Pilates Fitness Friday: Guiding Clients with Conditions like Lupus and Myasthenia

Senior client seated Pilates for strength, posture, and mobility.

This week I have been reflecting on something that often comes up in our work as Pilates teachers. How do we guide clients who are living with health conditions beyond our studio doors? I had a 69-year-old client with lupus and myasthenia gravis in her history. Two very different conditions but both with one key thing in common. They affect how, when and even if someone feels able to move.

We know Pilates has an incredible role to play in helping these clients build strength, regain confidence and improve their quality of life. But part of being a well-rounded teacher is being able to talk knowledgeably about other types of movement and activity they might consider. After all, we are helping them towards a whole life of better movement, not just one or two hours a week with us.

🌿 A Quick Recap on the Conditions

Lupus is an autoimmune condition where the body attacks its own tissues. It causes fatigue, joint pain and sometimes organ involvement.

Myasthenia gravis affects how nerves communicate with muscles. This leads to muscle weakness that worsens with activity but improves with rest.

Both conditions come with good days and bad days and our advice as movement professionals needs to honour that reality.

🏃‍♀️ General Exercise Recommendations

So what does the guidance say?✔️ Aerobic activity: Aim for 150 minutes a week of moderate intensity activity. This could be broken into manageable chunks even 10 minutes at a time. Walking, swimming or gentle cycling are often recommended.✔️ Strength training: Twice weekly, focusing on all major muscle groups. For some clients, bodyweight exercises or resistance bands may be enough.✔️ Balance and flexibility: Activities like Pilates, yoga or tai chi are excellent for maintaining stability and mobility.

With lupus and myasthenia, energy levels fluctuate. So these guidelines are a starting point, not a prescription.

⏳ How and When Should They Exercise?

💡 Timing mattersFor lupus, avoid exercising during a flare when joints are painful or inflamed.For myasthenia, fatigue builds with repeated effort so keep sessions short and include rest breaks. Early in the day may be better for many as muscles tire less.

💡 Frequency and pacingEncourage regular moderate movement instead of sporadic bursts of intense activity. Suggest clients listen to their body and use a stop before fatigue approach.

🪑 What Types of Exercise Work Well?

🌸 Chair-based classes

Perfect for clients with fatigue or balance issues. These classes can maintain strength and range of motion without putting undue stress on joints or muscles.

🚶‍♀️ Walking

A fantastic low impact option. Suggest flat even paths and encourage the client to pace themselves. Short frequent walks are often better than one long hike.

🏊‍♀️ Swimming or water aerobics

The buoyancy of water supports joints and muscles while allowing for aerobic work and resistance training. Great for clients with joint pain.

🧘‍♀️ Tai Chi and Yoga

Excellent for improving balance, coordination and calming the nervous system. Just remind clients to avoid positions that demand prolonged effort in myasthenia.

🗨️ Talking to Clients About Exercise

When clients ask about activity outside of Pilates you do not have to be an expert in every modality. Instead

• Acknowledge their condition: “With lupus and myasthenia we need to be careful about how your body responds.”

• Encourage medical clearance: Especially if they are thinking of starting something new.

• Offer broad suggestions: “Gentle walking, swimming or even a chair-based class could complement what we are doing here.”

• Empower them: “The key is finding what feels good and pacing it. On good days you may do a little more. On harder days it is okay to rest.”

📝 Key Takeaways for Teachers

✔️ Pilates is ideal for these clients but we must recognise the value of variety in movement.

✔️ Understand and respect fluctuating energy levels and symptoms.

✔️ Be ready to suggest or signpost other safe low impact activities that fit their lifestyle.

This Fitness Friday take a moment to consider how you could broaden the conversation with your clients. It is not just about what they do in your session. It is about how you help them weave movement gently into their whole week.