay!

In spite of what you often hear about Pilates being the go-to solution for back pain, it’s important to gently pause and say this: not all Pilates exercises are appropriate for every spine. If you’re dealing with back pain or new symptoms, the very first step should always be checking in with your doctor and getting a clear imaging and diagnosis for your specific situation.

I’ve been teaching Pilates for over 22 years, and I’m also someone who lives in a complicated spine every single day.

In 2024, I was diagnosed with spinal stenosis and spondylolisthesis in my lower back. Spinal stenosis means there is a narrowing of the space within the spine, which can reduce room for the nerves that travel through it. When that space becomes too tight, those nerves can become irritated or compressed, often causing pain, heaviness, numbness, or tingling that can move into the hips, buttocks, and legs. Along with that, I also have spondylolisthesis, which means one vertebra has shifted forward in relation to the one below it, creating instability and additional stress in the lower back.

Long before these diagnoses, at age 12, I had surgery for severe idiopathic scoliosis, which left me with 13 vertebrae fused and supported by a Harrington rod. For decades, the vertebrae below that fusion—L3 through S1—have quietly done the heavy lifting.

Pilates has been a gift in my life. It helped me build strength, awareness, and deep support around my spine for many years. And still—strength doesn’t change structure. Over time, the combination of narrowing space from stenosis and instability from spondylolisthesis made my lower spine far less tolerant of certain movements. Those changes began pressing on the nerves that travel through the hips, glutes, and down the legs. If you’ve experienced burning, aching, or a sense of weakness or fatigue in those areas, you know how unsettling that can be.

Pilates Exercises That Can Make Lumbar Stenosis Feel Worse

With spinal stenosis, movements that close down the space in the spine—especially repeated arching or compression—can increase symptoms. Exercises that may feel helpful to some bodies but can flare stenosis symptoms include:

• Swan and Swan variations

• Up Stretch/Up Dog

• Long Spine Extension

• Prone back extensions

• Jackknife

• High Bridges (arching your back)

• Standing backbends

• Any repetitive or loaded arching of the low back

  
  

If you notice symptoms during the exercise or hours later, that’s valuable information—not failure.

Exercises That May Aggravate Spondylolisthesis

Because spondylolisthesis involves movement and instability between vertebrae, exercises that increase shear forces or require high levels of spinal control can be especially challenging.

Movements that may aggravate symptoms include:

• Roll Over

• Teaser (especially full or fast versions)

• Double Leg Stretch with legs reaching very low

• Scissors with a large or forceful range

• Criss Cross (bicycles) with aggressive twisting

• High planks without deep abdominal support

  
  

These exercises aren’t inherently wrong—they simply may not be supportive for a spine that needs more stability and control.

A Gentle Reminder for Those Over 50

If you’re over 50, you’re not broken and you didn’t do anything wrong. Stenosis and arthritis are very common, even in people who have stayed active and strong throughout their lives.

Some of my clients have been diagnosed with cervical (neck) stenosis, where the space for nerves in the neck becomes more limited. In these cases, exercises that place prolonged load on the neck can increase symptoms, including:

• Roll Ups or Roll Downs where the head leads the movement

• The Hundred with the head lifted

• Pulling Straps that strain the neck

• Neck rolls or large head circles

• Any exercise that holds the neck in sustained flexion

  
  

Neck pain, headaches, or symptoms traveling into the arms are signs to slow down and modify.

The Encouraging Truth

Here’s what I want you to hear most clearly: there is still so much you can do.

You can strengthen your core in a way that supports your spine. You can improve posture and alignment. You can move with confidence and less fear. Pilates—when thoughtfully modified—can still be an incredibly supportive and empowering practice.

The key is communication and collaboration. Share your diagnosis and your lived experience with your physical therapist and/or experienced Pilates teacher. Together, you can choose exercises that respect your spine instead of challenging it unnecessarily.

Pilates isn’t about pushing through pain or earning gold stars. It’s about learning how to move with honesty, patience, and compassion.

And that approach—more than any single exercise—is where real, lasting progress begins.