Your Brain Is Running Your Posture Session… Whether You Know It Or Not
Monique Johnson
What every Pilates instructor and practitioner needs to know about the neuroscience behind the work we already do
You've coached the cue a hundred times. Lengthen through the spine. Draw the shoulder blades down. Find your neutral. And sometimes it clicks beautifully — and sometimes, no matter how precisely you cue or how hard your client tries, the posture just won't hold. They walk out the door and revert within minutes.
What if the issue was never about the muscles at all?
On February 19, 2026, the Pilates Method Alliance hosted a two-hour workshop on the neuroscience of posture, presented by Heba Abdel Gawad — a two-time Olympian in synchronized swimming, Z-Health Master Trainer, neuroscience coach, and creator of the internationally accredited NeuroPilates certification, joining live from Dubai. What she laid out doesn't contradict the Pilates principles we work within. It explains why they work — and shows us where to go when they're not working well enough.
The central shift? Posture is not only a muscle problem. It's a neurological one. And that changes everything about how we approach it.
1. The Real Reason Your Client Can't Find Extension
We spend a lot of time in the Pilates world talking about the multifidi, the intertransversarii, the deep spinal stabilizers. We cue them, load them, and sequence our sessions around them. But here's what neuroscience adds to that picture: those muscles don't just respond to exercise. They respond to a signal — and that signal comes from the inner ear.
Deep inside the ear is the vestibular system — three fluid-filled canals and two additional structures that together answer two questions for the brain at all times: Where am I going? and Which way is up? The three semicircular canals detect rotational movement of the head across three planes of motion. The other structures sense jumping and linear acceleration — think the feeling of a car pulling forward.
What makes this directly relevant to our work is the vestibulospinal tract — a descending neural pathway that takes information from the vestibular system and uses it to activate extensor muscle tone throughout the trunk and limbs to support upright posture. Including the deep stabilizers we've built our whole practice around.
When the vestibular system is underactive, that signal is weak. And a weak signal means altered vestibular input can influence postural stability and change how muscles are recruited during movement. or how diligent the client is. This is why some clients with significant kyphosis can do extension-focused work for months and see limited lasting change — the neurological drive for extension simply isn't strong enough.
The vestibular system develops first in utero and is strengthened through childhood movement — rolling, spinning, climbing, rough-and-tumble play. Sedentary lifestyles, screen time, and reduced childhood outdoor movement may affect it. Many of our adult clients are walking in with vestibular systems that haven't been properly challenged in years.
2. The VOR — And Why It Belongs in Your Sessions
One of the most useful and assessable outputs of the vestibular system is the vestibulo-ocular reflex, or VOR. This reflex stabilizes vision during head movement by producing compensatory eye movements that keep the visual image steady on the retina as the head moves through space.
You can test it in your studio in under thirty seconds. Ask your client to hold their thumb at arm's length and stare at their thumbnail. Then have them slowly rotate their head side to side, as if shaking their head "no," while keeping their eyes on the thumb throughout. A healthy VOR allows vision to remain relatively stable during head movement. VOR weakness shows up as blurry vision during the turns, mild nausea, or double vision.
For context: clients who get motion sick easily, who find busy visual environments overwhelming, or who feel "off" during exercises that involve head movement — these are often vestibular and VOR presentations.
The great news is that we can train this system with tools we already have. Try adding:
Head rotations during chair footwork, keeping the gaze fixed on a point across the room
Controlled head turns during mat work, eyes tracking to the ceiling
A walking exercise where the client maintains focus on a fixed distant point rather than letting their eyes wander
These are small additions to familiar exercises — but for a client with VOR weakness, they are genuinely therapeutic, not just variations.
3. The Brainstem and the Flexor-Extensor Balance
The brainstem — sitting at the base of the brain where it connects to the spinal cord — manages something Pilates practitioners care about deeply: the balance between flexion and extension. Specifically, two tracts govern this. The pontine reticulospinal tract activates extensors. The medullary reticulospinal tract activates flexors. The ongoing negotiation between these two is what determines whether a joint is centered, collapsed, or over-braced.
For our clients, this shows up as the chronic patterns we're so familiar with: the forward head that won't quite come back to neutral, the rib cage that never quite lifts, the hip that perpetually sits in a slight anterior tilt. These patterns often have a neurological basis, not just a structural one.
Here's the detail that changes clinical thinking: this system is ipsilateral. The right brainstem controls right-side positioning. The left brainstem controls the left. So the client who always injures the right side — right rotator cuff, right IT band, right knee, always the right — may have a pathway asymmetry driving that pattern. It's not random, and it may not be biomechanical at its root.
4. Cross-Pattern Work: There's a Neurological Reason It's in the Method
If the brainstem pathways are one-sided, it follows that input from the left side of the body feeds the right brainstem and right cortex — and vice versa. This gives us a clinical strategy that will feel familiar to anyone trained in contralateral or cross-pattern movement: working the opposite side intentionally can create neurological improvements on the affected side.
For a client with persistent right shoulder restriction, loading the left arm — strong bicep contractions, left arm reaches, left-side resistance work — sends neurological input to the right brainstem. For a client with generalized right-sided dysfunction, prioritizing left leg balance, left cerebellar coordination exercises, and left-side figure-8 patterns may do more for the right side than any direct right-side intervention.
This isn't departing from Pilates. It's the neuroscience explaining why contralateral work, spirals, and cross-body patterns are so powerful within our method — and how to deploy them more deliberately.
5. Eye Exercises as Part of Your Session Design
This is where the workshop got genuinely surprising: specific eye exercises activate the cerebellum and can directly support core stability and postural control. Three specific ones are worth knowing.
Pencil Push-Ups (Convergence Training) The client holds a pen at arm's length and slowly draws it toward their nose, tracking it with both eyes. The goal is to reach the nose without the image splitting or doubling. This trains ocular convergence and activates the middle cerebellum — the part of the brain responsible for trunk stability and coordination. For clients whose core recruitment feels neurologically inconsistent, this is a targeted and underutilized tool.
The Three-Circle Strip Draw a horizontal line with three evenly spaced circles on it. Have the client stare at the middle circle. With good binocular coordination, the two outer circles will appear to form an "X" pattern. Difficulty achieving this reveals something about how the two eyes are working together — and gives you another neurological data point about what your client's brain is managing.
Saccadic Movements Saccades are the rapid, dart-like eye movements the brain uses to shift gaze between points. The right cortex drives leftward saccades; the left cortex drives rightward ones. Practically: a client whose right arm doesn't swing properly during gait — often indicating underactivity in the right cortex — can benefit from practicing rapid rightward eye movements. It's a thirty-second add-on that directly stimulates the underactive area. Build it into warm-up. It takes no equipment and costs nothing.
6. Reading the Body Through a Neurological Lens
One of the most valuable sections of the workshop was Abdel Gawad's guidance on observation — how to read postural and movement patterns as neurological information, within our scope of practice, without making diagnostic claims.
Some key patterns to watch for:
Wide gait combined with kyphosis is a strong vestibular signal — the brain is widening the base of support because it doesn't fully trust its sense of where "up" is
Chronic motion sickness is a consistent indicator of vestibular weakness — ask about it in your intake
A pattern of same-side injuries across the history suggests a brainstem pathway asymmetry worth addressing through cross-pattern and contralateral work
Reduced or absent arm swing on one side during walking points to reduced cortical activity on that side
Significantly worse balance on one side warrants more cerebellar work on that side, not just more practice of the same balance challenge
For cerebellar assessment, rapid alternating movements — forearm supination and pronation, done quickly — can reveal asymmetry in cerebellar coordination. Compare both sides. Finger tapping speed comparisons offer similar information. These observations inform programming decisions without crossing into diagnosis.
The language we use matters enormously here. We describe what we observe ("I notice your gait tends to be a bit wider") and what the exercise does ("this challenges your balance system"). We don't diagnose. We integrate.
What This Means for How We Teach
Nothing in this workshop suggested that Pilates isn't working. It suggested the opposite — that our principles are neurologically sound, and that understanding the science beneath them helps us use them more precisely.
Adding spirals, figure-8 patterns, and novel coordination challenges into familiar exercises isn't just programming variety. It is deliberate cerebellar training. Prioritizing contralateral work for a client with unilateral issues isn't just good sequencing — it is targeted neurological rehabilitation within our scope. Cueing clients to focus on a fixed point during movement isn't just attention management — it is VOR training.
The brain is trainable at every age. The vestibular system responds to challenge. The pathways that drive posture respond to the right kind of input. And we — as Pilates professionals — are already delivering much of that input, every single session.
Now we know exactly why it works. And we know where to look when it isn't working well enough yet.
Workshop hosted by the Pilates Method Alliance, February 19, 2026. Presented by Heba Abdel Gawad, Z-Health Master Trainer and creator of the NeuroPilates certification program. 2 CECs available for live attendees. Closed captions available via info@artismethodalliance. Slides distributed post-session; limited replay access available.
