Why is Pilates so good? – The Evidence

Pilates is currently being practiced all over the world, but why is it so popular and what keeps people coming back?

Let’s start with why I like Pilates. Pilates makes me feel good, it relaxes me and it helps take my mind off the stresses that we face on a daily basis. Pilates also makes me stronger, physically and mentally, and improves my overall flexibility, but its benefits are endless.

I’ve listed below the different ways in which Pilates can help your body and these will form the basis of my blog posts over the next few weeks. I’ll be giving you some of the scientific reasoning behind why Pilates could be the answer you’ve been searching for and, give you the opportunity to understand your body to help you to reach your goals.

There is a lot of research out there about the benefits of Pilates (I’ve popped some links at the end of the article if you want to geek out) but in summary Pilates can:

  1. Help manage low back and chronic pain
  2. Aid bladder control
  3. Assist pregnancy and birthing
  4. Build lean muscles
  5. Increase bone density
  6. Improve balance and coordination
  7. Prevent injury
  8. Increase brain power
  9. Aid relaxation

Management of low back and chronic pain

A huge 80% of the UK population will develop low back pain (LBP) at some point in their lives. This is continuously increasing as we spend more time at computers, sitting in cars and less time working our postural muscles. Not only does this have a significant impact on each one of us, but the economy suffers too. In 2013, it was reported that 31 million working days were lost due to back, neck and muscle problems. This cost the UK economy 14 billion pounds that year. Now, imagine what we could do with that money!

Back pain has multiple causes, and from my experience as a Physio and Pilates teacher, I’ve seen so many different cases that there really is no size fits all approach to solving it. However, Pilates has been shown to be more effective at reducing pain and disability than medication and within the first 3 months of participation it is more effective at decreasing pain levels than other forms of exercise. Why is this? Predominantly it helps to restore muscular balance, which will improve movement patterns and load distribution.

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The Multifidus muscle in the back helps control our lower back posture and aids distribution of force to and from our legs. The size of this muscle has been shown to be significantly decreased in subjects with chronic LBP in comparison with other muscles of the lower back and pelvis. In acute one-sided LBP it is decreased on the side with pain.

Transversus Abdominis








It isn’t just muscle size that is affected, Hodges, 1996 also found that the activation of the Multifidus and the Transversus Abdominis (your deepest abdominal muscle) is delayed in subjects with LBP. This leaves your back vulnerable and the superficial muscles (between the deep muscles and the skin), which should provide your movement, not control, take over to try and provide the stability. This leads to spinal stiffness, which will alter movement patterns, causing dysfunction and potentially more pain, not helpful no!

Pilates movements work on recruiting and strengthening these deep muscles. This provides more support to the joints in the body, not just the spine. Resistance can be added to increase the level of exercise and this may further help the back by increasing the metabolism in the lumbar discs, aiding their repair.

Like with most things in life, you can’t expect results after doing it a couple of times, so it’s important to practice regularly. Research shows Pilates exercise performed twice a week for between 45 – 60 minutes significantly reduces the level of low back pain and increases your ability to lead the life you want. The trick is to build up gradually, progressing into more positions and movements as you go along.

It can be daunting at first, especially if you are in pain and have been for some time. 30% of those suffering will develop persistent LBP, with symptoms lasting greater than 6 weeks. Previously termed ‘Chronic pain’ is pain anywhere in the body lasting beyond normal tissue healing time, generally greater than 12 weeks. This discomfort is then very unlikely to go away without taking action. If you stop exercising your muscles and bones weaken and your cardiovascular fitness decreases, resulting in a vicious cycle of more pain. Your quadriceps muscles in the front of your thighs start to waste within 4 days of not doing anything, but take a lot longer to build up!


A huge 20% of the UK population will develop persistent pain somewhere in their lifetime. To put it into context, this is greater than the number of people with asthma or diabetes!  A systematic review of persistent pain by Geenen et al (2017) found pain, psychological function and quality of life either improved or remained unchanged with exercise and all participants’ function (ability to do day to day tasks) improved. The only adverse effects reported of exercising were increased muscle soreness from the activity, which subsided within 2 weeks. Getting the picture? Exercise is so important.

Exercise increases the production of internal opioids which block painful stimuli. Repeated exercise producing long-lasting pain relief. Determining the right level of exercise for an individual to enable them to commence activity as soon as possible is paramount to good management and recovery. Clinical Pilates (led by a health care professional) is preferable if you are in discomfort, so exercises can be adapted accordingly. What are you waiting for? Don’t let those niggles continue through 2018.


  • Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RWJG, Cabral CMN, Menezes Costa LC, Costal LOP. Pilates for low back pain (Review). Cochrane Database of Systematic Reviews, 2015, Issue 7, http://www.cochranelibrary.com
  • Mauríco Antônio da Luz Jr, Leonardo Oliveira Pena Costa, Fernanda Ferreira Fuhro, Ana Carolina Taccolini Manzoni, Naiane Teixeira Bastos Oliveira, Cristina Maria Nunes Cabral. Effectiveness of Mat Pilates or Equipment-Based Pilates Exercises in Patients with Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial. Physical Therapy, 2014, Vol. 94, No.5, 623-631.
  • Geenen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews (Review). Cochrane Database of Systematic Reviews, 2017, Issue 4, www.cochranelibrary.com
  • Muscolino JE, Cipriani S. Pilates and the “Powerhouse”. International Journal of Bodywork and Movement Therapies, 2004; 8:15-24
  • Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine, 1996, 15;21(22):2640-50.
  • Bryan, Melinda B.S, Hawson, Suzanne B.S. The Benefits of Pilates in Orthopaedic Rehabilitation. Techniques in Orthopaedics, 2003, vol.18, Issue.1, p126-129
  • Mooney V, Verna J, Morris C. Clinical management of chronic, disabling low back syndromes. Rehabilitation of the Spine: a Practitioner’s Manual. New York: McGraw-Hill, 2006.
  • Valerie Gladwell, Samantha Head, Martin Haggar, Ralph Beneke. Does a Program of Pilates Improve Chronic Non-Specific Low Back Pain?Journal of Sport Rehabilitation, 2006, Vol. 15, Issue. 4 P.338-350.

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I am a Chartered Physiotherapist and qualified Pilates Instructor. Prolates is a combination of my knowledge and experience of the two. I hope to share with you advice on injury management and relevant medical research, as well as enlighten you on Modified Pilates, which can help with recovery from injury, prevention of injury and enhance performance. Please do not hesitate to contact me with any queries, for as Joseph Pilates said 'Not only is health a normal condition, but it is our duty not only to attain it, but to maintain it.'

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