Pilates guide
Pilates works your hips in every direction they move: bridges and swimming for the back of the hip, the side kick series for the side and the inner thigh, leg circles and 90/90 turns for turning in and out, and standing work for balancing on one leg. In small trials, mostly of women and older adults, it made hips a little stronger and more flexible than doing nothing, and about as much as other exercise. It hasn't been shown to build more strength than training with weights.
This guide covers what your hips do and why they feel tight, what Pilates can and can't change (including your lower back and knees), the moves, the reformer, who should change what, and a free 25-minute class. If your hip hurts, start with our Pilates for hip pain guide; for the glutes alone, our Pilates for glutes guide goes further.
Pilates trains the hip pushing back, out to the side, across, turning in and out, and lifting the knee, then on one leg. This guide is for hips that work but feel weak, stiff or tight. If your hip hurts, our Pilates for hip pain guide comes first.
In the best trial, 18 weeks of Pilates raised hip strength held against a machine by 35.5% in women aged 60 to 80. Across 11 trials, Pilates built strength about as well as other exercise, not better. The trials are small and mostly in women and older adults.
Usually you've reached the stretch you tolerate, not a short muscle. Strength through the range built range about as well as stretching in reviews, so Pilates' strength moves count too. A pinch at the front of the hip is the joint: stay short of it.
For kneecap pain, hip and knee strengthening together beat knee exercises alone. For back pain, adding hip work helped a little at best, and two trials found no extra benefit.
Stronger side hips went with fewer injurious falls in a large study of older adults, and in one small trial hip strengthening cut falls. Add balance work if falls worry you.
Strength work on at least 2 days a week, until you need a short rest, is the guideline. Make the moves harder over the weeks with one-leg versions, a band or springs.
The hip is a deep ball and socket built to carry load. It bends (knee towards chest), extends (leg behind you), moves out to the side and across, and turns in and out. Its muscles do four jobs: pushing the hip forward (gluteus maximus and the hamstrings), holding the pelvis level on one leg (gluteus medius and minimus at the side), control on one leg and the inner thigh (the adductors), and lifting the knee (the hip flexors, mainly iliopsoas). Our hip joint page has the anatomy.
Joseph Pilates' 1945 mat sequence is full of hip work: the one leg circle, the shoulder bridge, the side kick (forward and back), swimming, the leg pulls and the kneeling side kick. A teaching platform describes the circle as giving "pelvic stabilization and mobilization of the hip joint". Classes today usually add a longer side kick series (side leg circles, the inner thigh lift), and the clam comes from rehabilitation and clinical Pilates rather than the classical mat. On the reformer, springs make the same directions harder or easier.
In 21 active adults, side-lying leg raises worked gluteus medius at about 81% of its maximum, against about 40% for two clam versions. Across 56 studies of muscle activity measured with electrodes (electromyography, or EMG), side-lying lifts with the hip turned slightly in, single-leg bridges, standing holds, step-ups to the side and side steps against a band worked the side glutes hardest; the clam wasn't among them. The clam does work the glutes far more than the small muscle at the front of the hip, which is why it's a good easy start.
In 18 experienced women, face-down Pilates moves worked gluteus maximus at about 20% to 33% of its maximum, swimming about 30%. In 60 women, the mat shoulder bridge worked it harder than a reformer hip roll. Muscle activity in one session isn't growth: in the one study that scanned the hips, 36 weeks of studio Pilates didn't change the size of the glutes or the deep hip muscles in 12 women, with no comparison group.
Usually a feeling at the end of a range rather than a short muscle: in stretching programmes, people mainly come to tolerate more stretch, as our hip mobility and hip openers guides explain. People who sat more than 7 hours a day and moved little had about 6 degrees less hip extension than active people who sat less, in a snapshot study of 98 adults. Bone shape sets some limits, especially for turning in.
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Women are on average more mobile in most directions, and hip sockets and thigh bones differ in depth and angle, so the stance that feels right differs too. Very flexible people need strength and control more than stretch: our Pilates for hypermobility guide covers it.
In Spain, 60 women aged 60 to 80 (49 finished) did Pilates, resistance training or no training, twice a week for 18 weeks. Strength holding the hip extended rose 35.5% with Pilates and 21.4% with resistance training, and only that measure beat no training. On a machine that measures strength through movement (isokinetic), every hip measure rose 27% to 34% within the resistance group and some within the Pilates group, but the groups didn't differ. Both groups improved everyday function tests and lean mass. There were no adverse events.
Twelve weeks of mat Pilates, made harder every 4 weeks, raised machine-measured hip strength in 14 women aged about 62, with no separate control group. In 48 active women aged about 65, mat and apparatus Pilates both improved leg and arm strength tests over 8 weeks against controls, with no difference between them. Two non-randomised studies of middle-aged women found more leg strength, about 13.5% in one.
Against doing nothing, Pilates improved strength in people aged 60 and over across 39 studies (a moderate effect, moderate certainty). Against other exercise, it built no more strength across 11 trials (very low to low certainty) or 24 trials in people over 60.
In 12 inactive women, 36 weeks of studio Pilates twice a week didn't change the size of gluteus maximus, medius or minimus on magnetic resonance imaging (MRI). There was no comparison group. Our Pilates for glutes guide covers growing them.
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In 32 women over 60, 3 months of Pilates improved trunk and hip bending, and static stretching improved them too; only trunk extension differed between the groups. In 20 older adults with no control group, 10 weeks of Pilates raised hip bending by 10% to 16%. Across 12 studies of adult women, Pilates improved the sit-and-reach test, which measures the hamstrings and lower back more than the hip; an earlier review of 9 trials found no clear flexibility gain.
Strength training improved range of movement about as much as stretching across 11 trials, and across 55 studies, except when it used body weight alone. So the side kick, bridges and 90/90 lifts count, and making them harder helps.
Eight weeks of mat Pilates let 85% of 40 healthy adults pass a pressure-cuff test of lower back control, against none of the controls, but that's a tummy test, not a one-leg task. In 36 young adults whose knee drifted inwards on a single-leg squat, Pilates and neuromuscular training both improved the knee angle (12 people per group). In 34 novice runners, 12 weeks of home Pilates didn't significantly change the knee drifting in while running. In 34 teenagers with kneecap pain, Pilates-based core work added to physiotherapy raised side hip strength more than physiotherapy alone, in a small trial.
Mat and apparatus Pilates improved strength and flexibility tests equally in older women. In 30 amateur footballers, reformer Pilates beat mat on agility and a hop test. On the Cadillac, where the spring is attached changes how the load peaks through a hip extension. You don't need a reformer; springs, bands and one-leg versions all make the work harder.
Our searches found no Pilates trial of hip strength in healthy adults under 60 with a proper control group, none that measured glute growth against a control group, and no study of muscle activity in the side kick, side-lying series or leg circle. A trial of clinical Pilates in hip osteoarthritis and two studies of the bridge on the mat and reformer have finished but posted no results.
The trials used 2 or 3 sessions of 45 to 60 minutes a week for 8 to 18 weeks. The NHS and the UK Chief Medical Officers ask for muscle-strengthening on at least 2 days a week, worked "to the point where you need a short rest before repeating the activity".
Move from two legs to one in the bridge, add a band above the knees, lower more slowly, or use heavier springs on the reformer (our editorial starting point). For bigger strength gains, add loaded hip work such as hip thrusts and step-ups: our guide to strengthening your hips has the plan.
Expect moves to feel easier within a few weeks and measurable strength changes over 8 to 18 weeks, as in the trials.
The NHS asks older adults to do "activities that improve strength, balance and flexibility on at least 2 days a week". The standing block of our class covers balance; our Pilates for balance guide goes further.
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Lying on your back: knee folds and fall-outs (2 sets of 5 to 10 each side, from the move pages' doses), windshield wipers (10 slow passes side to side, 2 rounds, from the move page's dose) and leg circles (5 circles each direction, each leg, from the move page's dose), small and with the pelvis still.
The shoulder bridge (3 to 5 kicks each leg, from the move page's dose), the wall bridge (8 to 10 reps, from the move page's dose) or a glute bridge (2 sets of 10 to 12, our Pilates glute workout), then swimming (2 to 3 sets of 20 to 30 seconds) and the single-leg kick (6 to 8 each leg), both from the move pages' doses.
3D demoShoulder bridge (Pilates)Intermediate · No equipment
3D demoWall bridge (feet-on-wall bridge)Beginner · A wall
3D demoGlute bridgeBeginner · No equipment
3D demoStaggered-stance bridge (offset bridge)Beginner · No equipment
3D demoSwimming (Pilates)Intermediate · No equipment
3D demoSingle-leg kick (Pilates one leg kick)Beginner · No equipmentThe side kick series: the side kick (8 to 10 each side, from the move page's dose), side leg circles (8 each direction, each side), side-lying leg raises (8 to 10 each side, our labral tear class and glute workout) and the inner thigh lift (10 to 12 each side, from the move page's dose). The clam is an easy start; skip it if the outside of your hip is sore. The kneeling side kick and side plank lift are harder.
3D demoSide kick (Pilates side kick series)Beginner · No equipment
3D demoSide-lying leg circles (Pilates side kick series)Beginner · No equipment
3D demoSide-lying leg raiseBeginner · No equipment
3D demoSide-lying inner thigh lift (Pilates side kick series)Beginner · No equipment
3D demoWall side leg lift (standing side kick at the wall)Beginner · A wall
3D demoClamshellBeginner · No equipment
3D demoKneeling side kick (Pilates side kick kneeling)Advanced · No equipment
3D demoSide plank with leg liftAdvanced · No equipmentThe 90/90 switch (10 slow switches, from the move page's dose), the 90/90 lift-off (3 holds of 5 to 8 seconds each way, each side, from the move page's dose) and standing hip circles (3 slow circles each way, from the move page's dose). Stop at any pinch in the groin.
Single-leg stands (2 holds of 20 to 30 seconds each leg, fingertips on a support, our labral tear class), the wall press (from the LEAP trial programme, as its page gives), then the hip airplane and step-ups when steady. The half-kneeling stretch eases the front of the hip; our Pilates for hip flexors guide has more.
From the move page's steps and dose; in Joseph Pilates' sequence the side kick goes forward and back. With pain on the outside of the hip, lie on your good side with a pillow between your knees, or use the wall side leg lift, as the move page advises.
See the movement on the 3D figure: Side kick (Pilates side kick series)
In 54 observational studies, people with low back pain had less hip range (especially turning in) and weaker side and back hip muscles than people without. These are snapshots, so they can't show which came first, and an earlier review rated the link between hip range and back pain as very low quality.
The length of the main hip flexor wasn't linked with back pain in 600 people, while back-muscle endurance was. In 118 adults, people with back pain had a little less hip flexor range, but body weight, not back pain, explained it. One session of hip flexor stretching tilted the pelvis by only 1.2 degrees and didn't change the curve of the lower back in 23 men.
Across 8 trials, hip strengthening helped back pain a little in the short term (about two thirds of a point on a 0 to 10 scale), at very low certainty, with no benefit later. Another review found a small gain and a third none. In trials, adding hip strengthening gave no extra benefit in 80 people, adding hip treatment made no difference in 76, and 8 weeks of hip flexor stretching did no better than no exercise in 30 women.
Pilates itself helps long-term back pain, and our Pilates for back pain guide has the trials. Yoga helps a little too, about as much as other back exercise, across 21 trials. Strong hips are worth having for their own sake; don't expect them to fix your back.
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For pain at the front of the knee around the kneecap, hip and knee strengthening together beat knee strengthening alone for pain (about 1.5 points on a 0 to 10 scale) and activity across 14 trials of 673 people, and later reviews agree. A 2016 consensus says: "Combining hip and knee exercises is recommended to reduce pain and improve function in the short, medium and long term". These trials aren't Pilates; Pilates side and back hip work is one way to do the hip half. Our Pilates for knee pain guide has the plan.
In 1,683 US adults aged 25 to 74, most hip movements were only 3 to 5 degrees smaller in the oldest group than the youngest; only hip extension fell by more than a fifth. Older adults who kept falling used about 11 degrees of hip extension while walking, against 14 in other older adults and 20 in young adults, in a small gait study. The swan, swimming and bridges work it.
Older adults had lower side hip strength, power and speed than young adults, and in the older group these went with slower stair climbing and chair rising (40 people). In another study of 42 adults, strength was already lower in middle age. Both are small snapshot studies.
In 952 adults aged 65 and over followed for a median of 11.5 years, each extra unit of side hip strength (1 newton per kilogram) went with a 16.5% lower risk of an injurious fall. That's an association, not proof. In 102 older adults, 12 weeks of hip strengthening cut falls against seated stretching and relaxation, but it was a small trial and we read only its summary. No Pilates trial has shown fewer falls; our Pilates for balance guide covers what does.
Never lie on the sore side. Lie on your good side with a pillow between your knees, or use the wall side leg lift, and leave out the inner thigh lift, as the move pages advise. Our Pilates for hip bursitis guide has the plan.
Keep knee folds, circles and bridges above the pinch, swing the side kick less far forward than back, and skip clams, as our labral tear class advises. Our Pilates for a hip labral tear guide covers impingement.
Follow your team's precautions. The hip twist and inner thigh lift carry the leg across the middle of the body, and after a front (anterior) approach the fall-out and swimming need your team's say-so, as their move pages say. Our Pilates after a hip replacement guide has the plan.
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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After the first trimester, keep time flat on your back to a few minutes and prop yourself up, and don't lie face down later in pregnancy, as the move pages advise. With pelvic girdle pain, skip the single-leg stand, which its page says can provoke it. Our Pilates in pregnancy guide has more.
The hip work suits most people with thin bones. Swap the hip twist for a knee sway with your feet on the floor, as its move page advises, and see our Pilates for osteoporosis guide for the rounding moves.
Footwork, the feet-in-straps series (frogs and leg circles) and side splits load the hip against a spring, and the springs can be made heavier as you get stronger. A teacher sets them.
In older women, mat and apparatus Pilates improved strength and flexibility tests equally. The mat moves here do the same job; a band adds load at home.
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The wall bridge, the wall side leg lift and the wall press give the same hip work standing or with your feet supported, and suit anyone who can't lie on their side or get down to the floor easily (our suggestion).
Our hips class trains every direction the hip moves, then balance on one leg. The glute, mobility and hip flexor classes go further on one part; the hip strengthening workout adds load.
A 25-minute Pilates class for healthy hips: the back and side of the hip, the inner thigh, turning at the end of your range and one-leg control.
25 minBeginner21 movesWallA 25-minute Pilates class for your glutes: bridges, the side kick series, face-down kicks and standing work at a wall, with a band to make it harder.
25 minBeginner16 movesWall, bandA 25-minute Pilates mobility class: standing joint circles, spine and hip work on the mat, strength at the end of your range, then sit-to-stands and balance.
25 minBeginner18 movesWall, bench or boxA 25-minute Pilates class for the hip flexors: pelvic control, hip flexor strength, the glutes and back of the hip, and a gentle pelvis-tucked stretch.
25 minBeginner16 movesBand, anchor pointA 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 30-minute session for hips that don't currently hurt: bridges, side-hip work, step-ups and single-leg control, an optional harder block, then balance.
30 minBeginner13 movesWall, bandA 15-minute hip opener: 90/90 switches, windshield wipers, CARs, Cossack squats, frog and pigeon.
15 minIntermediate8 movesWallStiffness that eases as you move is usually nothing to worry about. These are the signs that a hip needs checking, in the words of our hip pain guide, apart from the line marked as our suggestion. 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.
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Call 999 or go to A&E if you have sciatica on both sides, weakness or numbness in both legs that's severe or getting worse, or numbness around or under your genitals, or around your bottom (anus); if you find it hard to start peeing, cannot pee or cannot control when you pee; or if you do not notice when you need to poo or cannot control when you poo, and this is not normal for you. These could be symptoms of a serious back problem that needs to be treated in hospital as soon as possible.
Ask for an urgent GP appointment or get help from NHS 111 if you have severe hip pain that started suddenly but you've not had a fall or injured your hip, your hip is swollen and feels hot, the skin around your hip has changed colour, or you have hip pain, feel generally unwell and have a high temperature (or feel hot, cold or shivery). A hot, swollen hip with a high temperature can be a joint infection.
Bone pain that is constant or worse at night, especially with a lump, unexplained weight loss, fever or tiredness, or a past history of cancer.
A pinch at the front of the hip or ankle is the joint, not a stretch: stay just short of it, and see a GP or physiotherapist if it keeps happening (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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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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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.
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Hip flexor length wasn't linked with back pain in 600 people, 8 weeks of hip flexor stretching did no better than no exercise for back pain in 30 women, and adding hip work helped back pain a little at best.
Strength through the range built range as well as stretching in reviews, and very flexible hips need strength and control, not more stretch.
Side-lying leg raises worked the side glute about twice as hard, and the clam wasn't among the highest-activity moves across 56 studies. It's a good easy start that works the glutes much more than the front of the hip.
Training doesn't lengthen muscles: stretching changed muscle fibre length only trivially across 19 studies, and 36 weeks of Pilates didn't change hip muscle size on MRI. A leaner look comes from less body fat, which our guide to losing hip fat covers.
Hip dips come mostly from the shape of your pelvis and thigh bone, which no exercise changes; side hip work can build the muscle over them a little. Our hip dips guide explains what training can change.
Mat and apparatus Pilates improved strength and flexibility tests equally in older women. Springs help to make the work harder, and so do a band and one-leg versions.
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No trial found harm, and the best trial reported no adverse events. Most hip trouble in classes comes from a pinch in deep bends, lying on a sore outer hip or crossing the leg after a replacement, which the moves above change. Our hip pain after Pilates guide covers it.
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Yes, for strength, range and control. It works the hip in every direction, and in small trials, mostly of women and older adults, it made hips a little stronger and more flexible than doing nothing, about as much as other exercise.
The shoulder bridge and swimming for the back of the hip, the side kick series for the side, the single-leg circle and 90/90 turns for turning in and out, and standing hip circles and one-leg balance for control. Side-lying leg raises work the side glute harder than clams in lab studies.
Yes, if you move through the range and build strength in it. Tight hips are mostly what you tolerate, and strength training added range about as well as stretching. A pinch at the front of the hip is the joint, not tightness, so stay short of it.
It's good for both, but loosening or strengthening the hips adds little for most back pain: small, short-lived effects at best in trials. If your back hurts, our Pilates for back pain guide has what helps.
Yes: bridges, side-lying work, swimming and the kneeling side kick all work the glutes. To grow them you need load that keeps rising, which our Pilates for glutes guide covers; the one scan study found no glute growth from Pilates alone.
A little. In women aged 60 to 80, strength holding the hip extended rose 35.5% over 18 weeks, though resistance training improved machine-tested hip strength at least as much within its group. Make the moves harder over the weeks, and add loaded work for bigger gains.
Two or three times a week, on days that aren't back to back. The NHS asks for strength work on at least 2 days a week. Expect changes over 8 to 12 weeks.
Not in trials: the best one reported no harm. Stay short of a pinch in deep bends, don't lie on a sore outer hip, and follow your team's precautions after a hip replacement.
No exercise changes the bone shape that mostly makes hip dips. Side hip work can build the muscle a little; our hip dips guide explains what training can change.
Not clearly: mat and apparatus Pilates improved strength and flexibility tests equally in older women. Springs make it easy to add load, and so do a band and one-leg versions.
For pain around the kneecap, yes: hip and knee strengthening together beat knee exercises alone, and guidelines recommend the combination. Pilates side and back hip work is one way to do the hip half.
Taking the leg behind you is the range that falls most with age, and weaker side hips went with more falls in a large study. In one small trial, hip strengthening cut falls; add balance practice too.
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.
