The Real Reason Your Shoulders Won’t Relax (Hint: It’s Not Just Posture) and How Pilates Can Help
- Erica Takebayashi
- May 2
- 10 min read
Raise your hand if your neck and shoulders feel like they’re carrying the weight of the world.(If you’re raising your hand right now and wincing - I see you!)
Neck and shoulder tension is one of the most common physical complaints I see in my practice. It often shows up as stiffness, aching, or even sharp discomfort that seems to linger despite stretching or massage. Tight, achy shoulders aren't just about muscles. They're about your whole system - body, mind, and emotions.
Let’s explore why neck and shoulder tension happens, what science says about it, and how you can begin to release it in a deeper, more lasting way.
First, Why Does This Happen?
Our neck and shoulder region is designed for delicate, precise movements - think of the fine balance it takes to turn your head or reach overhead. Yet it also carries the heavy responsibility of supporting the weight of the head, which can weigh around 5kg or more. When stress, poor posture, or unresolved emotions enter the picture, this sensitive area becomes a natural holding zone.
Research in psychosomatic medicine suggests that emotional stress leads to increased muscle tension, particularly in areas such as the trapezius muscles . In other words, when we experience mental or emotional strain, our bodies literally brace and contract to protect us. Over time, this 'bracing' can become a habitual state.
(Translation: even thinking about that awkward conversation or your to-do list can cause tiny muscle contractions you don’t even feel... until you really, really do.)
When you factor in daily habits such as prolonged phone use, working on a laptop, or unconsciously clenching your jaw in an effort to stay composed, it's no surprise that tension begins to accumulate.
Common contributors include:
Postural patterns (like rounded shoulders from desk work)
Chronic stress triggering the sympathetic nervous system ("fight or flight" mode)
Unprocessed emotions, especially feelings like overwhelm, burden, or unsafety
Muscle imbalances and weakness around the core or shoulder girdle
The Science Behind Stress and Muscle Tension
Modern research has been digging into this stress-tension link, and the findings are eye-opening. Here are some highlights from the last decade that show how psychological stress and neck/shoulder tension go hand-in-hand:
Tight Muscles in Young Adults: A 2019–2021 study of 2,000 university students found that a whopping 86.4% of them had myofascial trigger points (essentially tight, tender “knots”) in their neck and shoulder muscles. These trigger points were significantly associated with the students’ levels of depression, anxiety, and stress. In other words, the more stress or emotional distress students reported, the more likely they were to have hard, sore spots in their neck/shoulder region. The researchers concluded that these muscle knots were “quite common” in stressed students
Stress and Neck Pain in Students: In a 2023 survey at King Abdulaziz University, over 50% of undergraduate students reported experiencing neck pain. What’s telling is that students with higher anxiety and depression scores had markedly worse neck pain on average (p < 0.001). In this study, psychological distress wasn’t a side note – it emerged as a significant factor influencing the intensity of neck pain. Essentially, students who were more anxious or down also tended to suffer more neck aches and discomfort. (Interestingly, lifestyle factors like lack of exercise and even heavy coffee drinking were linked to neck pain too – but stress stood out as a key piece of the puzzle.)
Lockdown Tension Spike: Researchers in Israel looked at college students during a COVID-19 lockdown (2020–2021) and observed a clear spike in neck problems correlated with stress. About 35.6% of students had at least moderate disability from neck pain during the lockdown – significantly more than before. On average, neck pain ratings climbed during the lockdown period. Not surprisingly, 59% of these students said they were under study-related stress. Statistical analysis showed that higher perceived stress (along with long hours sitting at a computer) was associated with a higher risk of serious neck pain issues. The sudden change to online learning, isolation, and anxiety during lockdown appeared to exacerbate neck muscle tension and pain, reinforcing how psychological stressors can translate into physical strain.
Chronic Stress as a Risk Factor: A comprehensive 2022 review of global neck pain research confirmed that psychological factors – especially long-term stress, anxiety, and depression – are important risk factors for neck pain. This means that across many studies, people who report chronic high stress or poor mental well-being are more prone to developing persistent neck pain. Lack of social support (which can amplify stress) was another contributor. So it’s not just one-off stress causing a stiff neck; it’s the ongoing, unrelieved stress that can set the stage for chronic neck issues.
Emotional Distress and Shoulder Pain: It’s not only the neck – the shoulders are equally prone to stress-related aches. A 2018 Norwegian study followed patients undergoing physiotherapy for shoulder pain. They found that individuals who had higher emotional distress at the start tended to have more persistent shoulder pain after therapy (and higher pain intensity ratings), compared to those with better emotional states. Notably, this held true even after physical treatment, suggesting that unresolved stress or anxiety can slow down recovery or keep the pain cycle going in the shoulder area. Consistently, other research reviews have noted that anxiety and depression are significant predictors of chronic shoulder pain conditions as well. In simpler terms, a “stressed-out mind” can feed a “stressed-out shoulder,” contributing to ongoing pain or impingement problems.
These studies – from large surveys to lab experiments – all point to the same conclusion: psychological stress often expresses itself as real, measurable tension and pain in our neck and shoulder muscles. Whether it’s students, office workers, or people already dealing with an injury, higher stress levels correlate with tighter muscles and more discomfort in these areas.
Why Does Stress Target the Neck and Shoulders?
Stress can cause muscle tension throughout the body, but the neck and shoulders seem to be especially vulnerable to that tight, achy feeling. Why do we tend to “tense up” in these spots? There are a few reasons:
Protective Reflex: Evolutionarily, when we’re threatened or anxious, our body’s reflex is to guard itself. The neck and shoulder region contains important structures (the spine, vital nerves, blood vessels), so tightening up here is like the body’s attempt to form a natural “armor.” You might notice if you’re startled or upset, your shoulders creep upward and neck stiffens – that’s a built-in defense mechanism. It’s useful for short-term protection, but if it stays activated, it leads to soreness.
Posture and Burden: Modern stress often comes while we’re also straining our necks – for instance, hunching over a computer, clenching a steering wheel in traffic, or looking down at a phone. When you add poor posture to stress, the effect on muscles compounds. Your neck muscles end up not only bracing for stress but also working overtime to support your head in awkward positions. Over time, this results in the familiar neck stiffness, shoulder tightness, and even upper back pain that so many stressed individuals report.
Muscle Memory of Tension: For many people, the neck and shoulders have basically learned to be the “stress ball.” We might unconsciously contract these muscles when concentrating or worrying – a habit that can persist even when we’re not actively stressed. This chronic low-level contraction reduces blood flow and causes waste metabolites to build up in muscles, which can trigger pain receptors. Essentially, our neck/shoulder muscles can get stuck in a loop of tightness once stress becomes frequent.
Physiologically, researchers have measured how stress affects these specific muscles. For example, experiments show that mental stress or even simulated work pressure causes a measurable increase in electrical activity of the upper trapezius (the large muscle spanning your neck and shoulders) – indicating more contraction. In a systematic review of such studies, scientists concluded that workplace stressors consistently led to moderate increases in neck and shoulder muscle activity. Another research team noted that some people are particularly sensitive: they reflexively tighten their trapezius under stress (detected via EMG, a muscle electrical activity test) and are more likely to develop neck pain as a result. This means the neck/shoulder area is, for many of us, the body’s stress barometer – tightening up automatically when our mind is under duress.
The Body-Mind Connection
The intimate link between psychological stress and physical tension doesn’t mean you’re doomed to live with a stiff neck forever. In fact, understanding this connection is the first step to breaking the cycle. Since stress can trigger muscle tightness, strategies that tackle both the mental and the physical aspects can offer relief.
On the emotional side, finding ways to reduce or manage stress is crucial – be it through mindfulness, meditation, counseling, or simply carving out relaxation time. Health experts emphasise that stress management and relaxation techniques are important for preventing and relieving neck pain. Essentially, calm the mind and you calm the muscles. On the physical side, you can directly target those tense muscles to get them to loosen up. Relaxation techniques, stretching and other stress-relieving activities and therapies can effectively reduce muscle tension, notes one pain management resource. This is where practices like gentle neck and shoulder stretches, Pilates, Yoga, massage, and myofascial release come in. These activities help release tight knots and improve blood flow to tense areas, sending signals to your nervous system that it’s okay to relax.
For instance, simple myofascial release exercises – like using a tennis ball or foam roller to gently massage the stiff spots around your neck and shoulder blades – can work wonders in relieving that “hard as a rock” feeling. (See video below for some easy techniques.) Such exercises physically break up muscle tension and, when paired with deep breathing, can also lower your stress hormones. It’s a one-two punch for stress-related tightness.
Finally, remember that neck and shoulder pain often has multiple causes. Stress is a big one, but things like ergonomics and fitness play a role too. The good news is that many of these factors are modifiable. Research shows that regular physical activity and good posture can protect against stress-induced neck pain, while chronic stress (if left unchecked) can make any existing neck/shoulder issue feel worse. So, taking care of your mental well-being and your musculoskeletal health together is the best approach. By managing stress and caring for your body – through stretches, myofascial release, proper breaks during work, and perhaps professional guidance when needed – you can significantly ease the tension in your neck and shoulders. In doing so, you’ll not only feel physically better but also empower yourself to handle stress without it “knotting you up” as much as before.
How Pilates Can Help
Strengthening the Core
One of the core principles of Pilates is strengthening the core. A strong core supports the spine and promotes better posture, which can significantly reduce tension in the neck and shoulders. When the core muscles are engaged, they provide stability and support, allowing the upper body to function more efficiently.
Incorporating exercises like the Hundred, Roll-Up, and Plank into your routine can enhance core strength. This foundation can relieve unnecessary strain on the neck and shoulders, leading to greater overall comfort.
Promoting Flexibility
Pilates is known for its emphasis on flexibility and mobility. Incorporating stretching exercises into your practice not only improves physical flexibility but also helps to release pent-up tension in the neck and shoulders.
Focus on stretches that target the upper body, such as the Swan and Neck Rolls. Gentle, controlled movements can promote a sense of release and help alleviate tension.
Focus on your breath
Breathing is a key component of Pilates and plays a significant role in the body-mind approach. Conscious breathing can relax the nervous system and reduce feelings of stress. Practicing deep, mindful breathing during Pilates sessions allows individuals to release tension and reconnect with their bodies.
Incorporate breath-focused exercises, such as the Pilates breathing pattern, into your routine. This will help to create a sense of calm and awareness, making it easier to understand where tension may reside.
Mindfulness and Relaxation
A body-mind approach requires mindfulness and relaxation techniques that complement Pilates practice. This may include elements of counselling, meditation, or other relaxation methods. By incorporating mindfulness into your Pilates practice, you can enhance your awareness of tension and how it affects you.
Consider setting aside time for meditation or visualisation exercises. These techniques can help release stress and tension, making your body more receptive to the movements of Pilates.
Integrating Physical Exercise Into Your Routine
Incorporating physical exercise into your daily routine enhances not only physical fitness but also mental well-being. Here are a few practical steps to integrate this holistic approach:
Set a Regular Schedule: Aim to practice physical exercise at least 2-3 times a week. Consistency is key to experiencing long-lasting benefits.
Join a Class or Workshop: Participating in classes or workshops can provide guidance and support, making it easier to stay motivated and engaged.
Create a Space for Practice: Designate a comfortable space in your home for physical exercise practice. Having a dedicated area can enhance your focus and commitment.
Track Your Progress: Keep a journal to document any changes in your physical and mental state. Reflecting on your journey can motivate you to maintain a body-mind approach to wellness.
Conclusion
Neck and shoulder tension need not be a constant in our lives. By adopting a holistic body-mind approach through Pilates, individuals can find relief from physical discomfort while enhancing their overall well-being. The connection between mind and body is invaluable, and practices that foster this awareness can lead to significant improvements in quality of life.
If you’ve experienced neck or shoulder tension, consider integrating these Pilates principles and techniques into your routine. Not only will they help relieve tension, but they will also promote a sense of balance and harmony within your body and mind.
Prioritize your health—both physically and mentally—and discover the transformative potential of combining Pilates with a holistic approach to tension relief.
Remember: Your Body Is Speaking to You
Neck and shoulder tension is not a flaw to be fixed - it's your body’s way of calling for attention, care, and recalibration. By approaching it with curiosity, compassion, and a mind-body perspective, you can not only find relief but foster a deeper sense of safety and ease within yourself.
At Reflexions Holistic Wellness, I weave these approaches into both movement and counselling sessions, supporting you to not just treat symptoms but listen to what your body truly needs.
If you’d like to explore personalised strategies to ease tension and restore balance, feel free to reach out.
References
Alghadir, A. H., Anwer, S., & Iqbal, A. (2021). The relationship between myofascial trigger points and psychological stress in university students. Journal of Pakistan Medical Association, 71(5), 1431–1435.
Alnaami, I. Y., et al. (2023). The association between psychological distress and neck pain among university students. Annals of Medicine and Surgery, 87, 1442–1449. https://doi.org/10.1016/j.amsu.2023.144275
Eshkol, T., Bar-Sela, S., & Kalichman, L. (2021). COVID-19 lockdown increased the prevalence of neck disability and neck pain in university students. Journal of Bodywork and Movement Therapies, 27, 511–517. https://doi.org/10.1016/j.jbmt.2021.04.019
Alshami, A. M. (2022). Prevalence and risk factors of neck pain among adults in the general population: A systematic review. Journal of Musculoskeletal & Neuronal Interactions, 22(4), 486–495.
Skaret, E., et al. (2018). Emotional distress as a predictor of persistent shoulder pain after physiotherapy. BMC Musculoskeletal Disorders, 19(1), 148. https://doi.org/10.1186/s12891-018-2083-7
Luime, J. J., et al. (2004). Does psychological distress influence recovery from shoulder complaints?. The Journal of Bone and Joint Surgery, 86(5), 743–750.
Lundberg, U., et al. (1999). Psychophysiological stress responses, muscle tension, and neck and shoulder pain: A review. Journal of Psychosomatic Research, 47(5), 409–419. https://doi.org/10.1016/S0022-3999(99)00018-5
American Psychological Association. (n.d.). How stress affects your health. Retrieved from https://www.apa.org/topics/stress/body
Australian Pain Management Association. (n.d.). Neck pain: Causes, prevention and treatment. Retrieved from https://www.painmanagement.org.au/neck-pain
Cooper, J. (2023). Why your neck hurts more when you're stressed. [Blog post]. https://drjessecooper.com/neck-stress-link
