The Flexion Connection Workout

Beginner students often complain about neck pain during Pilates, but there’s a smarter way to explore flexion while avoiding discomfort altogether.

By Karen Sanzo
Modeled with Marsha Kramer
Edited by Amanda Altman

Recently a group of new clients came to my studio complaining that Pilates hurt their necks. That’s when the Flexion Connection Workout was born. I devised a series of mat and Reformer classes that don’t require lifting the head against gravity. Let’s just say it changed the whole Pilates experience for them.

It’s not uncommon for people doing abdominal-strengthening work to feel flexion in the upper back/thoracic spine, since this is where most people have the most potential for flexion. When you lift your head—remember, it’s 15-plus pounds—using just the superficial neck muscles, your neck gets tired and your abdominals may not be optimally participating. To address this issue, and to enable the entire spine to participate in the movement, we have to invite the body to create flexion activity in other areas.

But how and where do we find and create these connections? First, it’s important to teach clients that strengthening the abs is not always about more lifting or more “navel to spine.” There are other ways to get there, but the movement has to make sense to the body that’s doing it. Sometimes it’s adjusting the body position or finding a new way of experiencing how these connections are replicated in other exercises.

Connections are key for teachers—connections with our clients, to their bodies, their minds. Sometimes I imagine myself as one of my clients: What would he/she want to know? How am I going to explain this? I need a toolbox of cues: cues for the front body, cues for the back body, anatomical cues, engineering cues. Cueing has to be gentle coaxing. Tactile feedback is important, but not everyone likes it. Each client responds differently and requires a slightly different approach for repatterning.

Using the matwork as a base sets the body up to learn new patterning. Then we’re using the Reformer and the Chair to teach the same concept. It’s important to note that flexion connection doesn’t mean resting forward. It isn’t passive—it’s active. It requires thought and consciousness to enable clients to make connections beyond the abdominals. As a result, they learn to do a multitude of exercises safely and effectively—and the Pilates “neck ache” is a thing of the past.

You can apply these concepts to many of the exercises in the Pilates repertoire. If the cue fits, use it. PS

Sneak peak of the exercises…


optimal front-body connection for supine matwork. Head and posterior rib placement are essential for preparing the deep neck flexors to activate, even before active lifting of the head against gravity.

STUDENT Lie on your back with your legs together and arms by your sides.
TEACHER Check the head/neck placement. If the chin is elevated, use a towel to position the occiput away from the C7 vertebrae.

MOVE Direct your gaze downward to facilitate a flexion connection in the deep neck flexors while allowing the bridge of your nose to pull slightly back toward your occiput. If the posterior ribs are elevated with an extension in the throaco-lumbar the teacher can use a wedge to help coax them toward the mat. Bend your knees with your feet flat on the floor, and lift one leg to tabletop; reach your opposite arm to your thigh. Creating this isometric force helps to facilitate a rotational flexion connection. The teacher can provide multidirectional feedback to the arms and/or thigh, monitor posterior rib position, and coax the armpit area to limit the anterior shoulder from lifting.

TEACHER NOTES Without optimal head placement, the sternocleidomastoid muscles will lift the head to the ceiling, rather than a nice sequential curve from the deep neck flexors. This is a key relationship that can be missed and lead to increased neck strain.

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