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Pilates (//; German: [piˈlaːtəs]) is a physical fitness system developed in the early 20th century by Joseph Pilates, after whom it was named. Pilates called his method "Contrology". It is practiced worldwide, especially in Western countries such as Canada, the United States and the United Kingdom. As of 2005, there were 11 million people practicing the discipline regularly and 14,000 instructors in the United States.
There is only limited evidence to support the use of Pilates to alleviate low back pain, or improve balance in elderly people. Evidence from studies show that while Pilates improves balance, limited data exists on whether this impacts on falls by the elderly.  Pilates has not been shown to be an effective treatment for any medical condition. There is some evidence regular Pilates sessions can help muscle conditioning in healthy adults, when compared to doing no exercise.
In his book Return to Life through Contrology, Joseph Pilates presents his method as the art of controlled movements, which should look and feel like a workout (not a therapy) when properly manifested. If practiced with consistency, Pilates improves flexibility, builds strength and develops control and endurance in the entire body. It puts emphasis on alignment, breathing, developing a strong core, and improving coordination and balance. The core, consisting of the muscles of the abdomen, low back, and hips, is often called the "powerhouse" and is thought to be the key to a person's stability. Pilates' system allows for different exercises to be modified in range of difficulty from beginner to advanced or to any other level, and also in terms of the instructor and practitioner's specific goals and/or limitations. Intensity can be increased over time as the body adapts itself to the exercises.
During the first half of the twentieth century, he developed a system of exercises which were intended to strengthen the human mind and body. Pilates believed that mental and physical health were interrelated.
In his youth he had practised many of the physical training regimes available in Germany, and it was from these he developed his own method. It has clear connections with the physical culture of the late nineteenth century, such as the use of special apparatuses and claims that the exercises could cure ill health. It is also related to the tradition of "corrective exercise" or "medical gymnastics" as typified by Pehr Henrik Ling.
Pilates said that the inspiration for his method came to him during World War One, while he was being held at the Knockaloe internment camp on the Isle of Man. He developed his method there for four years, working on his fellow internees .
Joseph Pilates accompanied his method with a variety of equipment, for which he used the term "apparatus". Each apparatus was designed to help accelerate the process of stretching, strengthening, body alignment and increased core strength started by the mat work. The best-known and most popular apparatus today, the Reformer, was originally called the Universal Reformer, aptly named for "universally reforming the body". Eventually Pilates designed other apparatus, including the Cadillac, Wunda Chair, High "Electric" Chair, Spine Corrector, Ladder Barrel and Pedi-Pole.
Pilates published two books related to his training method: Your Health: A Corrective System of Exercising That Revolutionizes the Entire Field of Physical Education in 1934, and Return to Life Through Contrology in 1945.
His first students went on to teach his methods, including: Romana Kryzanowska, Kathy Grant, Jay Grimes, Ron Fletcher, Maja Wollman, Mary Bowen, Carola Treir, Bob Seed, Eve Gentry, Bruce King, Lolita San Miguel, and Mary Pilates, Joseph's niece. Contemporary Pilates includes both the "Modern" Pilates and the "Classical/Traditional" Pilates. Modern Pilates is partly derived from the teaching of some first generation students, while Classical Pilates aims to preserve the original work as Joseph Pilates taught it.
A number of versions of Pilates are taught today and the majority are based on up to nine principles. Frank Philip Friedman and Gail Eisen, two students of Romana Kryzanowska, published the first modern book on Pilates, The Pilates Method of Physical and Mental Conditioning, in 1980 and in it they outlined six "principles of Pilates". These have been widely adopted—and adapted—by the wider community. The original six principles were concentration, control, center, flow, precision, and breathing.
Breathing is important in the Pilates method. In Return to Life, Pilates devotes a section of his introduction specifically to breathing "bodily house-cleaning with blood circulation". He saw considerable value in increasing the intake of oxygen and the circulation of this oxygenated blood to every part of the body. This he saw as cleansing and invigorating. Proper full inhalation and complete exhalation were key to this. He advised people to squeeze out the lungs as they would wring a wet towel dry. In Pilates exercises, the practitioner breathes out with the effort and in on the return. In order to keep the lower abdominals close to the spine; the breathing needs to be directed laterally, into the lower rib cage. Pilates breathing is described as a posterior lateral breathing, meaning that the practitioner is instructed to breathe deep into the back and sides of his or her rib cage. When practitioners exhale, they are instructed to note the engagement of their deep abdominal and pelvic floor muscles and maintain this engagement as they inhale. Pilates attempts to properly coordinate this breathing practice with movement.
Pilates demands intense focus, the way that exercises are done is more important than the exercises themselves.
"Contrology" was Joseph Pilates' preferred name for his method, and it was based on the idea of muscle control. All exercises are done with control, the muscles working to lift against gravity and the resistance of the springs and thereby control the movement of the body and the apparatus.
For practitioners to control their bodies, they must have a starting place: the center. The center is the focal point of the Pilates method. Many Pilates teachers refer to the group of muscles in the center of the body—encompassing the abdomen, lower and upper back, hips, buttocks, and inner thighs—as the "powerhouse". All movement in Pilates should begin from the center and move outward to the limbs.
Pilates aims for elegant economy of movement, creating flow through the use of appropriate transitions. Once precision has been achieved, the exercises are intended to flow within and into each other in order to build strength and stamina. In other words, the Pilates technique asserts that physical energy exerted from the center should coordinate movements of the extremities.
Using correct posture while doing Pilates exercises improves safety by correcting muscle imbalances and optimizing coordination.
Precision is essential to correct Pilates. The focus is on doing one precise and perfect movement, rather than many halfhearted ones. Here Pilates reflects common physical culture wisdom, gaining more from a few energetic efforts than from many listless ones. The goal is for this precision to eventually become second nature and carry over into everyday life as grace and economy of movement.
Correct muscle firing patterns and improved mental concentration are enhanced with relaxation.
With increased precision, motion becomes more efficient so there is less stress to perform the exercises.
In 2015 the Australian Government's Department of Health published a meta study which reviewed the existing literature on 17 alternative therapies including Pilates, in order to determine if any were suitable for being covered by health insurance. The review found that due to the small number and methodologically limited nature of the existing studies, the effectiveness of Pilates is uncertain. Accordingly In 2017 the Australian government named Pilates as a practice that would not qualify for insurance subsidy, saying this step would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence".
For the treatment of lower back pain, low quality evidence suggests that while Pilates is better than doing nothing, it is no more effective than other forms of physical exercise. There is some evidence regular sessions can help with the conditioning of the abdominal muscles of healthy people, when compared to doing no exercise. There is no good evidence it helps improve balance in elderly people.
In October 2000 "Pilates" was ruled a generic term by a U.S. federal court, making it free for unrestricted use.
As a result of the court ruling, the Pilates Method Alliance was formed as a professional association for the Pilates community. Its purpose was to provide an international organization to connect teachers, teacher trainers, studios, and facilities dedicated to preserving and enhancing the legacy of Joseph H. Pilates and his exercise method by establishing standards, encouraging unity, and promoting professionalism.
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