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Pilates

Steady-breathing Pilates for heart conditions: a 40-minute class with a long warm-up and a seated cool-down

A Pilates class for people with a heart condition, for after your cardiac rehab assessment or once your cardiac team agrees: a 15-minute warm-up that builds gradually, standing strength, a short block of head-level mat work, and a 10-minute cool-down sitting up. Keep breathing throughout and keep every effort at a level where you can talk. It adds strength and flexibility to your rehab and your walking or cycling; it never replaces them.

40 minBeginner22 movesA bench or box · A wall · A band · An anchor pointHip flexors · Shoulders · Abs · Glutes · Calves · Quads
Follow along: a timer, a cue and the next move, one step at a time.

Warm up, about 15 minutes

  1. Seated march3 min
    Beginner · Hip flexors, Quads, Abs · 3D demoEasy, sitting tall; you should be able to chatHarder: Standing march
  2. Shoulder rolls10 each way
    Beginner · Shoulders, Back, Neck · 3D demoElbows by your sidesHarder: Shoulder CARs (controlled articular rotations)
  3. Lateral breathing (Pilates breathing)5 breaths
    Beginner · Abs · 3D demoSitting; breathe into the sides of your ribsHarder: Roll-up (Pilates)
  4. Breath reach5 breaths
    Beginner · 3D demoOut-breath longer than the in-breath; in the first 6 weeks after a device, keep that elbow below shoulder heightHarder: Slow breathing (6 breaths a minute)
  5. Thoracic rotation5 each side
    Beginner · 3D demoSeated, arms crossed; small after breastbone surgeryEasier: Side-lying open bookHarder: World's greatest stretch
  6. Standing hip CARs2 slow circles each leg
    Beginner · Glutes, Hip flexors, Hip abductors · 3D demoHold the wall or a counterEasier: Hip circles on all foursHarder: 90/90 hip lift-off
  7. Standing march2 min
    Beginner · Hip flexors, Abs, Glutes · 3D demoA little briskerEasier: Seated marchHarder: Standing band hip flexion
  8. Wall calf stretch (gastrocnemius)15 s each side
    Beginner · Calves · 3D demoKeep breathingEasier: Seated calf stretch with a towelHarder: Heel-on-step calf and hamstring stretch
  9. Standing march4 min
    Beginner · Hip flexors, Abs, Glutes · 3D demoBuild to breathing a little harder but talking easilyEasier: Seated marchHarder: Standing band hip flexion

Standing strength

  1. Sit to stand from a chair2 sets of 8 to 10
    Beginner · Quads, Glutes, Hamstrings · 3D demoBreathe out as you stand; after breastbone surgery, push on your thighs to stand, 5 to 8 timesEasier: Sit to stand, pushing on the thighsHarder: Bodyweight squat
  2. Wall side leg lift (standing side kick at the wall)10 each side
    Beginner · Hip abductors, Glutes, Abs · 3D demoA hand on the wallHarder: Lateral band walk, band at the feet
  3. Slow calf raise10 to 15 slow
    Beginner · Calves · 3D demoHold a chair backEasier: Seated bent-knee calf raise (soleus raise)Harder: Standing dumbbell calf raise
  4. Wall push-up8 to 10
    Beginner · Chest, Triceps, Shoulders · 3D demoBreathe out as you push; after heart surgery or a new device, march on the spot instead until your team says arm work is fineHarder: Push-up
  5. Band row8 to 10
    Beginner · Back, Biceps, Shoulders · 3D demoA light band; the same swap after surgery or a new deviceHarder: Supported single-arm dumbbell row

Mat, head level

  1. Pelvic tilt into bridge8 slow
    Beginner · Glutes, Abs, Hamstrings · 3D demoGet down slowly using the chair; after breastbone surgery, repeat the standing block instead until your team agreesHarder: Glute bridge
  2. Knee fold5 each side
    Beginner · Abs, Hip flexors · 3D demoHead down, pelvis stillEasier: Supine heel slideHarder: Dead bug heel taps
  3. Single-leg circle (Pilates one leg circle)5 circles each direction, each leg
    Beginner · Abs, Hip flexors, Adductors · 3D demoBottom knee bent, small circlesHarder: Corkscrew (Pilates)
  4. Side kick (Pilates side kick series)8 each side
    Beginner · Hip flexors, Glutes, Hip abductors · 3D demoHead resting on your lower armHarder: Side-lying leg circles (Pilates side kick series)
  5. Clamshell10 each side
    Beginner · Hip abductors, Glutes · 3D demoThen roll to your side and sit for a few breaths before you get upEasier: Supine isometric hip abduction (belt press)Harder: Lateral band walk

Sit and cool down, about 10 minutes

  1. Seated march3 min
    Beginner · Hip flexors, Quads, Abs · 3D demoGradually slowerHarder: Standing march
  2. Cat-cow6 slow rounds
    Beginner · Back, Abs · 3D demoSeated, hands on your knees, head levelHarder: Half lord of the fishes (Ardha Matsyendrasana)
  3. Seated upper-back lift (sit tall, shoulders back)5 holds of 3 to 5 s
    Beginner · Back, Shoulders, Neck · 3D demoKeep breathingEasier: Elbows backHarder: Prone Y-T-W raises
  4. Mermaid (Pilates seated side bend)3 each direction, each side
    Beginner · Back, Abs, Shoulders · 3D demoOn a chair; on the device side, reach out to the side, not overheadHarder: Side bend (Pilates)
  5. Slow breathing (6 breaths a minute)5 min
    Beginner · 3D demoSitting, about 4 in and 6 out, no holdsEasier: Breath reachHarder: Crocodile breathing (prone diaphragmatic breathing)

Tips

  • Do this class after your cardiac rehab assessment, or once your team agrees. Keep walking or cycling on most days: Pilates is an extra, not your cardio.
  • Rate your effort while you exercise: you should be able to talk. On a beta blocker, go by how it feels, not your heart rate.
  • Never hold your breath. Breathe out on each effort, and come out of any position after a few breaths.
  • Don't lie down straight after the standing work, and stand up slowly after the mat.
  • After bypass or valve surgery, keep your upper arms close when you push or lift, and don't put weight through your arms until your team says so. After a pacemaker or ICD (implanted defibrillator), keep that elbow below shoulder height for the first 4 to 6 weeks.
  • With heart failure, skip the class on a day you feel more tired or breathless than normal, and weigh yourself first.
  • Carry your GTN (glyceryl trinitrate) if you have angina. Stop for chest pain, dizziness or palpitations; call 999 if chest pain doesn't settle with rest and your GTN.

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.

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Questions people ask

How long does the steady-breathing pilates for heart conditions: a 40-minute class with a long warm-up and a seated cool-down take?

About 40 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?

You need: A bench or box, A wall, A band, An anchor point. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 10 of its 22 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.