Gradual strengthening is one of the most effective strategies for most sports/over-use injuries. Research supports exercise as way of managing pain and rebuilding tolerance in tissue and joints. The Pilates equipment facilitates gradual strengthening without over-loading when there is pain. The mechanics of any injury may need to be deconstructed; movement patterns corrected and then building tolerance. Every sports injury is specific to the person and their training regime. Solving it requires a combination of the research and each person’s clinical presentation.