Pilates: are you wasting your money?

Athlete, Back, Back pain, Fitness, Health, Low Back Pain, Physio, Physiotherapy, Pilates, Sports, Wellbeing, Yoga

It’s Saturday morning.  As the scent of caffeine fills your nostrils and drags you from your bed to your nearest cafe in a zombified state, your senses are enlightened. Fluorescent free runs, tantalisingly tight tights and Lululemon logos fill your eyes, but what on earth are these people cueing up for?  The answer, Pilates.

Used by physiotherapists, dancers, gyms and the obvious, Pilates studios, the popularity of Pilates has reached pandemic proportions. So is Pilates just overpriced weight training for the young and trendy, or is it the panacea its proponents claim it to be?

Pilates for back pain:

Many (including health professionals) believe that Pilates and core strengthening are the only solution to crippling low back pain.  If this is you, it might be time to rethink this mantra.

Three great quality studies tell us that Pilates is better than rest in the short term, but is no more effective than normal gym based strengthening exercises at any time (1, 2, 3). Several other poorer quality studies have found general slight positive effects on back pain, but conclusive evidence is lacking (4, 5, 6). While two other studies have demonstrated that Pilates is better than nothing and also better than massage therapy (7, 8).

So what does this tell us?  Simply put, Pilates is probably better than massage or doing nothing, but no better than performing normal strengthening exercises in the gym.

Pilates for health, wellbeing, fitness: 

While Pilates may not be the most money efficient solution to your back problem, surely it’s worth it for the fitness benefits?

Sadly, no! Yes, Pilates improves body composition, specifically improvements in: balance, skin fold testing (fat:muscle measurement), lean muscle mass, body fat mass and flexibility have been reported (9, 10, 11). However, such improvements have been reported multiple times with traditional resistance training.  So this again indicates that yes, Pilates works, but it is really no better than going to your local gym.

Is it healthful:

Back pain: Clinical Pilates costs roughly AU$40 per class, which is AU$4160 per year if you go twice a week.  A gym membership costs AU$600-900 per year offering similar effects. Do the math.

Our rating: Moderately healthful, but no better than the gym.

Fitness, health, wellbeing: Fitness Pilates costs AU$20 per class, or roughly $2000 a year, whereas a gym membership costs between AU$600-900, offering similar benefits.  Again, the math, do it.

Our rating: Moderately healthful, but no better than the gym.

I hope this has been healthful.

27 thoughts on “Pilates: are you wasting your money?”

  2. I have never tried Pilates, but have done Callanetics off and on for years. Supposedly it was designed by a woman who suffered from chronic back pain and I know it relieves my sciatica, when I can do the exercises. Do you know if anyone has compared the effectiveness between these two programs for pain?

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    1. Hi Foguth,

      Thanks so much for the comment. There have been no scientific studies conducted on Callanetics to date.

      As a clinician, I would suspect it’s probably as effective as Pilates or resistance training for low back pain – moderately effective. Like Callanetics, Pilates was based devised by it’s founder to heal various injuries including low back pain.

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  3. I love Pilates and plan on doing it as long as I can. I have never seen more fit elderly people in my life than in my Pilates classes. Some of my fellow students are in their 70s and look like gymnasts. I played competitive women’s tennis for 10 years and the women with the best abdominals and core strength, by far, were the women who did Pilates as well. I could kick myself for not having started earlier because I have never felt stronger, in all areas then since I started practicing Pilates. I also do yoga but have not noticed that the yoga has the same effect as Pilates unless I do several hours a day, ( like I’ve done on retreats) which I do not have time for. Pilates is 50 minutes and highly effective. I also have not experienced any joint aches or pains since I started Pilates. I signed up for a six-month program in which I pay approximately $16 per class. I have excellent instructors I enjoy the company of my fellow students the class dynamics. I have done weight training, biking, yoga and competitive tennis and can say, without a doubt, that Pilates gives you the best value for your time and money. Yoga is my spiritual practice, my happy place, my place to find peace, and also keeps me very limber and strong but Pilates is my preferred exercise these days. Have you tried Pilates ?

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    1. Hi Myriam,

      Thanks for the comment. Yes, I’m a practicing physiotherapist and exercise scientist, so I teach and and have practiced Pilates extensively.

      I don’t disagree with you in saying that Pilates is an effective form of exercise. However, I can unequivocally say it is no more effective than gym based exercises. Multiple studies on thousands of people, have found it to be no better than gym based exercises. Statistically this holds much more strength than the opinion of one person. For example, you wouldn’t see a cardiac surgeon perform a triple bypass on a patient just because his/her aunty had one and thought it helped. If there was enough scientific data to support an intervention, then the surgeon would absolutely go ahead with the operation.

      The Pilates equipment works the same way as gym equipment – you’re pushing against resistance. Therefore, anything you perform on Pilates equipment you can perform on gym equipment.

      As for price, a gym membership with unlimited group classes per week is likely $16 – that’s a whole week as opposed to one class. Clinical Pilates costs much more.

      So, yes Pilates is great. But it’s scientifically proven to be no greater than gym based exercise.

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    1. Once again we may have to agree to disagree, I’m afraid Myriam.

      In regard to injury risk, I would say the two modalities have an equivalent injury risk. Take for example, exercises like: hundreds +/- crunch/oblique crunch, teaser, roll-ups. All these exercises, place a large flexion (forward bending) load on the lower back and if prescribed to the wrong individual, or too early on in a Pilates program pose a great risk of back injury. No different to many gym exercises.

      Yes, Pilates probably has a greater focus on ab based exercises. But there is no reason why such exercises couldn’t be completed in a gym program. Ultimately it comes down to the skill of your instructor, not the exercise modality.

      The biography you have referenced is not a scientific study, it’s the biography of Joseph Pilates and his experiences with Pilates. As he is essentially the foundation on which Pilates is built, that biography holds no more merit than testimonials produced by any company. It’s a nice story, but nothing more. It is merely the experience of one person, rather than a scientific study comparing the experiences of multiple persons under controlled, unbiased conditions.

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  5. Your article is limited in that you only concentrate on back pain. People attend Pilates classes for a whole host of other reasons, and getting people out and socialising has surely got to be better than going to the gym on your own? I have been to Pilates, and as a Chiropractor I also recommend people go to Pilates. As a professional I feel that I am in a position to recommend care, tailored to the individual. Some people need muscle relaxation as in massage, some people need realigning (that’s my job) and some people need strengthening, but only once they are in alignment. Hope this helps someone.

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    3. Regarding the social benefits of Pilates, I couldn’t agree more. But you could also attend group exercise classes at the gym, meaning Pilates doesn’t confer any benefit in that respect.

      Yes, I agree with you in that healthcare needs to be tailored and that’s were the current state of scientific literature is limited. However, if we were to take a large sample of the population we can still determine the interventions that are most likely to be effective.

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  8. Hmmm as a STOTT Certified Pilates Instructor for 8 years, I’m disappointed in this post. This a is a bold statement to make without the writer’s own knowledge of the Pilates method as it compares apples to oranges. Pilates is not simply a weight loss program or a back soother. It works to restore balance and control to the body in a sophisticated practice. The method is closer to yoga than to a gym membership or a massage. When taught properly by a reputable and certified Instructor, Pilates is a practice by which the client evolves over time both in the studio as well as how they carry themselves in their daily life. You can’t do a simple skin fold test or step on a scale to evaluate the efficacy of Pilates. Please be respectful to the practice and research it properly before posting such a premature and biased review.

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    1. Hi J9,

      I’m a physiotherapist with a doctoral degree and an exercise scientist with clinical and research experience. I teach Pilates, treat using Pilates exercise, have conducted research on Pilates and have attended various Pilates courses: DMA and APPI (Australian courses). So I’m more than qualified to write on the topic.

      I am aware that Pilates aims to teach body awareness and this is proposed to transfer over to everyday life. However, the research (there is now a fair bit of it) to date has time and time again demonstrated that Pilates and achieving this so called balance has no more of an effect than traditional resistance training on clinically meaningful measures of quality of life, disability and pain. Not meaningless and biased outcomes like skin folds . Furthermore, Pilates doesn’t appear anymore effective than resistance training on other measures of general health. So even if someone is feeling “more balanced” following Pilates, you would think this would translate to some sort of greater improvement than resistance training.

      The studies I have referenced were conducted by some of the best physiotherapists in the world and some for a long duration. Meaning they reflect the results one would expect to see in a class with a top Pilates instructor.

      All in all, I’m not saying Pilates is bad. It’s great, it’s as good as resistance training, but there is no evidence to suggest it is better than resistance training. This research is unbiased and by no means premature. If you can find a quality study that says anything but this, please bring it to my attention. I’m happy to change my opinion.

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  9. Since I write about topics some consider controversial it is nice to see someone else attempting to educate the public using scientific data rather than anecdotal evidence. I never expected to see comments that took your article so personally. Sometimes people need to take a step backward and re-read a posting curbing the emotional reaction and applying a logical rebuttal instead. I did not read this article as an attack on Pilates. I read it as an article determining whether Pilates was superior in measurable outcome to other forms of exercise. As a chiropractic physician, I would be arrogant to believe that chiropractic adjustments are the cure all in every case. Healing is best achieved combining various components and obtaining patient compliance with activities performed outside my office. Since finances need to be considered, I believe you proved the two main forms of exercise discussed had similar outcomes with a significantly reduced expense utilizing a gym membership over a Pilates membership. Those that can afford Pilates and comply with the recommended frequency should go down this path. Those looking to spend less, but also willing to comply with the recommended frequency should join the gym. I thought the article was well laid out and defended quite well.

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  10. Pilate is a form of exercise. We exercise at the gym. Just like every other exercises. It’s got it’s pros and cons.
    Personally. I do it all. I love Pilate. I love strength condition. Anything to get me active. And all I can say is. They all work together. Pilate has really helped my core strength overall.
    If it’s really worth it? That’s a matter of opinion. And everyone is entitle to his/her opinion. I respect urs. Doesn’t mean I have to agree.

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    1. Yep, I absolutely agree, Bello. Both are exercise. Scientific evidence says both are effective. Pilates is generally more expensive, but if a person’s preference is to do Pilates then good for them, the extra spending is probably warranted for them.

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      1. Let just say. I’ve never had to pay for Pilate before. It’s part of my gym membership subscription and opportunity to attend 2ce weekly so it has helped me. Maybe that’s why I’m so naive of the cost comparison. Lol. But yah!!! I won’t push my luck just so my gym doesn’t end the weekly sessions.
        And pls. Don’t tell them. Lol.

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  11. SO helpful, thank you. I have terrible lower back problems that have been completely stopping me from exercising. So I started going to pilates classes to strengthen my core and ‘cure’ my back problems, except the pilates made my back hurt so much that I’m back to doing nothing for a few days. Now I may have to rethink the pilates thing altogether. Thank you for the great information.

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    1. That’s a pleasure, Esther. I wouldn’t stop exercise all together, particularly if your back pain has been there for a while (>3-6 months). Trying an alternative form of non painful exercise, like lower limb strengthening exercises may be a viable option.

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