As a Physiotherapist (and someone who swears by the magic of a good Pilates session), I often get asked:
“Can I still do Pilates if I have arthritic knees?”
The short answer? Yes — but with care.
In fact, Pilates can be a wonderful way to support arthritic knees… once you know how to adapt it.
I’ll walk you through what to avoid, what to focus on, and how I managed it myself — even with a sore meniscus that made it very difficult to sit back on my heels.
Understanding Pilates and Arthritic Knees
Pilates is all about controlled movement, core strength, and alignment — all of which can actually help knees feel better. But not every Pilates movement suits every knee.
If you have arthritis in the knees, or a related issue like a torn or irritated meniscus (been there!), then some of the floor-based or kneeling exercises can feel anywhere from uncomfortable to completely off-limits.
But that doesn’t mean you need to give it up.
The key is to:
- Get your knees into better shape (stronger, more supported, less reactive),
- Avoid the specific triggers for your knees,
- And work with your body, not against it.
What I Learned from My Own Knees
After dealing with a sore meniscus, I couldn’t kneel or sit back on my heels without pain — so traditional Pilates moves like child’s pose, kneeling arm reaches, or certain reformer exercises were out.
But with some smart modifications and time spent strengthening and offloading my knees, I was back enjoying it again.
That’s what I want for you too.
Tips for Doing Pilates Safely with Arthritic Knees
1. Modify Kneeling Positions
If kneeling hurts, don’t do it. Use props, cushions, or stay off your knees entirely. A seated or side-lying version of an exercise can often offer the same benefit.
2. Focus on Strengthening Your Knees Outside of Class
Pilates isn’t always enough to settle arthritic knees — but my FREE Masterclass will help. You’ll learn how to settle a flare-up and how to strengthen & exercise safely.
👉 [Click here to join the FREE Arthritic Knee Masterclass]
3. Avoid Deep Flexion (like sitting back on heels)
It’s common for arthritic knees to hate deep bending. Keep movements within a comfortable range — it doesn’t have to be all or nothing. Often full straightening can also be irritating. Listen to your knees and let them guide you.
4. Communicate with Your Instructor
A good instructor will help you modify. If they know you’re dealing with knee issues, they can offer alternatives in real time.
5. Choose the Right Class
Some Pilates classes are more athletic or reformer-based. Others focus on gentle movement, rehab or even chair-based options. Start where your knees feel safest.
6. Strengthen Beyond Pilates
Many people think stretching and Pilates will “fix” their knees — but targeted strength and load management make a much bigger difference.
👉 That’s exactly what my Arthritic Knee Program is designed for.
When Pilates Might Still Be Too Much
Even with good strength and smart adaptations, some movements might stay off-limits — and that’s okay.
You might need:
- A pause from certain exercises during a flare-up,
- A modified class like clinical Pilates or rehab Pilates,
- Or a period of knee-focused rehab first.
It’s not failure — it’s strategy.
You Don’t Have to Give Up Pilates
Being told you have arthritis can feel like a life sentence — like you’re slowly being forced to stop the things you love. But it doesn’t have to be that way.
There’s so much you can do to take back control, rebuild your knees, and feel confident in your body again.
Whether you’re working toward a Pilates class, a walk up the hill, or a dance in the kitchen — I’m here to help you get there.
Let’s Get You Back to It!
FREE Masterclass: How to UPGRADE Your Arthritic Knee in Less Than 40 Minutes
Inside, you’ll learn how to:
- Avoid common exercise mistakes,
- Settle a flare-up,
- And try two simple strengthening exercises that knees love.
👉 [Click here to start the free class] — It’s the first step to getting back to what you love, Pilates included.
Take care, Helen
Helen Manders BSc (Hons) MCSP HCPC
Chartered Physiotherapist
Treating Arthritic Knees Since 2001
P.S. I would love to see you on the FREE Masterclass. Your knees will thank you!
