Pilates and Pelvic Floor Therapy – The Perfect Duo
Pilates has long been recognized by the fitness community as a really great core workout and receives most of its attention from women wanting to tone their midsection, but there’s a little more to it than that. Just over 100 years ago Joseph Pilates created this system of exercises for rehabilitation of injured soldiers in the First World War. Yes, you read that correctly, it’s a rehab method. While these exercises have been refined over the years with the latest research on anatomy and biomechanics, Pilates is being effectively used today by many rehab and sports medicine professionals all over the world.
With the essence of Pilates focusing on posture, alignment, core strength and stability, muscle balance, coordination, and agility, it is also the perfect exercise approach to utilize with pelvic floor physical therapy.
Here’s Why:
With many of the conditions that pelvic floor therapists treat, such as urinary incontinence, pelvic organ prolapse, diastasis recti, hernia, etc. the common underlying issue is poor intra-abdominal pressure control. What does this mean? Pressure control is how we effectively manage pressures that are applied throughout our torso and onto our various tissues, bones, ligaments, and organs, with everyday activities and bodily functions. Getting out of bed, squatting to pick up clothes from the floor, standing from sitting, running, jumping, sneezing, coughing and laughing all create pressure into the abdominal cavity. Similar to how a balloon fills up with air and the air is dispersed evenly throughout the balloon. This is how pressure spreads throughout our torso in a healthy body.
When there is dysfunction in this system due to movement restrictions from tightness in certain muscles or decreased range of motion in our joints (shoulders, spine, hips), the daily pressures that our body is subjected to bypasses the stiff and rigid areas and follows the path of least resistance. Think of the balloon again and imagine squeezing the top of the balloon as it inflates. Where does the air go? Yes, down to the bottom in the area that is not restricted. The same occurs within our body and this causes excessive pressure to one specific area (often the abdomen, groin and pelvic floor) and leads to weakening of those areas or tissues over time.
Where does Pilates fit in?
Often in traditional physical therapy you start with mat based exercises, laying on your back, where gravity is less of a factor on your body. Maybe then, you transition to a side lying position or on your hands and knees. You could be feeling great with these exercises and nearly symptom free, but at some point you have to make the transition to standing, upright, and more functional movements. Unfortunately, with many of the aforementioned pelvic floor-related conditions, this leads to a return of symptoms and can be incredibly frustrating. What’s great about Pilates and the use of Pilates equipment specifically is that you can start to train for activities such as squats, running, and jumping in a gravity-reduced position to safely and effectively progress the amount of resistance and force on your body for a more seamless transition into upright, functional movements and activities. With this steady progress, facilitated by the Pilates equipment, you actually get better faster!
Pilates exercises are also more dynamic than your usual gym and therapy exercises, mimicking the way we move in our everyday lives. So, not only is your body being effectively challenged in different ways, it’s fun to do!
Research backs this up as well!
A systematic review and metanalysis on the Pilates method and pain in pregnancy reveals that when Pilates was utilized in prenatal fitness, it led to reduced pelvic pain, reduced occurrence of abdominal diastasis, and improved functional capacity during and after pregnancy.
Pilates has also been proven to improve pelvic floor contraction timing and speed, according to a study assessing the effectiveness of Pilates on the pelvic floor of elderly women. When some patients present with urinary incontinence, but have a strong pelvic floor contraction, it is often the timing and speed of their contraction that is lacking. This further demonstrates how Pilates can help resolve urinary incontinence.
Not to mention, it can help men with urinary incontinence too. A higher percentage of men had complete resolution of urinary incontinence following a Prostatectomy in the group that underwent Pilates exercises, compared to conventional pelvic floor muscle training.
Finally, a recent study published in the Journal of Bodywork and Movement Therapies concluded that postpartum women who participated in Pilates before delivery resulted in lower symptom severity regarding stress urinary incontinence, and therefore Pilates should be encouraged by health professionals to those in the prenatal period.
While many pelvic floor conditions often affect women in the perinatal stages, it's important to know they can also affect men. At Evolve Pelvic Health & Wellness we offer this fun and effective approach to pelvic floor therapy for all genders.
Linsay Hall is the owner of Evolve Pelvic Health & Wellness and offers a unique approach to pelvic floor therapy with the integration of Pilates exercises and equipment.
Learn more about her and her approach here.