Pilates for teenagers: growing bodies, sport, posture, mental health and a routine

One part of an active week

Teenagers need an average of at least 60 minutes a day of activity that makes them breathe faster, with a mix that builds muscles and bones. Only about half of 5 to 16 year olds in England get it, fewer girls than boys.

Sources 1, 2, 3

Strength training is safe with good teaching

Supervised strength training hasn't been shown to injure growth plates or stunt growth, and the NHS says young people can use weights if a qualified adult trains and supervises them.

Sources 4, 5, 2

A little help for posture and trunk strength

In small school trials, mostly from one research group, short Pilates sessions twice a week built trunk endurance and kept the upper back from rounding; another trial in teenage girls found no change in posture.

Sources 6, 7, 8, 9

Exercise helps mood; Pilates hasn't been tested for it in teenagers

Across hundreds of trials in young people, exercise eased depression and anxiety by a moderate amount, more with moderate and harder effort. We found no Pilates trial in teenagers with depression or anxiety.

Sources 10, 11, 12

Back pain is common and usually not serious

About a third of young people have low back pain over a year, and school bags aren't a proven cause. Back pain that lasts in a teenager who arches or twists in sport needs checking for a stress fracture in the spine.

Sources 13, 14, 15

No minimum age, even for the reformer

Studio age limits are studio policy, not a health rule. Reformers are built for adults, so a good teacher checks the fit and supervises closely.

Source 16

The guidelinesStrong evidence

The UK Chief Medical Officers say 5 to 18 year olds "should engage in moderate-to-vigorous intensity physical activity for an average of at least 60 minutes per day across the week", with "a variety of types and intensities" to build movement skills, muscular fitness and bone strength, and less time sitting. The World Health Organization adds vigorous activity, and activities that strengthen muscle and bone, on at least 3 days a week.

Sources 1, 17, 18, 2

Where Pilates fits

Pilates builds muscle strength, trunk endurance and control. The Chief Medical Officers say "Bone strengthening involves moderate and high impact activities", and Pilates has little impact and is mostly light to moderate, so pair it with sport, running and jumping (our reading, as our Pilates for kids guide says).

Sources 1, 19, 20

Most teenagers don't get enoughStrong evidence

In England in 2024 to 2025, 49% of 5 to 16 year olds met the guideline (boys 52%, girls 46%), and 28% averaged less than 30 minutes a day. Worldwide, 81% of 11 to 17 year olds don't get enough.

Sources 3, 21

Growth plates and growthStrong evidence

The US National Strength and Conditioning Association says "To date, injury to the growth cartilage has not been reported in any prospective youth resistance training research study", and that there's no evidence it harms growth. In a review of 22 supervised programmes, training didn't affect height or weight, and injuries were rare.

Sources 4, 5

It worksStrong evidence

Strength training makes children and teenagers stronger, more so with age. The American Academy of Pediatrics and an international consensus support supervised strength training for young people.

Sources 22, 23, 24

Supervision mattersEmerging evidence

In US emergency departments, weightlifting injuries in younger children were mostly accidents, such as dropped weights. The NHS says young people can use weights if a qualified adult trains them and supervises them.

Sources 25, 2

Early, small studiesMixed evidence

A 2020 review of 11 studies in children and young people called the research preliminary, with programmes that varied widely. Most Pilates trials in teenagers are small.

Sources 26, 27

PostureEmerging evidence

A 2024 review found moderate-certainty evidence that Pilates improves the upper-back and lower-back angles a little in children and teenagers against doing nothing. In 236 teenagers, 15 minutes twice a week in school PE (physical education) for 9 months kept the upper-back curve from increasing while their classmates' increased; in 103 teenagers with a rounded upper back, the same dose for 38 weeks reduced the curve by about 5.6 degrees more than in the comparison group. These are small trials, mostly from one research group, which we read as abstracts.

Sources 27, 6, 7

Trunk endurance and hamstringsEmerging evidence

In 441 teenagers, 10 minutes of Pilates twice a week in PE for 12 weeks improved the endurance of the tummy and back muscles and hamstring flexibility, and most gains lasted 12 weeks after it stopped. In 52 teenagers who'd had back pain, 6 weeks of Pilates improved back muscle endurance more than no programme.

Sources 8, 28

When Pilates didn't helpMixed evidence

In 45 girls aged 13 to 16 with rounded shoulders, 6 weeks of Pilates didn't change head, shoulder or upper-back angles, while corrective exercise and the Alexander technique did.

Source 9

Young athletesEmerging evidence

In 30 young volleyball players, 8 weeks of Pilates three times a week reduced landing errors; in 15 young footballers, 15 sessions of mat Pilates increased leg strength; and baseball players gained trunk strength in a study without a comparison group.

Sources 29, 30, 31

Knee painEmerging evidence

In 34 teenagers with pain at the front of the knee, Pilates-based core work added to physiotherapy for 3 months reduced pain and improved strength more than physiotherapy alone.

Source 32

Conditioning, not a replacement

Trunk training improved sport-specific performance across 31 studies in athletes, and small Pilates trials in young athletes found better landing technique and strength. Pilates adds to a teenager's sport, coaching and strength training; it doesn't replace them.

Sources 33, 29

Dancers, gymnasts and other bendy athletes

Work in the middle of your range and build control rather than more stretch; our Pilates for hypermobility and Pilates for dancers guides have more.

Common, and usually not seriousEmerging evidence

About a third of children and teenagers (34%) have low back pain over a year, and 42% of adolescent athletes. A review of 69 studies found no convincing evidence that school bags cause it. Supervised exercise lowered pain by about 3 points out of 10 in two small trials.

Sources 13, 34, 14, 35

Stress fractures in sports that arch the backEmerging evidence

A stress fracture in the back of a lower vertebra (spondylolysis) was behind 30% of back pain in 1,025 adolescent athletes. In a trial of 64 athletes with one, starting physiotherapy straight away got them back to sport 38 days sooner than resting first, with fewer recurrences.

Sources 15, 36

Signs that need a checkEmerging evidence

Pain at night, constant pain, numbness or weakness, fever, bladder or bowel changes, or a visible change in the shape of the spine. The warning signs below give the details.

Sources 37, 38, 39

In Pilates

If your back hurts more when you arch, skip the swan, swimming, rocking and kicks and do the bird dog; if it hurts more bending forward, skip roll-ups and rolling. Get pain that lasts more than a couple of weeks checked (our suggestion, from the moves' own cautions).

ScoliosisMixed evidence

A Cochrane review is very uncertain whether exercises reduce the curve, and Pilates trials are poor quality; one small trial found Schroth exercises did better than Pilates. Sport is encouraged: the scoliosis specialists' society SOSORT recommends staying active in sport, and the NHS says children with scoliosis "can usually do most types of exercise". Our Pilates for scoliosis guide has more.

Sources 40, 41, 42, 43, 44, 45

Bendy joints

Keep moves in the middle of your range and build control. The NHS advises gentle, low-impact exercise and regular breaks, and NHS physiotherapy teams use Pilates with teenagers with hypermobility, back pain and posture problems.

Sources 46, 47

Growth spurtsEmerging evidence

In high school students, growing wasn't linked to losing flexibility. If you're growing fast, cut back the jumps before the strength work, as our strength workout for teenagers suggests (our editorial suggestion), and get knee or heel pain that keeps coming back checked.

Source 48

Exercise helps moodStrong evidence

Across 375 trials in 5 to 18 year olds, exercise eased depression (moderate certainty) and anxiety by a moderate amount; moderate-intensity and mixed exercise helped depression most and strength training helped anxiety most. Low-intensity training didn't clearly ease anxiety.

Sources 10, 49, 11

Pilates and moodMixed evidence

We found no Pilates trial in teenagers with depression or anxiety. Across 32 trials at all ages, Pilates helped quality of life and self-esteem, with limited or unclear effects on depression and anxiety.

Sources 12, 50

What NICE says for young people with depressionStrong evidence

Offer advice on regular exercise and encourage "a structured and supervised exercise programme of typically up to 3 sessions per week of moderate duration (45 minutes to 1 hour) for between 10 and 12 weeks". Exercise sits alongside the help a GP or mental health team gives, never in place of it.

Source 51

Body imageEmerging evidence

More active teenagers tend to feel better about their bodies, but "fitspiration" posts on social media made body dissatisfaction worse, especially in younger people. In 2,287 young adults, women who did yoga or Pilates had disordered eating as often as others, and men who did them used extreme ways of controlling their weight more often. Train for what your body can do, not how it looks.

Sources 52, 53, 54, 55

When exercise becomes a problem

Exercise that feels driven by rules or guilt, or that carries on despite injury or illness, can be part of an eating disorder; the NHS lists "exercising too much" among the signs. A small Pilates programme was safe for girls with anorexia in specialist care, but that's for the treatment team to decide.

Sources 56, 57, 58

No minimum age

No guideline sets a minimum age for Pilates or the reformer. The Pilates Association Australia says what matters on equipment is "the size of the child, the appropriateness of load and instability", with no more than 4 young people per teacher on equipment (8 on the mat).

Source 16

Learn the reformer with a teacher

Springs and a moving carriage need teaching: in one case report, an adult dislocated both shoulders on an unsupervised reformer session. Start with a teacher, and tell them about injuries, scoliosis, bendy joints or a health condition.

Sources 59, 16

Upside-down moves

The same teachers' body says inversions such as the roll-over and jack knife, and apparatus work, "should be taught with caution" to children and adolescents because of "the potential load on bone growth plates". They aren't needed, so our class leaves them out.

Source 16

What the trials used

10 to 15 minutes twice a week inside school PE for 12 weeks to 9 months, and 50-minute sessions three times a week for 8 weeks in young athletes.

Sources 6, 8, 29

Our suggested week

Our editorial starting point:

• An average of an hour a day of activity that gets you out of breath, with running, jumping or sport for your bones.
• Our 25-minute Pilates class once or twice a week.
• Strength training 2 to 3 times a week if you want it, taught and watched by an adult who knows the moves.
• Short breaks from sitting through the day.

Sources 1, 2

For everyone

Leave out the roll-over, jack knife, control balance, boomerang, crab and neck pull, as our Pilates for kids guide does, and the high scissors and high bicycle. Roll back only to your shoulder blades in rolling like a ball, on a soft mat.

Source 16

Back pain that's worse arching

Skip the swan, swimming, rocking and kicks, and do the bird dog instead. If the pain lasts more than a couple of weeks, get it checked.

Source 15

Bendy joints

Stop reaches before the end of your range in the saw, spine stretch and mermaid, and keep your elbows and knees soft.

Sore wrists

Use fists or your forearms in planks and leg pulls; the forearm plank keeps weight off bent-back wrists.

Knee pain below the kneecap

Pad kneeling moves or half-kneel on the other knee, as our Osgood-Schlatter guide suggests.

Chest pain or fainting while exercising: call 999

Call 999 if:

• You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
• The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
• You have chest pain and feel sweaty, sick, light-headed or short of breath.
• Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.

Sources 60, 61, 62

Back pain with these signs: call 999

Back pain with numbness around the genitals or bottom, new trouble peeing or controlling the bladder or bowels, or weakness or numbness in both legs. These can be signs of cauda equina syndrome, which needs treating in hospital urgently.

Source 63

An urgent GP appointment or NHS 111 the same day

Sudden pain in the hip, thigh or knee, a limp, or not putting any weight on 1 leg: an urgent GP appointment or NHS 111 the same day. Hip problems can sometimes be felt in the thigh or knee.

Source 64

Back pain: see a GP

• A teenager in a sport that arches or twists the back, such as gymnastics, dance, diving, volleyball, cricket fast bowling, baseball pitching, weightlifting, football or rugby, with back pain that lasts more than a couple of weeks, is worse arching back or stops them training: get it checked by a GP or sports physiotherapist. It can be a stress fracture in the spine.
• See a GP if your child is under 6 and has back pain, or if back pain lasts more than 4 weeks, stops them doing things, is getting worse or disturbs their sleep, or comes with weight loss, night sweats, a change in the shape of their spine, stiffness or difficulty moving, or pins and needles, weakness or numbness. This is the advice of the NHS children's physiotherapy services in Gwent (Aneurin Bevan University Health Board) and in York and Scarborough. A high temperature or feeling unwell needs help the same day, and bladder or bowel changes, numbness around the genitals or bottom, or symptoms in both legs need 999 (see above).
• A teenager's upper back that looks rounded and stays rounded when they stand up straight or lie flat, especially if it looks sharp or angled when they bend forward: see a GP. A growing teenager's curve may need X-rays and a specialist, and a brace only works before growth ends.
• Back pain and stiffness that persists in a teenager or young adult. Ankylosing spondylitis tends to start at that age and can affect the whole spine.

Sources 38, 39, 15, 37

If you need help now

If you are thinking about suicide or can't keep yourself safe, call 999 or go to A&E. For urgent help, call Samaritans free on 116 123, any time, or in England call 111 and select the mental health option. In the US, call or text 988.

Call Samaritans free on 116 123, any time, day or night (UK and Ireland). If you're under 19, you can also call Childline on 0800 1111.

Source 65

Low mood that won't lift

The NHS says: "If you think your child is depressed, or you're concerned about their general wellbeing, make an appointment with them to see a GP." The charity YoungMinds runs a free parents' helpline on 0808 802 5544, Monday to Friday, 9.30am to 4pm.

Source 66

Eating and exercise

Exercising compulsively, or to control your weight or make up for eating, can be a sign of an eating disorder. Our exercise and eating disorders guide explains the signs and where to get help.

The NHS lists signs such as spending a lot of time worrying about your weight and body shape, exercising too much, and having very strict habits or routines around food. If that sounds like you, see a GP as soon as you can. You can also talk in confidence to the eating disorder charity Beat: 0808 801 0677 (England), 0808 801 0432 (Scotland), 0808 801 0433 (Wales) or 0808 801 0434 (Northern Ireland), 3pm to 8pm, Monday to Friday.

Sources 58, 67

Periods and training

Training hard on too little food harms health and performance in girls and boys: this is called relative energy deficiency in sport (REDs). See a GP if you miss 3 periods in a row, your periods haven't started by 15, or you keep getting injured or feel exhausted.

Sources 68, 67

Stop the session if

You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.

Source 69

"Teenagers shouldn't do strength training: it stunts growth"Strong evidence

No prospective study of supervised training has found growth-plate injuries, and training didn't affect height. It makes young people stronger.

Sources 4, 5, 22

"Pilates is all the exercise a teenager needs"Strong evidence

Teenagers need an average of an hour a day of activity that gets them out of breath, with impact for bones. Pilates is one part.

Sources 1, 18

"Pilates fixes bad posture"Mixed evidence

Short school programmes kept the upper back from rounding in a few small trials from one group, but another trial found no change. Small differences in posture are normal and rarely cause pain.

Sources 6, 7, 9

"School bags cause back pain"Emerging evidence

A review of 69 studies found no convincing evidence that they do.

Source 14

"Teenagers lose flexibility when they grow"Emerging evidence

In high school students, growing wasn't linked to losing flexibility.

Source 48

"There's a minimum age for reformer Pilates"Mixed evidence

No guideline sets one. What matters is whether the equipment fits and how closely the teacher supervises.

Source 16

"Pilates is just for girls"Emerging evidence

Trials included teenage boys in school PE, football and baseball.

Sources 8, 30, 31

"Gentle exercise is best for anxiety"Emerging evidence

In young people, moderate and harder exercise eased anxiety, while low-intensity programmes didn't clearly help.

Sources 11, 10