The Flexibility Paradox
The Flexibility ParadoxYou may be surprised to discover that your back pain has worsened despite a dedicated yoga or Pilates practice. You may have been stretching regularly, following your’s guidance and doing everything they’ve been told will help, yet your discomfort persists or even intensifies.
This experience isn’t unusual. Whilst yoga and Pilates offer many benefits, clinical evidence and our experience suggests that for some, certain aspects of these practices may contribute to back pain even when performed properly.
What the Research Shows
Clinical reviews have identified that yoga-related injuries most commonly involve repeated bending forwards and backwards or spinal flexion and extension, particularly in people with underlying risk factors . Other research shows that joint hypermobility is associated with increased musculoskeletal pain, reinforcing the importance of stability and control alongside flexibility (Tobias et al., 2013).
The Balance Between Flexibility and Stability
Your spine requires a delicate balance between mobility and stability. Think of your spine as a ship’s mast: too rigid and it might snap in strong wind, but too flexible and it can’t support the sails properly.
The lumbar spine is designed to provide stability whilst allowing controlled movement. When movement repeatedly occurs at extreme ranges without adequate muscular control, stress is transferred to passive structures such as discs, ligaments and facet joints. This is consistent with biomechanical analyses of yoga-related injuries, where hyperflexion and hyperextension of the spine were the most frequently associated movement patterns leading to soft-tissue and bony injuries.
Here at Sundial, we often see individuals with back pain who demonstrate excellent flexibility but insufficient control and strength to support that range during daily activities.
Why Yoga and Pilates Can Aggravate Back Pain
1. Excessive Forward Bending (Flexion)
Many popular yoga poses—such as forward folds, seated stretches and poorly controlled Downward Dog—require repeated spinal flexion.
A clinical review of patients presenting with yoga-related injuries found that spinal flexion and extension movements were most frequently implicated, with some cases involving compression fractures in individuals with reduced bone density (Awan & Laskowski, 2019). While these injuries are not common, they highlight that repetitive or forceful flexion can be problematic, particularly when layered on top of prolonged sitting and existing postural loading from desk work.
Repetitive forward bending can cause stress on the low back discs which can lead to microtears in the disc wall and, eventually, a disc prolapse and painful sciatica.
2. Hypermobility Without Stability
Some people are naturally hypermobile, meaning their joints move beyond typical normal ranges. For these individuals, additional stretching may increase symptoms rather than relieve them.
A large study demonstrated that joint hypermobility is a significant risk factor for musculoskeletal pain, which suggests that excessive mobility without adequate stabilising control can predispose people to pain. This fits in with something we see at Sundial: hypermobile patients with back pain often respond better to stabilisation and strengthening strategies than to further flexibility training.
Many yoga and Pilates classes, however, prioritise achieving deeper ranges of motion rather than developing the muscular control needed to safely support those ranges.
3. End-Range Loading
Poses that involve holding the spine at the extreme end of its range (deep twists, prolonged backbends or advanced forward folds) place sustained load on spinal structures.
The Mayo Clinic review of yoga-related injuries highlights that end-range spinal loading, particularly in flexion and extension, is a recurring mechanism associated with injury presentations. When these positions are held for prolonged periods or progressed too quickly, they may aggravate underlying vulnerability.
4. One-Size-Fits-All Approach
Group exercise classes cannot provide individualised assessment. This matters because risk factors such as hypermobility, reduced bone density, previous injury and poor motor control significantly influence how the spine responds to movement.
What is beneficial for one person may be inappropriate for another, which is something we know well here at Sundial Clinics.
When Flexibility Becomes a Liability
The spine does not require maximal flexibility to function well; it requires controlled movement within an appropriate range. As we’ve seen, research linking joint hypermobility to increased musculoskeletal pain suggests that more movement of the “wrong sort” is not inherently protective and may, in some individuals, increase symptom risk if not matched with stability.
Yoga and Pilates excel at improving body awareness and mobility, but they do not always adequately address:
- Motor control under load
- Progressive strengthening
- Individual risk assessment
- Functional resilience for daily life
What Should You Do Instead?
Get a Proper Individual Assessment
- Our Sundial chiropractors can assess your movement patterns, identify excessive mobility or instability, and determine whether your current exercise routine is supporting or aggravating your symptoms.
- This individualised approach is particularly important, given evidence that certain spinal movements (especially repeated end-range flexion and extension) are more commonly associated with injury in yoga practitioners.
Focus on Stability Before Mobility
- For many people with back pain, stability-focused exercises such as dead bugs, bird dogs, and controlled bridging provide more benefit than stretching alone.
- This is especially true for individuals with hypermobility, where strengthening and control are key to reducing pain risk.
- Our physiotherapists and chiropractors can help you find the right kind of exercise programme to support your needs.
Modify Your Practice
- You do not need to abandon yoga or Pilates entirely. Instead:
- Reduce stretch depth by 20–30%
- Avoid repeated deep forward bending, particularly first thing in the morning
- Emphasise control over depth
- Incorporate strengthening variations
- Seek instructors who understand therapeutic modification
Add Load-Bearing Exercise
- Progressive resistance training teaches the spine to tolerate real-world loads safely. Controlled spinal loading helps build resilience, rather than relying solely on passive flexibility.
The Role of Professional Treatment in Recovery
Chiropractic care combines hands-on treatment, such as spinal manipulation to restore joint mechanics, with targeted stabilisation exercises. This approach addresses both symptom relief and the underlying movement patterns associated with pain.
Clinical findings and research consistently show that individuals with excessive mobility often improve when treatment prioritises control and strength rather than further stretching.
If you’re a Brighton resident struggling with back pain despite a dedicated yoga or Pilates practice, seeking professional assessment is worthwhile. Here at Sundial, our modern approach to chiropractic care combines manual therapy, appropriate exercise prescription and patient education to help you move better and feel better based on what your body actually needs, not generic advice.
Your back doesn’t need to bend like a gymnast’s: it needs to be strong, stable and resilient for whatever life throws at it.
Frequently Asked Questions
Can yoga and Pilates cause back pain?
Yes, yoga and Pilates can contribute to back pain in certain individuals, particularly those who are hypermobile, who perform excessive forward bending without adequate stability training, or whose individual needs don’t match what’s being taught in class. Not everyone experiences this, but it’s more common than many people realise. The exercises themselves aren’t inherently harmful, but when they’re not matched to individual needs, they can aggravate existing problems.
Is it better to stretch or strengthen your back?
For most people with back pain, strengthening and stability exercises are more beneficial than stretching alone. Your spine needs controlled strength more than extreme flexibility. However, the ideal approach depends on your individual presentation: some people do need more mobility work. Here at Sundial, we can assess whether you need more mobility or stability work based on your specific movement patterns and pain presentation.
Can you be too flexible in your back?
Absolutely. Excessive spinal flexibility without corresponding muscular control creates what clinicians call “clinical instability.” This means your spine moves too much during everyday activities, placing excessive stress on discs, ligaments and joints. While this sounds counterintuitive to many people who assume that flexibility is always beneficial, too much mobility without adequate control can be just as problematic as being too stiff.
What is the best exercise for back stability?
Stability exercises that have proven helpful for many people include “dead bugs”, bird dogs, planks performed with proper form, and controlled bridging exercises. These teach your nervous system to maintain a stable, neutral spine position during movement. However, the “best” exercise varies by individual. A chiropractor can assess your specific needs and prescribe exercises tailored to your movement patterns and pain presentation.
Should I stop doing yoga if I have back pain?
You don’t necessarily need to stop yoga entirely, but you should modify your practice. Avoid repeated deep forward bending, reduce stretch depth by 20-30% and focus on strengthening variations of poses. Working with a qualified instructor who understands therapeutic modifications is essential. If you are in Brighton, consider seeking assessment from our chiropractors who can provide guidance on which movements to avoid and which to emphasise for your particular situation.
How does chiropractic treatment help with back pain from yoga?
Chiropractic treatment combines spinal manipulation to restore proper joint mechanics along with personalised exercise prescription. This approach addresses both immediate pain relief and the underlying movement patterns contributing to symptoms. A chiropractor can identify whether excessive flexibility is contributing to your symptoms and develop an appropriate treatment plan that may include hands-on treatment, specific exercises and guidance on modifying your yoga or Pilates practice.
What’s the difference between mobility and stability?
Mobility refers to your range of motion—how far your joints can move. Stability refers to your ability to control that movement and maintain proper positioning under load. Optimal control throughout your available range is more important than maximum flexibility. Many people with back pain have plenty of mobility but lack the stability to control it safely during everyday activities.
Are forward bends bad for your back?
Forward bends aren’t inherently “bad,” but repeated forward bending (spinal flexion), particularly under load or first thing in the morning, can stress spinal structures. For people who already sit hunched at desks all day, additional forward bending in exercise can compound existing problems. This doesn’t mean forward bends should always be avoided, but they should be performed mindfully, balanced with extension and stability work and considered in the context of what your spine experiences throughout the rest of your day.
How do I know if I’m hypermobile?
Signs of hypermobility include joints that bend beyond normal ranges, ability to perform extreme stretches easily, frequent joint clicking or popping and a history of sprains. If you can easily place your palms flat on the floor without bending your knees, bend your thumb back to touch your forearm or hyperextend your elbows and knees, you may be hypermobile. A chiropractor or physio at Sundial can formally assess hypermobility and determine if it’s contributing to your back pain.
When should I see a chiropractor for back pain?
You should consult a chiropractor if you experience persistent back pain lasting more than a few weeks, pain that worsens despite rest or exercise modifications, or discomfort that interferes with daily activities. Additionally, if you’re doing yoga or Pilates and finding your back pain is getting worse rather than better, professional assessment is important. Chiropractic treatment can identify contributing factors and provide targeted manual therapy combined with appropriate exercise prescription.
At Sundial Clinics, our recommendations are informed by current research, clinical guidelines and hands-on experience treating thousands of Brighton residents with back pain. We prioritise individual assessment and exercise prescription over one-size-fits-all advice. This article is intended for general educational purposes only and does not constitute individual medical advice. Yoga and Pilates are beneficial for many people, and not everyone will experience pain or injury from these practices. Research cited highlights potential risk factors associated with specific movement patterns and individual characteristics, such as hypermobility or reduced bone density. Individual assessment by a qualified healthcare professional is essential to determine appropriate care.
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.
References
1. On yoga-related injuries: Awan, R., & Laskowski, E. R. (2019). Soft Tissue and Bony Injuries Attributed to the Practice of Yoga: A Biomechanical Analysis and Implications for Management. Mayo Clinic Proceedings, 94(3), 385-387.
This study reviewed 89 patients with yoga-related injuries over 12 years and found that poses involving hyperflexion and hyperextension of the spine were most commonly associated with injuries, including compression fractures in patients with osteopenia or osteoporosis.
2. On hypermobility and back pain: Tobias, J. H., Deere, K., Palmer, S., Clark, E. M., & Clinch, J. (2013). Joint hypermobility is a risk factor for musculoskeletal pain during adolescence: Findings of a prospective cohort study. Arthritis & Rheumatism, 65(4), 1107-1115.
This prospective cohort study found that joint hypermobility is a significant risk factor for musculoskeletal pain, supporting the concept that excessive flexibility without adequate stability can contribute to pain.