Pilates

Endometriosis-friendly Pilates: a 20-minute mat class with a flare-day stop point

This class follows the pelvic exercise programme Endometriosis UK publishes, which is made of Pilates-style moves. It starts by letting your tummy and pelvic floor soften with the breath, then adds gentle deep-tummy work at about a fifth of your full effort, small moves on your back, side and front, and stretches. There are no pelvic floor squeezes or hard core holds: with pelvic pain, the pelvic floor often needs to relax, not tighten. On a flare day, stop after the first block and go straight to the rest at the end. No trial has tested Pilates for endometriosis, and this class goes alongside your treatment, not instead of it.

20 minBeginner14 movesNo equipmentPelvic floor · Abs · Glutes · Hip abductors · Back · Shoulders

Follow along: a timer, a cue and the next move, one step at a time.

Breathe and let go

Slow breathing (6 breaths a minute)2 min
Beginner · 3D demoOn your back with knees bent and a pillow under them, or on your side; let your tummy rise on the in-breath without pushingEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)
Pelvic floor relaxation (reverse Kegel)5 breaths
Beginner · Pelvic floor · 3D demoOn each in-breath, let the pelvic floor soften and drop; never push down. Flare-day stop point: go straight to the rest at the end

Deep tummy, gently

Side-lying tummy draw-in5 holds of up to 10 s
Beginner · Abs · 3D demoDraw the lower tummy in at about a fifth of your full effort and keep breathing; if other muscles grip, relax and resetHarder: Bird dog, one limb at a time
Lateral breathing (Pilates breathing)5 breaths
Beginner · Abs · 3D demoHands on your lower ribs; breathe into the sidesHarder: Roll-up (Pilates)

On your back

Pelvic tilt into bridge8 slow
Beginner · Glutes, Abs, Hamstrings · 3D demoTilt your pelvis, then peel up a little at a time and roll down the same wayHarder: Glute bridge
Knee fold5 each side
Beginner · Abs, Hip flexors · 3D demoLift one foot just off the mat, tummy softEasier: Supine heel slideHarder: Dead bug heel taps
Hundred (Pilates)20 to 50 beats
Intermediate · Abs, Hip flexors, Shoulders · 3D demoHead down, knees bent with feet on the floor or in a tabletop; small arm pulsesEasier: Wall hundred (wall Pilates)Harder: Boomerang (Pilates)
Hip windshield wipers8 slow passes
Beginner · Glutes, Adductors · 3D demoKnees together, feet down; let the knees sway side to side within comfortEasier: Supine heel slideHarder: 90/90 switch

Side and front

Clamshell8 each side
Beginner · Hip abductors, Glutes · 3D demoLift the top knee only as far as your pelvis stays stillEasier: Supine isometric hip abduction (belt press)Harder: Lateral band walk
Swimming (Pilates)20 s
Intermediate · Back, Glutes, Shoulders · 3D demoLegs only, one at a time, arms relaxed, a pillow under your tummy; skip it if you're bloatedEasier: Mermaid (Pilates seated side bend)Harder: Leg pull back (Pilates leg pull up)

Stretch

Cat-cow6 slow waves
Beginner · Back, Abs · 3D demoMove with your breath, within comfortHarder: Half lord of the fishes (Ardha Matsyendrasana)
Child's Pose (Balasana)60 s
Beginner · Back, Shoulders, Glutes · 3D demoKnees wide to leave room for your tummyHarder: Extended puppy pose (Uttana Shishosana)
Reclined figure four (eye of the needle, Sucirandhrasana)30 s each side
Beginner · Glutes · 3D demoHold behind your thigh; never press on the kneeHarder: Pigeon preparation (Eka Pada Rajakapotasana prep)

Rest

Corpse pose (Savasana)3 min
Beginner · 3D demoOn your back or side, with pillows; let your jaw, shoulders, tummy and pelvic floor go

Tips

Two or three times a week, with a rest day in between, as Endometriosis UK suggests; walk, swim or cycle gently on other days if you can.
On a flare day, do the first block and the rest, or just breathe, with heat and your usual painkillers.
If a move brings on pelvic pain, leave it out. If you have pain with sex or trouble emptying your bladder or bowel, see a pelvic health physiotherapist: they can tell whether your pelvic floor needs relaxing, strengthening or both.
After surgery, wait until your team says core work is fine; full recovery after keyhole surgery to treat endometriosis can take 6 to 8 weeks.
Pelvic pain that is severe or getting worse, or comes with feeling faint, pain in the tip of your shoulder or heavy bleeding, needs 999 or A&E.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

Guides that recommend it

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Questions people ask

How long does the endometriosis-friendly pilates: a 20-minute mat class with a flare-day stop point take?

About 20 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

No equipment: your body and some floor space. A mat makes floor work more comfortable.

Is it suitable for beginners?

It is written for beginners. 6 of its 14 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.