Pilates guide
Pilates can help you get back from a hamstring strain (a pulled hamstring), as part of your rehab rather than instead of it. No trial has tested Pilates after a hamstring injury. The evidence is for starting gently within days, making the hamstring work before you stretch it, and building back to running and sprinting step by step, which our hamstring strain guide sets out. Many Pilates basics, such as bridges, planks, side planks and one-leg balance, are moves that rehab already uses.
Some Pilates moves need to wait. The roll-up, the saw, the spine stretch and the straight-leg scissors bend the hip deeply with the knee straight, the kind of slow stretch that caused the slowest-healing strains in studies of dancers.
This guide shows which Pilates moves fit each stage of a pulled hamstring, which to leave until you can sprint without pain, the reformer, what a strong core can and can't prevent, and the warning signs, with a 25-minute class. If you felt a pop near your sitting bone, with a large bruise or trouble walking or sitting, go straight to the warning signs.
No trial has tested Pilates after a hamstring strain or tear. The evidence is for early, gentle loading, lengthening exercises, strength work such as the Nordic curl and a step-by-step return to sprinting, which our hamstring strain guide sets out. Pilates can carry parts of that plan; it doesn't replace it, or a physiotherapist's advice.
The NHS advises protecting, resting, icing, compressing and raising the leg for the first 2 to 3 days, then keeping it moving once pain allows. Starting rehab 2 days after a thigh or calf strain rather than 9 got people back to sport sooner in a trial. Breathing, ab work with your knees bent and bridge holds suit the first days.
A programme built on three lengthening exercises got 75 elite footballers back to training in 28 days rather than 51, and 56 sprinters and jumpers back in 49 days rather than 86. Starting those exercises on day 1 added nothing in a later trial of 90 athletes, so there's no need to rush.
In 24 athletes, rehab with agility and trunk exercises (planks, side planks, bridges and one-leg balance) had 1 re-injury in 13 at a year, against 7 in 10 after stretching and strengthening. A second trial of 29 found few differences. These are the parts of rehab that a Pilates class does well.
Strains from slow, deep stretches with the knee straight took a median of 50 weeks to recover in dancers, against 16 weeks for sprinting strains. The roll-up, the saw and the straight-leg scissors are that shape, so they wait until you can sprint without pain (our reading of the moves; no study has tested Pilates moves after a strain).
Trials of core training haven't measured core stability, and programmes credited with halving hamstring injuries also included the Nordic curl. The Nordic curl and warm-up programmes carry the prevention evidence, though even that is uncertain in the strictest analyses, and stretching doesn't prevent strains.
The hamstrings are the muscles at the back of the thigh. The NHS describes a sharp pain at the back of the leg during exercise or sport, sometimes with a snapping feeling or a pop in a severe injury, then tenderness, swelling and bruising. It says mild injuries usually get better in a few days, and severe ones can take weeks or months. In men's professional football, hamstring injuries are now about a quarter of all injuries, with a median of 13 days out.
Strains during sprinting hurt at once but heal faster. Strains during slow, deep stretches with the knee straight, such as a high kick or the splits, sit close to the sitting bone, feel milder at first and took far longer to heal: a median of 50 weeks in 15 professional dancers, against 16 weeks in 18 elite sprinters. Strains that involve the tendon high up took longer in the rehab trials too, whatever the programme.
In the most severe injuries the tendon tears away from the sitting bone. The NHS says surgery may be needed for the most serious hamstring injuries, and recovery takes several months. A pop near the sitting bone with a large bruise needs checking the same day, before any exercise (see the warning signs).
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Older age and a previous hamstring injury are the strongest risk factors for the next one (a previous injury 2.7 times the risk, a recent one 4.8 times). In professional football about 18% of hamstring injuries were repeats, two thirds of them within 2 months of going back. In one MRI study, 79% of re-injuries were in the same place and more than half came within 25 days of returning.
Experts suggest that controlling the pelvis while sprinting may ease the strain on the hamstrings, and one expert group names Pilates among ways to train it, while saying the evidence is very small. In 60 amateur footballers, more trunk and buttock muscle activity during sprinting went with fewer hamstring injuries. That's a link, not proof that training the trunk prevents strains.
Joseph Pilates worked with injured soldiers and later dancers, but that history isn't evidence that Pilates treats injuries. What Pilates offers after a strain is the trunk and hip control work that rehab uses (planks, side planks, bridges, one-leg balance and controlled leg movements with the pelvis still). Most Pilates hamstring studies measured flexibility, not injuries.
No trial of Pilates after a hamstring injury. The rehab evidence comes from a few small trials, mostly in elite athletes.
Our searches of PubMed, Europe PMC and ClinicalTrials.gov found no trial of Pilates after a hamstring strain, tear or tendon injury. The Pilates hamstring studies measured flexibility, strength, posture or back pain, and a 2025 review of Pilates in football found no study that counted hamstring or groin injuries.
In two Swedish trials from one research group, a programme built on three lengthening exercises (the Extender, the Diver and the Glider) returned elite footballers to full training in a mean of 28 days against 51, and sprinters and jumpers in 49 against 86, compared with conventional exercises. Pooled across 10 trials, lengthening exercises roughly tripled the rate of return without changing re-injury, though only 2 trials were of good quality. Starting them on day 1 rather than later didn't speed the return in 90 men.
In 50 recreational athletes with a severe thigh or calf strain, starting rehab 2 days after the injury rather than 9 got them back to sport after 63 days rather than 83 (figures from the research group's later review), with similar healing and strength. Not every strain in that trial was a hamstring.
In 43 men, rehab that allowed pain up to a tolerable level returned players in a median of 17 days against 15 for strictly pain-free rehab (no real difference) and recovered 15% more knee-bending strength. An expert consensus adds that early rehab should avoid high strain, and that sprinting should be pain-free before you go back.
In 24 athletes in the USA, agility and trunk stabilisation had 1 re-injury in 13 at a year, against 7 in 10 after stretching and isolated strengthening, though the return to sport didn't differ significantly. A later trial in 29 people found few differences against running and lowering strength work. A 2023 analysis of 9 trials concluded that trunk and agility work can prevent re-injury but doesn't shorten recovery, and the Cochrane review (2 trials, searched to 2012) calls the evidence limited. All of this is rehab, not prevention.
In the only trial of stretching dose, stretching 4 times a day rather than once shortened rehab from about 15 days to 13 in 80 athletes. No trial compares stretching with not stretching after a strain, and most rehab methods haven't been tested in trials.
A 2023 analysis credited football prevention programmes with core exercises with 47% fewer hamstring injuries, but those programmes also included the Nordic curl, so the core part can't be separated. Trials of trunk training haven't measured trunk stability. At a European championships, athletes who did more core training had fewer hamstring injuries, but there were only 5 injuries and the authors call it preliminary.
Programmes that include the Nordic curl were linked with about half as many hamstring injuries across 15 studies of 8,459 athletes, and two football trials found big falls. But only 5 of those studies randomised players to the Nordic itself, and pooling them leaves the effect uncertain. A 2026 analysis of 11 football trials found the FIFA 11+ warm-up reduced hamstring injuries (low certainty) and the Nordic curl on its own didn't clearly do so.
Across 25 trials (26,610 people), stretching didn't prevent sports injuries, while strength training cut them to under a third. In elite football, flexibility training on its own made no difference to hamstring strains.
Pilates increased hamstring flexibility in a review of 21 mostly small studies, with mixed results in athletes and gains that faded within 2 weeks of stopping. In 30 amateur footballers, mat or reformer Pilates improved agility and hop tests, and in 15 youth players it raised leg strength; neither counted injuries. Across 11 trials, Pilates built strength about as well as other exercise. One professional club used reformer Pilates as one of seven changes for a player with repeated strains, which can't show what Pilates did. In elite Australian footballers, Pilates was what players did while waiting for a tested trunk programme: the comparison, not the treatment.
For the first 2 to 3 days the NHS advises protection, rest, ice, compression and raising the leg, and to avoid heat (such as hot baths and heat packs), massage and alcohol for the first 3 days. Then: "When you can move your leg without pain stopping you, try to keep moving it so your hamstring does not become stiff."
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Mild to moderate discomfort that you find tolerable is fine during exercise; in a trial, working that way did no harm and recovered more strength. In the lengthening exercises (the Extender and the Diver), stop just before pain. Sharp pain, or a limp afterwards, means back off for a session or two.
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Breathing, ab work with your knees bent, side-lying hip work and bridge holds from about day 3, once walking is comfortable. Hamstring loading (single-leg bridges, swimming, the single-leg kick and the Diver-style deadlift) from about week 1, once you can walk briskly without pain. The long straight-leg moves come back once you can sprint without pain. These start times are our editorial guidance, built from the NHS advice and the rehab trials, not trial rules, and they follow the stages of our hamstring strain guide.
Before a class, tell the teacher about the injury so they can swap or shrink the long stretches and kicks. The NHS advises getting advice from a healthcare professional first if you have an injury, and stopping straight away if you feel pain or become unwell.
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The steps follow the move's own page; the exercise is the nearest move to the Extender in Askling's lengthening programme.
See the movement on the 3D figure: 90/90 hamstring stretch (active knee extension)
From about day 3, once walking is comfortable. Lateral breathing: "5 to 8 breaths at the start of every session", from the move page's dose. Heel slides: "10 slow repetitions each side, once or twice a day", from the move page's dose, only as far as is comfortable. Knee folds: "2 sets of 5 to 10 each side, every other day", from the move page's dose. Dead bug heel taps, 2 sets of 6 each side, and clams, 2 sets of 10 each side (our editorial starting point). Bridge holds: 5 holds of 20 to 30 seconds, both feet down (our hamstring strain guide's first stage). The hundred with your knees bent: "50 beats to start", from the move page's dose, head down if your neck tires. The 90/90 hamstring as in the steps above.
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoSupine heel slideBeginner · No equipment
3D demoKnee foldBeginner · No equipment
3D demoDead bug heel tapsBeginner · No equipment
3D demoClamshellBeginner · No equipment
3D demoGlute bridgeBeginner · No equipment
3D demoHundred (Pilates)Intermediate · No equipment
3D demo90/90 hamstring stretch (active knee extension)Beginner · No equipmentOnce you can walk briskly without pain, 3 times a week. Single-leg Romanian deadlift: 3 sets of 6 each leg, bodyweight, every other day, fingertips on a wall, reaching your arms forward and stopping just before pain, like Askling's Diver (our hamstring strain guide). Swimming: "2 to 3 sets of 20 to 30 seconds", from the move page's dose, small and slow at first. Single-leg kick: "6 to 8 each leg (the classical sequence uses 6)", from the move page's dose, kicking gently. Single-leg bridges, 2 sets of 6 to 8 each side; knee side plank then side plank, 2 holds of 20 to 30 seconds each side; single-leg stand, 2 holds of 30 seconds each leg (our editorial starting point). Leg pull front: "3 to 5 each side (the classical sequence uses 3)", from the move page's dose. Hip airplane: "2 sets of 5 slow turns each leg (our editorial starting point)", from the move page's dose, holding a counter. The shoulder bridge as a march at first, lifting each foot a little, adapted from the move page's dose, because the full kick takes the straight leg into a deep hip bend.
3D demoSingle-leg Romanian deadliftAdvanced · A dumbbell
3D demoSwimming (Pilates)Intermediate · No equipment
3D demoSingle-leg kick (Pilates one leg kick)Beginner · No equipment
3D demoSingle-leg glute bridgeIntermediate · No equipment
3D demoKnee side plankBeginner · No equipment
3D demoSide plankIntermediate · No equipment
3D demoSingle-leg standBeginner · A wall
3D demoLeg pull front (Pilates leg pull down)Advanced · No equipment
3D demoHip airplaneAdvanced · No equipment
3D demoShoulder bridge (Pilates)Intermediate · No equipmentAlongside the running and sprinting steps in our hamstring strain guide. Nordic curl: 2 to 3 sets of 4 to 6 (our hamstring strain guide), or the band-assisted Nordic: "2 sets of 3 to 6 slow lowers, twice a week, moving from a heavier band to a lighter one over several weeks (our editorial starting point)", from the move page's dose. These aren't Pilates moves, but they're the strength work with the prevention evidence. Leg pull back: "3 each side (the classical sequence uses 3)", from the move page's dose; bend the knees if the hamstrings cramp. Shoulder bridge with the full kick: "3 to 5 kicks each leg (the classical sequence uses 3)", from the move page's dose.
Small and to a mild pull from about week 3, with your knees soft; full range once you can sprint without pain (our suggestion: no study has tested these moves after a strain). The spine stretch forward's and the saw's pages already say: "With a recent hamstring injury, keep the reach small (our suggestion)." Leg circles: "5 circles each direction, each leg (the classical sequence uses 5)", from the move page's dose, small circles. Spine stretch forward: "3 to 5 reps (the classical sequence uses 3)"; saw: "3 to 4 each side"; single straight-leg stretch: "8 to 10 each side"; double straight-leg stretch: "6 to 10 reps"; side kick: "8 to 10 each side"; roll-up: "3 to 5 slow reps (the classical sequence uses 3)"; teaser: "3 reps (the classical sequence uses 3)", each from the move page's dose. The open-leg rocker comes last of all.
3D demoSingle-leg circle (Pilates one leg circle)Beginner · No equipment
3D demoSpine stretch forward (Pilates spine stretch)Beginner · No equipment
3D demoSaw (Pilates)Intermediate · No equipment
3D demoSingle straight-leg stretch (Pilates scissors)Intermediate · No equipment
3D demoDouble straight-leg stretch (Pilates lower lift)Advanced · No equipment
3D demoSide kick (Pilates side kick series)Beginner · No equipment
3D demoRoll-up (Pilates)Intermediate · No equipment
3D demoTeaser (Pilates)Advanced · No equipment
3D demoOpen-leg rocker (Pilates rocker with open legs)Advanced · No equipmentBend your knees in the roll-up and the spine stretch, keep the saw's reach short, and keep front kicks small with no pulses until you can sprint without pain. Stop for a sudden sharp pain or a pop at the back of the thigh, which the NHS lists as signs of a hamstring injury.
Cramp at the back of the thigh in bridges is common early on. The shoulder bridge's page says: "If the hamstring cramps, bend the standing knee more and walk the foot closer."
Say no to anyone pressing you deeper into a forward fold or pushing a straight leg towards you while the hamstring heals (our suggestion).
Keep stretches mild and in the middle of your range, and favour the strengthening moves: the NHS says not to overextend your joints just because you can.
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The roll-up, the spine stretch forward and the saw also round the spine; with osteoporosis, our Pilates for osteoporosis guide has the swaps.
A classical beginner reformer session runs footwork, the hundred, feet in straps (leg circles and frogs), the short box, the elephant and the knee stretches. Footwork with your knees bent works the back of the leg without stretching it and suits the middle weeks. Feet in straps, the elephant and other straight-leg stretches wait until later and come back small (our suggestion, matching the mat order above).
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No trial has tested the reformer after a hamstring injury. Tell the teacher about the injury so they can set the springs and the range.
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In a worldwide expert agreement, going back to play needed medical clearance, no pain when the muscle is pressed or tested, flexibility similar to the other side, good field tests and feeling ready. A later consensus made pain-free sprinting a firm rule and couldn't agree a flexibility benchmark. Being able to do a Pilates class doesn't mean you're ready.
More than half of re-injuries came within 25 days of going back in one study, and two thirds of repeat injuries in professional football within 2 months. Keep your strength work going after you return.
Once you're back, a Pilates class once or twice a week can keep up trunk and hip control (our suggestion), alongside the Nordic curl or your team's warm-up programme, which carry the prevention evidence. Our Pilates for sprinters and Pilates for footballers guides cover training around a sport.
Our 25-minute class follows the first two stages of our hamstring strain guide: the hamstrings working, not stretching, with no roll-ups, saws or straight-leg kicks. Its structure is our editorial choice. Do it 3 times a week from about a week in, alongside the rehab plan. The Nordic and prevention routines belong to the last stage; the sprinters and footballers classes come after you're back; the flexibility routine comes last, once sprinting is pain-free. If you prefer yoga, try the yoga class for a hamstring injury.
A 25-minute Pilates class for the weeks after a hamstring strain: trunk work with the knees bent, bridges, the lengthening moves from the trials, and balance.
25 minBeginner15 movesWall, dumbbellA 25-minute yoga class for the weeks after a hamstring strain: hamstrings working, not stretching, trunk and balance, and two lengthening moves from the trials.
25 minBeginner16 movesWall, dumbbellA 20-minute hamstring session to do twice a week, climbing from ball curls and slider lowers to Nordic curls and the full Nordic, at home or in the gym.
20 minBeginner8 movesExercise ball, anchor pointThe Nordic hamstring and Copenhagen adduction programmes from the football trials: a 10-week build, three adductor levels, then once a week in season.
15 minIntermediate6 movesWall, anchor pointA 25-minute off-track Pilates class for sprinters' easy days: trunk control while the legs move, hip flexors, the back of the thigh, side hips and one-leg balance.
25 minIntermediate17 movesBand, anchor pointA 25-minute Pilates class for footballers: trunk control, the groin and outer hips, hamstrings with the hip extended, and balance, for recovery days.
25 minBeginner17 movesOther / check instructions, wallA 30-minute mat Pilates workout for runners, adapted from one small trial's programme: the abdominal series, side kicks for the hips, planks and balance.
30 minIntermediate18 movesWallA 12-minute routine to loosen tight hamstrings with strap stretches, PNF, folds and hinges.
12 minBeginner7 movesNo equipmentThese are the warning signs from our hamstring strain and back of thigh pain guides, 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.
Same day: a pop near the sitting bone, a large bruise high on the back of the thigh, or you cannot put weight on the leg. The tendon may have pulled away from the bone, which needs assessing before you start these exercises.
Same day (NHS 111 or your GP): you felt a pop or tearing high on the back of your thigh, near the sitting bone, and it's very painful, there's a lot of swelling or bruising (which can spread down the thigh over the next few days), it hurts to walk or stand, or sitting is painful. The tendon may have come away from the bone. Ask for a scan within days. That timing is our suggestion: no source gives a fixed deadline, but this injury is easily missed, and a specialist needs to see it while every option is still open.
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Same day, for an X-ray (our suggestion): a teenager with sudden pain at the sitting bone after a sprint, a kick or the splits, often with a pop, especially if walking or sitting hurts. While the bones are still growing, the tendon can pull off a piece of bone.
Call 999 or go to A&E: severe pain after a fall onto your hip or bottom, or you cannot walk or put weight on the leg.
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Get help from NHS 111 if you think you've injured your hamstring and it's very painful, or the pain is getting worse; there's a large amount of swelling or bruising, or the swelling or bruising is getting worse; it hurts to walk or stand using the injured leg; your leg feels very stiff or is difficult to move; it's not feeling any better after treating it yourself; or you have a very high temperature or you feel very hot, but also cold and shivery, which could be signs of an infection.
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Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. It could be a blood clot (deep vein thrombosis, DVT), which is more likely while you're moving about much less than usual or after a hospital stay.
Call 999 or go to A&E if breathing suddenly becomes difficult, if pain in your chest or upper back comes on suddenly with breathlessness or a very fast heartbeat, or if someone passes out. Do not drive yourself. It can be a blood clot that has reached the lungs.
Call 999 if:
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.
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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.
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No trial compares stretching with not stretching after a strain, and more frequent stretching saved under 2 days in the only dose trial. What shortened the return was an early start and controlled lengthening under load, stopping just before pain. Strains caused by slow, deep stretching took longest to heal.
No trial has tested it. The trunk work that looks like Pilates helped in one small trial and not clearly in a second, and always alongside agility, running and strengthening.
More trunk muscle activity went with fewer injuries in one group of footballers, but no trial has shown that core training prevents hamstring strains: the trials didn't measure core stability, and the programmes credited with fewer injuries included Nordic curls. Most trunk and hip measures weren't risk factors for knee injuries either.
Pilates does improve sit-and-reach flexibility, but the gains fade within weeks of stopping, and stretching didn't prevent sports injuries across 25 trials or hamstring strains in elite football. Older age and a previous injury are the strongest risk factors.
Bridges, the leg pull and the single-leg kick work the back of the thigh, and across 11 trials Pilates built strength about as well as other exercise. But mat Pilates alone is too light for the lowering strength, such as the Nordic curl, that the evidence favours (our reading).
The trunk exercises in the rehab trials were done on the floor at home. In one small football trial, mat and reformer Pilates both improved test scores. A reformer helps a teacher set the load, but it isn't needed.
Healing on scans was still incomplete when people went back, more than half of re-injuries came within 25 days of returning, and experts want pain-free sprinting, strength and field tests first.
It can be a good part of getting back, if it fits around your rehab rather than replacing it. No trial has tested Pilates after a hamstring strain; the evidence is for early, gentle loading, lengthening exercises and a step-by-step return to sprinting. Pilates suits the trunk, hip and bridge work in that plan.
Yes, gently, once the first 2 to 3 days have passed and walking is comfortable: breathing, ab work with your knees bent, bridge holds and side-lying hip work leave the hamstring at rest. Leave out the roll-up, the saw, the spine stretch and straight-leg moves until later. If you felt a pop near your sitting bone with a large bruise, get it checked the same day first.
The NHS advises protecting and resting the leg for the first 2 to 3 days, then keeping it moving once pain allows. Starting rehab within days rather than waiting got people back sooner in a trial. Our suggestion is gentle mat work from about day 3, hamstring loading from about a week, and long stretches last.
At first, the moves that bend the hip deeply with the knee straight: the roll-up, the saw, the spine stretch forward, the single and double straight-leg stretches, the teaser, the open-leg rocker and big front kicks. Strains from slow, deep stretches like these took longest to heal. Bring them back small once you can sprint without pain.
Bridges, the swimming, the single-leg kick and single-leg bridges work the hamstring without stretching it, and planks, side planks and one-leg balance match the trunk work in rehab trials. Add the 90/90 hamstring and a single-leg Romanian deadlift, the nearest moves to Askling's lengthening exercises, stopping just before pain.
Mild to moderate discomfort that you find tolerable is fine; in a trial, working that way did no harm and recovered more strength. In the lengthening exercises, stop just before pain. Sharp pain, or a limp afterwards, means back off for a session or two.
It can be, with a teacher who knows about the injury. Footwork with your knees bent works the back of the leg without stretching it; feet in straps and the long stretches wait until later. No trial has tested the reformer after a hamstring injury.
Not on current evidence. A strong core hasn't been shown to prevent hamstring strains, and stretching doesn't prevent sports injuries. The prevention evidence is for the Nordic curl and warm-up programmes such as the FIFA 11+, though even that is uncertain in the strictest analyses.
It's an exercise-library name for the single straight-leg stretch, or scissors, where you pull one straight leg towards you with small pulses. It stretches the hamstring quickly, so after a hamstring strain it comes back late and small.
The NHS says mild injuries usually get better in a few days and severe ones can take weeks or months. With lengthening exercises, elite footballers returned in about 4 weeks and sprinters in about 7, and strains near the tendon took longer.
A previous injury is one of the strongest risk factors, and re-injuries tend to come early and in the same place, often within a month of going back. Finishing the rehab plan, including pain-free sprinting and Nordic curls, matters more than any class. See a physiotherapist after a second strain in the same place.
A strain starts suddenly during sport and is tender in the muscle. Pain spreading below the knee with tingling or numbness points to the back (sciatica), and a deep ache low in the buttock that builds over weeks is more often high hamstring tendinopathy; each has its own guide.
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.
