How Safe is Pilates?

At a recent industry conference, a panel discussion referenced a figure suggesting there had been 45,000 Pilates-related injuries in Australia, reportedly based on AusPlay data. The statement understandably raised concern among attendees and prompted an important question:

How safe is Pilates — and what does the evidence actually show?

A review of AusPlay and national injury datasets revealed that Australia does not currently collect injury statistics specific to Pilates. It is therefore likely that this figure reflected a misunderstanding of participation or survey data rather than documented injury incidence.

This highlights an important reality: despite Pilates being practised by hundreds of thousands of Australians each week, reliable national safety data specific to Pilates does not yet exist.

What the Evidence Shows

Available research provides reassuring findings. Across clinical trials and exercise epidemiology, Pilates demonstrates one of the lowest injury risks among commonly practised physical activities.

Pilates exercises are typically low impact, controlled and progressively loaded, and are most often delivered in supervised environments. Systematic reviews — including those considered in the Australian Government’s Natural Therapies Review — report very few adverse events, with many studies recording none.

In the absence of national Pilates-specific surveillance, safety comparisons rely on a standard sports medicine measure: injuries per 1,000 hours of participation.

How Pilates Compares With Other Activities

Activity	Estimated Injury Rate (per 1,000 hours)	Common Injury Types	Why Injuries Occur
Pilates	0.6–1.0	Muscle strain, aggravation of existing conditions, occasional falls from equipment	Injuries usually occur when exercises are progressed too quickly, balance challenges exceed participant capability, or supervision is limited in group equipment settings
Yoga	1–2.5	Wrist strain, hamstring tears, lower back irritation	Injuries often arise from pushing into extreme flexibility or attempting advanced poses without adequate strength or control
Gym / Resistance Training	2–4	Shoulder injury, lower back strain, muscle tears	External weights place high load on joints and tissues, particularly when technique deteriorates under fatigue
High-Intensity Functional Training	3–9	Shoulder and spine injuries, tendon overload	Rapid, repetitive movements performed under fatigue combine speed and load, increasing technical error risk
Running	6–12	Knee pain, Achilles tendinopathy, stress fractures	Repetitive impact forces accumulate over thousands of steps, leading to gradual overload rather than sudden accidents

These estimates are derived from published systematic reviews and injury epidemiology studies across exercise modalities. Direct population-level injury surveillance specific to Pilates is not currently available in Australia.

Why Running Feels Safe — Despite Higher Injury Rates

Running consistently demonstrates one of the highest injury rates of recreational activity, yet it is widely perceived as low risk. This reflects how people interpret risk rather than actual incidence.

Running injuries usually develop gradually through overuse and are familiar to most people. By contrast, reformer incidents may involve falls or moving equipment and appear more dramatic, attracting greater media attention even when overall risk remains comparatively low.

Why Reformer Pilates Is Receiving Attention

Australia has experienced rapid growth in group reformer studios. Increased participation naturally increases the visibility of injuries, particularly when equipment is involved.

Similar public scrutiny has accompanied periods of rapid expansion in personal training, yoga and high-intensity fitness programs. Attention typically reflects growth and visibility rather than unusually high risk.

What We Are Seeing in Practice

Like many experienced practitioners, I have recently discussed serious fractures occurring in group reformer environments, including an incident involving fractures to both shoulders following a fall.

In the recent cases, the instructors were not members of the Pilates Association Australia (PAA). While individual incidents cannot determine overall risk, they reinforce an important point: how Pilates is delivered matters.

Encouragingly, claims data from the PAA professional indemnity insurance program show very low injury reporting among members relative to participation levels — consistent with research describing Pilates as a low-risk activity when appropriately supervised.

Safety Is About Delivery

All physical activity carries some risk. Evidence across exercise professions consistently shows that safety depends on appropriate progression, supervision, instructor education and professional judgement.

Pilates is uniquely adaptable, supporting both general wellbeing and more complex health needs. Maintaining clear professional standards helps ensure this adaptability remains safe as participation grows.

An Opportunity for the Profession

Increased public discussion about Pilates safety presents an opportunity. As participation expands, strengthening professional standards and developing better injury surveillance allows Pilates to demonstrate objectively what practitioners observe daily — that it is a safe and effective form of exercise when delivered appropriately.

The Bottom Line

Current evidence indicates that Pilates remains a low-risk, highly adaptable form of physical activity, comparing favourably with many widely accepted exercise modalities.

The real question for our profession is not whether Pilates is safe, but:

How do we ensure safe, high-quality Pilates delivery keeps pace with the rapid growth of participation across Australia?

Answering that question will be central to maintaining public confidence and supporting the long-term future of the profession.