Pilates is often touted as the best way to strengthen your pelvic floor but that isn’t necessarily true. The best way to get stronger in your pelvic floor is to make sure it is functioning properly, which means a few things:
* You need length as well as strength – your pelvic floor muscles can’t contract effectively if they are over tight
* You need your pelvic floor to work in conjunction with your diaphragm. They work in synergy and if one isn’t moving properly then the chances are the other one isn’t either.
* You need your pelvic floor to be reflexive – it isn’t just about strength. It needs to react to the movement you are making – i.e. it needs to be relaxed when you are relaxed. Conversely, it needs to switch on and offer support when you need it. This can happen both consciously and unconsciously.
When you are exercising it is important that you are working within the realms of your own body. If you create too much intra-abdominal pressure (or IAP – the pressure created within our core when we move) for your core to control, this can cause problems. So while Pilates CAN be brilliant for the pelvic floor, it can also be unhelpful as lifting both legs off of the floor and then lifting your head creates lots of intra-abdominal pressure and that pressure has to go somewhere. It may go out and make your abdominals dome or it may go down and cause you to bear down into the pelvic floor.
One reason Pilates is so great for the pelvic floor is that it strengthens so many other muscles – the pelvic floor doesn’t stand on its own in the way we are often led to believe. By strengthening your gluts, your legs, your abdominals and improving your posture, you are making a difference to your pelvic floor health.
* If you are experiencing symptoms you need to go and get specialist advice on this – any leaking, feelings of dragging/heaviness are not to be put up with
* When you are exercising, check your abdominals. If they are pushing outwards you are not controlling the IAP and you need to modify the exercise accordingly.
* Make sure you are co-ordinating the breath with the movement – exhale on the effort because when you exhale your pelvic floor naturally lifts and offers support
* Make sure you are working on releasing your pelvic floor as well as strengthening it. We are looking for a well-functioning pelvic floor, not just a strong one!
Here are my favourite Pilates exercises for pelvic floor health:
On all 4s with a neutral spine, keep your pelvis neutral as your shift your weight forwards and backwards, making sure you don’t allow your tailbone to tuck under. This is a great way to release the pelvic floor, especially if you have spent much of the day sitting down
Lying in neutral spine with your knees bent up and your feet in parallel. Exhale to relax and ten connect to the pelvic floor and tuck your pelvis under feeling your sit bones draw together. When you have found the tucked pelvis press into your feet to lift your pelvis off of the floor and think of peeling your spine up one vertebrae at a time. Make sure that you don’t lift your ribcage at the top. Inhale at the top then exhale to soften your ribcage and slowly peel the spine back down making sure your pelvis stays tucked until you release back into neutral. Repeat about 8 times.
Lying in neutral with your feet together. Inhale to open both legs about half way to the floor. Exhale to allow your abdominals to drop then draw your sit bones and hip bones together, connect to your centre and pull the legs back together again. Think of the legs being heavy and using your pelvic floor and abdominals to pull them back to the middle. Repeat 8 times.
Lying on your side with your knees bent up and your feet roughly in line with your sit bones. Try and think of your pelvis being level so you are reaching your top hip away from you and getting a sense of lift in your underneath wait. Inhale to spiral your top leg outwards to open the knee. Exhale to close the leg (You could put a ball or cushion between your legs here and gently squeeze with your inner thighs for more pelvic floor connection). Think of the opening action coming from your hip joint so you are focusing on mobilising while keeping your pelvis stable. Repeat about 10 times on each side
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