Pilates: returning after an injury

Risks and order of return

The method is progressive, but ranges and rolling movements can bother the back; resume with simple, slow exercises and steady breathing.

Pilates: start with basic mat exercises without forcing the range. Add springs or resistance afterwards.

Bringing the movement back in four stages

1. 1

   Breathing and gentle core activation, on the floor, reduced range.

2. 2

   Basic floor exercises, short sets, no forced bending of the back.

3. 3

   Longer core and mobility exercises, small props.

4. 4

   Advanced exercises, equipment (reformer), full range and intensity.

Common injuries in this sport

• Lower back (lumbar)Avoid deep roll-ups and extreme rotations; keep the pelvis stable.
• Hip and gluteus medius (tendinopathy)Avoid large hip ranges; work the glutes in a stable position.
• Neck (cervical)Keep the neck long and neutral and avoid rolling on the neck.

Preparation exercises

• Dead bug

  Lying on your back, arms to the ceiling, knees at 90 degrees: lower one heel towards the floor keeping the low back flat, then alternate.

  To start: 3 sets of 8 per side, slowly, once a day.

  Variations, mistakes and progression

  Easier

  Move only the legs, arms on the floor.

  Harder

  Opposite arm and leg together, leg straighter.

  Common mistakes

  • Letting the lower back lift off the floor.
  • Holding your breath.

  Moving on

  When 3 × 10 with opposite arm and leg is done with the back flat.

• Bird dog

  On all fours, extend one arm and the opposite leg keeping the back steady, hold 5 seconds then switch.

  To start: 3 sets of 8 per side, 5-second hold, once a day.

  Variations, mistakes and progression

  Easier

  Leg only, or arm only.

  Harder

  10-second holds, then bringing elbow and knee under the belly between reps.

  Common mistakes

  • Lifting the leg too high and arching the back.
  • Letting the pelvis rotate.

  Moving on

  When 3 × 10 is done without the pelvis moving (a glass on your lower back would not fall).

• Glute bridge

  Lying on your back, knees bent, lift the hips squeezing the buttocks, hold 2 seconds, lower slowly. Later: on one leg.

  To start: 3 sets of 12, 2 seconds at the top, every other day.

  Variations, mistakes and progression

  Easier

  Smaller range, feet closer to the buttocks.

  Harder

  On one leg, then with your shoulders on a sofa.

  Common mistakes

  • Arching the lower back instead of squeezing the glutes.
  • Letting the knees drift apart or together.

  Moving on

  When 3 × 12 on one leg is easy, with the pelvis staying level.

• Clamshell

  Lying on your side, knees bent, feet together: open the top knee without moving the pelvis. Add a band later.

  To start: 3 sets of 15 per side, every other day.

  Variations, mistakes and progression

  Easier

  Smaller opening, no band.

  Harder

  Band around the thighs, then a 2-second hold at the top.

  Common mistakes

  • Rolling the pelvis back to open wider.
  • Going fast and feeling it in the back rather than the buttock.

  Moving on

  When 3 × 20 with a band is easy: move on to the side plank or band walks.

• Scapular retraction (band row)

  Band anchored in front of you, pull the elbows back bringing the shoulder blades together, return over 3 seconds.

  To start: 3 sets of 12, 3 seconds back, every other day.

  Variations, mistakes and progression

  Easier

  No band, just bring the shoulder blades together.

  Harder

  Stronger band, with a 2-second hold at the back.

  Common mistakes

  • Shrugging the shoulders to the ears.
  • Pulling with the hands rather than the shoulder blades.

  Moving on

  When 3 × 15 with a medium band is easy.

• Prone back extension

  Lying on your front, hands by your temples, eyes on the floor: lift your chest a few centimetres while squeezing your glutes, hold 3 seconds, lower slowly.

  To start: 3 sets of 10, 3-second hold, every other day.

  Variations, mistakes and progression

  Easier

  Arms by your sides, barely lift the chest.

  Harder

  Arms straight in front (Superman position), or opposite arm and leg together.

  Common mistakes

  • Lifting the head and tipping the neck back.
  • Going too high and arching the lower back.

  Moving on

  When 3 × 12 is easy with no lower-back pain the next day.

The doses are starting points. Stay at 2 out of 10 discomfort at most, during and the next day; otherwise switch to the easier version or go back to the previous exercise.

Equipment and set-up

• A comfortable mat and, if possible, a session guided by a qualified instructor.
• Small equipment (ball, band) to vary without forcing.
• Tell the instructor about your injury.