No trial of Pilates for the feet
No trial has tested Pilates for foot strength, foot pain or the toes. The few Pilates foot studies are small: flat feet, one ankle study that let players choose their group, and balance in older adults.
Source 1
Pilates guide
Pilates for the feet and ankles: footwork, the toes and the arch, balance, the reformer's footbar, what the evidence shows, and a class to follow
No trial has tested Pilates for the feet in general. Mat Pilates is mostly lying and side-lying, so your feet do little except point and flex; standing work, wall work and reformer footwork are where they work. What does have evidence is training the small muscles inside the foot, which improved arch measures, balance and strength a little in small trials, though not pain; and in older adults, weak toes and sore feet go with more falls. Pilates fits as the leg, hip and balance work around those foot exercises.
A specific foot problem has its own guide: flat feet, heel pain and bunions are covered in our other Pilates guides, and a new, painful or hot foot needs the warning signs below first.
This guide covers what reformer footwork is and how to do it without a reformer, the toes and the arch, balance and falls, weak ankles, bare feet, grip socks and shoes, diabetes and numb feet, the warning signs, and a class to follow.
The short version
Your feet work in standing work and footwork
Reformer footwork starts a classical class: lying on the carriage, you press it out and back with your feet on the footbar in several positions, about 10 times each, as the makers' manuals give it. On a mat, wall bridges and standing heel raises do a similar job (our suggestion).
Foot exercises help a little, not with pain
Across 13 small trials, training the small foot muscles improved arch measures, balance and strength more than doing nothing, but not pain. A 2026 review found no trial that measured injuries.
Weak toes and sore feet go with falls
In older adults, weaker toes and foot pain went with more falls, in studies that rarely allowed for other causes. A podiatry package with home foot and ankle exercises cut falls in one trial of 305 people, but not significantly in a larger one of 1,010.
Pilates helps balance tests, not falls
Across 39 studies of older adults, Pilates improved balance about as much as other exercise, with no fewer falls shown. Falls guidelines ask for balance and strength exercise 3 or more times a week for at least 12 weeks.
Know the warning signs
With diabetes, a new foot problem needs the same day. A snap at the back of the heel, one sore spot on a bone, or a hot, swollen joint needs checking. The full list is below, in the words our foot guides use.
What Pilates asks of your feet
Mat, standing and wall work
Mat Pilates is mostly lying, seated and side-lying, so the soles take little weight; your feet still point and flex in leg circles, the side kick series and many other moves. Standing work, wall work and reformer footwork are where the feet and calves take load.
Reformer footwork
Lying on your back on the carriage, you press it out and back with your feet on the footbar. The classical manual starts with the balls of the feet on the bar, heels together and toes apart (the Pilates "V"), 10 times, on 4, 3 or 2 springs, then the arches and the heels in parallel. A contemporary guide lists heels, toes, toes wrapped round the bar, the "V", rising and lowering the heels, a wider stance and "running" (one heel lowering as the other knee bends), 10 of each on 2 to 4 springs. Classical teachers cue you to avoid locking the knees back and to "separate feet hip distance for knees that overlap".
What the manuals warn about
The classical manual's footwork precautions are ankle problems (check with a doctor first) and sensitive feet, for which it suggests a pad over the footbar; the contemporary guide lists the ankle, knee, hip bending and spinal compression. The knee stretch series kneels with the toes bent under against the shoulder blocks, and its precaution includes "inability to flex the foot or toes".
What's known about footwork's loadEmerging evidence
Very little. The force on the footbar has been measured in one volunteer, and estimating it from the springs was imprecise. In 15 people, footwork-style leg pushes were done with two different hip strategies depending on which way they pushed the bar. No study has measured the foot muscles in footwork, or what it does to the arch.
The Foot Corrector and Toe CorrectorStrong evidence
The Pilates Method Alliance lists the Foot Corrector and the "Toe and Finger Correctors" among Joseph Pilates' inventions. Modern versions are sold with claims that they strengthen the arch, which no study has tested.
The small muscles of the foot
The small muscles inside the foot support and steady the arch. A 2015 concept paper called them the "foot core" and said "the intrinsic muscles are largely ignored by clinicians and researchers". Training them is usually done with the short foot exercise, toe curls and toe spreading, sitting first, then standing, then on one leg.
Source 19
Feet, balance and fallsEmerging evidence
In 176 people with an average age of 80, weaker toes and disabling foot pain each went with falls over a year. In 312 people aged 60 to 90, fallers had weaker big toes (11.6% against 14.8% of body weight) and lesser toes. Across 14 cohorts, foot pain roughly doubled the odds of falling, and weak toe muscles raised them by about two-thirds to double, though few studies allowed for other causes. Stronger toes went with better balance in a review of 9 mostly snapshot studies.
Footwork without a reformer
Our suggestion: a mapping of the reformer footwork series to mat and standing moves, with about 10 of each as the reformer makers' manuals give the series. No study has compared them. The moves are the wall bridge, slow calf raise, tibialis raise and towel toe curl, below.
- Lie on your back with your feet on a wall, knees bent to about a right angle: the footbar turned on its side.
- Heels on the wall: press into a small bridge and lower, about 10 times.
- The balls of your feet on the wall, heels lifted: the same, about 10 times.
- Stand at a wall, heels together and toes a little apart (the "V"): rise through the big toe for a count of 2 and lower for a count of 4, about 10 times.
- The same with your feet hip-width and parallel.
- "Running": lift one heel as the other lowers, 20 times, holding the wall.
- Shins: back against a wall, lift the fronts of both feet, then sit and curl a towel towards you with your toes.
See the movement on the 3D figure: Slow calf raise
What the evidence says
No trial of Pilates for the feetStrong evidence
Our searches of PubMed, Europe PMC and ClinicalTrials.gov in October 2026 found no trial of Pilates for foot strength, foot pain or the toes. One Pilates trial in footballers with unstable ankles is registered and not yet recruiting.
Source 1
The Pilates foot studies are smallMixed evidence
In 22 women with flat feet, 8 weeks of mat Pilates improved walking rhythm and side-to-side sway against no exercise; in 91 women, Pilates "did not improve postural control and proprioception in individuals with flatfeet"; in 40 children, mat Pilates changed neither balance nor the arch. In 51 college footballers with unstable ankles, players chose Pilates or balance training ("The allocation of training was based on the players' preferences"), with no group doing neither; both improved. Our Pilates for flat feet guide covers the flat feet studies.
Pilates and the ankles in older adultsEmerging evidence
In 22 women with an average age of 75.7, 10 weeks of ankle-focused Pilates improved ankle movement and walking, in a study with no comparison group. In 55 people aged 65 to 95, reformer Pilates once a week for 10 weeks improved balance, mobility and ankle bend against no exercise, though falls weren't counted. Across 11 small studies of muscle and joint problems in the arms and legs, Pilates eased pain, at very low certainty.
Foot muscle training: a little, not for painEmerging evidence
Across 13 randomised trials, training the small foot muscles beat control on arch measures, balance, strength and disability, with wide confidence intervals, but "The IFM exercises were not superior" for pain (IFM means the intrinsic foot muscles, the small muscles inside the foot). A 2026 review of 13 trial reports in mostly young, active people found no trial that measured injuries and only very low certainty for balance, concluding the evidence doesn't support foot training alone "as an injury-prevention strategy". An earlier review found no evidence on how the arch moves when you walk.
In older adults: small trialsEmerging evidence
In 9 studies of fair quality, foot strengthening in older adults improved strength, balance and mobility, "possibly reduced fall risk" and had "little effect on gait". In 123 older adults, adding the short foot exercise to leg strength training improved a standing balance test more than leg training alone. In 33 active older adults, 12 weeks of supervised foot training eased concern about falling but didn't change walking speed.
Feet and fallsMixed evidence
In 305 older people with disabling foot pain, a podiatry package (insoles, footwear advice, home foot and ankle exercises and a booklet) cut falls by 36% over a year, though the number of people who fell didn't drop significantly. In a larger UK trial of 1,010 people, a similar package cut falls by a non-significant 12%, though fewer people fell twice or more. The world falls guidelines ask for exercise with balance and functional work "three times or more weekly" for at least 12 weeks, and checks of the feet and footwear; the NHS advises activities that improve strength and balance at least twice a week.
Pilates and balanceEmerging evidence
Across 39 studies of 1,770 older adults, Pilates improved balance at very low to moderate certainty, "comparable to other forms of exercise", "but not to reduce the number of falls or the fear of falling". A 2026 network meta-analysis of 12 trials found a similar gain at very low certainty and didn't rank Pilates above other exercise. The world falls guidelines say supervised group exercise "such as Pilates or yoga" eased concern about falling most. Our Pilates for balance guide covers it.
Ankles that give wayStrong evidence
After an ankle sprain, exercise programmes cut repeat sprains over a year (14 trials, 2,182 people), and balance (proprioceptive) training cut sprains by about 41%; an umbrella review of 37 reviews found "Strong evidence supported exercise" for ankles that keep giving way. Pilates hasn't been properly tested here, so add one-leg balance and band work for the ankles.
Toes and ankles, sitting
Barefoot or in thin socks. Towel toe curl, 2 sets of 12 each foot; seated calf raise, 15 (our foot and ankle routine). Ankle circles, "10 slow circles each way with each foot (our editorial starting point)"; ankle circles standing (ankle CARs), "5 slow circles each way with each ankle, morning and evening (our editorial starting point)" (the move page's dose for each). The short foot exercise has no 3D demo yet: our Pilates for flat feet guide has its steps, 10 holds of 5 seconds.
Footwork lying down
Point the foot, then flex it, at the top of each leg circle and with each side kick (our suggestion). From the moves' pages: wall bridge, "8 to 10 reps; one-leg version, 5 each side", feet flat on the wall, later on the balls of the feet; single-leg circle, "5 circles each direction, each leg"; side kick, "8 to 10 each side"; shoulder bridge, "3 to 5 kicks each leg", standing foot flat and big toe down.
Heels, toes and shins, standing
Hands on a wall. Slow calf raise, 2 sets of 10, rising through the big toe, first with your feet parallel and then in the "V" (our suggestion); tibialis raise, 15; band ankle eversion and inversion, 8 each side, slowly (our foot and ankle routine). Heel walk, 10 steps along a counter (our strength and balance exercises for seniors workout). Single-leg calf raise from a step, 3 sets of 8 to 12 each leg (our bunions guide), starting on flat ground.
3D demoSlow calf raiseBeginner · A wall
3D demoTibialis raiseBeginner · No equipment
3D demoBand ankle eversionBeginner · A band + A bench or box
3D demoBand ankle inversionBeginner · A band + A bench or box
3D demoHeel walkBeginner · No equipment
3D demoSingle-leg calf raise from a stepIntermediate · A step + A wallBalance
Next to a counter. Single-leg stand, 2 holds of 30 seconds each leg; tandem stance then heel-to-toe walk, 30 seconds, then 10 steps (our foot and ankle routine). Semi-tandem stance, 2 holds of 10 seconds with each foot in front (our Pilates for balance class). Single-leg reach, "3 rounds of 5 reaches in each direction, each leg (our editorial starting point)" (the move page's dose), once a one-leg stand is steady.
Calves, gentle
Knee straight, then knee bent: 3 holds of 30 seconds each side (our Pilates for plantar fasciitis guide).
What to change or leave out
Toes tucked under your weight
Kneel with your toes tucked under only if it's comfortable, and skip it with bunions, big toe arthritis or pain under the ball of your foot.
Full tiptoe with a sore toe
The slow calf raise's own caution: "With pain in the ball of the foot or big toe arthritis, stop short of full tiptoe."
A sore heel or arch
Keep footwork springs light, the balls of your feet on the bar and the range small, and leave out the jumpboard while it hurts (our suggestion, as our Pilates for plantar fasciitis and flat feet guides say).
Hypermobile ankles
Keep foot and ankle work in the middle of the range rather than pushing to the end (our suggestion, from our Pilates for hypermobility guide).
Bare feet, grip socks and shoes
Bare feet or grip socksMixed evidence
No study has compared bare feet, socks, grip socks or shoes in Pilates; barefoot or grip socks are fine on a mat for most people. Non-slip socks were studied for hospital falls: "There was no strong or conclusive evidence that they prevent hospital falls", and in 42 older women at home they didn't cut falls. Grip socks stop you slipping; they don't support your feet (our suggestion).
Diabetes or numb feet: shoesStrong evidence
The international diabetic foot guideline asks people with diabetes at risk of foot ulcers to protect their feet by "not walking barefoot, not walking in socks without shoes, or not walking in thin-soled slippers, whether indoors or outdoors", and says limited barefoot work belongs only in a supervised programme. The NHS: "If you have numb feet, it's easy to cut your foot by stepping on something sharp."
With numb feet or diabetes, do standing work and footwork in shoes and check your feet before and after (our suggestion; our Pilates for diabetes guide covers foot care).
Shoes and falls
For older adults, the NHS advises shoes or slippers "that fit well, do not slip off and have a good grip", and the world falls guidelines ask clinicians to check footwear, including going barefoot, and the feet, and to consider a podiatrist.
Where foot pain belongs
Pilates for the feet is for stronger feet and ankles. A specific problem has its own guide.
Classes
Our feet-first Pilates class does seated foot work, standing heel raises and balance, then Pilates for the hips; it was written for flat feet but suits any feet. Do it 2 to 3 times a week, with the foot and ankle routine on other days. For balance and falls, the Pilates for balance class; with a sore heel or diabetes, those classes instead.
Feet-first Pilates for flat feet: a 25-minute class for the arches, ankles, hips and balance
A 25-minute Pilates class for flat feet: seated foot and ankle work, standing heel raises and balance, then Pilates for the hips and a gentle calf stretch.
25 minBeginner14 movesOther / check instructions, A bench or box
Foot and ankle strengthening routine: toes, arches, calves and balance
A 15-minute barefoot routine for stronger toes, arches, calves and ankles, finishing with balance. You need only a towel, a wall and a resistance band.
15 minBeginner11 movesA wall, Other / check instructions
Standing Pilates for balance: a 25-minute counter and mat class
A 25-minute Pilates class for steadier balance: standing balance and leg strength at a kitchen counter, then mat work for your trunk and hips.
25 minBeginner17 movesA wall, A bench or box
Pilates for plantar fasciitis: a 25-minute class that starts sitting, keeps you off your feet, and ends with heel raises
A 25-minute Pilates class for heel pain: sole and calf stretches before you stand, mat Pilates lying down, heel raises every second day, and short standing work.
25 minBeginner15 movesA bench or box, Other / check instructions
Shoes-on Pilates for diabetes: a 30-minute head-up strength class
A 30-minute Pilates class for type 2 diabetes: standing strength in your shoes, then mat work for hips, back and trunk, head up throughout and finishing seated.
30 minBeginner16 movesA bench or box, A wall
Mid-range Pilates for dancers: a 25-minute mat class for feet, turnout control and trunk
A 25-minute Pilates class for dancers: feet and calves, turnout control from the hip, trunk endurance and back extension, all in the middle of your range.
25 minBeginner17 movesOther / check instructions, A bench or boxWarning signs: when to get help
These are the warning signs our foot pain, stress fracture and Pilates for flat feet guides use, word for word. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Call 999 or go to A&E
- Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
- Call 999 or go to A&E: a foot or leg that is suddenly cold, pale, numb, weak or very painful without an injury. A sudden loss of blood supply is a vascular emergency.
- Call 999 or go to A&E: you have diabetes and a foot ulcer with a fever or signs of sepsis, an ulcer with poor circulation, a possible deep infection of the soft tissues or bone in the foot (with or without an ulcer), or gangrene. The National Institute for Health and Care Excellence (NICE) asks for these to go straight to hospital.
Source 14
Get help the same day
- Same day: a sudden snap or pop at the back of the heel or calf, or a feeling of being kicked there, then walking flat-footed and being unable to push off, stand on tiptoe or climb stairs. It could be an Achilles tendon rupture or a broken heel bone. Go to A&E or a minor injuries unit, or contact NHS 111.
- Same day: you have diabetes and a new foot problem, such as an ulcer or wound, signs of infection, or a hot, swollen foot with a change in colour, even if it doesn't hurt. Contact your diabetes foot team or GP: NICE asks for these to reach a specialist foot service within 1 working day, and a suspected Charcot foot is kept off weight until it has been checked.
- Same day: a sudden, very painful, hot, swollen, red joint, often the big toe but sometimes the middle of the foot (the midfoot) or the ankle, especially with a high temperature, feeling shivery or being unable to eat. It may be gout, but it could be a joint infection (septic arthritis), which is urgent.
- Same day (NHS 111 or an urgent treatment centre): after an injury, you can't put weight on it or walk more than a few steps, the pain is very bad or getting worse, there is a lot of swelling or bruising or it is getting worse, it feels very stiff, or it's not feeling any better after treating it yourself. Get the same help if you also have a very high temperature, or feel hot, cold or shivery: this could be an infection. If you think it's broken, don't treat it yourself.
- Same day: skin on the foot that is painful, hot and swollen. It could be a skin infection (cellulitis).
Contact a GP immediately
Contact a GP immediately (or NHS 111 if you can't): severe burning foot pain that carries on even when you're resting, skin turning pale, shiny, smooth and dry, wounds or ulcers on your feet that don't heal, or toes that become cold and numb, then turn red and then black. The blood supply to the foot may be failing.
See a GP or podiatrist
- One spot on a foot bone that hurts with every step and later at night: a possible stress fracture.
- Pain in one spot on the shin or a foot bone that you can point to with a fingertip, worse with impact and later present at rest or at night: a possible stress fracture.
- Pain that isn't better after 2 weeks of looking after it yourself, is getting worse, keeps coming back, or stops you doing normal things.
- Tingling or loss of feeling in the foot, or a foot that feels weak.
- Any foot pain if you have diabetes: foot problems can be more serious.
- An ankle that keeps giving way months after a sprain.
- A high arch that is new, getting higher or only in one foot, or high arches with weakness, tripping, numbness or ankles that keep giving way: see a GP. It can be the first sign of a nerve condition.
- Flat feet that are painful, stiff, weak or numb, that you didn't have before, or that affect only one foot, or flat feet and you often get foot or ankle injuries or have problems with walking or balance.
- A child's heel or foot pain that isn't clearly linked to activity, or that comes with swelling or redness. With a high temperature, or if your child seems unwell, get help the same day: an urgent GP appointment or NHS 111.
During Pilates
The exceptions: pain in one spot on a bone should be pain-free, because it could be a stress fracture, and Health New Zealand says don't push through it; burning, tingling or numbness means stop that movement; and if your feet are numb, check your skin after exercise, as Diabetes UK advises.
With numb feet, keep a hand on a counter or wall.
Chest pain or fainting while exercising: call 999
Call 999 if:
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Unusual breathlessness
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
Stop the session if
You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
Source 47
Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
Source 47
Myths
"Pilates footwork strengthens your arches"Strong evidence
No study has measured what footwork does to the arch or the foot muscles. Foot muscle exercises change arch measures a little, and the short foot and toe exercises do that job directly.
"Strong feet prevent injuries"Mixed evidence
No trial of foot muscle training has measured injuries, and the balance effect is very low certainty. Balance training does cut repeat ankle sprains.
"Pilates prevents falls"Emerging evidence
Pilates improves balance tests in older adults, but trials haven't shown fewer falls. Weak toes and foot pain go with falls, so foot work is worth adding, as part of balance and strength exercise 3 or more times a week.
"Always do Pilates barefoot"Strong evidence
Bare feet, socks and shoes haven't been compared in Pilates. With diabetes or numb feet, the international guideline advises against walking barefoot or in socks without shoes.
"You need a reformer or a Foot Corrector for your feet"Strong evidence
Heel raises, toe curls, the short foot and balance work on a mat or standing do the same jobs, and the Foot Corrector's arch claims have never been tested.
"Foot exercises cure foot pain"Emerging evidence
Foot muscle training didn't beat control for pain across 13 trials. Foot pain needs its cause found first: our foot pain guide maps the usual ones.
Source 5
Read next
- Pilates for flat feet
- Pilates for plantar fasciitis
- Pilates for bunions
- Pilates for balance
- Reformer Pilates
- Pilates for diabetes
- Pilates for dancers
- Pilates for neuropathy
- Yoga for feet
- Fascia release for the feet
- How to strengthen your feet
- Foot pain
- Ankle pain
- The abductor hallucis
- The tibialis posterior
- The peroneals
- Foot and ankle exercises
- Balance exercises
- The Pilates guide
Questions people ask
Is Pilates good for your feet?
It can be part of it: standing work, wall work and reformer footwork train your calves and feet, and Pilates improves balance tests in older adults. No trial has tested Pilates for foot strength or foot pain, so add the foot exercises with evidence: toe curls, the short foot, heel raises and one-leg balance.
What is Pilates footwork?
The opening exercise of a classical reformer class. Lying on the carriage, you press it out and back with your feet on the footbar in several positions (heels, the balls of the feet, the arches, heels together in a "V"), about 10 times each, then heel raises and "running".
Can I do Pilates footwork without a reformer?
Roughly, yes: a bridge with your feet on a wall, slow heel raises with your feet parallel and then in a "V", shin raises and towel curls cover the same jobs. That mapping is our suggestion, and no study has compared them.
What are the best Pilates exercises for feet and ankles?
Towel curls and ankle circles sitting, heel raises through the big toe and shin raises standing, one-leg balance, band work for the ankles, and Pilates leg and hip work such as leg circles, side kicks and bridges. Our feet-first class puts most of them in order.
Should I do Pilates barefoot or in grip socks?
Either is fine on a mat for most people; no study has compared them, and grip socks weren't shown to prevent falls in hospitals. With diabetes or numb feet, wear shoes for standing work and footwork, and check your feet before and after.
Does Pilates help balance and prevent falls?
It improves balance tests in older adults about as much as other exercise, but trials haven't shown fewer falls. Falls guidelines recommend balance and strength exercise 3 or more times a week for at least 12 weeks; our Pilates for balance guide covers it.
Is Pilates good for weak ankles?
One-leg balance and band work help ankles that keep giving way: exercise programmes cut repeat sprains. The one Pilates study in unstable ankles let players choose their group, so it can't tell us much. See a GP for an ankle that keeps giving way months after a sprain.
What is the Pilates Foot Corrector?
A small sprung apparatus Joseph Pilates designed for the feet, which the Pilates Method Alliance lists among his inventions. No study has tested it; towel curls, the short foot and heel raises do similar jobs.
Why do my feet cramp in Pilates?
No study has looked at it. Pointing the foot hard in leg work can bring on a cramp in the sole or calf: ease the point, flex the foot, and build up foot work gradually (our suggestion). Cramp-like pain with numbness, a cold or pale foot, or pain that carries on at rest isn't ordinary cramp: see the warning signs on this page.
Can Pilates cause foot pain?
No study links Pilates to foot injuries. Long standing blocks, bare feet on hard floors, the jumpboard and heavy springs can aggravate a sore heel or arch, so build up new standing work and footwork gradually (our suggestion).
I have diabetes. Is foot work in Pilates safe?
Usually, with care: check your feet before and after, wear shoes for standing work, and ask your diabetes foot team before barefoot exercise. A new foot problem, such as a wound, signs of infection or a hot, swollen foot, needs your diabetes foot team or GP the same day, even if it doesn't hurt.
How long until my feet feel stronger?
Foot programmes in older adults ran for 8 to 12 weeks in trials, and a diabetes foot guideline suggests an 8 to 12 week programme. Do foot work most days and Pilates 2 to 3 times a week (our suggestion), and expect strength and steadiness rather than a new foot shape.
Sources
- PubMed, Europe PMC and ClinicalTrials.gov · Our searches for studies of Pilates in the feet and ankles (October 2026)
- Balanced Body · Contrology classical reformer manual: the footwork, the elephant and the knee stretch series (maker's manual, 2021; read in full)
- Balanced Body · Allegro reformer user guide: footwork, kneeling abdominals and arm work (maker's guide; read in full)
- Pilatesology · Reformer footwork series: set-up, goals and cues (classical exercise encyclopedia; read in full)
- Jaffri 2023 · Training the small foot muscles: 13 trials (systematic review and meta-analysis, J Athl Train)
- Monteiro 2026 · Foot muscle programmes and injury-related outcomes: 13 trial reports, 462 people (systematic review, Sports)
- Menz 2006 · Foot and ankle risk factors for falls in 176 older people (cohort study, J Gerontol A)
- Mickle 2009 · Toe weakness, toe deformity and falls in 312 older adults (cohort study, Clin Biomech)
- Valeriani 2026 · Foot and ankle risk factors for falls: 14 cohorts (systematic review and meta-analysis, Health Sci Rep)
- Spink 2011 · A podiatry programme to prevent falls in 305 older people with foot pain (randomised trial, BMJ)
- Cockayne 2017 · REFORM: a podiatry programme to prevent falls in 1,010 older people (randomised trial, PLoS One)
- de Campos Júnior 2024 · Pilates for balance and falls in older adults: 39 studies, 1,770 people (systematic review and meta-analysis, Complement Ther Clin Pract)
- Montero-Odasso 2022 · World guidelines for falls prevention in older adults (guideline, Age Ageing; read in full)
- NICE NG19 · Diabetic foot problems: prevention and management (guideline)
- NHS · Heel pain
- Brodt 2014 · Measuring the force on the reformer footbar in one volunteer (lab study, J Appl Biomech)
- Cantergi 2015 · Muscle strategies for leg pushes on a reformer, in 15 people (lab study, J Electromyogr Kinesiol)
- Pilates Method Alliance · History of Pilates (read in full)
- McKeon 2015 · The foot core: a new way of thinking about the small foot muscles (concept paper, Br J Sports Med)
- Quinlan 2020 · Toe strength and balance in people over 60: 9 studies (systematic review, Gait Posture)
- Kim 2026 · Pilates for walking and balance in 22 women with flat feet (pilot randomised trial, Int Biomech)
- Ghorbani 2026 · Pilates and balance in 91 women with and without flat feet (study, Foot Ankle Spec)
- Neves 2021 · Mat Pilates, balance and the arch in 40 school children (randomised trial, J Bodyw Mov Ther)
- Jiang 2022 · Pilates or balance training in 51 footballers with unstable ankles (non-randomised study, Int J Environ Res Public Health; read in full)
- Choi 2021 · Ankle-focused Pilates and walking in 22 older women (study without a comparison group, J Women Aging)
- Roller 2018 · Reformer Pilates for falls risk in 55 older adults (randomised trial, J Bodyw Mov Ther)
- Barnet-Hepples 2025 · Pilates for muscle and joint problems in the arms and legs: 11 studies (systematic review, Ann Phys Rehabil Med)
- Willemse 2022 · Foot muscle strengthening and walking and balance in adults (systematic review, J Foot Ankle Res)
- Futrell 2022 · Foot muscle strengthening in older adults: 9 studies (systematic review, J Am Geriatr Soc)
- Lai 2025 · The short foot exercise added to leg strength training in 123 older adults (randomised trial, BMC Geriatr)
- Willemse 2026 · STIFF: 12 weeks of foot muscle training in 33 active older adults (randomised trial, Gait Posture)
- NHS · Falls
- Zhao 2026 · Pilates and other exercise for balance in older adults: 12 trials, 491 people (network meta-analysis, Front Public Health)
- Wagemans 2022 · Exercise after an ankle sprain and repeat sprains: 14 trials (systematic review and meta-analysis, PLoS One)
- Wang 2023 · Preventing ankle sprains (systematic review and meta-analysis, Clin Rehabil)
- Hu 2025 · Treating and preventing chronic ankle instability: 37 reviews (umbrella review, Foot Ankle Surg)
- Jazayeri 2021 · Non-slip socks in hospitals (rapid review, Int J Qual Health Care)
- Razmjouie 2025 · Non-slip socks, balance and falls in 42 older women at home (randomised trial, J Am Podiatr Med Assoc)
- IWGDF 2023 · Preventing foot ulcers in people with diabetes (International Working Group on the Diabetic Foot guideline; read in full)
- NHS · Peripheral neuropathy: complications (past its review date: reviewed October 2022, review due October 2025)
- NHS · Complications of type 2 diabetes
- NHS · Pain in the top of the foot
- NHS · Pain in the bottom of the foot
- NHS · Broken leg
- NHS · Heart attack
- NHS · Chest pain (past its review date: reviewed August 2023, review due August 2026)
- NHS · Pilates for beginners
Exercise education, not a personal prescription, and clinical review of these guides is pending. If you are pregnant, have a health condition or have had recent surgery, check with a doctor, midwife or physiotherapist before starting, and stop for sharp or increasing pain. Health disclaimer.