For many women between 45 and 60, injuries or persistent aches can feel like an unwelcome sign of “slowing down.” It’s easy to think that pain or injury means you should stop moving altogether — but that’s often the opposite of what your body needs.

Recently, at 53 I suffered a skiing injury that had me off my feet for 4 weeks. This reminded me of the challenge of how to keep moving when injury strike! Often well-supported movement is one of the best ways to recover safely, stay strong, and maintain confidence in your body — especially when you’re working through an injury.

In this blog, we’ll explore:

• The most common injuries for women in midlife

• What you can do to keep moving safely

• How Pilates can be adapted to work with, not against, your body’s healing process

Common Injuries for Women 45–60

Let’s start with what we often see in the studio:

1. Low Back Pain
2. Hip Pain (e.g., bursitis, hip impingement, arthritis flare-ups)
3. Shoulder Strain or Rotator Cuff Issues
4. Knee Pain (including arthritis or meniscus irritation)
5. Foot Problems (like plantar fasciitis)

These injuries can come from wear and tear, changes in hormones affecting tissue health, or simply the reality of decades of busy living — lifting kids (and grandkids), gardening, working at a desk, or doing repetitive movements.

The key is not to freeze in fear. Instead, we learn to adapt.

Why Keep Moving When You’re Injured?

It’s tempting to rest completely, but total rest often delays healing. Gentle, appropriate movement brings circulation to tissues, keeps joints mobile, and prevents weakness or stiffness from setting in.

Pilates is particularly suited to “moving with injury” because it’s adaptable, low-impact, and focuses on alignment and breath. When guided well, your Pilates practice can help you:

✅ Reduce pain
✅ Improve circulation to injured areas
✅ Maintain strength around the injury
✅ Prevent compensations that lead to new injuries
✅ Support mental well-being and body confidence

How to Move Safely with Common Injuries

Let’s look at each one more closely — with practical Pilates tips.

1. Low Back Pain

Why it happens:
Weak or uncoordinated deep core muscles, tight hip flexors, poor posture, or old injuries can all contribute. Hormonal shifts can also affect connective tissue, making old back niggles flare up.

Pilates protocols:

• Focus on gentle pelvic tilts, supported imprinting, and breath-led core engagement.

• Use props like a small cushion under the head or knees for comfort.

• Keep movements slow and controlled — quality over quantity!

• Avoid loaded spinal flexion (like full roll-ups) until pain subsides.

Safe Pilates moves to try:

• Supine pelvic clock (tilting pelvis in small circles)

• Supported knee folds (one leg at a time)

• Bridging with focus on spinal articulation, not height

• Side-lying leg lifts to strengthen glutes

2. Hip Pain

Why it happens:
Bursitis, hip arthritis, or tight hip muscles can make hips sore, stiff, or pinchy. Prolonged sitting and lack of balanced movement often add to the problem.

Pilates protocols:

• Avoid repetitive hip flexion if it aggravates your pain.

• Work on gentle hip strengthening in pain-free ranges.

• Keep pelvis stable — avoid large swinging leg movements.

Safe Pilates moves to try:

• Clamshells (side-lying) to wake up glutes

• Shoulder bridge with small range to open the front of hips

• Supine hip circles (tiny range, focus on control)

• Standing side leg lifts with light support

3. Shoulder Strain or Rotator Cuff Pain

Why it happens:
Shoulder injuries are common after years of lifting kids, carrying bags, or sitting with rounded posture. The small stabilising muscles in the rotator cuff can weaken, leading to pinching or strain.

Pilates protocols:

• Keep shoulders away from ears — focus on scapular (shoulder blade) stability.

• Avoid heavy resistance overhead if painful.

• Do movements with arms below shoulder height at first.

• Add gentle shoulder mobility with breath.

Safe Pilates moves to try:

• Wall angels for gentle shoulder opening

• Arm circles lying on your back

• Scapular retraction exercises (e.g., “hug a tree” with resistance band)

• Thread the needle (spinal twist) if comfortable

4. Knee Pain

Why it happens:
Years of sports, arthritis, or imbalances in the hips and feet can stress the knees. Weak glutes or quads can also mean the knee joint does more work than it should.

Pilates protocols:

• Avoid deep knee bends if painful.

• Focus on strengthening glutes and inner thighs to support knee tracking.

• Work on alignment — knees should track over second toe.

• Add gentle quad strengthening without high impact.

Safe Pilates moves to try:

• Side-lying leg lifts

• Clamshells

• Small squats using a chair or wall for support

• Footwork on the Reformer with light resistance (guided by a teacher)

5. Plantar Fasciitis

Why it happens:
Tight calves, weak foot muscles, unsupportive shoes, or walking habits can lead to heel and arch pain.

Pilates protocols:

• Stretch calves and strengthen foot muscles.

• Keep weight evenly balanced on the feet during standing exercises.

• Avoid high-impact or jumping movements.

Safe Pilates moves to try:

• Foot doming (seated, lift your arch)

• Calf stretching with the band

• Toe spreads and scrunches

• Footwork on the Reformer, focusing on pressing through the whole foot

General Tips for Practicing Pilates with an Injury

• Tell your teacher: Always share how you’re feeling. At Move to Nurture, we adapt every class — no one should ever feel they need to push through pain.

• Use props: Small cushions, bands, balls, or blankets make a big difference to support and alignment.

• Listen to your body: A little gentle discomfort as you stretch is okay. Sharp pain or catching sensations are not.

• Stay consistent: Even 10–15 minutes of mindful Pilates daily helps keep you connected and confident.

The Confidence to Keep Going

One of the greatest gifts of Pilates in midlife is that it teaches you how to work with your body — not punish it. You learn that an injury doesn’t mean you’ve failed — it’s a chance to pause, listen, and rebuild smarter.

Every time you show up on your mat, you remind your body that you trust it. You remind your mind that you are not broken — just adapting.

And you remind yourself that strength is not about perfection, but about meeting your body where it is — with kindness, curiosity, and just the right amount of challenge.

Ready to Move — Safely?

If you’re working through an injury, you don’t have to do it alone. At Move to Nurture Pilates, I specialise in supporting midlife women to find sustainable, safe ways to stay strong — even when life throws a few bumps in the road.

If you’d like guidance on how to adapt your Pilates practice, get in touch. Book a private session where your injuries are understood, and your confidence is always the priority.

Let’s keep you moving — with care, courage, and a body you can trust.