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Writer's pictureAmy Sasso

What Science Really Says About Posture and Pain

Updated: Nov 19

A Fresh Take for Pilates Teachers


If you're anything like me, you probably learned that the body needs to be perfectly aligned and symmetrical for optimal function. Well, get ready for some mind-blowing research that has shaken up everything we thought we knew about posture, pain and movement.


In 2011, Eyal Lederman published a groundbreaking paper titled "The fall of the postural–structural–biomechanical model in manual and physical therapies: Exemplified by lower back pain" that challenged many long-held beliefs about posture, alignment, and pain.

This paper has significant implications for how we teach and practice Pilates, especially given how much emphasis we traditionally place on precise alignment and "correct" posture.


girl stretching over ball


Your Body is Way Tougher Than You Think


Remember being told that every little imbalance could lead to problems? Turns out, our bodies are incredible at adapting and handling variation. Here are some fascinating examples:


  • Shoulder studies found that three-quarters of people with no pain have what we'd consider "problems" on their scans  - things like joint wear and tear, bone spurs, and fluid buildup. Yet they're going about their lives just fine!


  • When it comes to back pain, significant leg length differences (up to 20mm!) don't typically cause problems. Your body's just like, "No biggie, I got this!"


  • Here's a wild one: Men can naturally lose 25% of their muscle mass between 50 and 75 years old without it affecting their function. The body needs to lose more than 30% before it starts limiting daily activities.


  • Disc degeneration isn't a reliable predictor of back pain. In fact, a massive study of nearly 35,000 Danish twins found no meaningful difference in back pain between young and old folks, despite older people typically having more wear and tear.



woman's shoulder

The Truth About "Perfect" Posture: What Research Actually Shows


Let's bust some myths with real research findings:


  • A huge study of teenagers found that their spinal curves, posture, and asymmetries had zero connection to developing back pain as adults.


  • Pregnant women with increased lordosis (that curved lower back we often try to "fix") didn't have more back pain than those without it.




pregnant woman doing pilates


Core Training (It's Not What You Think!)


The research on core training might change how you think about those endless planks and hollow holds. Studies show that during normal standing, those deep core muscles we obsess about are barely working at all - we're talking less than 1% of their maximum capacity! Even when carrying a heavy load (like 70 pounds!), they only increase to about 3% of maximum effort.


Walking? Your rectus abdominis (your "six-pack" muscle) is chilling at about 2% of its max, while your external obliques are hanging out at around 5%. Even when lifting or bending with a 33-pound weight, you're only looking at a tiny increase in muscle activity.


What does this mean? Your body is incredibly efficient and doesn't need perfect muscle activation to function well. This explains why people can lose significant muscle mass and still move just fine in their daily lives.



man and woman doing plank exercise


Practical Recommendations for Pilates Teachers (The Good Stuff!)


Stop the Over-Correction Game


Instead of nitpicking every little alignment detail, focus on helping your clients feel strong and capable in their movements. Research shows that even significant physical variations (like leg length differences) don't typically cause problems.


Let your clients know that their "imperfections" are normal and okay!


Build Confidence, Not Perfection


Rather than making clients feel like their bodies need fixing, help them discover what they can already do well. Share with them the research showing how resilient bodies are - like those shoulder studies where "imperfect" shoulders work just fine. This knowledge can be incredibly empowering!


Focus on Function Over Form


Instead of chasing perfect alignment, help clients build strength and capability for their daily lives. If someone can effectively and comfortably perform their daily tasks, does it really matter if their pelvis is slightly tilted? (Spoiler alert: research says no!)


Embrace Individual Differences


Posture does not equal pain. This is what the research shows. Use this knowledge to celebrate your clients' unique movement patterns rather than trying to force everyone into the same mold.



woman doing pilates on a reformer machine

Moving Forward: A New Way to Think About Movement


The way we think about movement is evolving, and it's pretty exciting! Instead of seeing the body as a machine that needs perfect alignment, we're starting to understand it more like a living, adapting organism that's incredibly good at finding its own way to move efficiently.


Think about it - if we needed perfect posture and alignment to function well, most of us would be in trouble! But that's not what the research shows. Instead, we're seeing that bodies are remarkably adaptable and capable of functioning well with all sorts of variations.


This doesn't mean we throw good form out the window - since form/technique will predict which muscles are working the most and we can use this knowledge to help our clients meet their goals and needs.


But it does mean we can relax a bit about minor variations and focus more on helping people build strength, confidence, and capability in their movement.


After all, the goal isn't to create perfect postures - it's to help people move better, feel better, and live better lives.


Every person who walks into your studio brings their own unique body story. Our job isn't to rewrite that story to match some idealized version of perfection, but to help them write the next chapter - one that's full of confidence, capability, and joy in movement.



group of happy women who exercise


What do you think about this perspective? How might it change your approach to teaching? I'd love to hear your thoughts and experiences in the comments below!


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