Reformer injuries are on the rise – are we surprised?

In recent years, there has been somewhat of a ‘boom’ with group reformer classes, not just in health clubs or dedicated Pilates studios, but also in more ‘boutique-like studios delivering their own interpretation of reformer Pilates. For me, observing this trend, as well as the increasing number of accidents and injuries that are reported, is for me, a little bit like travelling back in time and experiencing the aerobics boom of the early 80’s all over again. Yes, I was there!

There has been no shortage of media coverage of these incidents, but it’s more than likely also that many incidents have gone unreported. Two such headlines include:

‘When did Reformer Pilates in London become so dangerous? (The Standard. 2025)

and

‘The dangerous side of Reformer Pilates you don’t see on Instagram (Daily Mail. 2025).

Before we proceed any further, I feel the need to highlight the difference between reformer Pilates and group reformer training. This was discussed in a separate article and you can follow the inserted link to refresh yourself if you need to. They are not the same practice, but this isn’t always obvious, especially to the participant.

Reformer Pilates: Injuries, litigation and risks

The current group reformer craze that is sweeping the fitness industry has both positive and negative outcomes.

A double-edged sword

On the one hand, there is a movement trend that is gaining people’s interest and inspiring them to move more. It’s hard to say that this is a bad thing.

On the other hand, several litigations have been reported, both by the media and individuals, describing a range of injuries that have been caused by participation in many of these classes and sessions. Some injuries are minor, some are much more serious, including tendon tears, fractures, slipped discs and other more serious and debilitating injuries (The Standard. 2025; Daily Mail. 2025).

Specific injuries and litigation

Further examples of injuries being reported are shared by Lewitt and McPherson (2024), reporting:

• a spontaneous cerebrospinal fluid leak
• bilateral simultaneous shoulder dislocation
• a fall whilst doing a ‘non-Pilates’ exercise on the reformer*

*this incident alone resulted in significant financial compensation being awarded to the injured party.

Outside of the mainstream media, there are also reports in the industry of other ongoing legal cases and personal injury claims being made for similar incidents. Speaking to me on this matter, Lee Cain, Managing Director of HFE said:

“We’ve been contacted on a few occasions for advice and commentary by litigants and legal professionals alike about cases like these. We’ve seen all sorts, from people delivering sessions without any qualifications, to people completing online courses with little in the way or formal instruction or assessment. It’s pretty clear that the standards are quite low in some cases.”

What is the root cause of the problem?

Like most things, it’s hard to say that there is a single cause.

Two issues reported by the Daily Mail (2025) that are reported to be contributing to the rise in reformer injuries include those:

1. 1. people attempting to cash in on the reformer Pilates boom and opening facilities without sufficient reformer Pilates training and/or experience
2. facilities cramming far too many reformers into a single room or studio for the purpose of maximising revenues and their return on their investment (we all know reformers aren’t cheap)

No real surprises there!

There are also reports of reformer sessions taking place in studios where strobe lighting and the equivalent of rave music are being played. This sounds to me very much like some of the group exercise sessions that were around in the late 80s – no observation, no opportunity to see and correct technique, and no actual teaching taking place. But now, now we have the addition of a piece of apparatus that challenges stability, complexity, and which significantly adds to the potential risk of serious injury.

If I recall correctly, there were in fact incidents reported in the 1980s where strobe-like lighting triggered seizures with some participants. Now, I more than anyone appreciate a party atmosphere on occasion, but there is a time and a place for it, and certainly not while I am taking part in exercise or movement practices.

I like to move with mindful purpose and conscious awareness of my body (to keep my 60+ year old body safe), regardless of the type of session I am participating in. I am also pretty sure that was one of the core principles of Pilates, to move with purpose and consciousness.

As Joseph Pilates himself (1945) stated:

“Concentrate on the correct movements each time you exercise, lest you do them incorrectly and thus lose all the vital benefits of their value”.

Risks of group reformer training

As we know, the use of any equipment in exercise (e.g., kettlebells, stability balls, discs, resistance machines, skipping ropes, steps etc) adds additional challenge and with that challenge comes specific risks, which need to be mitigated with good instruction and/or technique (mindful movement).

The cornerstone of any teacher-led exercise practice is good instruction and technique. But outside of this, there are also a number of other considerations that increase liability for the instructor, and/or the operator providing the service.

Manufacturers of Pilates reformers advise that their equipment should only be used for the purpose for which it is intended (e.g., Pilates). This provides manufacturers with some protection against future potential litigation and places greater responsibility on users, teachers and operators to ensure apparatus is used appropriately.

Now, something of great importance to remember is that the universal reformer was designed by Joseph Pilates to be used as a part of the Pilates system, supporting participation of, and performance in, the full matwork repertoire. Those who understand the system will understand the apparatus and the risks that need to be managed.
As a piece of apparatus, there are several features on the reformer which significantly affect ‘stability’; the sliding carriage and its various spring settings being one such feature. The straps are also another. Both must be used with appropriate caution and care.

The reformer certainly wasn’t designed to be used as a piece of generic exercise kit for exercise instructors to add to their toolbox and do whatever exercise they like, irrespective of whether it’s part of the Pilates repertoire or not. Unfortunately, in many cases it appears this may be exactly how some are using it!

On this issue, Lee Cain, Managing Director here at HFE also commented; “sessions are being called reformer Pilates when effectively they are delivering generic body conditioning exercises with springs and a carriage. Often, these exercises have nothing to do with Pilates. In the wrong hands, the reformer can become like a human catapult, and people need a lot more training on this equipment than they are currently getting. In some cases, they are attending courses online without even getting any supervised training or instruction with their course tutor. It’s complete madness.”

I’ve also seen some very dubious, ‘non-Pilates’ exercises being performed on social media, coupled with advertisements to do a quick half day online training (with no entry-training). It’s like ‘learn a few exercises, call it Pilates reformer’ and away you go. We explore this more in our Reformer Pilates Standards and Education article.

Balancing risks and benefits

Every instructor and every leisure facility has a ‘duty of care’ and this should include a comprehensive risk assessment (individuals, equipment, and environment) prior to delivering any exercise session. A key part of this risk assessment is to identify the potential hazards, along with who could be harmed, how they could be harmed, and the likelihood and severity of the harm that could be caused (low to very high). Usually, any risk rated more ‘medium’ would require additional strategies to be put in place to minimise these risks.

Now, the first rule of risk management is to eliminate it. For example, don’t lift heavy object on your own (manual handling); don’t attempt to put out a fire (fire safety), don’t use strobe lighting if it isn’t needed; and don’t use the reformer like a piece of gym kit (especially if you haven’t been appropriately trained).

If the risk cannot be eliminated, then other risk management strategies are implemented to reduce the risk. For example, where manual handling is concerned, specialist training, using equipment and/or other people to help lift the heavy object are common place. Measures to isolate the risk so less people are affected are also taken (e.g., close doors so the fire cannot spread), and control the risk by putting even more measures in place that are specific to that risk.

So, for a reformer session, simple control measures could involve limiting the numbers of participants in a session, or increasing the supervision (e.g., the number of instructors), using apparatus as it was intended (so please, no dumbbell exercises at the same time as performing a carriage or legs in straps exercise), and also ensuring equipment is well maintained. It’s crucial also that teachers are appropriately trained and that they undertake industry-recognised Pilates teacher training, alongside other control measures.
The combined aim of these controls is to protect the public and protect the instructor and service provider against potential litigation.

A call for action

Lewitt and McPherson (2024) assert “There is a call for the public to be more aware of the risks in an environment where the focus is on apparatus, and gyms and fitness instructors “cutting corners.”

They make several other recommendations to standardise the provision of ‘reformer’ sessions, which include clear standards with global recognition and clear occupational codes. However, they are also aware of the ‘commercial interests of those promoting exercise using the label ‘Pilates’, including manufacturers of apparatus’.

Conclusion

With injuries on the rise and increased cases of litigation being presented, it is essential to respect and use apparatus for its intended purpose – the reformer is not another piece of gym kit!

It is also essential that an appropriate risk assessment is conducted by a competent person (e.g., somebody with sufficient Pilates training), so that potential risks are identified and managed!

Perhaps it is also time to reflect on what happened during the 80s’ with group exercise and what has evolved since then, and learn from these experiences.
We’ll explore this more in the next article on Pilates Standards of Education.

References

Daily Mail (2025) The dangerous side of Reformer Pilates you don’t see on Instagram. Accessed on 05/07/2025; Available from: https://www.dailymail.co.uk/femail/article-14514429/dangerous-Reformer-Pilates-Instagram.html

The Standard (2025) When did Reformer Pilates in London become so dangerous? Accessed on 05/07/2025; Available from: https://www.standard.co.uk/lifestyle/reformer-pilates-unsafe-dangerous-injury-b1217211.html

Lewitt, M. S and McPherson, L.A (2024) Pilates’ in 2024: Useful Clinical Tool or Commercial Catchphrase? Accessed on 23/06/2025; available from: https://www.heraldopenaccess.us/openaccess/pilates-in-2024-useful-clinical-tool-or-commercial-catchphrase

Pilates, J. and Miller, W. J. (1945) Return to life through Contrology. USA: J.J. Augustin. Republished in 1998, USA: Presentation Dynamics.

Author

Debbie Lawrence. MA.

Expert Writer and Consultant

Debbie is a highly experienced writer and consultant in the exercise and fitness industry with over 40 years’ experience. She holds a master’s degree in education and is the author of 13 books published by Bloomsbury Publishing. Additionally, Debbie has also ghost-written numerous training resources and educational products, including many of those used here at HFE. Debbie's goal is to be a continual 'seeker of knowledge’, always reflective and always learning, striving to inspire others to remain curious and open to learning and developing more. Debbie still finds time to teach classes to the public, working primarily with adults who have long-term health conditions.