Pilates for Seniors: An Honest Look and a Safe Routine

Pilates can be a good fit for older adults. In research it improves balance, core control and flexibility, it's gentle on the joints, and many people simply enjoy it. But it isn't a substitute for strength training: the evidence that it builds muscle strength is mixed, it hasn't been shown to build bone, and wall Pilates hasn't been studied at all. Here's my honest take, what to watch for if you have osteoporosis, and a safe six-move routine to try at home. For the bigger picture, see our guide to exercises for seniors.

I get asked about Pilates, and lately about wall Pilates, all the time. Usually it's after someone has seen a video promising a flat stomach or a "whole new body" in 28 days. So let's look at what Pilates really does and doesn't do for us as we get older.

What Is Pilates?

Pilates is a system of controlled movements, done on a mat or on a spring-loaded machine called a reformer, that focus on the core: the muscles around your trunk, hips and lower back. Classes emphasize slow, precise movement, good alignment and steady breathing. Many moves are done lying down, on your hands and knees, or seated.

What Does the Research Say About Pilates for Older Adults?

Balance: this is where the evidence is most consistent. Several reviews of studies in older adults found Pilates improved balance compared with doing no exercise.^1,2,3 The catch is that many of those studies were small and of low quality, so the benefits may be overstated.¹

Falls: one review found Pilates lowered measures of fall risk,³ but the most recent and most careful review found it didn't reduce the number of falls or fear of falling, and it worked about as well as other types of exercise.⁴

Strength: here the reviews disagree. One found Pilates improved strength,³ while a 2024 review of 24 trials found no clear strength benefit compared with no exercise, and no difference compared with other exercise.⁵ In a trial of women around 70, a balance and core resistance training program improved balance, trunk strength and leg power more than Pilates did.⁶ In another, Pilates and weight training each had their own strengths, and both groups improved the same amount on a walking test.⁷

Bones: Pilates hasn't been shown to improve bone density.⁸ Bone responds to impact and to heavy, progressive resistance, which Pilates doesn't usually provide. My post on exercises to increase bone density explains what does.

So Pilates is a good balance and core workout, but not a complete program.

What About Wall Pilates?

Wall Pilates uses a wall for support and resistance: you might do bridges with your feet on the wall, leg lifts, wall sits and arm work. It became popular on social media, often with dramatic before-and-after promises.

Here's the honest answer: as of October 2026, I couldn't find a single published study of wall Pilates. Any benefits are borrowed from research on mat and reformer Pilates, and the big claims aren't backed by evidence.

That doesn't make it bad. The wall gives you something steady to push against, many of the moves are gentle on the joints, and it's an easy way to move at home. Just think of it as a core and mobility workout, not a way to build the muscle and bone that keep you independent. And look carefully at each move: many wall Pilates routines include crunch-style curls, which aren't a good idea if you have osteoporosis.

How Does Pilates Compare With Strength and Balance Training?

Our guides to strength training and balance exercises cover the other two.

Is Pilates Safe If You Have Osteoporosis?

It can be, with changes. Many classic Pilates moves curl the spine forward: the roll-up, the hundred, rolling like a ball, the teaser and crunch-style curls. Bending forward from the waist like this can increase the risk of a spine fracture when bones are fragile. The Bone Health & Osteoporosis Foundation advises people with osteoporosis to avoid sit-ups, crunches and toe touches, and says Pilates may need to be avoided or modified.¹⁰

The concern goes back to a small but striking 1984 study: women with spinal osteoporosis who did forward-bending (flexion) exercises had far more new spine fractures than those who did back-extension exercises.⁹ It was a small study, but it's the reason forward flexion under load is still avoided with osteoporosis.

A Safe 6-Move Pilates-Style Routine

These six moves keep your spine in a neutral position, so they're a good choice for most people, including those with low bone density. Move slowly, breathe out on the effort, and keep your belly gently drawn in. Do the routine 2–3 times a week.

Dead Bug

6–8 each side

1. Lie on your back with your knees bent and feet flat, arms reaching toward the ceiling.
2. Gently draw your belly in so your lower back stays in contact with the floor.
3. Slowly slide one heel out along the floor (or lower one foot to tap the floor), then bring it back. Switch sides.

Make it easier

Move just one leg at a time and keep your arms still.

Make it harder

Straighten the leg farther from your body as you lower it.

Bird-Dog

8–10 each side

1. Start on your hands and knees, wrists under shoulders, knees under hips.
2. Lift your right arm and left leg until they're straight, keeping your back flat and core engaged.
3. Hold for a few seconds, lower, and repeat on the other side.

Make it easier

Lift only the leg, keeping both hands down.

Make it harder

Hold for 5 seconds before switching.

Glute Bridge

8–10, holding 5–10 seconds

1. Lie on your back, knees bent, feet flat, arms at your sides.
2. Press through your heels to raise your hips until your body forms a straight line from shoulders to knees.
3. Squeeze your glutes, hold, then lower slowly.

Make it easier

Lift your hips only an inch or two.

Make it harder

Hold the bridge and march one foot off the floor at a time.

Side-Lying Leg Lift

8–10 each side

1. Lie on your side with your head resting on your arm, hips stacked and the bottom knee bent.
2. Keeping the top leg straight and your toes pointing forward, lift it toward the ceiling.
3. Lower slowly. Do all your reps, then turn over.

Make it easier

Bend the bottom knee for more stability and make the lift smaller.

Make it harder

Pause at the top for 2 seconds, or add a light ankle weight.

Wall Slide

5–8, holding 5 seconds

1. Stand with your back against a wall, feet about a foot in front of you and hip-width apart.
2. Slowly slide down the wall, bending your knees as if starting to sit, keeping your knees over your toes.
3. Hold, then press through your heels to slide back up.

Make it easier

Slide only a few inches down.

Make it harder

Slide a little lower and hold for 10–20 seconds.

Wall Push-Up

8–10, 2–3 rounds

1. Stand a few feet from a wall and place your hands on it at shoulder height.
2. Keeping your body in a straight line, bend your elbows to bring your chest toward the wall.
3. Push back to the start with slow, controlled movement.

Make it easier

Stand closer to the wall.

Make it harder

Stand farther away, or use a sturdy counter instead of the wall.

To bring this into daily life, add the suitcase carry: carrying a bag in one hand teaches your core to keep you centered while you walk, which is exactly what it needs to do when you carry groceries.

How Do You Choose a Pilates Class?

• Look for an instructor experienced with older adults, and ideally with osteoporosis and joint replacements.
• Start with a beginner, gentle or "mature movers" class, and keep the class small enough that the instructor can watch your form.
• Tell the instructor about your health, especially low bone density, a joint replacement or back problems, and ask how they'll modify forward-bending moves.
• Notice how you feel afterward. You should feel worked, not sore in your joints or back.

Where Does Pilates Fit in Your Week?

A balanced week after 60 includes strength training on at least two days, balance practice, and aerobic activity like walking. Pilates can cover some of your balance and core work, and it's a lovely way to stretch. A week might look like this:

• Two or three days: strength training (legs, hips, back and arms, with resistance that keeps getting more challenging)
• One or two days: Pilates
• Most days: a walk, plus a few minutes of balance practice

Our guide to how much exercise seniors need has a full sample week. And if you'd like help putting it together, our trainers can build a program that includes the Pilates-style moves you enjoy, in your home in the Colorado Springs and Tri-Lakes area or online.