Pilates for swimmers: shoulder blades, trunk and hips, loose shoulders, and what it does for your swimming

No peer-reviewed Pilates trial in swimmers

We found none. A 2025 preprint, not yet peer reviewed, reported better flexibility and figure scores after 8 weeks of Pilates in 18 young artistic swimmers.

Sources 1, 2

Core training helps short sprints in young swimmers

Across 11 studies of swimmers aged 11 to 20, core training made 50 m freestyle about 1 second faster, but the effect on 100 m was unclear, and one 8-week trial found no difference. Whether it carries over to adults is our reading, not tested.

Sources 3, 4, 5

Swimmer's shoulder is mostly an overloaded tendon

Most young elite swimmers had shoulder pain, and it tracked how much they swam. Sudden jumps in training and weak endurance at the back of the shoulder predicted pain.

Sources 6, 7

Loose shoulders need control, not more stretch

Shoulder looseness is a risk factor, hypermobile athletes had about 3 times the odds of shoulder injury, and stretching aggravated painful shoulders in a survey of swimmers.

Sources 8, 9, 10

Stretch only a clear stiffness

The cross-body stretch restored about 20 degrees of lost inward turning in a small trial. Skip it if your shoulder feels loose.

Source 11

Dryland strength beats swimming alone

Adding strength training to swimming improved performance by about 2% to 2.5%. Pilates is one part of dryland work, not all of it.

Sources 12, 13

Shoulders, an arched back and the kick

Your arms do most of the work, so the shoulder takes thousands of strokes a session, and the front of the shoulder can be pinched as the hand enters the water. All strokes hold the lower back arched for streamlining, more in breaststroke and butterfly, and the breaststroke kick strains the inside of the knee.

Sources 14, 15

Who gets shoulder pain

91% of 80 young elite swimmers had had shoulder pain, and about 1 in 5 female swimmers aged 8 to 77 had pain that limited them. The links with moderate certainty are shoulder looseness and instability, rotation range, past pain and competitive level; a later review found shoulder strength endurance the most important link you can change.

Sources 6, 16, 7, 8, 17

What Pilates offers, and what it doesn't

Shoulder-blade control lying face down and on your hands, trunk endurance in a streamlined line, hip control for your kick, and upper-back rotation for breathing. Elite swimmers' shoulders are often loose already, so Pilates for swimmers should stop short of end-range stretches. Links between core stability and arm injuries are thin, and Pilates doesn't replace heavier dryland strength work.

Sources 18, 19, 12

No peer-reviewed Pilates trials in swimmersMixed evidence

Our searches found no peer-reviewed trial of Pilates in swimmers. In a preprint, 18 artistic swimmers aged 13 to 15 who did two 60-minute Pilates classes a week for 8 weeks gained more flexibility and scored better on two figures than those who did their usual gym routine. It hasn't been peer reviewed, and loose-shouldered swimmers may not need more flexibility.

Sources 1, 2

Core training and 50 m sprintsEmerging evidence

A 2025 review of 11 studies in 218 swimmers aged 11 to 20 found core training made 50 m freestyle 1.06 seconds faster (moderate certainty); the effect on 100 m was unclear (low certainty). A second review of 16 trials in 438 youth swimmers found the clearest effect for 50 m and backstroke, with programmes of about 8 weeks, up to 3 sessions a week. In one trial, 12 weeks of core training cut national-level juniors' 50 m times by about 2%.

Sources 3, 4, 20

Not every trial agreesMixed evidence

In 32 swimmers, 8 weeks of extra core training twice a week made no difference between groups, and the effect on longer distances is unknown. All these trials were in young swimmers; that masters swimmers would gain the same is our reading.

Sources 5, 3

Strength training added to swimmingEmerging evidence

Across 27 studies, swimming plus strength training beat swimming alone, by about 2% to 2.5%. In a network of 36 trials, water plus dryland resistance training ranked first, and core and power training helped 25 m sprints and starts.

Sources 12, 13

It tracks training loadEmerging evidence

In young elite swimmers, the overloaded tendon showed up more with more hours and distance swum. In 201 youth swimmers followed for 2 seasons, sudden jumps in training load and weaker endurance at the back of the shoulder predicted pain.

Sources 6, 7

Shoulder-blade and posture workEmerging evidence

In 30 competitive swimmers, five shoulder and shoulder-blade exercises twice a week for 12 weeks limited the season's loss of rotator cuff strength. In elite swimmers, an exercise programme reduced forward head and rounded shoulder posture. Neither trial counted injuries.

Sources 21, 22

What this means for Pilates

Prone shoulder-blade work, scapular push-ups and trunk endurance train what swimming wears down. No programme has been shown to prevent swimmer's shoulder, so pair Pilates with the shoulder care routine and build your swimming gradually (our reading).

Sources 17, 21

Looseness is a risk factorEmerging evidence

Shoulder looseness and instability were among the risk factors with moderate certainty across 29 studies. Athletes with hypermobile joints had about 3 times the odds of a shoulder injury, and 8 times with a hypermobile shoulder, on low-quality evidence. Elite swimmers had looser shoulders than recreational swimmers.

Sources 8, 9, 18

Stretching can aggravate a painful shoulderEmerging evidence

In a survey of 1,262 US swimmers with a painful shoulder, stretching was among the activities that aggravated it. The NHS says "do not overextend your joints just because you can".

Sources 10, 23

The one stretch with trial supportEmerging evidence

In 54 adults (not swimmers), the cross-body stretch, 5 holds of 30 seconds once a day for 4 weeks, restored about 20 degrees of inward turning on the stiffer side; the sleeper stretch's 12 degrees wasn't significant. Use it only if one shoulder is clearly stiffer turning in, and skip it if your shoulder feels loose.

Source 11

What to expect

Core training helped 50 m sprints in young swimmers, and dryland strength training helped more broadly. Pilates trunk work is a reasonable way to do core training, but the trials' core programmes weren't Pilates by name (our reading). For speed, keep heavier dryland strength and jump work, as our swimming page sets out.

Sources 3, 4, 12, 13

Butterfly backs and breaststroke kneesEmerging evidence

In 341 elite swimmers, butterfly went with 2.5 times the risk of low back pain and the 200 to 400 m breaststroke with 5 times the risk of knee pain. Keep back extension small if arching hurts, and work your hips both ways for the breaststroke kick; with inner knee pain, skip deep kneeling and side-sitting (our reading).

Sources 15, 14

Pilates and back pain in generalEmerging evidence

Across 10 trials, Pilates eased long-lasting back pain about as much as other exercise. It hasn't been tested in swimmers.

Source 24

Our suggested week

Our editorial plan, built on the trials:

• Pilates once or twice a week, after easier pool sessions or on separate days, for at least 8 weeks, the length of most core training trials.
• The shoulder care routine twice a week, as in the 12-week swimmer trial.
• Two dryland strength sessions a week, as our swimming page sets out.
• Lighter dryland work in the week or two before a key race.

Sources 4, 21, 12

BonesEmerging evidence

Swimmers' bone density is similar to that of people who don't exercise, and mat Pilates isn't impact work. Add jumps or impact on land.

Source 25

Weight on your hands

With a painful or loose shoulder, swap the leg pull front, push-up and side bend for wall push-ups or the knee hover, keep your elbows soft, and skip the leg pull front while your shoulder hurts.

Sources 8, 9

The front of the shoulder

Skip rocking with pain at the front of the shoulder, and hold a towel between your hands for the double-leg kick.

Overhead reaches

With a sore shoulder, reach forward rather than overhead in the roll-up and double-leg stretch, and keep your arms by your sides in the swimming exercise.

Long shoulder stretches

Skip long doorway stretches, hanging and the sleeper stretch, especially if your shoulders are loose.

Sources 8, 10, 11

Inner knee pain

With breaststroke knee pain, skip kneeling side kicks and side-sitting, and do the mermaid on a chair.

A shoulder that looks out of place: go to A&E

Call 999 or go to A&E (accident and emergency) if, after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.

Source 26

Shoulder pain with chest pain: call 999

Call 999 for shoulder or arm pain with chest pain that feels tight or squeezing, or chest pain that spreads to your arms, neck or jaw, especially with shortness of breath, sweating or feeling sick. It could be a heart attack.

Source 27

Same day: urgent GP appointment or NHS 111

Sudden or very bad shoulder pain; you cannot move your arm; the arm or shoulder is badly swollen or has changed shape; pins and needles that do not go away; no feeling in the arm; the arm is hot or cold to the touch; pain that started after an injury such as a fall; or severe pain in both shoulders.

Source 28

See a GP or physiotherapist

Pain that is getting worse or has not improved after 2 weeks of looking after it yourself, or it is very hard to move your arm; in many areas you can refer yourself to physiotherapy. Also if your shoulder has partly or fully come out of joint, or you worry it might, and for a child or teenager whose shoulder pain lasts more than 2 weeks, keeps coming back or stops them training (our suggestion).

Source 28

Back pain

A teenager's low back pain that lasts and is worse arching backwards, as in butterfly, breaststroke or push-offs, may be a stress fracture of the spine: get it checked.

Call 999 or go to A&E (accident and emergency) if you have back pain with pain, tingling, weakness or numbness in both legs, a loss of feeling around your genitals or bottom, or changes in your bladder or bowels. These can be signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.

Source 29

Fainting: call 999

Call 999 if someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.

Source 30

During Pilates

With a loose shoulder, stop an exercise or shrink its range if you feel the shoulder is about to slip. Discomfort up to about 5 out of 10 that settles by the next session is fine; sharp, pinching or worsening pain isn't.

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 an operation.

Source 31

"Swimmers should stretch their shoulders as far as they go"Emerging evidence

Shoulder looseness is a risk factor, hypermobile athletes had more shoulder injuries, and stretching aggravated painful shoulders in a survey. Stretch only a measured stiffness, such as lost inward turning.

Sources 8, 9, 10, 11

"Core work makes you swim faster"Emerging evidence

Partly. Core training made 50 m freestyle about 1 second faster in young swimmers, but the effect on 100 m was unclear, one trial found nothing, and adults have barely been studied.

Sources 3, 5

"Pilates prevents swimmer's shoulder"Mixed evidence

Untested. No programme has been shown to prevent it in swimmers; shoulder strength endurance is the target with most support.

Sources 17, 21

"The Pilates swimming exercise trains your stroke"

It's a mat exercise lying face down with alternating arm and leg lifts. It trains back and glute endurance, not your stroke.

"Swimming and Pilates build strong bones"Emerging evidence

Swimmers' bone density is similar to that of people who don't exercise. Add impact work on land.

Source 25