The Pilates Method: History, Principles and Equipment

What Pilates is

Pilates is a method of exercise and physical movement designed to stretch, strengthen and balance the body, according to the Pilates Method Alliance, a US professional association for the field. [1] A systematic review of 119 research papers found the literature broadly agrees on a definition: a mind-body exercise that focuses on strength, core stability, flexibility, muscle control, posture and breathing, done on a mat or with specialized equipment. [2] This page covers history, principles and equipment. For the evidence on specific conditions, see Pilates for low back pain and Pilates for older adults. The broader overview is on the Pilates guide.

Where it came from

Joseph Hubertus Pilates was born in Mönchengladbach, Germany, in 1883. [3] In 1913 he went to England; when World War I began he was held with his circus troupe on the Isle of Man, where, according to the Pilates Method Alliance, he was one of several physical culturists who led the camp's daily exercise routines. [3] After the war he returned to Germany, and he and his wife Clara taught in a New York City studio after emigrating to the US in 1926. [1]

By the late 1930s, the Alliance says, New York dancers sought him out, and he became known for working with their injuries. [3] His book Return to Life Through Contrology appeared in 1945, and he died in 1967. [3] The Alliance also credits Clara Pilates with adapting the exercises for people who were more seriously ill or injured. [1]

Two cautions about this history. First, the account comes from a professional association that trains and certifies teachers, so treat it as a trade body's telling. Second, Joseph Pilates held large beliefs about what his method could do for society, including reducing the need for hospitals and prisons, and the same source says his efforts to win acceptance from the medical and educational systems were largely unsuccessful. [3] Those beliefs are part of the story, not evidence. In October 2000 a US court ruled that "Pilates" is a generic designation for a method of exercise and denied its use as a trademark. [3]

The principles and the equipment

Traditional Pilates teaching names six principles: centering, concentration, control, precision, flow and breathing. The systematic review above found they were mentioned in only about 23% of papers on average, and apart from breathing they were not mentioned in papers on people with low back pain. [2] That matters when you read a trial: "Pilates" in a study may be a physiotherapist's exercise program in Pilates style, not a class taught as Pilates originally was.

Classes are most commonly offered in three formats: group mat classes, group reformer classes, and private or small-group sessions on the full range of apparatus. [1] The apparatus includes the Reformer, Trapeze Table, Ladder Barrel, Wunda Chair and Spine Corrector. [1] The Alliance says the prototype of the Universal Reformer came from Pilates's own equipment designs. [3]

Mat or equipment? The only direct comparison we read is one small trial in 38 people with multiple sclerosis. Mat and reformer groups improved by similar amounts, though trunk-flexor strength rose more with the reformer. [4] Proper evidence not found for a systematic review comparing mat and equipment Pilates across conditions: we searched PubMed for "reformer Pilates randomized" and "Pilates equipment versus mat exercises" and found only single trials. So a reformer is not shown to be better, or worse, than a mat.

What research shows, at a glance

1. Low back pain

   Low to moderate

   Better than minimal care for pain and disability; no conclusive edge over other exercise [5]

2. Older adults, balance

   Low to moderate

   Meta-analyses favor Pilates over comparison groups [6][7]

3. Bone density in postmenopausal women

   Insufficient, trials few and weak

   No significant effect in the trials pooled [8]

4. Mat versus reformer

   Insufficient

   One small trial, similar benefit [4]

The first row rests on a Cochrane review, and the detail is on the back pain page. Movement trials cannot hide from participants which treatment they receive, so expectation can shape self-reported results.

Teachers and training

Teacher training is organized by professional associations. The Pilates Method Alliance describes itself as a not-for-profit professional association that supports third-party certification for teachers and teacher trainers. [11] Wikipedia's Pilates entry states that Pilates is not professionally regulated, without specifying a country, so ask locally. [12] A certificate shows what training someone completed, not how well they will adapt exercises to your body. For ideas on what to ask, see Tai Chi, Qigong and Pilates teacher qualifications. We do not list or rank teachers or studios.