At its’ core – Pilates and Pelvic floor health    

Pilates educationPathologies
Written By Louise Taube

Strengthening the Pilates Pelvic Floor: A Guide to Better Health

Introduction

How often do you teach Pelvic floor exercises to your clients?

At its’ core, we know that Pilates focuses on what Joseph Pilates referred to as the “powerhouse” or the central region of the body, including the abdominal muscles, lower back, and hips. Now, we include the pelvic floor wAnd when we talk about the core in Pilates we now also include the Pelvic floor. The Pelvic floor is affected by the breath and any increase or decrease in intra-abdominal pressure. Through Pilates we can create a better functioning pelvic floor, especially if there is stress incontinence (leaking with a cough or a sneeze). For someone who has a weakened pelvic floor we must choose exercises that create less intra-abdominal pressure until pelvic floor strength and control is gained.

Exercises that may be too strong for a weak pelvic floor include the full hundred, double leg lowers, abdominal exercises with legs in an open kinetic chain, and abdominal curls. For people with weak pelvic floor we also need to include exercises to gain awareness of how to relax the pelvic floor, as often a weak pelvic floor may also be unable to relax. It is a tricky progression, for we eventually want our clients to be able to progress with the Pilates technique, but not at the expense of weakening the pelvic floor.In this article we discuss why the Pelvic floor is something that shouldn’t be taken lightly.

What is the Pelvic Floor and Why is It Important?

The pelvic floor is a group of muscles located at the base of the pelvis, forming a supportive sling that stretches from the pubic bone to the tailbone. These muscles play a crucial role in various bodily functions, including supporting pelvic organs, controlling urinary and bowel functions, and contributing to sexual health. The pelvic floor is all that is holding up all the contents of the trunk, so it needs to be in good working order.

A weakened pelvic floor can lead to several issues, including:

  • Urinary incontinence

  • Pelvic organ prolapse

  • Sexual dysfunction

  • Low self-esteem

Maintaining a strong and functional pelvic floor that is also able to relax (as required during childbirth, defecating, and urinating) as well as lift (when busting to go to the toilet but the door is locked, when sneezing or coughing and not wanting to leak or gas off). A well-functioning pelvic floor is essential for overall health and well-being, and some may even say happiness. Weakness or dysfunction in these muscles can lead to issues such as urinary incontinence, pelvic organ prolapses, sexual dysfunction and low self-esteem. Conversely, overactive pelvic floor muscles can also cause discomfort and other complications such as painful sex, and being unable to enjoy activities such as cycling, horse riding or even sitting. Therefore, achieving a balanced, functional pelvic floor is key to preventing and addressing these concerns.

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How Pilates Benefits Pelvic Floor Health

Pilates offers several benefits for pelvic floor health, primarily through its focus on core strength and body awareness. Here’s how Pilates can positively impact the pelvic floor:

1.  Strengthening the Core: Pilates emphasises the importance of a strong core, which includes the muscles of the transversus abdominis, multifidus, and pelvic floor muscles. Strengthening these muscles can provide better support for the pelvic organs and enhance overall stability. Exercises like the knee drops, knee floats, and knee stirs are excellent for building core strength at a beginner level, which indirectly benefits the pelvic floor. Pelvic floor activation can be cued with these exercises. Remember like any muscle, the pelvic floor can get tired, so do not cue a pelvic floor lift for every exercise.

2. Improving Muscle Control: Pilates teaches precise muscle control and awareness, helping individuals better engage their pelvic floor muscles. By practicing exercises that involve both contraction and relaxation of the pelvic floor, individuals can develop greater control and coordination of these muscles. This improved control can help with issues such as incontinence and pelvic pain. A great way to gain more awareness of pelvic floor is to practice lifting and relaxing the pelvic floor while sitting on a fit ball, or a rolled-up towel.

3. Enhancing Posture and Alignment: Proper posture and alignment are fundamental principles of Pilates. What might surprise you is that mMisalignment and poor posture can contribute to pelvic floor dysfunction by placing undue pressure on the pelvic organs and muscles. Pilates exercises focus on correcting alignment and promoting proper posture, which can relieve unnecessary pressure on the pelvic floor and support its function. It’s important to understand that aA slouched posture may create more pressure on pelvic floor, so by lengthening through the spine, it can take some downward pressure off the pelvic floor and allow more space for the internal organs. A great Cue is to lift out of the waist and to lengthen through the crown of the skull to achieve more axial elongation and take downward pressure off the pelvic floor.

4. Increasing Flexibility and Mobility: Flexibility and mobility are essential for maintaining a healthy pelvic floor. Pilates includes a range of stretching and mobility exercises that can help improve flexibility in the pelvic region and surrounding muscles. For instance, exercises like the cat stretch on the Cadillac, Wuanda Chair or Reformer can help release tension and improve flexibility in the pelvic floor, especially in the spinal extension phase of the exercise.

5. Facilitating Breath Awareness: Breath control is a key component of Pilates practice. Proper breathing techniques can support pelvic floor function by promoting relaxation and reducing tension. Breathing can help engage the pelvic floor muscles naturally and can be particularly beneficial for those dealing with pelvic floor tension or discomfort. You can cCue a lift of pelvic floor with an exhale and relax with an inhale. It’s also important that you cCue to relax the belly to assist with relaxing the pelvic floor.

Exercises to Include and Avoid for Pelvic Floor Health

There are also many exercises that may be too strong for a weak pelvic floor. These include the

  • Full hundred

  • Double leg lowers

  • Abdominal exercises with legs in an open kinetic chain

  • Abdominal curls

For people with weak pelvic floor, who need to strengthen pelvic floor, we also need to include exercises to gain awareness of how to relax the pelvic floor, as often a weak pelvic floor may also be unable to relax. It is a tricky progression, for we eventually want our clients to be able to progress with the Pilates technique, but not at the expense of weakening the pelvic floor.

Integrating Pelvic Floor Awareness into Your Pilates Routine

Don’t underestimate that iIncorporating pelvic floor awareness, activation and relaxation can be a valuable step toward enhancing pelvic floor health. For those new to Pilates, I recommend starting with a few foundational exercises incorporating the pelvic floor and gradually progressing to more advanced movements is recommendedovertime.

It’s also important to note that if someone does have pelvic floor issues, Pilates should be complemented with education on how to:

  • proper toilet habits (avoiding straining)

  • Maintaining a fiber-rich diet

  • Staying hydrated

  • Consulting a pelvic health physiotherapist go to the toilet without straining, maintaining a balanced diet with lots of fibre, staying hydrated, and seeing a pelvic health Physiotherapist.

Conclusion

Pilates is a powerful exercise method that offers numerous benefits for overall health, with an opportunity to gain awareness of the pelvic floor muscles. By improving core strength, muscle control, posture, flexibility, and breath awareness, Pilates can play a significant role in enhancing pelvic floor health and addressing related issues. Whether your new to Pilates or looking to deepen your practice, incorporating pelvic floor awareness activation and relaxation can support a healthier, more balanced pelvic floor and contribute to overall well-being, self-esteem and happiness.

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Louise Taube is a renowned Pilates teacher trainer with a deep passion for helping others improve their physical health and well-being through Pilates. With over two decades of experience in the industry, Louise has become a sought-after expert in Pilates education, particularly in training instructors to teach specialized populations, including women’s health and particularly pregnancy and postnatal. She is known for her holistic approach, blending traditional Pilates techniques with modern science to create safe and effective programs tailored to individual needs. Louise's dedication to her craft and her ability to inspire both students and fellow instructors have made her a respected leader in the Pilates community.

FAQs

  1. How can Pilates improve pelvic floor health?
    Pilates strengthens the core, enhances muscle control, and promotes better posture, all of which support pelvic floor health.

  2. What Pilates exercises are best for a weak pelvic floor?
    Gentle exercises like knee drops, knee floats, and pelvic floor activation during core work can help strengthen a weak pelvic floor.

  3. Should I avoid certain Pilates exercises if I have pelvic floor issues?
    Yes, avoid exercises like full hundred and double leg lowers that increase intra-abdominal pressure. Focus on controlled movements that engage and relax the pelvic floor.

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References

References and Resources
Bo, Kari. (2014) Evidence-Based Physical Therapy for the Pelvic Floor. United Kingdom: Elsevier Health Sciences

Louise Taube
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