Reformer Headrest Positions and When to Use Each One

A reformer headrest typically has two or more positions: down (flat) and raised. On many models, adjustments are made in incremental notches. The starting rule is simple: down when you want to lengthen and align the neck, raised when the client’s anatomy requires it to keep the head comfortable and neutral. What determines the final choice is the individual, the exercise, and your specific equipment model.

This guide is designed for instructors and studio owners who adjust reformers every day. You will learn what positions exist, how to safely change them, how to choose based on the exercise, and what to do when a client experiences neck discomfort.

Key Takeaways

• Down (flat) is the default baseline: it encourages the neck to lengthen and the thoracic spine to settle neutrally.
• The raised position is justified by the client's anatomy—such as pronounced thoracic kyphosis or a noticeable forward head posture—not merely for comfort.
• To choose correctly, check alignment: the ear aligned over the center of the shoulder and the jawline roughly perpendicular to the carriage.
• In exercises where the client rolls up, a flat headrest helps prevent excessive cervical flexion.
• Always adjust the headrest while the carriage is stationary, ensure it locks securely in place, and consult your equipment's manual.

Table of Contents

• What the Headrest Is and How Many Positions It Has
• How to Safely Adjust the Headrest Position
• How to Tell if the Position Is Correct: Head and Neck Alignment
• When to Keep the Headrest Down
• When to Raise the Headrest
• How to Choose the Position Based on the Exercise
• Neck Discomfort: When to Modify the Position and Whom to Consult
• Common Headrest Mistakes
• What to Look for in a Headrest When Buying a Reformer
• Studio Protocol: How to Standardize Adjustments
• Frequently Asked Questions
• Sources

What the Headrest Is and How Many Positions It Has

The headrest is the padded component at the head of the carriage where the client rests their head during supine exercises. It might seem like a minor detail, but it influences how the entire body aligns: it determines the position of the neck, the ribcage, and, by extension, the pelvis.

Not all reformers handle it the same way. In the manual for a studio reformer with tower, for example, the headrest has three positions adjusted by a wooden support block underneath. In the lowest position, the block folds toward the top and the headrest lies flat. Other models use a pin mechanism, a lever, or a bracket with fixed angles. That's why the first check is always the same: identify what mechanism your equipment has and how many positions it allows.

In practical terms, almost all setups come down to three concepts:

If your model only has two positions, the top and bottom rows apply. If it has more, use the intermediate settings thoughtfully and check alignment in each case.

How to Safely Change the Headrest Position

The adjustment should be made by the instructor, not the client mid-exercise. A guide to safely adjusting a reformer recommends making adjustments while the carriage is stationary, adjusting one component at a time, and verifying that each part is securely locked before bearing weight. For the headrest, the ultimate reference is always the manufacturer’s manual.

A quick routine that works well in the studio:

1. Stop the carriage and ask the client to sit up or step off the equipment if the mechanism requires it.
2. Adjust only the headrest. Don't move the footbar or springs at the same time—this way, you’ll know exactly which adjustment caused any discomfort.
3. Check the lock. Press down with your hand using your body weight before the client lies down.
4. Have the client lie down and check alignment (explained below).
5. Repeat the check whenever changing exercises or apparatus.

Teacher training programs also emphasize this as part of pre-class setup: the Level 1 manual from Positive Action Pilates includes headrest position as part of the reformer setup checklist, along with other adjustments. If you train new instructors at your studio, make this check a standard habit at the start of every class. Our guide on how to adjust reformer straps complements this routine with another key checkpoint reviewed during every session.

How to Know If the Position Is Right: Head and Neck Alignment

There is no universally correct position. The right one is the one that places the head and neck in neutral alignment for that specific person. The studio reformer manual provides two simple checkpoints to verify with the client lying down:

• The ear should align over the center of the shoulder.
• The jawline should be nearly perpendicular to the carriage.

Translated to what you see from the side: the chin neither points toward the ceiling nor drops toward the chest, and there is no noticeable gap between the back of the neck and the support. If the chin tilts up and the cervical spine compresses, the support is too low for that individual. If the chin drops toward the chest and the neck is overly flexed, it is too high.

A helpful tip for new instructors: observe the client in profile before starting the first exercise, not after. Adjusting the height beforehand is much easier than interrupting a set in motion.

What "Neutral Position" Means Here

In Pilates, a neutral position honors the natural curves of the spine rather than flattening or exaggerating them. In the neck, this means a gentle curve without tension, without the client needing to press down through the back of the head. The headrest is the tool that allows you to bring each body closer to that baseline.

When to Keep the Headrest Down

It is the default option in most cases. An article from MyAcademy on the reformer headrest points out that when the focus is alignment, the standard practice is to place it down: this allows the cervical spine to lengthen and the thoracic spine to settle into a more neutral position.

Typical situations to keep it down:

• Footwork. The client is lying down, with stable pelvis and ribs. The studio reformer manual indicates the low position for clients with a relatively flat thoracic spine and shallow rib cage, during leg and footwork and in any supine exercise.
• Roll-up exercises. The same manual warns, in a safety note, that the flat position is used with all clients performing exercises where they roll onto their shoulders. A flat headrest prevents them from overly flexing the cervical spine and injuring the neck.
• Clients without postural limitations. If alignment looks good flat, there is no reason to add height.
• When you want the neck to work. Routinely raising the support reduces cervical control and encourages passive resting; the aforementioned MyAcademy note explains it this way.

A frequent objection: "my clients like it up." That's true, and there's a reason for it. With the headrest raised it feels easier, like resting your head on a pillow, and the neck muscles stop working. The problem is that a forward head posture is associated with weakness and poor coordination of stabilizing muscles, so constantly propping it up can reinforce the very issue you want to improve. Explain this to the client in a single sentence and give them a couple of classes to adapt.

When to Raise the Headrest

Raising it is not a mistake. It is a tool used for a specific reason. The same source notes that there are clear situations where elevated support is appropriate, including clients with more pronounced thoracic kyphosis or a clearly forward head posture. In those cases, forcing the flat position forces the client to extend their neck backward and compress the back of the neck, which is the opposite of what you want.

Signs to raise it:

• When down, the chin lifts and the back of the neck pinches against the support without the client being able to relax it.
• The client reports tension or pinching at the base of the skull when lying down.
• There is an obvious thoracic curve that lifts the head off the headrest.
• A physical therapist or physician indicated it as part of a treatment plan.

When raising it, use the lowest setting that resolves the issue. Then check again: ear over shoulder and jawline nearly perpendicular to the carriage. And keep the goal in sight: over time, if mobility allows, lower the height.

How to Choose the Position Based on the Exercise

Height is not set once per client. It changes with the exercise, because the demand on the neck changes. These are working guidelines for your instructor judgment, not manufacturer mandates; always verify them against your equipment manual.

If you're unsure between two settings, choose the lower one where the client can maintain alignment without tension. Ask them to breathe calmly for a few seconds: if the neck relaxes, the adjustment is right.

Neck Discomfort: When to Adjust the Position and Whom to Consult

The headrest is not a treatment. It is a comfort and alignment adjustment within a class. If a client experiences persistent pain or discomfort, the answer is not to keep guessing heights.

• Mild discomfort that appears upon lying down (tension in the back of the neck, pressure at the base of the skull): try a different setting with the carriage stationary, recheck alignment, and observe whether it resolves during the next set.
• Discomfort that appears when rolling up: lower the headrest to flat and reduce the range of motion. The cited manual explicitly warns of the risk of overly flexing the cervical spine.
• Pain radiating down the arm, tingling, dizziness, or pain that persists after class: stop the session and advise the client to consult a physician or physical therapist before returning to exercises that load the neck.
• Clients with cervical injuries, surgeries, or history: request clearance or specific instructions from their physical therapist or doctor and work within those, not based on intuition.

For those working with rehabilitation clients, it is worth looking at how therapeutic reformer Pilates is approached, with private sessions designed for injuries, post-surgery recovery, and pregnancy. If your studio includes physical therapists or chiropractors, clearly define in writing who determines each client's adjustments and how they are recorded.

Common Headrest Mistakes

1. Raising it by default "just to keep them comfortable." This is the most common mistake and the one that most reduces neck work.
2. Not checking the lock mechanism. An improperly secured headrest can shift under the weight of the head. Always double-check before loading weight.
3. Adjusting several things at once. If you change the headrest, footbar, and springs simultaneously, you won't know what to correct if something feels off.
4. Using the same height for everyone. A tall person with a deep ribcage does not need the same setup as a shorter person with a flat spine.
5. Ignoring the manual. Mechanisms vary across manufacturers and models; your equipment's documentation is always the ultimate reference.
6. Overlooking the headrest during maintenance. Pins, support blocks, and upholstery also wear out. Include this component in your reformer maintenance routine and keep reformer replacement parts on hand.

What to Look for in a Headrest When Buying a Reformer

If you are outfitting a studio, the headrest says a lot about the build quality of a piece of equipment. Before buying, consider:

• Number of positions and ease of adjustment. Your instructors will be adjusting it dozens of times a week.
• Firm locking mechanism, free of wobbling or noise under load.
• Upholstery and foam density, which must withstand daily commercial use.
• Availability of replacement parts and local support in Mexico.
• Compatibility with third-party accessories, a topic we cover in our guide to reformer accessory compatibility.

At Pilates de México, we work with the MetaLife line, crafted from certified Lyptus® FAS wood and stainless steel hardware, engineered for years of daily classes. You can check out the Infinity and Advanced lines, explore our accessories, and, if you prefer to spread out the investment, review our financing options. We can also advise you so your studio runs smoothly from day one; start with our guide on setting up a reformer studio.

Studio Protocol: How to Standardize Adjustments

A studio with multiple instructors needs consistent criteria. This prevents every class from starting at a different height and keeps clients from receiving mixed messages.

1. Define your studio's baseline position (flat/down, unless otherwise indicated).
2. Record each client's optimal position in their profile, along with the date.
3. Establish who can change it and at what point during the class.
4. Perform an opening check: before the first class of the day, test the headrest lock on all equipment.
5. Train new instructors using the specific model manual and a supervised adjustment practice session.
6. Incorporate this point into your safety guidelines. Our operational safety guide for reformer studios provides a solid foundation to build upon.

This organized approach saves class time and minimizes incidents. Furthermore, if you are opening your first studio, it is one of the habits that separates a professional operation from an improvised one; be sure to also review our guide on common mistakes made by new Pilates studio owners.

Frequently Asked Questions

Should the reformer headrest be up or down?

By default, it should be down: this encourages the neck to lengthen and allows the thoracic spine to settle into neutral. It is raised when a client's anatomy requires it, such as in cases of pronounced thoracic kyphosis or significant forward head posture. Always ensure the ear aligns directly over the center of the shoulder.

How many positions does a reformer headrest have?

It depends on the model. Some feature two positions, others three or more, and the mechanism varies: wooden support blocks, locking pins, or levers. Consult your equipment's manual to learn the exact positions and proper adjustment method.

What should I do if a client experiences neck pain on the reformer?

Stop the exercise, check alignment, and test a different height with the carriage stationary. If pain persists, radiates down the arm, or is accompanied by tingling or dizziness, advise consulting a physician or physical therapist before continuing with exercises that load the neck.

Can I adjust the headrest while the client is lying down?

It is not recommended. Adjustments should be made with the carriage stationary, adjusting one component at a time and verifying it is securely locked before bearing weight. Ask the client to sit up or step off the reformer if the mechanism requires it.

Why is a flat headrest recommended for roll-over exercises?

Because a flat support helps prevent excessive flexion of the cervical spine when the client rolls onto their shoulders, reducing the risk of neck injury. This is noted in the manual for a studio reformer with tower.

Sources

• Studio Reformer with Tower Manual (headrest positions and safety notes)
• Pilates Movement Monday: The Truth About the Reformer Headrest
• How to Adjust a Reformer Safely, Part by Part
• Pilates Reformer Level 1 Student Manual, Positive Action Pilates (2024)
• Therapeutic Reformer Pilates

Recommended Reading

• Reformer Cleaning: Complete Maintenance Guide
• How to Replace Reformer Springs in Your Studio
• How to Adjust Reformer Straps: A Guide for Instructors and Practitioners
• Complete Guide to Reformer Installation in Mexico