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Navigating the Pilates Studio: What to Do When a Client Has an Autoimmune Disease

Working in Pilates with conditions
It is vital that clients get a release to exercise

Autoimmune diseases bring a complex range of challenges, impacting both physical and emotional wellness. As a Pilates instructor, understanding the good days, bad days, and symptoms to watch for can make a world of difference for your clients.

The Importance of Medical Clearance

Before engaging in a Pilates programme, it's essential for clients with autoimmune diseases to receive medical clearance. This not only ensures their safety but also provides personalised guidance from healthcare providers.

Types of Autoimmune Diseases and Their Impact

Understanding common autoimmune diseases like lupus, rheumatoid arthritis, and multiple sclerosis is crucial. Each comes with its own set of limitations and symptoms, affecting how you tailor a Pilates programme.

Common Symptoms to Watch For
  • Fatigue

  • Joint pain or stiffness

  • Skin rashes

  • Cognitive issues (e.g., "brain fog")

  • Sensitivity to temperature Being aware of these symptoms can help you adapt your approach on both good and bad days.

The Journey of Good Days and Bad Days

Physical and emotional states can fluctuate drastically. Good days offer an opportunity for a more robust routine, while bad days necessitate a softer, more nurturing approach.

Strategies for Bad Days
  • Reduced Intensity: Scale back the exercises.

  • Mindfulness and Breathing: Incorporate breathing exercises and mindfulness.

  • Open Communication: Discuss comfort levels and adapt as needed.

Tailoring the Programme

Be prepared with various exercise modifications and props to tailor the programme according to each day's conditions.

Monitoring and Adjusting

Regular check-ins allow for ongoing assessment of comfort levels and the suitability of exercises, helping you to adapt in real-time.

Instructor’s Role in Mental Wellbeing

Pilates' mind-body focus can be especially beneficial for mental wellbeing, which is often compromised in individuals with autoimmune diseases.

Legal and Ethical Considerations

It's imperative to keep waivers and informed consents updated. Act within your scope of expertise and refer clients to healthcare providers for medical advice beyond your remit.


Being an effective Pilates instructor for clients with autoimmune diseases requires flexibility, compassion, and a deep understanding of their symptoms and fluctuations. By adopting such an approach, you can create a nurturing environment that accommodates both good and bad days.

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