Reformer Pilates: Gym Trend or Smart Rehab? A Chiropractor Weighs In

I’ve just come out of my third Pilates class, and as a chiropractor, I thought I’d cruise through it. I’m relatively healthy, exercise regularly, and most of my patients assumed I’d find it easy. Spoiler alert: the Pilates shakes are real.

Afterwards, I met up with a colleague, proudly telling them I’d “finally tried Reformer Pilates.” That’s when they hit me with it: “You didn’t do Reformer Pilates. You did a fitness class… that just happened to use a reformer.”

I laughed, but I’ll admit, it felt like being smacked in the face by the reality of not actually knowing what I’d signed up for.

Naturally, I went down a rabbit hole of research to prove them wrong. But what I found surprised me. In this blog, I’ll share what I learned, what Pilates actually is, and most importantly, what I think of it now, both as a beginner and as a chiropractor.

A Brief History of Pilates

Pilates began with one man: Joseph Hubertus Pilates (1883–1967). A German-born fitness innovator, he originally called his method Contrology. While interned in England during World War I, he attached springs to hospital beds so bedridden patients could exercise. This was the prototype of the Reformer machine we see in studios today.

Drawing from both Western calisthenics and Eastern practices like yoga and martial arts, Joseph created a system designed to improve strength, flexibility, and alignment. His approach wasn’t just physical; he believed movement was a way to train the mind as much as the body.

In 1923, Joseph and his wife Clara opened a New York studio. Dancers, actors, and performers quickly became devoted clients, appreciating how the method built control, posture, and resilience. Joseph famously insisted that “a few well-designed movements, properly performed, are worth hours of sloppy calisthenics.”

In those early days, Pilates training was highly individualised. Clients worked one-on-one with Joseph, Clara, or their assistants, often using the Reformer, Cadillac, or Chair to prepare for mat work (which he viewed as the ultimate test of control). Group apparatus classes didn’t exist — the work was tailored, tactile, and detail-driven. Instructors would often correct clients by hand, “sculpting” them into alignment.

After Joseph’s death in 1967, his students, now known as the Pilates Elders, carried on his work. They opened studios across the U.S. and beyond, bringing Pilates into dance, therapy, and eventually mainstream fitness.

By the 1980s and 1990s, celebrity endorsements propelled Pilates into the public eye. A turning point came in 2000 when a U.S. court ruled that “Pilates, like yoga and karate, is an exercise method and not a trademark.” Suddenly, anyone could use the name, and Pilates exploded worldwide.

Reformer Pilates Today: Tradition vs. Modern Classes

If you walk into a Pilates studio today, you’ll often see rows of Reformers with 8–12 people moving in sync under one instructor’s guidance. It looks impressive, but it’s a very different picture from Joseph Pilates’ original vision.

In his New York studio, Reformer apparatus sessions were individualised. Each client followed their own tailored programme while Joseph, Clara, or an assistant made constant adjustments. Group sessions were limited to mat classes, which could be safely taught to several people at once. For apparatus work, precision and close supervision were considered essential.

Modern group Reformer classes, while popular and accessible, naturally lose some of that one-to-one detail. With one instructor watching many bodies, alignment and technique can slip, something Joseph himself warned against when he said poor form undermines the benefits of his method.

That said, not all Pilates today is delivered in big groups. Many specialist studios still offer private or small-group sessions, with organisations like the Pilates Foundation recommending class sizes of 1–6 for apparatus work. The principle remains the same: done with accuracy, Pilates can transform strength and posture; done carelessly, it risks strain or reduced benefit.

The growth of large group formats is largely practical. Group classes are cheaper for clients, more profitable for studios, and more inviting for those who feel nervous about one-on-one training. Add in social media exposure and high-energy hybrids like Megaformer workouts, and it’s easy to see why Pilates has broadened beyond its roots.

Today, Pilates is a spectrum, from classical, detail-driven one-to-one instruction to modern, fitness-style group formats. Both can be valuable, but the experience (and the results) may feel very different.

What the Research Says

Pilates has grown into a global phenomenon, with millions of people practicing it in studios, gyms, and even online. But what does the science actually say about its benefits?

• Core strength and posture: Research consistently shows Pilates activates the deep abdominal muscles that support the spine. This explains why it’s often recommended for posture and back health.

  
  

• Low back pain: A 2015 Cochrane review found Pilates provided moderate improvements in pain and function for people with chronic low back pain, at least in the short to medium term. However, when matched against other structured exercise programmes, Pilates wasn’t necessarily superior. The key factor is doing something, not necessarily Pilates alone.

  
  

• Flexibility, balance, and endurance: Studies suggest regular practice improves overall muscle endurance, flexibility, and balance, all important for healthy movement and reducing injury risk.

  
  

• Older adults and athletes: Early evidence shows benefits for these groups too, but more high-quality trials are still needed.

  
  

At the same time, reviews highlight that Pilates is not a miracle cure. Like any form of exercise, its benefits come from how it’s practiced and how consistently it’s done. Good instruction, precision, and regularity matter far more than simply showing up once in a while.

My Thoughts as a Chiropractor: Should You Do It?

When patients ask me whether they should try Pilates, my answer is always: it depends.

If you’re in pain, for example, with an acute episode of low back pain or sciatica, I usually recommend starting with simple, targeted movements you can manage safely at home. Often, these are Pilates-inspired exercises, but adapted to avoid aggravating your symptoms and to help stabilise your spine first.

Once your pain has settled and your body is moving more confidently, that’s when Pilates can become a really valuable tool. At that stage, it can help build strength, improve flexibility, and keep you moving well, provided it’s taught with attention to technique.

From my own experience, Reformer Pilates has been both challenging and enjoyable. My wife (who first persuaded me to go) loves the smaller class environment, the supportive atmosphere, and the way instructors make hands-on corrections. That sense of community is something you don’t always get in a traditional gym.

So, should you do Pilates?

• If you’re healthy and curious: absolutely, it can be a fantastic way to build strength and control.

  
  

• If you’re recovering from pain or injury: yes, but only when guided appropriately and at the right stage of your recovery.

  
  

Like any form of exercise, Pilates isn’t magic. But practiced with precision and consistency, it can be a great way to support your body for the long run.

The Benefits of Pilates for Everyday Life

Pilates can be a game-changer in our busy lives. It’s not just about getting fit; it’s about enhancing our daily activities. Let’s explore how Pilates can positively impact our everyday routines.

Improved Posture

In our fast-paced world, many of us spend hours hunched over desks or glued to screens. This can lead to poor posture and discomfort. Pilates focuses on core strength and alignment, helping to counteract the effects of prolonged sitting. By engaging the deep muscles that support your spine, you can stand taller and feel more confident.

Stress Relief

Life can be stressful, and finding ways to unwind is essential. Pilates encourages mindful movement and breathing, which can help reduce stress levels. The focus on control and precision allows you to disconnect from daily worries and reconnect with your body. It’s a mini-vacation for your mind!

Enhanced Flexibility

As we age, flexibility tends to decline. Pilates can help maintain and even improve your flexibility. The controlled movements stretch and strengthen muscles, making everyday tasks easier and reducing the risk of injury. Imagine bending down to tie your shoes or reaching for something on a high shelf without discomfort!

Better Balance and Coordination

Whether you’re navigating a busy street or simply walking up stairs, balance is crucial. Pilates improves coordination and balance through its emphasis on controlled movements. This can be especially beneficial as we age, helping to prevent falls and maintain independence.

A Supportive Community

Joining a Pilates class often means becoming part of a supportive community. Sharing the experience with others can motivate you to stay committed to your fitness journey. Plus, the camaraderie can make workouts more enjoyable!

Conclusion

Pilates has come a long way from Joseph Pilates’ original studio in New York to the group reformer classes you’ll find in gyms and studios today. Whether you’re drawn to it for fitness, posture, or simply curiosity, the key is practising with precision and consistency.

If you’re unsure whether Pilates is right for you, especially if you’re dealing with pain, start small, get the right guidance, and remember that what works best will always depend on your body’s needs.

At the end of the day, Pilates isn’t about chasing perfection. It’s about learning to move better, feel stronger, and take control of your body. In my opinion, as both a chiropractor and a beginner, it makes it well worth exploring.

✨ Thinking about starting Pilates, or unsure what exercise is right for you?

As chiropractors, we help people understand their bodies, recover safely, and move with confidence. If you’d like personalised guidance on your back health, posture, or exercise choices, you can book an appointment today and take the next step toward feeling stronger and more in control.

References

1. Pilates Central UK. History & Origins of Pilates. Retrieved from https://www.pilatescentral.co.uk/history-origins-pilates/

2. Pilates Foundation UK. Pilates History. Available at: https://www.pilatesfoundation.com/about-pilates

3. McGrath, Jan. (2023, October 6). Pilates as it was intended. The Pilates Journal. https://pilatesjournal.com/articles/as-pilates-was-intended

4. Bowen, M. (Pilates Elder). Interview excerpts on Joseph Pilates’ teaching methods. Quoted in Pilates Foundation UK.

5. Australian Government Department of Health (2015). Review of the Effectiveness of Natural Therapies: Pilates. Available at: https://www.health.gov.au/resources/publications/natural-therapies-review-2024-pilates-evidence-evaluation?language=en

6. Yamato, T. P., Maher, C. G., Saragiotto, B. T., Hancock, M. J., Ostelo, R. W. J. G., Cabral, C. M. N., Costa, L. C. M., & Costa, L. O. P. (2016). Pilates for low back pain: Complete republication of a Cochrane Review. Spine, 41(12), 1013–1021. https://doi.org/10.1097/BRS.0000000000001398