Neutral Spine and The Core

Why do we harp on this so much?

Neutral Spine is one of the most subtle, yet powerful principles in the Pilates lexicon. When the spine is neutral you have three spinal curves—cervical, thoracic, and lumbar—which function to absorb shock when running, jumping, or simply walking around town. And ultimately, if you live in Neutral Spine, you will be putting the least amount of stress on the muscles and bones. That’s the beauty of perfect posture: it actually feels better. We want to maintain and reinforce these natural curves and that is why we often work in Neutral Spine when performing stability exercises in Pilates. 

Finding Neutral Spine

Not as easy as you might think!

The first place to start is to find Neutral Pelvis, which is easily defined by objective measures: The ASIS (the hip bones) and the pubic bone form a triangle which forms a plane that should be parallel to the floor when lying down. You (or your client) can feel these bony landmarks with your fingers when supine, and this triangle of bones, when neutral, should create a flat table that could support a filled-to-the-brim double martini. When your pelvis is neutral, your martini will be perfectly balanced. If your pelvis is tilted forward (anterior pelvic tilt—arching your low back too much off the floor) or tilted back (posterior pelvic tilt—flattening your low back onto the floor), your martini will spill in one of those directions. When lying supine in Neutral Pelvis you should have two areas that do not touch the floor beneath you: your neck and your low back (cervical and lumbar spine, respectively).

Neutral Pelvis vs. Neutral Spine

When lying supine, the spine does not act the same way as it does when standing, so you need to make adjustments accordingly. Some people may find, when supine, that being in Neutral Pelvis puts their lumbar or thoracic spine into too much extension, and they will feel uncomfortable in this position. Why? Because even though their pelvis is neutral, their spine is not neutral—they have too much lumbar or thoracic curve and their back extensor muscles are contracted. This is not comfortable!

Neutral Spine cannot be measured objectively like Neutral Pelvis since everyone has different spinal curvatures, skeletal structures, and musculature. These put the spine into different positions when lying down. Even the size of someone’s derriere will change how the spine configures itself when supine. But as an instructor, your goal is to help your client find the optimal position of the spine and pelvis that allows the back muscles to remain relaxed while supine, while still maintaining some curvature.

Touch Your Clients

To help clients find Neutral Spine, trainers can put their hands underneath their client’s lumbar spine to feel for too much space—your hand should not be able to slide all the way under the back to the other side. There should be a small space under the lumbar spine (not a huge one!). Also your hand should not be able to slide under their thoracic spine (ribcage). If you notice that the ribcage is lifted, cue your client to drop and release the ribcage down to the mat by engaging the upper abdominals. The thoracic spine should be making complete contact with the mat. 

Trainers should also feel for contracted spinal extensor muscles—these muscles should stay relaxed. Ask your client if they feel comfortable—believe me, they’ll know! 

If necessary, tell the client to tilt the pelvis in the posterior direction, flattening their lumbar curve, to make the spine more neutral. For some, the pelvis needs to be slightly posterior for the spine to feel neutral and comfortable in the supine position. It is essential that the client feel comfortable when performing supine exercises, so if necessary, tuck them under a little. This is their Neutral, when lying down.

Supported Neutral

Neutral Spine can be supported by placing a folded up towel or sticky mat underneath any portion of the spine that is unable to make contact with the mat. This is particularly good for people with anterior pelvic tilt or lordosis (who will need a folded up towel or sticky mat under their lumbar spine so that they can feel the contact on their lumbar spines- it’s like bringing the mat up to them), and also for the opposite picture; You may place a support under the lumbar spine of someone who has a posterior pelvic tile to encourage more curvature in the lower back. Also people with too much cervical curve or forward head may need support under their head to allow the neck to lengthen as will people with. Kyphosis (these two issues often come together). 

Supine Pilates stabilization exercises should never be performed with the spine unsupported (with too much extension), so make adjustments with each client individually so that they understand their Neutral Spine. Giving your client a proprioceptive tool under their back will help them to feel their abdominals engaging more and they will love you for it!

Neutral Spine vs. Flat Back

Old school Pilates taught “flat back,” essentially to flatten the curve of their lower back when doing Pilates stabilization exercises and put the pelvis in a posterior tilt. But research has confirmed that doing stabilization exercises with a neutral pelvis/spine is more effective than “flat back.” Because the Core-Tet (a phrase I use to refer to the quartet of muscle groups that support the spine: transversus abdominis, multifidus, pelvic floor, and diaphragm) includes the back muscles, it is essential to maintain the lumbar extension curve in order to recruit these muscles. When in flat back the back muscles are on stretch, so they are not available to stabilize the spine. 

Neutral Spine for Stabilization Exercises Only

You don’t do every exercise in neutral spine!

I use Neutral Spine in stabilization exercises, meaning when the spine is staying still and limbs are moving (tiny steps, footwork, planks, kneeling series, squats, etc.) When doing articulation exercises (roll downs, roll over, mermaid, snake, twist, etc.) you will not maintain a neutral spine, but will be stretching the back muscles and moving through flexion and extension, rotation, and side-bending. The spine needs to be stable when necessary and also mobile. Joseph Pilates famously said, “You are only as old as your spine.” Old people seem old because their spines are often stiff. 

Exceptions to Neutral Spine: Stenosis

People with stenosis of the lumbar spine should do posterior pelvic tilt when doing stabilization exercises since spine extension puts strain on the anterior structures of the spine. People with stenosis should avoid all spine extension exercises.