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Instructing Clients with Cancer


As a Pilates instructor, it is quite common to take clients who are either undoing going cancer treatment or recovering following treatment. In fact, more and more studies are highlighting the physical and psychological benefits of Pilates in clients’ treatment and recovery. After radiation and chemotherapy, it is common for people to lose muscle mass and Pilates can be a great option for regaining strength. While some people may choose to perform Pilates while undergoing cancer treatment, this may not be an option for others who feel too unwell to exercise during treatment. Because of this, as a Pilates instructor, you will more commonly encounter clients in your classes who are recovering following cancer treatment.

While each type of cancer can very different and pose individual implications for Pilates, here are some general tips for instructing Pilates to clients with cancer.

TIP #1: Change Class Focus

The focus of your classes should be on gentle, light exercise and stretching rather than pushing clients hard. Don’t focus on the aesthetics of Pilates, for example, “this exercise is great for toning and lifting the buttocks”. As this is most likely not a priority for anyone going through or recovering from treatment. Instead focus on helping and motivating the client to feel well as they gain strength and mobility.

TIP #2: Rest as Needed

Be aware that clients undergoing treatment may be weaker than normal and most likely won’t feel well. This means that they may need to take more rest breaks. Don’t push the client to continue if they want to rest.

TIP #3: Limit Position Changes

The client may feel unwell or nauseous if undergoing treatment and constantly moving positions (getting up and down) may exacerbate the nausea. If this is the case, try to limit position changes as much as possible.

TIP #4: Utilise Props

If the client is feeling nauseous, you can keep the head up with a head cushion to make them more comfortable.

TIP #5: Change Room Temperature as Needed

Ask your client how the room temperate feels (they may feel unwell if the room is too warm) and set the room temperature accordingly for comfort.

TIP #6: Sessions May be Shorter

Session duration may differ from week to week depending on how the client is feeling. Give permission for the client to leave earlier if they are feeling unwell.

TIP #7: Balance May Be Affected

Certain treatments or medications may affect a client’s balance. If this is the case, avoid exercises which could be dangerous (such as standing up on the reformer).

TIP #8: Avoid Lying on Surgical Scars

If a client has had any surgery as a part of their treatment, scars can be uncomfortable to lie on. Always be guided by a client’s health care professional when it comes to limitations.

TIP #9: Immune System May be Compromised

The client’s immune system may be affected following treatment. As a result, they may easily pick up viruses or bugs. Because of this, always ensure that your studio, clinic or gym is clean and any equipment used is disinfected prior to use. If offering reformer classes, it’s a good idea to provide clean hand straps or head cushions for anyone whose immune system may be compromised.

TIP #10: Nerve Damage May Be Present

Chemotherapy and radiation can cause nerve damage and/or tingling. If this is the case, be guided by the client’s health practitioner. Keep in mind that nerve damage may affect sensation or touch For example, holding hand straps on the reformer or pushing through the feet on the footbar of the reformer can be painful. If this is the case, Matwork Pilates may offer a better alternative.

TIP #11: Be Aware of Movement Restrictions

Anyone who has had surgery may have movement restrictions. For example, breast surgery may affect arm movement. If lymph nodes have been removed, the client may have swelling or lymphedema. In this case, be guided by the client’s health care practitioner.

TIP #12: Check in After the Class

We have already mentioned that you should be guided by the client and how they are feeling throughout the class, but also keep in mind that a client may feel okay during the session, but then feel exhausted for days afterward. We recommend checking in with the client in the days after the class to see how they are feeling. This will help you to gauge intensity for the next class.

As with all health conditions, as a Pilates instructor, you should liaise with your clients’ health practitioner prior to the client through a class.


REFERENCES (2018). Staying mobile after surgery | Breast Cancer Network Australia. [online] Available at: [Accessed 13 Nov. 2018].

Bernardo, L. (2007). The effectiveness of Pilates training in healthy adults: An appraisal of the research literature. Journal of Bodywork and Movement Therapies, 11(2), pp.106-110. (2018). Cancer Survivors: Pilates and an Improved Quality of Life | Pilates | Balanced Body. [online] Available at: [Accessed 13 Nov. 2018].

Sener, H., Malkoc, M., Ergin, G., Karadibak, D. and Yavuzsen, T. (2017). Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial. Journal of Breast Health, 13(1), pp.16-22.

Together Against Cancer. (2018). Pilates :: Together Against Cancer. [online] Available at: [Accessed 13 Nov. 2018].




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