Pilates Movement Monday: The Truth About the Reformer Headrest

Headrest slightly raised reduces cervical control and encourages passive neck support.

The headrest on the Reformer looks like a minor adjustment, but it has a significant influence on how the body organises itself. It is one of those small details that quietly determines whether you are reinforcing good alignment or simply making the exercise more comfortable.

Most clients will naturally choose comfort. As teachers, we are aiming for something quite different. We are trying to restore alignment. When working with postural correction, particularly forward head posture or increased thoracic kyphosis, the objective is to retrain the head to sit more appropriately over the spine. This means encouraging support from the deep stabilising muscles rather than allowing the head to fall forward or be passively supported.

This is where the position of the headrest becomes important. In most cases, particularly when focusing on alignment, the headrest is best placed down. This allows the cervical spine to lengthen and encourages the thoracic spine to settle into a more neutral position.

It also invites the deep neck flexors and upper back muscles to engage and support the head rather than relying on external support. If the headrest is raised too early, the body tends to relax into it. The head becomes passively supported, and the opportunity to develop strength and control is reduced. In simple terms, the headrest can easily become a crutch, and like most crutches, it is comfortable but not especially helpful in the long term.

This is why clients often prefer the headrest up. It feels easier, much like resting the head on a pillow. The neck muscles are no longer required to work, and the body settles into a familiar pattern. However, forward head posture is closely associated with weakness and poor coordination in the stabilising muscles, so consistently supporting the head can reinforce the very issue we are trying to address.

That said, there are clear situations where support is appropriate. For clients with a more pronounced thoracic kyphosis or a significant forward head position, placing the head flat on the carriage may not be realistic. It can create unnecessary tension or place the cervical spine into a strained position. In these cases, a small amount of support, such as a folded towel or a lower adjustment of the headrest, can help bring the head into a more neutral alignment.

The key point is that this support should not become permanent. It is a temporary strategy that allows the client to work more effectively while gradually improving their alignment. Over time, the aim is always to reduce the level of support as strength, awareness, and control improve.

From a teaching perspective, this requires observation and judgement. Starting with the headrest down where possible gives you a clear view of how the client organises their spine. If the position cannot be maintained without strain, a small amount of support can be introduced. As the client progresses, that support should be reduced. Explaining this process to the client is essential, as understanding the purpose behind the adjustment often makes them far more willing to move away from what simply feels comfortable.

It is also worth remembering that the position of the head influences far more than just the neck. It affects the organisation of the ribcage, the mobility of the thoracic spine, the positioning of the shoulder girdle, and even breathing patterns. When applied with this level of attention, Pilates can contribute to improved posture and overall spinal alignment.

So while the headrest may seem like a small detail, it plays a meaningful role in how the body learns to support itself.

If the headrest is always up, the body never really has to work. If it is always forced down, the body may simply resist. The real skill lies in knowing when to support and when to challenge.

And unfortunately, that part cannot be adjusted with a lever.

References

National Institutes of Health. Effects of Pilates on Forward Head Posture. 2016.https://pmc.ncbi.nlm.nih.gov/articles/PMC4968495/

National Institutes of Health. The Effect of Pilates Exercise on Posture. 2023.https://pmc.ncbi.nlm.nih.gov/articles/PMC10885405/