In my Feldenkrais training, one of my assistant trainers mentioned almost offhandedly that her entire private practice was filled with middle-aged women in pain from too much Pilates. I filed that away.

Then I opened my own practice. And there they were.

Women with strong, disciplined bodies. Consistent practitioners, some for years. And pain that wasn't responding to more of the same. I got curious about what was happening.

What Pilates does well

If you do Pilates regularly and feel great, this post isn't for you. Keep going. What follows is for the people who are doing everything right and still hurting.

Pilates deserves its reputation for a lot of things. It builds genuine core strength. It develops body awareness. It creates the kind of consistent practice habit that most movement modalities struggle to produce. Joseph Pilates -- who called his method Contrology -- developed it originally to help bedridden patients build enough strength to get out of bed. The foundation is functional, and the intent was rehabilitative.

For people who have no movement practice, Pilates is often genuinely transformative. It builds strength in areas that have been neglected. It creates a relationship with the body that many people have never had. Done well, with a skilled instructor focused on functional movement, it is valuable.

The problem isn't Pilates. The problem is what happens when effort becomes the goal rather than ease.

Where it can go wrong

Joseph Pilates built his method around control. Moshe Feldenkrais built his around a different principle entirely. Feldenkrais was a physicist and a judo black belt. He wanted people to be able to move in any direction at any time -- to always have options, to never be caught off balance or off guard. His method was built around functional freedom rather than controlled strength.

These are genuinely different aims. And the difference shows up in how the body responds over time.

Pilates, as it is increasingly taught and practiced, emphasizes muscular effort, aesthetic outcome, and controlled form. The cue "engage your core" is repeated so consistently that many practitioners are chronically bracing -- not just during class but throughout their day. The nervous system learns what it practices. If you practice sustained muscular effort, the nervous system learns to sustain muscular effort. All the time. Even when you're just walking to your car.

A fair counter-argument: maybe it's not the Pilates. Maybe women who are already stiff and dysregulated are simply drawn to a method that promises control and structure. There's probably truth in that. People who feel out of control of their bodies often seek practices that emphasize control. What's worth considering is whether the method then reinforces the pattern that brought them there -- or helps them move through it. A method that teaches the nervous system to brace more thoroughly is not helping someone who already braces. It's giving them a more disciplined version of what they already do.

The instructor matters too. Pilates taught by someone focused on functional movement, contralateral patterns, and ease produces a different body than Pilates taught for visible definition and controlled form. The method is not monolithic. What it has become in many studios is different from what Joseph Pilates intended.

There's also a simpler variable worth naming: frequency. Two or three Pilates sessions a week is a very different nervous system input than five or six. The body needs time between sessions to integrate what it has learned and to move in other ways. When Pilates becomes the only movement practice, and it's happening daily, the nervous system has no contrast. It gets one signal, repeated relentlessly, and it optimizes for that signal. The result is a body that is very good at Pilates and increasingly less good at everything else.

Too much of a good thing is not a good thing.

I started noticing something in my practice. Women who had done Pilates consistently for years often walked in a very specific way. Everything moving together. Homolaterally -- the same arm and leg moving forward at the same time rather than the contralateral pattern that healthy gait requires. Stiff through the torso. Controlled rather than fluid.

I started calling it the Pilates walk.

I once watched a class let out and observed the students leaving. Several of them walked with that same quality -- rigid, effortful, everything braced. Like the control from the studio had followed them out the door.

The legal backstory that explains everything

In 2000, a Manhattan federal court ruled that the word Pilates could not be trademarked. It was declared a generic term -- like yoga or aerobics -- meaning anyone can use it. One Pilates Elder summarized the result plainly: "You can stand on a rock twirling a hula hoop and call it Pilates. And some do."

The contrast with Feldenkrais is instructive. The Feldenkrais Guild protected its trademark and maintained rigorous certification standards -- an 800-hour training program. The result is that Feldenkrais stayed small and niche while Pilates exploded into every gym, hotel fitness center, and streaming platform with wildly varying quality and no governing standard.

This matters for the pain question. When someone says they do Pilates, it tells you very little about what they're actually doing, who taught them, or whether their instructor understands functional movement. Some Pilates instruction is excellent. Some is aesthetics-focused core work with no attention to whole-body coordination. The name no longer distinguishes between them.

The hypertonic muscle problem

The clinical term for what I was seeing is hypertonic musculature -- muscles that are chronically over-contracted, maintaining a level of tension that doesn't release even at rest.

This matters because a muscle that can't fully release can't fully function. A chronically contracted muscle has a shortened functional range. It's also a muscle that is constantly consuming energy -- which is why people who are very muscularly toned often report chronic fatigue and tension that doesn't resolve with rest.

The nervous system sets the resting tone of your muscles. When you train the nervous system to maintain high muscular effort -- through years of "engage, hold, control" -- it learns to keep those muscles activated. The muscles don't know they're supposed to relax when you leave the studio.

Stretching doesn't reliably fix this. You can stretch a hypertonic muscle and feel temporary relief, but the nervous system will reinstate the holding pattern because that's what it has learned to do. The pattern itself needs to change.

When effort becomes the issue

There's a point in any movement practice where more effort stops producing better results and starts producing problems. In Pilates, that point often arrives when the aesthetic goal -- the rock hard body, the visible definition, the tightly controlled form -- overrides the functional goal.

A body organized around maximum effort is not a body that moves freely. It's a body that is always slightly braced. Always slightly defended. The joints that need mobility to function well -- the hips, the thoracic spine, the shoulder girdle -- get compressed by the chronic tension surrounding them. Pain follows. Often in the shoulders, the neck, the lower back. Often in ways that doctors can't explain structurally because the problem isn't structural. It's a pattern.

The women who came to me hadn't done anything wrong. They had followed instructions. They had worked hard. They had been consistent. The very qualities that made them good Pilates practitioners were the ones creating the problem.

What contralateral movement has to do with it

Healthy human movement is contralateral. When the right leg goes forward, the left arm goes forward. The spine gently rotates with each step. This counter-rotation is not decorative -- it's how the spine stays mobile, how the discs stay hydrated, how the nervous system maintains a dynamic relationship between the upper and lower body.

Many Pilates practitioners lose this. The emphasis on core bracing and controlled movement trains the torso to stay stable rather than to rotate. Over time, the contralateral pattern -- the natural gentle twist of walking -- gets suppressed. The spine stops rotating. The hips and shoulders compensate. Pain develops in the areas doing the compensating.

In my practice, I worked on restoring this pattern directly. Getting the spine to rotate. Getting the arms and legs to move in opposition. Getting the torso to participate in movement rather than brace against it. The change was often immediate and visible. The walk changed. The pain changed.

What complements Pilates -- and what replaces it

I'm not suggesting anyone stop their Pilates practice. Pilates doesn't always address what Feldenkrais Awareness Through Movement® does.

Awareness Through Movement lessons work on the nervous system's ability to organize the body efficiently -- with minimum effort rather than maximum control. They specifically work on the movements that Pilates tends to suppress: rotation, counter-rotation, side bending, the fluid relationship between parts. They ask the nervous system to release rather than engage. To explore rather than control. Many lessons specifically encourage the natural contralateral walking patterns that Pilates can suppress.

For a dedicated Pilates practitioner, a consistent Awareness Through Movement practice is not a replacement. It's the missing piece. It teaches the nervous system that it doesn't have to brace all the time. That ease is available. That the body can be strong and fluid rather than strong and rigid.

And if you're doing Pilates five or six times a week and you're in pain -- consider what two or three times a week plus a daily ATM lesson might do instead. Less of one input. More variety. A nervous system that gets to practice both effort and ease rather than effort alone.

Different Feldenkrais practitioners have different philosophies on this. Some believe in giving people the awareness to keep doing what they love -- even if it's causing tightening -- and use ATM to complement and counterbalance. That's a valid approach.

My mentor took a harder line. Stop everything else while we work together. And the evidence in my practice supported it. When my students quit Pilates entirely during our work together, their pain resolved faster. Once they were out of pain, I encouraged them to return to whatever they loved -- with greater awareness and more options available to them.

Moshe Feldenkrais was openly critical of ballet -- the chronic tightening, the extreme demands on the body. And yet he worked with prima ballerinas. He didn't tell them to stop. He gave them something that made them better at what they did and less damaged by it.

For the research behind the method, visit pauseture.com/research.