Pilates guide
Mobility is more than flexibility: it's the range you can reach and control yourself and, as you get older, how easily you get about. Pilates trains both, moving your spine, hips and shoulders slowly through their range with your trunk steady. In trials of older adults, it improved flexibility, balance tests and how quickly people got up and walked, about as much as other exercise, though the trials were small and the certainty low.
It hasn't been shown to cut falls, so pair it with standing balance and strength work.
This guide covers the difference between mobility and flexibility, Pilates for the hips, spine and shoulders, mobility as you get older, what the trials show, the joint warning signs, and a 25-minute class that goes from standing to the floor and back.
Flexibility is how far a joint can move; mobility is the range you can reach and control yourself and, as you get older, getting about. In a trial, extra range from stretching didn't show up in how people moved, and strength at the end of the range did better than hard stretching.
Its leg circles, spine twist, mermaid and swan take joints through their range slowly, with the trunk steady, and strength work through a full range builds range about as well as stretching. Add joint circles, holds at the end of your range and the everyday moves: sit to stand, and getting down to the floor and up.
In people over 60, Pilates improved flexibility against no exercise across 39 trials (low certainty), people were about 0.9 seconds faster at getting up and walking across 6, and physical measures improved moderately across 51 trials of people over 55.
Pilates improved balance test scores about as much as other exercise, but the largest review found no drop in falls or fear of falling. Preventing falls needs balance and functional exercise 3 or more times a week for at least 12 weeks, and most Pilates classes give too little of it, so add standing balance work.
In head-to-head trials, Pilates matched or trailed other training, and it didn't clearly build strength in older adults. Choose what you'll keep doing.
Range falls only a few degrees at most joints as you get older. A hot, swollen joint, stiffness lasting more than 30 minutes after waking, or stiffness in both shoulders over 50 that's worst in the morning needs a GP or NHS 111 (the warning signs below).
Flexibility is the range a joint can move through, often helped by gravity, a strap or a partner; the American College of Sports Medicine (ACSM) calls flexibility exercise "Crucial to maintaining joint range of movement". In fitness, mobility usually means the part of that range you can reach and control yourself, which needs strength and control as well as flexibility (a fitness usage, not a research definition).
In older people's health care, mobility means getting about: "the ability to move oneself (e.g., by walking, by using assistive devices, or by using transportation) within community environments". The NHS describes flexibility exercises as "activities that improve the ability of a joint to maintain the movement necessary for carrying out daily tasks and physical activity" and lists Pilates among them. This guide covers all three: range, control of range, and getting about.
After 6 weeks of hip stretching, 24 young men had much more range when moved by someone else but didn't use it in lunges, twists or on an elliptical trainer: "changes in passive ROM or core endurance do not automatically transfer to changes in functional movement patterns" (ROM means range of motion). In 39 dance students, strengthening at the end of the range and gentle stretching improved the range they could lift through more than hard stretching, while all the groups gained the same range when moved by someone else.
Most Pilates moves take a joint through its range under control. A teaching platform describes the single-leg circle as giving "pelvic stabilization and mobilization of the hip joint", the spine twist as a way to "increase spinal and trunk mobility" and the saw as helping "increase spinal rotation"; the Pilates Method Alliance describes the spine corrector as "all about aligning and mobilizing the spine". Strength through a full range built range about as well as stretching across 11 trials. Chair and standing versions exist if you can't get down to the floor.
Not reliably on its own. A review of 22 studies in healthy adults over 65 found "conflicting information regarding both the relationship between flexibility interventions and functional outcomes or daily functioning." Adding spinal flexibility exercise to aerobic exercise added nothing to daily function in 134 older adults, though hip and ankle stretching improved range and walking speed in one trial of 40. Balance, strength and everyday moves such as sit-to-stands and stepping are what reliably help.
Across 39 trials in people aged 60 and over, Pilates improved flexibility against no exercise, at low certainty; mat Pilates improved hip and lower back flexibility across 9 trials, and an earlier review of 10 studies found a smaller effect. In 20 people aged about 70, with no control group, 10 weeks of Pilates raised spinal bending, side bending and rotation by 16% to 40% and hip bending by 10% to 16%.
A review of 6 trials found people were about 0.9 seconds faster on the timed up and go test, which times standing up, walking and sitting back down. We read that review only as an abstract, which prints its confidence interval oddly, and its trials varied a lot and had a high risk of bias. Across 39 trials, everyday function improved at low certainty, and across 51 trials of adults over 55 (2,485 people), physical measures improved moderately against no exercise and a little against other exercise, with no harms reported. Reformer Pilates once a week for 10 weeks improved the up and go, balance, walking and hip and ankle range against no exercise in 55 people aged 65 to 95 at risk of falls.
In the same 20 older adults without a control group, shoulder range improved after 10 weeks. In 69 women after breast cancer surgery, the shoulder range gained with 16 weeks of mat Pilates wasn't kept at 6 and 12 months, so keep going.
Reviews of 6 to 39 trials found better balance test scores in older adults, about as good as with other exercise, at very low to moderate certainty. A 2026 analysis of 423 trials in people over 60 found 18 of 19 types of exercise improved balance and "stretching showed no clear benefit". Pilates had the largest estimate for balance while moving, but the authors add: "These estimates do not establish superiority."
The largest review, of 39 studies and 1,770 people, found Pilates improved balance but "not to reduce the number of falls or the fear of falling". Only a few studies counted falls. In 60 women over 65 living in care homes, the Pilates group had fewer falls, but the comparison group lived in a different home. A pilot trial of 53 people aged 61 to 84 found 42% fewer fall injuries, which could have been chance; a full trial would need 804 people. A review of 12 trials found only two reported the number of falls.
Two more trials with falls in their titles measured balance tests, not falls, and a Spanish trial registered to count falls for a year has posted no results. No large enough Pilates trial has counted falls.
In the Pilates trials that described their exercises, only 2% to 36% challenged balance moderately or strongly. The World Falls Guidelines recommend "balance challenging and functional exercises (e.g. sit-to-stand, stepping), with sessions three times or more weekly which are individualised, progressed in intensity for at least 12 weeks and continued longer for greater effect". In the Cochrane review, exercise cut the rate of falls by 23% (59 trials, high certainty), and "No trials compared flexibility or endurance exercise versus control." An Australian position statement from 2025 agrees that balance and strength training work best.
Across 24 trials of 1,190 older adults, of low quality, Pilates didn't significantly build strength against no exercise, or differ from other exercise; the authors say "it is not feasible to recommend Pilates exercises as a means to improve strength, endurance and muscle power in the older adults." Another review found a moderate gain.
About the same, sometimes behind. In 44 people aged 60 to 69, aerobic exercise for the same total time beat Pilates for walking speed and balance while moving, though both improved getting up and walking and fear of falling. In 153 people over 55, sensorimotor training improved every test over 24 weeks, while the 22 who did Pilates didn't improve significantly. In small trials, Pilates did about as well as resistance training, a stretching method, Latin dance or traditional balance training, each better on some measures. Against yoga, flexibility improved about equally in one small trial.
No trial has compared Pilates with mobility drills such as controlled joint circles, and we found no study of Pilates and joint fluid, cartilage or "hydration".
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Bend, arch, twist and side bend. Cat-cow: "8 waves, slower than feels natural", the move page's dose. Wall roll-down: "3 to 5 slow reps", from the move page's dose. Spine twist: "3 to 4 each side (the classical sequence uses 3)", from the move page's dose. Mermaid: "3 each direction, each side", from the move page's dose; sit on a chair if side-sitting hurts. Thoracic rotation: "6 rotations per side, moving with the breath", the move page's dose. Side-lying open book: "8 to 10 slow openings each side, pausing 2 seconds at the end (our editorial starting point)", from the move page's dose. Swan: "5 to 6 reps", from the move page's dose, with small lifts.
3D demoCat-cowBeginner · No equipment
3D demoWall roll-down (wall Pilates)Beginner · A wall
3D demoSpine twist (Pilates)Beginner · No equipment
3D demoMermaid (Pilates seated side bend)Beginner · No equipment
3D demoThoracic rotationBeginner · No equipment
3D demoSide-lying open bookBeginner · No equipment
3D demoSwan (Pilates swan dive)Intermediate · No equipmentCircles and control. Single-leg circle: "5 circles each direction, each leg (the classical sequence uses 5)", from the move page's dose. Side-lying leg circles: "8 each direction, each side", from the move page's dose. Standing hip circles (CARs, controlled articular rotations): "3 slow circles each way with each leg, 20 to 30 seconds a circle (our editorial starting point)", from the move page's dose, holding a wall. Hip windshield wipers: "10 slow passes side to side, 2 rounds (our editorial starting point).", the move page's dose. 90/90 switch: "10 slow switches, pause at the ends", the move page's dose; hands behind you are fine. Shoulder bridge: "3 to 5 kicks each leg (the classical sequence uses 3)", from the move page's dose.
3D demoSingle-leg circle (Pilates one leg circle)Beginner · No equipment
3D demoSide-lying leg circles (Pilates side kick series)Beginner · No equipment
3D demoStanding hip CARsBeginner · A wall
3D demoHip windshield wipersBeginner · No equipment
3D demo90/90 switchIntermediate · No equipment
3D demoShoulder bridge (Pilates)Intermediate · No equipmentRange you can use needs strength there. 90/90 hip lift-off: "3 holds of 5 to 8 seconds each way, each side (our editorial starting point).", the move page's dose; cramp in the glute or hamstring is common and harmless, but back off for sharp groin pain. Leg pull front: "3 to 5 each side (the classical sequence uses 3)", from the move page's dose. Wall angel: 8 slow slides, a small range is fine (our shoulder mobility routine).
Shoulder circles: "3 slow circles each way with each arm, 20 to 30 seconds a circle (our editorial starting point)", from the move page's dose; any extra range from circles is short-lived. Breath reach: "5 breaths, exhale longer than inhale", the move page's dose. Neck circles: "3 slow circles each way, once or twice a day (our editorial starting point)", from the move page's dose; with a sore neck, use separate turns and nods. Ankle circles: "5 slow circles each way with each ankle, morning and evening (our editorial starting point)", from the move page's dose.
Range falls a little at most joints. In 436 Canadians aged 55 to 86, shoulder range fell about 5 to 6 degrees a decade and hip bending 6 to 7. In 674 healthy people aged 2 to 69, women were more mobile at every age. In 1,683 US adults, the youngest and oldest groups differed by only 3 to 5 degrees at most hip and knee movements, apart from taking the thigh behind you, and the authors wrote that "any substantial loss of joint mobility should be viewed as abnormal and not attributable to aging".
Hip extension, taking the thigh behind you, falls most with age and matters for your walking stride. In older adults, hip flexor stretching raised it by a few degrees, with only a trend in walking, and lengthened the stride only in people who started limited. The swan, the shoulder bridge and standing hip circles work it.
UK guidelines ask older adults to do "activities aimed at improving or maintaining muscle strength, balance and flexibility on at least 2 days a week", and the NHS asks for its flexibility exercises "at least twice a week". A Pilates mobility class counts towards it.
Falls prevention needs standing balance and functional exercise 3 or more times a week, made harder over at least 12 weeks. Our Pilates for balance guide and class do that, and our Pilates for seniors guide covers bones and choosing a class.
It's worth practising, so a fall is less frightening and you can get to the mat. The move page advises: "The first few times, practise with someone present and a sturdy chair close by." If you can't or shouldn't get down, chair Pilates does the same job.
Balance and functional exercise, such as sit-to-stands and stepping, cut the rate of falls, and Pilates classes have rarely included enough of it. Sit to stand: 2 sets of 5 slow (our Pilates for balance class). Get up and down from the floor: "5 to 8 slow cycles down and up, changing the leading leg (our editorial starting point)", from the move page's dose. Side-stepping: "10 steps each way, next to a counter (the NHS balance exercises)", from the move page's dose. Single-leg stand: 3 holds of 5 to 10 seconds each side, fingertips on a counter (our Pilates for balance class). Wall side leg lift: "10 to 12 each side", from the move page's dose.
From the move page's steps. Its page advises practising with someone present and a sturdy chair close by the first few times, and checking which positions are allowed with your surgeon or physiotherapist first after a hip or knee replacement or with acute back pain.
See the movement on the 3D figure: Get up and down from the floor
Modify or avoid exercises that round your back deeply or repeatedly, especially with a weight: sit-ups, toe touches, Pilates roll-downs and curl-ups, and extreme yoga forward folds. Bend from the hips instead. You do not need to avoid bending, twisting or lifting altogether: move smoothly and keep your upper back straight.
Twisting should be safe if you do it smoothly and comfortably. Slow down and shorten fast or forceful twists, and leave out the added weight.
In the wall roll-down, keep your hands on your thighs, keep the cat small, and leave out rolling like a ball and the roll-over, as the move pages advise.
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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.
The goal is control at the end of your range, not more range.
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Follow your team's limits on deep hip bending, crossing the middle and kneeling, and check the floor work with them first. The hip windshield wipers' page says: "If you have a hip replacement, check with your surgeon before adding internal rotation drills." Our Pilates after a hip replacement and Pilates after a knee replacement guides have more.
Stop if neck circles bring on dizziness, light-headedness or tingling into an arm. Make the movement smaller, with separate turns and nods, and see a GP if it keeps happening. Our neck pain guide has more.
Keep head-down positions such as the wall roll-down brief, as the move pages advise.
The roll-over and the jack knife need range rather than build it, and their pages list cautions for the neck, osteoporosis and glaucoma, so they aren't part of a mobility session (our suggestion).
The Pilates Method Alliance describes the reformer's adjustable springs, the Cadillac as "perfect for stretching, strengthening, and flexibility exercises" and the spine corrector as "all about aligning and mobilizing the spine".
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In 38 people with multiple sclerosis, mat and reformer Pilates gave similar gains in balance and getting about, and in 24 women after the menopause, mat Pilates with small props did as well as equipment Pilates. Reformer Pilates improved getting about in older adults at risk of falls. No trial we found compares mat and reformer for mobility in older adults; the mat and chair moves above are enough.
Starting points, not prescriptions.
Pilates trials in older adults mostly ran 2 or 3 sessions a week for 8 to 12 weeks. Our editorial starting point is a Pilates mobility class 2 or 3 times a week, with walking on other days.
Add standing balance and strength work so that balance practice reaches 3 or more times a week for at least 12 weeks; the class doesn't replace the balance and strength training the falls guidance recommends.
Give it 6 to 8 weeks, and judge it on how easily you move, get up from the floor or turn to look behind you, not on how far you reach (our suggestion).
Our 25-minute class goes from standing joint circles to the floor for the spine and hips, then back up for sit-to-stands and balance; its structure is our editorial choice. Do it 2 or 3 times a week alongside walking and strength training. The flexibility class adds held stretches, the balance class more standing balance, the over-50s and chair classes a gentler start, and the mobility routines are drill-based. If you prefer yoga, try the yoga mobility flow.
A 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 flexibility: roll-downs, spine stretches and twists, hip circles and held stretches for the hamstrings, hips and back.
25 minBeginner14 movesNo equipmentA 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 movesWall, bench or boxA 20-minute beginner mat Pilates session for over-50s with no deep or repeated rounding of the spine, plus back strengthening and standing balance.
20 minBeginner13 movesWallA 20-minute chair Pilates workout for beginners and older adults: breathing, sitting tall, gentle spine and leg moves, and a standing finish at the chair.
20 minBeginner14 movesBench or box, something with weightA 12-minute routine to move every joint through its range under control: slow neck, shoulder, hip and ankle circles, spine and hip rotation, and deep squats.
12 minBeginner10 movesWallA 15-minute routine that moves your neck, upper back and lower back through bending, arching, side bending and twisting, then holds the spine steady.
15 minBeginner12 movesNo equipmentTwenty minutes of joint circles, a standing flow and end-of-range strength: yoga for range you can reach and control, for desk days, rest days or older joints.
20 minBeginner16 movesStep, wallStiffness that eases as you move is usually nothing to worry about. These are the signs that a joint needs checking, in the words of our hip, knee, shoulder and mobility guides, 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.
Stop if neck circles bring on dizziness, light-headedness or tingling into an arm. Make the movement smaller, with separate turns and nods, and see a GP if it keeps happening. Our neck pain guide has more.
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 someone who has fallen may have hurt their head, back, neck or hip, or can't get up. Call 111 if they may be in pain, injured or unwell, and see a GP if you've had a fall or are worried about your balance.
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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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Flexibility is the range a joint can move through; mobility is the range you can control and, in older people's health care, getting about. Extra range from 6 weeks of stretching didn't show up in how people moved.
Its moves combine range with control and trunk strength, and in older adults it improved balance and function as well as flexibility. It didn't clearly build strength, though.
It improves balance test scores, but the largest review found no drop in the number of falls or fear of falling, and no large enough falls trial exists. Falls prevention needs balance and functional exercise 3 or more times a week for 12 weeks or more.
Range falls only a few degrees at most joints with age, and a big loss of range in one joint isn't normal ageing. Stiffness lasting more than 30 minutes after waking needs a GP.
Not on its own: gains from stretching alone didn't carry over into movement, and flexibility training's effect on daily function in older adults is conflicting.
No trial shows that mobility routines prevent injuries, and stretching didn't prevent sports injuries across 25 trials.
We found no study measuring joint fluid, cartilage or muscle "hydration" after Pilates.
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Mat and reformer Pilates both improved range and function in small trials, and did about equally well when compared head to head. Choose what you can get to and keep doing.
Yes, moderately. In older adults it improved flexibility, the timed up and go test and other physical measures compared with no exercise, though at low certainty. It trains range under control, which is what mobility means in fitness.
Flexibility is how far a joint can move; mobility is the range you can reach and control yourself and, as you get older, getting about. You can gain flexibility without moving any better, so practise range in movement.
Yes, a little. Most of the trials are in people over 60, and Pilates improved flexibility, balance scores and getting up and walking, much as other exercise does. Add standing balance and strength work for falls.
Not on current evidence. It improves balance test scores, but the largest review found no drop in the number of falls, and only a pilot trial counted falls properly. Falls prevention needs balance and functional exercise 3 or more times a week for at least 12 weeks.
It works the hips through their range: leg circles, side-lying circles, the side kick and the shoulder bridge, plus hip circles and the 90/90 switch. In older adults, mat Pilates improved hip and lower back flexibility across 9 trials. Our Pilates for your hips guide adds hip strength and control.
It moves the spine in every direction: rolling, twisting, side bending and arching. In 20 older adults without a control group, spinal bending and twisting improved by 16% to 40% in 10 weeks. With osteoporosis, swap rounding and rolling moves for hinges and smooth twists.
The swan, mermaid, breath reach and shoulder circles take the shoulders through their range, and shoulder range improved in a small uncontrolled study of older adults. In women after breast cancer surgery, the shoulder range gained with mat Pilates wasn't kept at 6 and 12 months, so keep going. If a shoulder hurts, our Pilates for shoulder pain guide can help; for strength and reach, see our Pilates for your shoulders guide.
Neither clearly: in one small trial at matched effort, 8 weeks of either improved flexibility about equally. Choose the one you enjoy and will keep doing.
Not quite. Mobility routines are mostly joint circles and drills, while Pilates adds trunk control and strength, and no trial has compared them. Our mobility Pilates class mixes both.
No. Mat and reformer Pilates did about equally well when compared head to head in small trials. Use what you can get to; a chair class suits anyone who can't get down to the floor.
Two or three times a week; most trials ran for 8 to 12 weeks, and UK guidance asks older adults for strength, balance and flexibility work on at least 2 days a week. Judge it after 6 to 8 weeks on how easily you move.
Gentle movement usually eases everyday stiffness, and in arthritis, exercise is part of treatment (our Pilates for arthritis guide covers it). But stiffness lasting more than 30 minutes after waking, or a hot, swollen joint, needs a GP.
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.
