Pilates vs. Physical Therapy: Where Each One Fits
I see this scenario quite a lot from my own clients: an injury happens, they start physical therapy, and midway through start wondering whether they should just keep doing Pilates instead, since many of the exercises look the same. The honest answer is you usually need both, working together, not one instead of the other.
What Physical Therapy Does
Physical therapy is medical care. A physical therapist is licensed to diagnose, and their job is to treat an injury, manage a condition or rehab you after surgery or injury, generally within a specific timeframe tied to your recovery. In practice, most PT sessions stay tightly focused on the injured area itself, largely because insurance-covered visits are limited and every session is focused on that specific diagnosis. Whether the rest of your body is staying strong, mobile and balanced while that injury heals is generally not something your PT has time for.
Where Pilates Fits
This is exactly where my job starts. When a client is in active physical therapy, I ask not only for a diagnosis but to see the exercises their PT has assigned. And in the past, there have been instances where I have called a PT directly on a client's behalf when I needed more detail. During our sessions, I am watching whether the rest of the body is compensating for the injury: an imbalance forming because someone has been favoring one side, muscles atrophying because someone has been told to rest or even mobility being lost in a joint nowhere near the actual injury.
Here is a really great example. I had a client who was midway through physical therapy for a shoulder injury. Her PT sessions and home exercises were working as they should. Instead of overworking that shoulder, in our sessions we spent our time focused keeping the rest of her body — her other arm and shoulder, her hips and spine — strong and mobile. This way she was not walking out of recovery with new imbalances she picked up from months of favoring one arm. Once she was cleared, we had a body that needed a little more balancing but was strong, not one that needed a second round of fixing.
On the other hand, I had another client who was seeing a PT but was not doing her assigned exercises at home, and she was not happy with her progress. Once we started incorporating those PT exercises into our sessions, her recovery took a turn in the right direction. Both clients needed the same kind of care, just in different forms, a plan molded to fit the individual. It is one of my main philosophies: meet the client where they are, without judgment.
What This Looks Like in Practice
If you are doing both PT and Pilates at once, keep these in mind:
A new injury, surgery or undiagnosed pain always starts with a physical therapist or doctor. That has to come first.
If you are already in physical therapy, tell your Pilates instructor. I want to see what your PT has assigned so we are not overworking the area or working against their plan.
Pilates fills the gap PT doesn’t cover: the rest of your body. Staying strong and balanced while one area heals is exactly how you avoid a second injury once you are cleared.
Where This Goes Next
This article is part of a broader dive into Pilates for pain and injury. For more:
If you are working with a physical therapist right now and want a plan that supports what they are doing, that's exactly what I do one-on-one. Contact me here.
A quick note: This article is educational, not medical advice. If you're dealing with pain that is new, severe or persistent, please see a doctor for a proper diagnosis before starting any new movement practice.