Knee-Friendly Pilates: Transformative Exercises for Joint Health
How often do you use the Stability Ball with your clients? Do you utilise it enough? Could you do more? We speak with Pilates Professional Lana de Wit from Laros Pilates about how she gets the most from exercises with the Stability Ball.
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I’ve always loved activities that challenge balance and control, like rollerblading and ice skating. When I first tried Pilates, I was captivated by how the trainer used the Stability Ball to make the class both challenging and addictive. That experience inspired me to master the ball, integrating it with Pilates, Personal Training, and Functional Range Conditioning (FRC), and applying it to my work with clients.
In this article, I’ve focused on Stability Ball exercises that use optimal muscle engagement and improved biomechanics. We need to ensure that we have a balanced activation of the quadriceps, hamstrings, glutes and core leading to more effective strength development around the knee joints.
By using efficient movement patterns, we will also reduce undue stress on the knees and joining surrounding structures. "Prevention is better than cure" and we can improve the way we perform these exercises by focusing on technique correction when guiding our clients to prevent degenerate conditions.
We can also improve the way we perform these exercises by maintaining technique correction especially when coaching or guiding clients through the following exercises.
I’ve chosen several positions to promote comprehensive muscle engagement. We all know that lying down (supine) allows for controlled movements without the impact of gravity, while seated exercises focus on isolating without the influence of body weight. Initially using lying down and seated exercises minimises the load on the knee joints making it more suitable for individuals with pain or arthritis. These “controlled positions” allow for precision.
Standing exercises mimic everyday activities and sports where endurance is needed to support the knees during weight-bearing activities. Enhancing proprioception and balance is crucial for preventing falls and knee injuries.
Standing also improves the body’s ability to sense its position in space therefore should only be applied to those who are ready to advance. So, let’s walk through some of my favourites.
SUPINE (Start and Progress)
Pelvic Press (Half Lift) Holds Lying on the Mat
Setup:
○ Lie on your back on a mat with your arms by your sides, palms facing down
○ Place your feet on top of a stability ball. Your legs should be bent at the knees, and the ball should be close enough that your knees are at a 90-degree angle
Starting Position:
○ Your feet should be on the ball with ankles plantar flexed, your pelvis tilted posteriorly
Performing:
○ Press through your heels down into the ball and lift your hips towards the ceiling, only raising them halfway up. Your glutes should be engaged, and you should feel tension in your hamstrings
○ Hold this position for 10 counts, maintaining the engagement in your glutes and hamstrings
○ Perform 3 Repetitions (holds while lifted). Aim for 2 - 3 Sets.
○ Slowly lower your hips back down towards the mat, keeping control and avoiding any jerky movements
○ Make sure you keep the ball from being pressed forward.
Breathing:
○ Exhale as you lift your hips up
○ Inhale to pause
○ Breathe normally to CONTRACT for 10 counts
○ Exhale as you lower your hips
2. Pelvic Press (Half Lift) Press & Pull Lying on the Mat
Setup:
○ Lie on your back on a mat with your arms by your sides, palms facing down
○ Place your feet on top of a stability ball. Your legs should be bent at the knees, and the ball should be close enough that your knees are at a 90-degree angle
Starting Position:
○ Your feet should be on the ball with ankles plantarflexed, your pelvis tilted posteriorly
Performing:
○ Press down through the soles of feet into the ball and lift your hips towards the ceiling, only raising them halfway up. Your glutes should be engaged, and you should feel tension in your hamstrings
○ Press the ball out till the knees are almost straight and then pull the ball back to the start position with control
○ Complete 8 - 10 Repetitions. Aim for 2-3 sets, taking a short break between sets if needed
○ Slowly lower your hips back down towards the mat, keeping control and avoiding any jerky movements
○ Make sure you keep the ball from being pressed forward.
Breathing:
○ Exhale as you lift your hips up
○ Inhale to pause
○ Exhale to press out
○ Inhale to pull in
○ Exhale as you lower your hips
SEATED (Start and Progress)
3. Sit-to-Half-Squat Holds Seated on the Stability Ball
Setup:
○ Sit on a stability ball with your feet flat on the floor, hip-width apart. Your knees should be bent at a 90-degree angle. Your hips 90-degrees to the knees
○ Maintaining length through the Spine
○ Place one hand on the ball for stability
Starting Position:
○ Sitting inclined forward on the ball with your shoulders square and your gaze forward
○ Keep your feet firmly planted on the floor
Performing the Half Squat:
○ Slowly stand up from the ball by pushing through your heels and engaging your quadriceps, hamstrings, and glutes
○ Maintain the inclined Spine position, make sure you engage your core
○ Lift your hips until you are in a half squat position, with your knees bent at about 135 degrees
○ Use your hand on the ball for balance and support
○ Hold the position for 5 counts. Perform 10 - 15 Repetitions. Aim for 2 - 3 Sets
Returning to the Starting Position:
○ Slowly lower your hips back down to sit on the ball, maintaining control and keeping your movements smooth
Breathing:
○ Inhale to prepare
○ Exhale as you stand up to the half squat position
○ Breathe normally
○ Exhale to sit with control
4. Sit-to-Half-Squat Single Leg Seated on the Stability Ball
Setup:
○ Sit on a stability ball with your one foot flat on the floor, the other knee bent back next to the ball
○ Your “working” knee should be bent at a 90-degree angle. Your hip 90-degrees to the knee
○ Maintaining length through the Spine
○ Place one hand on the ball for stability
Starting Position:
○ Sitting inclined forward on the ball with your shoulders square and your gaze forward
Performing the Half Squat:
○ Slowly stand up from the ball driving the one foot through the ground engaging your quadriceps, hamstrings, and glutes and CORE
○ Maintain the inclined Spine position
○ Lift your hips until you are in a half squat position with your supporting hip facing straight forward
○ The working single leg maintains the alignment of knee to second toe
○ Use your hand on the ball for balance and support
○ Hold the position for 5 counts
○ Slowly lower your hips back down to sit on the ball, maintaining control and keeping your movements smooth
○ Then do the next repetitions with the hold
○ Perform 5 repetitions aiming for 2 sets. Alternating the legs after the first set
Breathing:
○ Inhale to prepare
○ Exhale as you stand up to the half squat position
○ Breathe normally
○ Exhale to sit with control
5. Hip Extension Circles Lying Over the Stability Ball
Setup:
○ Place a stability ball on the floor and position yourself face down over the ball
○ Your hips should be resting on the ball, and your upper body should be supported by your hands on the floor
○ Your legs should be extended straight behind you, with your toes touching the ground
Starting Position:
○ Core engagement is paramount
○ Keep your head in a neutral position, looking down at the floor
○ Ensure your pelvic is posteriorly tilted and “square” to the ball
Performing the Hip Extension Circles:
○ Slowly lift one leg straight up towards the ceiling, keeping it extended and your toes pointed. Avoid bending the knee
○ Lift your leg until it is in line with your body and continue to “draw” circles the size of a soccer ball without compromising your pelvis position
○ As you circle an emphasis must be on the SPEED staying the same without the ball moving
○ 10 Repetitions each leg (remembering to change direction) Stay on the same side then adjust to the other side
“10 Repetitions each leg (remembering to change direction) Stay on the same side then adjust to the other side”
Returning to the Starting Position:
○ Slowly lower your leg back down to the starting position, maintaining control and avoiding any jerky movements
○ Repeat the movement with the other leg
Breathing:
○ Inhale as you lower your leg
○ Breathe normally to circle
○ Exhale as you lift your leg
STANDING (Start and Progress)
6. Single Leg Squat with One Foot on a Stability Ball in Front
Setup:
○ Place a stability ball in front of you on the floor
○ Stand tall with your feet hip-width apart, and then place one foot on the stability ball. The ball should be close enough that you can comfortably reach it with your foot and the knee bent
Starting Position:
○ Engage the core for stability
○ Keep your standing leg straight but not locked, and maintain an upright posture
○ Place your hands on your hips or extend them in front of you for balance
Performing the Single Leg Squat:
○ Slowly bend the knee of your standing leg, lowering your hips towards the ground inclining the spine slightly forward
○ As you squat down, the foot on the stability ball will roll slightly forward. Control the movement to ensure the ball doesn’t roll too far
○ Push down through the foot of your standing leg without scrunching your toes; additionally maintain knee alignment
○ Fixing your gaze on a stationary object in front of you to help maintain stability and control
○ If you find it difficult to balance, hold onto a stable surface like a wall, chair, or railing with one hand for additional support
○ 10 - 15 SLOW repetitions. Aim for 2 sets each leg.
Breathing:
○ Inhale as you lower into the squat
○ Exhale as you push back up to the starting position.
7. Single Leg Squat (and half Press) with One Foot on a Stability Ball Behind
Setup:
○ Place a stability ball behind you on the floor - with your trainer holding the ball to steady for the ankle resting on it
○ Stand tall lengthening out the spine and working leg
Starting Position:
○ Engage the core for stability
○ Place your hands on your hips or extend them in front of you for balance
Performing the Single Leg Squat and Press:
○ Slowly bend the knee of your standing leg, lowering your hips towards the ground inclining the spine slightly forward WHILE pressing the ball behind keeping the back knee bent (not going to straight)
○ As you squat down, control the movement to ensure the ball rolls in a straight line behind you
○ Push down through the foot of your standing leg without scrunching your toes; additionally maintain knee alignment
○ Fixing your gaze on a stationary object in front of you to help maintain stability and control
○ If you find it difficult to balance, hold onto a stable surface like a wall, chair, or railing with one hand for additional support
○ Perform 8 SLOW repetitions. Aim for 2 sets each leg.
Breathing:
○ Inhale to prepare
○ Exhale as you lower into the squat and press
○ Inhale TO HOLD
○ Exhale as you push back up to the starting position.
8. Single Leg Squat (Full Press) with One Foot on a Stability Ball Behind
Setup:
○ Place a stability ball on the floor behind you. Trainer support.
Starting Position:
○ Engage your core and with your hands on your hips, extended in front of you for balance, or holding onto a stable surface for support.
Performing the Single Leg Squat and Press:
○ Slowly bend the knee of your standing leg, lowering your hips towards the ground. Keep your knee aligned with your second toe
○ As you squat down, allow the foot on the stability ball to roll backward, keeping your balance and control
○ Lower yourself as far as you can comfortably go without compromising form / experiencing any pain
○ Push through the heel of your standing leg to return to the starting position, straightening your knee and bringing your hips back up
○ Perform 8 SLOW repetitions. Aim for 2 sets each Leg.
Breathing:
○ Inhale to prepare
○ Exhale as you lower into the squat and press
○ Inhale TO HOLD
○ Exhale as you push back up to the starting position.
Watch a video of these exercises here
Lana de Wit is a Pilates instructor and educator with 17 years of experience. After earning her Master’s in Health and Welfare Management, she completed her Pilates certification in Cape Town, South Africa, and expanded her training with STOTT and PEAK PILATES in the USA. Lana has lectured internationally, specializing in core strength using the Stability Ball. She recently became a Functional Range Conditioning Mobility Specialist. Passionate about helping others, Lana focuses on improving movement and achieving optimal health.