Arthritis and exercise: can Pilates really help?

If you have arthritis, you may shy away from exercising due to the pain or restriction of movement it causes. However, exercise is an essential part of managing your symptoms, and one of the core treatments for osteoarthritis.¹

Pilates can be a useful low-impact option for people with arthritis. Its controlled movements can help build strength and improve joint mobility, and small studies suggest benefits for pain and function in knee osteoarthritis. The key is choosing movements that suit your joints and adapting them with a qualified instructor or physiotherapist.^{2, 3}

Broadly speaking, it's recommended that those with arthritis participate in regular exercise suited to their needs and abilities. Low-impact describes the forces on your joints, rather than how hard you are working. Pilates is one option to combine with other activities you enjoy, such as walking, cycling or swimming.¹

What is Pilates?

Pilates is a form of exercise that focuses on strengthening the body, particularly the core muscles, to improve overall fitness and boost wellbeing. It combines controlled movements with breathing and attention to posture.²

Pilates can be adapted for different ages, abilities and fitness levels. If you're a beginner or have a medical condition such as arthritis, supportive equipment and modified movements can help you take part. Speak to a healthcare professional before starting if you are unsure what is suitable.²

Although the research into Pilates for arthritis is still developing, it has potential benefits. Regular practice can help with posture, muscle tone, balance and joint mobility, as well as relieving stress and tension.²

How Pilates can support healthy joints

There are a number of ways Pilates may help manage symptoms of arthritis and support healthy joints, including improved body awareness, stronger muscles and better movement control.

Pain is one of the major symptoms in both osteoarthritis and rheumatoid arthritis. Often, therapeutic exercises are prescribed to help with arthritis. In a small trial involving 41 people with knee osteoarthritis, both Pilates and conventional exercises improved outcomes, with greater improvements in pain and disability in the Pilates group. This is encouraging, but does not establish Pilates as the best exercise for everyone. If you've already been prescribed therapeutic exercises by your practitioner, ask how Pilates could fit into your existing programme.³

Pilates may also play a role in improving body awareness with arthritis. Body awareness, or proprioception, helps you sense the position and movement of a body part. A small study reported at a rheumatology conference found that three Pilates sessions per week for ten weeks improved the sense of movement in people with knee osteoarthritis, although joint position sense did not significantly improve. These early findings need further research.⁴

Pilates can also be useful if you are looking to build strength and stability. Research in healthy adults found that three sessions per week for eight weeks improved lower-body muscle strength and postural stability. That does not mean Pilates has been shown to prevent arthritis, but it supports its role as a way to keep moving and build physical capacity.⁵

Pilates has also been explored as rehabilitation after joint replacement. A preliminary report described a modified programme after total hip or knee replacement. However, it's important for exercises to be adapted according to the joint involved and your stage of recovery. Follow your surgeon's and physiotherapist's advice before returning to classes or floor exercises.⁶

Although much of the research into Pilates is focused on osteoarthritis, it has also been studied in rheumatoid arthritis. A small eight-week study found improvements in fatigue and quality of life in the Pilates group, but did not show a significant improvement in pain. Pilates may complement your care; continue any medicines and treatment recommended by your rheumatology team.⁷

How to get started with Pilates

Adding Pilates into your week can be simple. Many clinical Pilates instructors offer classes throughout the week, including sessions after work and over the weekend. Start with a manageable session length and build up gradually, rather than trying to copy the frequency used in a research study.

In-person classes are an ideal way to start your Pilates practice, as the instructor can help you to adapt exercises to your abilities and restrictions. Studios may also provide equipment used to modify movements for beginners. Tell your instructor which joints are affected and about any recent surgery.

If you're unsure whether Pilates is right for you, many studios offer introductory classes. Private lessons may also be available if you prefer more personalised support, or don't like exercising in a group setting. Additionally, if you prefer exercising from home, there are online classes available to follow along with, including a free NHS Pilates-inspired class for people with arthritis. Check suitability with your healthcare professional before following it.²

Simple Pilates exercises to discuss with your instructor

You do not need an advanced routine to get started. These examples come from NHS physiotherapy Pilates guidance. Ask your instructor or physiotherapist to show you the technique and choose suitable movements and repetitions before trying them at home.⁸

1. Relaxed breathing and alignment: Lie on your back with your knees bent and feet supported, if comfortable. Let your shoulders relax and breathe steadily, allowing your ribs to expand. Your instructor can help you find a comfortable starting position.
2. Gentle pelvic tilts: From the same position, slowly tilt your pelvis to bring your lower back towards the mat, then return to a relaxed position. Keep the movement small and controlled.
3. Heel slides: With your knees bent, slowly slide one heel away along the mat, then bring it back. Keep your pelvis steady and work within a comfortable range before changing sides.

Supporting your joints alongside exercise

If you've got arthritis, adding suitable low-impact exercise into your weekly routine, like Pilates, can be an important step in managing your symptoms. Alongside this, aim for a balanced diet and, where appropriate, support a healthy weight to reduce the load on your joints.¹

If you are exploring nutritional support as part of your routine, compare the ingredients and daily servings in our joint and bone supplement range. Our joint-care supplements guide explains the main options to help you choose support that suits your needs.

Pilates and arthritis FAQs