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Strength & conditioning for Pilates

An evidence-based guide to the strength and conditioning that sits alongside a regular Pilates practice. Pilates builds qualities that genuinely matter: strength-endurance, trunk and hip control, mobility, body awareness and, on the reformer, the ability to work against spring resistance through a full range. Its loads are mostly light and its demand on the heart and lungs is modest, so a few qualities are left for the rest of your week: heavier strength, pulling and grip, bone-loading, and aerobic fitness. This covers what Pilates asks of the body, the strength work that complements it, how to fill the aerobic gap, how to stay injury-resilient, and how to programme it all around a Pilates week. Practical, honest, and grounded in exercise-science consensus.

Here's the short version: Pilates gives you strength-endurance, trunk and hip control, and mobility. The work that complements it adds heavier lower- and upper-body strength (pulling and grip included), bone-loading through heavier and, where suitable, impact exercise, and regular aerobic activity towards the weekly guideline. Pilates plus two heavier strength sessions and some brisk aerobic work covers almost every base the activity guidelines describe. Everything below is the detail behind that sentence.

On this page

  1. The demands of Pilates
  2. Key strength work, and why it matters
  3. Conditioning: building your aerobic fitness
  4. Staying injury-resilient
  5. Programming it around your Pilates week
  6. Where Strathlon fits
  7. Common questions
  8. Takeaways
  9. References

A framing note before the detail. Exercise science is well studied, but people differ enormously: age, training history, joint health, bone health, pregnancy and goals all change what's right for you. So this is written as can, tends to and is associated with, the language of likelihood, and every specific number is a population-level guide drawn from published research, with a numbered source. It's general education; medical or coaching advice and an individualised programme come from a qualified professional.

The demands of Pilates

Pilates is a system of controlled, low-impact exercises done either on a mat, using body weight and sometimes small props such as bands, balls or rings, or on a reformer, a sliding carriage on rails whose springs set the resistance. Both styles share the same core demands: slow, precise movement, sustained holds, coordinated breathing, and a constant emphasis on controlling the trunk and pelvis while the arms and legs move.

Muscularly, that makes Pilates a test of strength-endurance and control. The trunk muscles work almost continuously; the hip extensors, abductors and rotators control the pelvis through bridges, leg circles and side-lying work; and the muscles around the shoulder blades stabilise the upper body through planks, push-ups and arm work. On the reformer, the springs add adjustable resistance through the whole range of a movement, and lighter springs can make some exercises more demanding to control, because the moving carriage has to be steadied with less help.

What does that build? In a randomised trial of 50 active middle-aged adults, two 60-minute mat classes a week for 12 weeks improved abdominal endurance, hamstring flexibility and upper-body muscular endurance compared with a control group, while changes in posture and balance were too small to be statistically significant.[1] In adults aged 60 and over, a meta-analysis of 39 studies found moderate improvements in balance, strength, flexibility and everyday function, and a large effect on the risk of falls, with low-to-moderate certainty.[2] Together, that's an honest picture of what Pilates develops well.

The demand on the heart and lungs is modest. Scientists rate activities in METs (metabolic equivalents, multiples of the energy you use at rest), and the 2024 Compendium of Physical Activities classes 1.6–2.9 METs as light and 3.0–5.9 as moderate.[3] It lists mat Pilates at 1.8 METs and general Pilates at 2.8.[4] A laboratory study found that heart rate, blood lactate and blood pressure stayed close to resting values during both a reformer and a mat session, with any rise too small to be statistically significant,[5] and a 2026 meta-analysis put a typical session at around 3.0–3.7 METs.[6] The loads are mostly light too: body weight, small props or springs. That's ideal for endurance, control and range of motion, and it leaves room for heavier strength work elsewhere in the week.

Common misconception → correct it. "Pilates covers everything, so it's all I need." Pilates genuinely counts as muscle-strengthening activity: the NHS lists it among the muscle-strengthening activities that count towards its guideline of strengthening work on at least two days a week.[7] What it supplies in smaller doses is heavy loading, impact for bone and sustained aerobic work. Adding those makes your Pilates practice part of a complete week.

Key strength work, and why it matters

The aim of strength work alongside Pilates is to add the qualities that light loads develop more slowly: maximal strength in the big lower- and upper-body movements, pulling strength and grip, and bone-loading. A handful of movement patterns does almost all of it.

Movement pattern Examples What it adds to a Pilates practice
Squat Goblet squat, leg press, split squat Heavier loading through the quads and glutes than body weight or springs usually provide, for stairs, lifting and sport.
Hip hinge Romanian deadlift, deadlift, hip thrust Heavy work for the glutes and hamstrings, and one of the most useful bone-loading patterns in the gym.
Push Push-up progressions, dumbbell bench press, overhead press Upper-body pressing strength under heavier loads than planks and spring arm work.
Pull Rows, lat pulldown, assisted pull-up Back and arm strength that balances pressing, supports an upright posture, and trains grip.
Carry Farmer's carry, suitcase carry Grip, trunk and shoulder strength under load: a natural next step for the trunk control Pilates teaches.
Impact (where suitable) Small jumps, hops, step-downs Impact loading for bone, built up gradually and only where suitable (see the osteoporosis note below).

How heavy, and how often? The American College of Sports Medicine's position stand on resistance-training progression recommends that novices use loads they can lift for about 8–12 repetitions, with more experienced lifters working across a wider range that eventually emphasises heavier loads of around 1–6 repetitions.[8] ACSM's broader guidance is resistance exercise for each major muscle group on 2–3 days a week,[9] and the World Health Organization recommends muscle-strengthening activity involving all major muscle groups on two or more days a week for all adults.[10] Pilates can count towards that; one or two heavier sessions a week add what the springs and body weight supply less of. Beginners and older adults should start light, learn the movements well and add load gradually.

Two of those patterns deserve a closer look. Heavier loading builds bone. Bone responds best to high-magnitude loads applied quickly, which is why the LIFTMOR randomised trial tested exactly that in postmenopausal women with low bone mass: eight months of twice-weekly, closely supervised resistance and impact training, with five sets of five repetitions above 85% of each woman's one-repetition maximum. Lumbar-spine bone density rose by about 2.9% while a low-intensity home-exercise group lost about 1.2%, and only one minor adverse event was reported.[11] The UK consensus statement on exercise for osteoporosis likewise recommends resistance and impact exercise to maximise bone strength.[12] Pilates' light, low-impact loads give bone a gentler signal, which is exactly why heavier lifting earns its place beside it.

Pulling and grip are the other gap. Pilates includes plenty of pressing and holding positions, and reformer straps add some pulling against springs, but rows, pulldowns and carries can load the back, arms and hands far more heavily. Grip strength is worth having: in the PURE study of almost 140,000 adults in 17 countries, each 5 kg lower grip strength was associated with a 16% higher risk of death from any cause over a median of four years of follow-up.[13] That's an association, and whether training your grip extends life is still an open question, but a strong back and strong hands are useful in daily life either way.

A common worry among Pilates regulars is that lifting will make them stiff. The evidence is reassuring: a meta-analysis of 11 randomised trials found that strength training and stretching produced similar gains in range of motion.[14] Train through a full, controlled range, as Pilates has already taught you to, and the two practices support each other.

Conditioning: building your aerobic fitness

Pilates does train the heart and lungs a little. A 2019 meta-analysis found that Pilates programmes produced a moderate improvement in VO2max (a standard measure of aerobic fitness), with an effect size (a standardised measure of how big a change is) of about 0.57 compared with control groups, in studies of both healthy and clinical groups.[15] With typical sessions in the light-to-moderate range, though,[6] reaching the weekly aerobic guideline usually takes some other aerobic activity alongside a few Pilates classes a week.

That guideline, from the World Health Organization, is 150–300 minutes of moderate-intensity aerobic activity a week, or 75–150 minutes of vigorous activity, or an equivalent mix.[10] The NHS uses the same core numbers: at least 150 minutes of moderate or 75 minutes of vigorous activity a week, spread across the week.[7] Some practical ways to fill it:

  • Brisk walking. The simplest option: a moderate-pace walk sits at around 3.8 METs and a brisk walk at around 4.8.[4]
  • Cycling, swimming, rowing or the cross-trainer. Low-impact choices that suit people who come to Pilates for joint-friendly training.
  • Running or a faster-paced class, if you enjoy them. Vigorous minutes count for roughly twice as much under the guideline: 75 vigorous minutes do the job of 150 moderate ones.[10]
  • Brisker Pilates. Shorter rests push a session's energy cost up, from around 2.0 METs with long rests towards 3.4 with rests of 60 seconds or less.[6] Faster-flowing classes can move part of your Pilates time into the moderate band.

ACSM's guidance also includes neuromotor exercise (balance, agility and coordination) on 2–3 days a week and flexibility work on at least two days a week.[9] Pilates contributes naturally to both.

Do aerobic work and strength training get in each other's way? Less than people fear. An updated meta-analysis of 43 studies found that adding aerobic training to strength training left gains in muscle size and maximal strength intact, though gains in explosive strength were somewhat blunted, especially when both were done in the same session.[16] Pilates itself places little stress on the heart and lungs,[5] so it tends to slot around both comfortably.

Common misconception → correct it. "If I add running or cycling, I'll lose the strength I'm building." For muscle size and maximal strength, the pooled evidence shows aerobic training alongside strength work leaves those gains intact; the blunting is mainly in explosive strength, and mostly when both happen in the same session.[16] Separate a hard run from a heavy lift by a few hours or a day where you can, and enjoy both.

Staying injury-resilient

Pilates is low-impact and widely used in rehabilitation settings,[5] but a few areas deserve care, especially as classes become more advanced. For a painful or persistent problem, a physiotherapist or doctor is the right person to see.

  • Neck. Many mat exercises lift the head and shoulders off the mat and hold them there. If your neck tires or aches before your trunk does, rest your head between repetitions, support it with a hand, or choose the head-down version. Building trunk endurance gradually tends to take the load off the neck over time.
  • Lower back. Pilates has reasonable evidence for non-specific low back pain. A Cochrane review of 10 trials (510 participants) found low- to moderate-quality evidence that Pilates reduces pain and disability compared with minimal intervention, while how it measures up to other forms of exercise remains an open question; the authors suggest the choice can rest on personal preference and cost.[17] A larger Cochrane review of 249 trials found moderate-certainty evidence that exercise in general probably helps chronic low back pain.[18] So Pilates is a good option among several, and heavier strength work for the hips and trunk sits comfortably alongside it. If back pain is severe, getting worse or comes with other symptoms, see a doctor or physiotherapist first.
  • Osteoporosis and spinal flexion. Pilates includes a lot of forward curling of the spine. The UK consensus statement on exercise for osteoporosis recommends avoiding postures that involve a high degree of spinal flexion, alongside resistance and impact exercise for bone and spinal extension exercise for posture; it also advises that people with vertebral fractures or multiple low-trauma fractures usually limit impact to the equivalent of brisk walking.[12] If you have osteoporosis or a history of fragility fractures, tell your instructor, swap deep curling exercises for neutral-spine and extension-based alternatives, and get individual guidance.
  • Hypermobility. For very flexible people, the most useful work tends to be strength and control within the range they already have, with less emphasis on pushing into end range. Guidance for hypermobility-related conditions puts physiotherapy-led management at the centre, while noting the research base is still limited.[19]
  • Wrists. Planks, push-ups and kneeling work put body weight through the wrists. If they ache, try making fists, using push-up handles, folding the mat under the heel of the hand, or switching to forearm versions, and build up wrist-loading time gradually.
  • Pregnancy and after birth. The American College of Obstetricians and Gynecologists (ACOG) advises that activity in an uncomplicated pregnancy is safe and desirable, with long periods lying flat on your back best avoided after about 20 weeks; after birth, exercise can resume gradually once medically safe.[20] The NHS says to avoid lying flat on your back for long periods, particularly after 16 weeks, and to tell your class teacher you are pregnant.[21] Get individual clearance from your midwife, GP or obstetrician.

The connecting thread is progressive, controlled loading. Tissues adapt to the loads you gradually expose them to, so the way to build a resilient neck, back, hips, wrists and bones is to load them a little more over time, with good control, and to adapt each exercise to suit your body today.

Common misconception → correct it. "Pilates is the one exercise that fixes back pain." It's a well-supported option: Pilates helps pain and disability compared with minimal intervention, and exercise in general probably helps chronic low back pain.[17][18] The best programme for your back is the one you'll keep doing, and that can include Pilates, strength training, walking or a mix of all three.

Programming it around your Pilates week

Pilates runs year-round with practice sessions only, so if you practise two or three times a week, programming is refreshingly simple. A few principles:

  • Two heavier strength sessions a week. Full-body sessions built around a squat or hinge, a push, a pull and a carry cover the patterns above. Progress the load gradually, technique first.
  • Aerobic activity on most days. Brisk walks, rides or swims spread across the week work towards the 150-minute guideline.[10]
  • Pilates on almost any day. It places little stress on the heart and lungs,[5] so it fits around everything else. If a class leaves your trunk tired, do heavy squats or deadlifts first or on another day.
  • Busy weeks. When time is short, strength holds up well on very little: a narrative review found that strength and muscle size can be maintained for up to 32 weeks with as little as one session a week and one set per exercise, as long as the intensity (the load relative to your strength) is maintained, while older adults may need two sessions and 2–3 sets to maintain muscle size.[22]
  • Beginners and older adults. Start with body weight and lighter loads, learn the movements well, and build up gradually. Older adults gain extra value from balance-and-strength work on three or more days a week,[10] and Pilates can provide part of it.
Day A sample week with Pilates twice Notes
Monday Strength A: squat, push, pull, carry Heaviest lower-body work early in the week.
Tuesday Pilates (mat or reformer) Control and strength-endurance.
Wednesday Brisk walk, ride or swim Moderate aerobic minutes.
Thursday Strength B: hinge, push, pull, single-leg Heavy hinging on a non-Pilates day keeps your trunk fresh for it.
Friday Pilates (mat or reformer) A brisker class adds moderate-intensity minutes.
Saturday Longer walk, ride or swim The week's biggest aerobic session.
Sunday Rest or an easy walk Recovery.

That's one example among many. With Pilates three times a week, add a session on Wednesday or Sunday and keep the two strength days apart.

Where Strathlon fits

Where Strathlon fits. Strathlon builds you a workout plan around your goal, and Pilates now has its own place in the app as a sport. Pick it from the main sports list (it sits under Gymnastics & Fitness, and searching for “Pilates” or “reformer” finds it), then choose Mat Pilates or Reformer Pilates, each 45 minutes by default. Your Pilates sessions sit on the days you choose, and every one is a practice session. Choosing Pilates leaves the exercises in your workout plan unchanged: sport-specific accessory work comes with the Sports Performance goal for sports such as running or football. So if your plan already covers some of the patterns above, keep doing them, and treat anything else from this guide, such as extra pulling, carries or impact work, as your own addition alongside it. On the Nutrition tab, a day with a Pilates session is filed under the Sport Training target type, alongside Training and Rest, and each session adds a modest, conservatively estimated amount of energy to that day's calorie allowance, based on the published energy cost of Pilates and scaled to your body weight. A one-off class can be logged with + Add activity on the Plan tab, and if you record a Pilates workout on Apple Watch, or in any app that saves a Pilates workout to Apple Health, Strathlon matches it to that day's planned Pilates session once you have allowed it to read workouts from Apple Health. Pilates is still listed under Gym classes too, and logging it either way is fine. For a specific injury or condition, a physiotherapist or a qualified instructor is the right next step.
Common misconception → correct it. "Heavy lifting is too risky for me, so I'll stick to Pilates." With good coaching and gradual progression, heavier training can be both safe and unusually beneficial. In the closely supervised LIFTMOR trial, postmenopausal women with low bone mass trained at above 85% of their one-repetition maximum for eight months, improved their bone density, and reported only one minor adverse event.[11] Start light, learn the technique, progress gradually, and get individual clearance if you have osteoporosis, a fracture history or another medical condition.

Common questions

Is Pilates enough strength training on its own?

It counts: the NHS lists Pilates among the activities that count towards its guideline of muscle-strengthening on at least two days a week.[7] Its loads are mostly light, though, so adding one or two heavier sessions a week (squats or hinges, pushes, pulls and carries) builds the maximal strength, grip and bone-loading that springs and body weight supply in smaller doses.

Does Pilates count as cardio?

A little. A typical session sits in the light-to-moderate range, and a meta-analysis found Pilates programmes moderately improved aerobic fitness.[6][15] Even so, most people need other aerobic activity, such as brisk walking, cycling or swimming, to reach the 150–300 minutes of moderate activity a week that the World Health Organization recommends.[10] Faster-flowing classes with short rests sit at the higher end.

Should I do Pilates and weights on the same day?

You can. Pilates places little stress on the heart and lungs,[5] so it fits around lifting comfortably. If a class leaves your trunk or legs tired, do the heavy squats or deadlifts first, or on a different day, so the muscles that brace a heavy lift are fresh.

Will lifting weights make me less flexible?

The evidence suggests lifting can improve your flexibility: a meta-analysis of 11 randomised trials found that strength training and stretching produced similar gains in range of motion.[14] Lifting through a full, controlled range, the way Pilates has taught you to move, lets the two practices support each other.

Is Pilates good for back pain?

It's a well-supported option. A Cochrane review found low- to moderate-quality evidence that Pilates reduces pain and disability in non-specific low back pain compared with minimal intervention, while how it measures up to other exercise remains an open question, so the choice can rest on preference and cost.[17] If your pain is severe, getting worse or comes with other symptoms, see a doctor or physiotherapist first.

Mat or reformer: which is better for strength?

Both build strength-endurance and control. The reformer's springs add adjustable resistance through the whole range of a movement, and a laboratory study found reformer sessions cost somewhat more energy than mat sessions.[5] Mat work needs just a mat and your body weight, and travels anywhere. Choose the one you enjoy and can do consistently, and add heavier strength work alongside either.

Takeaways

  • Pilates builds control and strength-endurance. Trials show gains in abdominal endurance, flexibility and upper-body endurance, and in older adults, balance, strength and a lower risk of falls.[1][2]
  • Its loads and aerobic demand are modest. Typical sessions sit at light-to-moderate intensity, so heavier strength work and aerobic activity complete the week.[6]
  • Lift heavier on two days a week. Squat, hinge, push, pull and carry patterns cover what springs and body weight supply in smaller doses.[9][10]
  • Load your bones. Heavier resistance and, where suitable, impact exercise are the recommended route to bone strength.[11][12]
  • Fill the aerobic gap. Aim for 150–300 minutes of moderate activity a week; brisk walking, cycling and swimming are easy additions.[10]
  • Mind the neck, back and wrists. Modify head-lifts and wrist-loading, avoid deep spinal flexion if you have osteoporosis, and get help for persistent pain.[12]
  • Busy weeks need little. One heavy session a week can maintain strength for months.[22]
  • Pregnant? Get clearance first. Avoid long spells lying flat on your back, tell your instructor, and follow your midwife's or doctor's advice.[20][21]

If you remember one thing, make it this: Pilates and heavier training are partners in the same week. Pilates gives you control, strength-endurance and mobility; heavier lifting and brisk aerobic work add maximal strength, bone-loading and an aerobic engine. Strathlon keeps the bookkeeping honest: your Pilates sessions on the days you choose, your workout plan alongside them, and a modest energy allowance on the days you practise.

Pair this with the Pilates fuelling guide for how to eat around your classes and everyday energy needs: the fuelling companion to this training guide.

References

Numbered sources for the specific figures, effect sizes and named studies above. Where a claim reflects agreed guidance rather than a single trial, the citation is to the position stand or consensus statement of the body concerned, with the country or international remit named. Much of the Pilates-specific research is small and of low-to-moderate certainty, which is why this guide reports the authors' own caveats alongside their results.

  1. Kloubec JA. Pilates for improvement of muscle endurance, flexibility, balance, and posture. Journal of Strength and Conditioning Research. 2010;24(3):661–667. Randomised trial of 12 weeks of twice-weekly mat Pilates in 50 active middle-aged adults, the source for what improved (abdominal endurance, hamstring flexibility, upper-body muscular endurance) and what changed too little to be statistically significant (posture, balance). PubMed 20145572
  2. Fernández-Rodríguez R, Álvarez-Bueno C, Ferri-Morales A, Torres-Costoso A, Pozuelo-Carrascosa DP, Martínez-Vizcaíno V. Pilates improves physical performance and decreases risk of falls in older adults: a systematic review and meta-analysis. Physiotherapy. 2021;112:163–177. The source for the balance, strength, flexibility, function and falls-risk effects in adults aged 60 and over. PubMed 34332493
  3. Herrmann SD, Willis EA, Ainsworth BE, Barreira TV, Hastert M, Kracht CL, et al. 2024 Adult Compendium of Physical Activities: A third update of the energy costs of human activities. Journal of Sport and Health Science. 2024;13(1):6–12. The source for the definition of a MET, the intensity bands, and the age range the adult values cover. PubMed 38242596 · PMC10818145 full text
  4. Herrmann SD, Willis EA, Ainsworth BE, et al. 2024 Adult Compendium of Physical Activities: Conditioning exercise and Walking codes. The Compendium website entries for “Pilates, traditional, mat” (code 02103, 1.8 METs) and “Pilates, general” (code 02105, 2.8 METs), and the walking codes used for comparison. Compendium: conditioning exercise · Compendium: walking
  5. de Souza Andrade L, da Silva Almeida I, Mochizuki L, Sousa CV, Falk Neto JH, Kennedy MD, et al. What is the exercise intensity of Pilates? An analysis of the energy expenditure, blood lactate, and intensity of apparatus and mat Pilates sessions. Journal of Bodywork and Movement Therapies. 2021;26:36–42. Reformer and mat sessions measured in 18 healthy young women: the source for the energy costs and low cardiovascular stress. PubMed 33992270 · DOI 10.1016/j.jbmt.2020.12.007
  6. Vitor GBB, de Oliveira LC, Pessôa RAG, Aguiar AF, de Oliveira RG. Metabolic intensity and energy cost of Pilates exercises: an exploratory systematic review and meta-analysis of limited and heterogeneous evidence. Systematic Reviews. 2026;15(1):42. The source for the average MET values, their uncertainty, and the effect of rest intervals. PubMed 41495794 · PMC12869938 full text
  7. National Health Service (NHS, United Kingdom). Physical activity guidelines for adults aged 19 to 64. NHS physical activity guidance for adults, the source for the weekly aerobic and strengthening targets and for Pilates being listed among muscle-strengthening activities. NHS physical activity guidelines
  8. American College of Sports Medicine. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Medicine and Science in Sports and Exercise. 2009;41(3):687–708. ACSM position stand on progression models in resistance training, the source for the novice and advanced loading ranges. PubMed 19204579
  9. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and Science in Sports and Exercise. 2011;43(7):1334–1359. ACSM position stand on the quantity and quality of exercise, the source for resistance, neuromotor and flexibility work days per week. PubMed 21694556
  10. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine. 2020;54(24):1451–1462. World Health Organization (WHO, international) guidelines, the source for the 150–300 minute aerobic range, muscle-strengthening on two or more days a week, and the extra balance and strength work advised for older adults. PubMed 33239350 · PMC7719906 full text
  11. Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research. 2018;33(2):211–220. The LIFTMOR trial, the source for the bone-density results, the training protocol, the single minor adverse event and the principle that bone responds to high-magnitude loading. PubMed 28975661
  12. Brooke-Wavell K, Skelton DA, Barker KL, Clark EM, De Biase S, Arnold S, et al. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. British Journal of Sports Medicine. 2022;56(15):837–846. UK consensus statement on exercise for osteoporosis, the source for resistance and impact exercise for bone, spinal extension work, and avoiding a high degree of spinal flexion. PubMed 35577538 · PMC9304091 full text
  13. Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Orlandini A, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;386(9990):266–273. The source for the association between lower grip strength and all-cause mortality. PubMed 25982160
  14. Afonso J, Ramirez-Campillo R, Moscão J, Rocha T, Zacca R, Martins A, et al. Strength Training versus Stretching for Improving Range of Motion: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2021;9(4):427. Meta-analysis of 11 randomised trials, the source for strength training and stretching producing similar range-of-motion gains. PubMed 33917036 · PMC8067745 full text
  15. Fernández-Rodríguez R, Álvarez-Bueno C, Ferri-Morales A, Torres-Costoso AI, Cavero-Redondo I, Martínez-Vizcaíno V. Pilates Method Improves Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2019;8(11):1761. Meta-analysis of Pilates and VO2max, the source for the aerobic-fitness effect size. PubMed 31652806 · PMC6912807 full text
  16. Schumann M, Feuerbacher JF, Sünkeler M, Freitag N, Rønnestad BR, Doma K, et al. Compatibility of Concurrent Aerobic and Strength Training for Skeletal Muscle Size and Function: An Updated Systematic Review and Meta-Analysis. Sports Medicine. 2022;52(3):601–612. Updated meta-analysis of 43 studies, the source for aerobic training leaving muscle size and maximal strength gains intact while blunting explosive strength, mostly when done in the same session. PubMed 34757594 · PMC8891239 full text
  17. Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RW, Cabral CM, et al. Pilates for low back pain. Cochrane Database of Systematic Reviews. 2015;(7):CD010265. Cochrane review of 10 trials, the source for Pilates helping pain and disability compared with minimal intervention, and for how it measures up to other exercise remaining an open question. PubMed 26133923 · PMC8078578 full text
  18. Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews. 2021;9:CD009790. The source for exercise in general probably helping chronic low back pain. PubMed 34580864 · PMC8477273 full text
  19. Engelbert RH, Juul-Kristensen B, Pacey V, de Wandele I, Smeenk S, Woinarosky N, et al. The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome. American Journal of Medical Genetics Part C. 2017;175(1):158–167. Guidance on physiotherapy for hypermobility-related conditions, the source for physiotherapy's central role and the limited research base. PubMed 28306230
  20. American College of Obstetricians and Gynecologists (ACOG, United States). Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstetrics and Gynecology. 2020;135(4):e178–e188. ACOG guidance on exercise in pregnancy and after birth, the source for the 150-minute target, hydration and heat advice, lying on the back after 20 weeks, and returning to exercise after birth. PubMed 32217980 · ACOG Committee Opinion 804
  21. National Health Service (NHS, United Kingdom). Exercise in pregnancy. NHS guidance on exercise in pregnancy, the source for avoiding lying flat on your back after 16 weeks, avoiding strenuous exercise in hot weather, and telling your class teacher you are pregnant. NHS: exercise in pregnancy
  22. Spiering BA, Mujika I, Sharp MA, Foulis SA. Maintaining Physical Performance: The Minimal Dose of Exercise Needed to Preserve Endurance and Strength Over Time. Journal of Strength and Conditioning Research. 2021;35(5):1449–1458. Spiering and colleagues on the minimal dose of exercise needed to preserve strength, the source for maintaining strength on one session a week and the higher dose older adults may need. PubMed 33629972

This is general educational information. For medical or coaching advice, speak to a qualified professional. The exercise-science figures here are drawn from published research and framed as population-level guides: individual responses vary widely with age, training history, joint and bone health, and pregnancy, and are best personalised with a qualified professional. Anyone with pain, an injury, osteoporosis or low bone density, hypermobility, a heart or other medical condition, or who is pregnant or postpartum, should consult a physiotherapist, physician or midwife before starting or changing an exercise programme. See our Terms for more.

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