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Pilates

Up-in-stages Pilates for low blood pressure: a 25-minute class that wakes your legs before you stand

A 25-minute class for low blood pressure or light-headedness when you stand up. You get down to the floor once and up once: all the lying, side-lying and all-fours work is in one block, then you come up in stages, wake your legs up on a chair, and stand at a counter with your legs working. Your head stays level with or above your heart throughout. In small studies done outside Pilates, moving and tensing the legs before and while standing reduced the drop in blood pressure; no trial has tested Pilates for low blood pressure, so the order is our editorial choice. If you keep getting dizzy or fainting, see a GP as well.

25 minBeginner17 movesA bench or box · A wallAbs · Hip flexors · Calves · Quads · Glutes · Hip abductors
Follow along: a timer, a cue and the next move, one step at a time.

On a chair (about 3 minutes)

  1. Lateral breathing (Pilates breathing)5 breaths
    Beginner · Abs · 3D demoSitting tall; make the breaths smaller if you feel light-headedHarder: Roll-up (Pilates)
  2. Seated march1 min
    Beginner · Hip flexors, Quads, Abs · 3D demoHold the sides of the seatHarder: Standing march
  3. Seated bent-knee calf raise (soleus raise)15
    Beginner · Calves · 3D demoLift both heels high, then lower slowlyHarder: Slow calf raise

Down to the mat (about 1 minute)

  1. Get up and down from the floor1 slow cycle, ending on the floor
    Beginner · Quads, Glutes, Abs · 3D demoUse the chair: one knee, then both, then sit to the side. If you can't or shouldn't get down, do the next two blocks on a bedEasier: Sit to stand from a chairHarder: Bodyweight get-up

On your back, legs working (about 7 minutes)

  1. Ankle circles10 pumps, then 5 circles each way, each foot
    Beginner · Calves, Shins · 3D demoPoint and pull your toes: your calf muscles help pump blood back upHarder: Ankle CARs (controlled articular rotations)
  2. Supine heel slide8 each side
    Beginner · Hip flexors, Hamstrings, Quads · 3D demoSlide the heel away and backHarder: Hip windshield wipers
  3. Knee fold6 each side
    Beginner · Abs, Hip flexors · 3D demoSlow and rhythmicEasier: Supine heel slideHarder: Dead bug heel taps
  4. Pelvic tilt into bridge8 slow
    Beginner · Glutes, Abs, Hamstrings · 3D demoBreathe out as you lift; your head stays downHarder: Glute bridge
  5. Single-leg circle (Pilates one leg circle)5 circles each direction, each leg
    Beginner · Abs, Hip flexors, Adductors · 3D demoSmall circlesHarder: Corkscrew (Pilates)
  6. Dead bug heel taps6 each side
    Beginner · Abs, Hip flexors · 3D demoOne heel at a time; your back stays stillEasier: Bent-knee fall-outHarder: Forearm plank

On your side and on all fours (about 5 minutes)

  1. Clamshell10 each side
    Beginner · Hip abductors, Glutes · 3D demoAnkles together, hips stillEasier: Supine isometric hip abduction (belt press)Harder: Lateral band walk
  2. Side kick (Pilates side kick series)8 each side
    Beginner · Hip flexors, Glutes, Hip abductors · 3D demoHead resting on your armHarder: Side-lying leg circles (Pilates side kick series)
  3. Bird dog5 each side
    Beginner · Back, Abs, Glutes · 3D demoFists if your wrists hurtEasier: Bird dog, one limb at a timeHarder: Bear crawl

Up in stages (about 2 minutes)

  1. Get up and down from the floor1 slow cycle, ending standing
    Beginner · Quads, Glutes, Abs · 3D demoFrom all fours, put one foot forward and push up with the chair, then sit straight down on it for a minuteEasier: Sit to stand from a chairHarder: Bodyweight get-up
  2. Seated bent-knee calf raise (soleus raise)15
    Beginner · Calves · 3D demoPump your legs before you standHarder: Slow calf raise

Standing at a counter, legs working (about 5 minutes)

  1. Sit to stand, pushing on the thighs5 slow
    Beginner · Quads, Glutes, Triceps · 3D demoSqueeze your thighs and buttocks as you rise; pause with your hands on the counterHarder: Bodyweight squat
  2. Slow calf raise2 sets of 10
    Beginner · Calves · 3D demoHold the counterEasier: Seated bent-knee calf raise (soleus raise)Harder: Standing dumbbell calf raise
  3. Wall side leg lift (standing side kick at the wall)8 each side
    Beginner · Hip abductors, Glutes, Abs · 3D demoA hand on the counterHarder: Lateral band walk, band at the feet
  4. Standing march1 min
    Beginner · Hip flexors, Abs, Glutes · 3D demoKeep moving rather than standing still. Before you sit, cross your legs and squeeze for a few breaths to practise the counter-manoeuvreEasier: Seated marchHarder: Standing band hip flexion

Seated finish (about 2 minutes)

  1. Lateral breathing (Pilates breathing)5 breaths
    Beginner · Abs · 3D demoSitting. Before you get up, march your feet and squeeze your legsHarder: Roll-up (Pilates)

Tips

  • Drink a glass of water before the class, and don't do it straight after a big meal (our suggestion, from the NHS's advice to drink more water and eat small, frequent meals). With a heart condition or a daily fluid limit, check with your doctor before drinking more.
  • If you feel faint, stop, lie down and raise your legs. Use the counter-manoeuvres if you can't lie down.
  • Practise the counter-manoeuvre once in each class while you feel well, so it comes quickly when you need it: cross one leg in front of the other while standing, then tense your leg muscles and clench your buttock and tummy muscles.
  • 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.
  • Keep the room cool, and skip hot classes while you get symptoms (our suggestion).
  • Mornings and after meals are the worst times for many people; choose a time of day when you feel steadiest (our suggestion).
  • If you keep getting dizzy or fainting, or it started with a new or changed medicine, see a GP: the warning signs are on our Pilates for low blood pressure guide.

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 up-in-stages pilates for low blood pressure: a 25-minute class that wakes your legs before you stand take?

About 25 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. 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. 7 of its 17 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.