Clinical Pilates: Does it Actually Work?

Clinical Pilates is a form of physical exercise that is focused particularly on an individual’s balance, posture, proximal stability, strength, flexibility and breath control. It is becoming more commonly employed by Physiotherapists in the management of injuries, chronic conditions and post-operative rehabilitation. Most commonly, Clinical Pilates involves exercises on the mat, the ball, the use of the Trapeze table or the Reformer.

Clinical Pilates targets the strengthening of your deep spinals muscles, hip and pelvic musculature including the deep layer of abdominal muscles and pelvic floor muscles.  It helps the body to restore normal movement patterns and normal timing of muscle activation.  This improves the control and efficiency of the body.

Clinical Pilates (differing from generic Pilates and Pilates classes) is a tailored exercise program according to the needs and goals of each individual client. Your Physiotherapist identifies this key issue by applying carefully selected exercises to patients with specific injuries based on a complete Physiotherapy treatment. This ensures that clients achieve outcomes and long-term health goals.

Some of the key benefits of Clinical Pilates have been identified in the literature as;

  • Improved posture
  • Improved core stability
  • Improved tone of the abdominal muscles and pelvic floor
  • Improved balance, flexibility and strength
  • Increased muscle coordination
  • Prevention of lower back and neck pain

There are varying levels of research available to support the use of Clinical Pilates to achieve the key benefits outlined above. I have included just a few of the studies to give you an idea of what is being repeatedly identified and supported in the literature.

There are a number of studies that have found in the presence of back pain and neck pain, there is associated muscular weakness and dysfunction of the core muscles and stabilising muscles. Pilates has been found to retrain these stabilization muscles for the lower back and neck, thereby reducing the compressive loads of the pain sensitive structures, and normalising muscle control around these structures thereby reducing pain in the lower back, neck, reducing the frequency of headaches and improving posture (Gladwell 2006, Horvath 2005, Moffett & McLean, 2006, Segal et. al., 2004).

Balance, proprioception and flexibility are key areas that have also been shown to improve with the engagement of Pilates. Each of these key areas may be inhibited in the presence of pain, leading to increased healing time and the development of compensatory movement patterns. In a number of studies, these key areas of balance, proprioception and flexibility were found to be improved in participants who undertook Pilates in comparison to those who participated in other forms of rehabilitation, or received no intervention (Segal et. al., 2004, Bryan & Hawson, 2003).

It is widely acknowledged that there are large number of key research based benefits of Clinical Pilates relevant to any age and every physical ability. Clinical Pilates is an excellent form of rehabilitation for many conditions of the spine and limbs and should be something you can consider when seeing your Physiotherapist.

For more information, please speak with your treating Physiotherapist today.


Sophie Halsall-McLennan


Fresh Start Physiotherapy



Bryan, M & Hawson, S (2003). The benefits of Pilates exercise in orthopaedic rehabilitation. Techniques in Orthopaedics, 18(1), 126-129. Gladwell, V., Head, S., Haggar, M., &

Gladwell, V., Head, S., Haggar, M., & Beneke, R. (2006). Does a program of Pilates improve chronic non-specific low back pain? Journal of Sport Rehabilitation, 15, 338-350.

Moffett, J., & McLean, S. (2006). The role of physiotherapy in the management of nonspecific back pain and neck pain. Rheumatology, 45, 371-378.

Segal, N.A., Hein, J., & Basford, J.R. (2004). The effects of Pilates training on flexibility and body composition: An observational study. Archives of Physical Medical Rehabilitation, 85, 1977-1981.

About The Author

Sophie Halsall-McLennan is the owner of Fresh Start Physiotherapy and has a special interest in Hand Therapy and Shoulder Rehabilitation.  She has a Bachelor of Physiotherapy from Charles Sturt University, over 13 years of clinical experience as a Physiotherapist and is registered with AHPRA. She is also a lecturer at Deakin University.

The Benefits Of Clinical Pilates

As Physiotherapists, we often get asked what the difference is between Clinical Pilates classes and gym run classes. Although both versions use machines called reformers, that is where the similarities end.

Firstly…what actually is Pilates?

Pilates is a form of exercise targeted at improving your core strength, balance and stability. It focuses on building strength in your deeper layer of abdominal muscles, your deep supportive spinal muscles and your hip/pelvic musculature. The idea being that building a strong core foundation will allow your body to function at a higher capacity, improve your posture and reduce the incidence of lower back pain.

Clinical vs Gym/studio Pilates

The first major difference is that Clinical Pilates reformer classes are run by fully qualified Physiotherapists, not Pilates Instructors. This means that not only does your Instructor have 4 years of university training in anatomy, physiology and injury management, they are also trained in what is known as “clinical reasoning”. This means that they are fully qualified and highly trained to assess you and establish which particular type of exercise is suitable for your injury or condition, whether that be lower back pain, shoulder pain, a medical illness or pregnancy. Your Physiotherapist will also be able to modify your exercise program to account for flare ups or changes in your injury on a particular day or week. Hence, your Clinical Pilates program is specifically tailored to meet your needs.

The second major difference is the class size. Clinical Pilates classes are usually kept to a maximum of 3 or 4 people per group, ensuring that you receive adequate supervision and attention, in order to monitor technique and prevent injury. Gym classes often have 10-12 people in a class, sometimes up to 20! It is impossible for the instructor to monitor technique and also modify exercises for the individual. When using any piece of exercise machinery whether it be a reformer or gym machine, correct technique is essential otherwise injuries can occur. It can be very difficult to monitor each person closely in bigger class sizes, which is why classes are kept small.

Why should I do Clinical Pilates if I don’t have an injury?

You don’t need to have an injury to attend Clinical Pilates classes, many people attend classes to keep fit and healthy, enjoying the personalised attention that a small class size allows. It gives them the peace of mind to know that they are performing the exercises correctly under qualified supervision. Clinical Pilates improves core strength, changes your body shape, assists with posture and alignment, and provides a safe way to tone the whole body.

There can be the misconception that Clinical Pilates won’t be as challenging as a gym based reformer class. However, this is not the case at all. Programs can be as challenging as the individual requires and are always modified and progressed over time as your body adapts. It all comes back to the small class sizes, and therefore having the ability to individualise programs.

Written by Sally Maple. (Modified by Sophie H-M)

Physiotherapist and Director of Port Melbourne Physiotherapy & Pilates