Using Pilates to Lengthen the Pelvic Floor Muscles

When we think of Pilates, we think of controlled movement patterns that work through a range of motion which ultimately come together in a gentle flow with ease and fluidity. The breath adds elements of concentration and precision in the sequencing of the movement. The practice of Pilates emphasizes mindfulness and neutral alignment in order to unite groups of muscles that work together to support movement which ultimately helps individuals function better in their daily lives.

The pelvic floor is frequently mentioned during Pilates sessions (“don’t forget about that pelvic floor” or “don’t forget to engage and lift the pelvic floor”). In considering the functionality of the pelvic floor, we can deepen the knowledge around this groups of muscles during a Pilates session if we give more meaning behind the statement “don’t forget about that pelvic floor.” After all, people want to know: what about the pelvic floor!?!?

The pelvic floor works similarly as described above in the first paragraph. It is a group of muscles that move through their range of motion, often shortening for some tasks and lengthening for others. During breathing specifically, this group of muscles naturally (without you having to do anything!) gently lengthens on the inhale and gently contracts on the exhale.  Since we breathe all day every day, it’s worthy to appreciate the natural “pulsating” of the pelvic floor muscles with our own natural breath pattern (might I mention this happens in both males and females). Furthermore, this group of muscles works in unison with other muscle groups as a part of a system, such as the abdominal diaphragm and deeper core muscles. So what does all of this mean?

For decades, the word ‘kegel’ has been synonymous with the pelvic floor and is typically associated with squeezing, holding, and strengthening of the pelvic floor muscles. In Pilates, we think of engaging and strengthening the core and pelvic floor together. This is a good start, especially for pelvic floors that have confirmed weakness. However, let’s consider a broader concept of the function of the pelvic floor. (Check out this article from a woman who knows!) A well-functioning pelvic floor will contract AND lengthen with your natural movement and breathing. In certain circumstances, such as with urinary incontinence and pelvic pain/low back pain, the pelvic floor muscles may require a little extra cueing with the help of a pelvic health PT to either relax or activate (rather than simply attempting to only squeeze, hold, and clench all the time). This extra cueing helps the brain recognize this group of muscles to create muscle memory and enhance the system so that the muscles can eventually function without you having to even think about it (example: all that hard work you do week in and week out during a Pilates class and/or during those physical therapy sessions = improved abilities in gardening, jogging, biking, or even simply chores around the home).

The moral of the story:  consider the pelvic floor as a muscle group that is functional (ie, used daily) and relationship-based. It does not prefer to be over-engaged nor under-utilized. Just like any other muscle group of the body, it works best during task specific movements in which the brain facilitates the partnership of muscles acting together. Knowing all of this, Pilates is perfect for prenatal and postpartum women experiencing pelvic girdle pain (say that 5x fast!). It teaches you that you don’t always have to be squeezing and tightening to get somewhere! If fact, it’s usually just the opposite. Being aware of the full capacity of the pelvic floor will you get back to the walking trail, performing household duties, and chasing around those kids worry-free.  

Published by kacannon

Kelsea Cannon, PT, DPT, PRPC is a physical therapist, pelvic health specialist, and integrative women's health coach who feels passionate about helping women restore wellness and balance in their lives. Her dedication lies in merging her comprehensive orthopedic, pelvic health, Pilates, and health coaching expertise to manage pregnancy-related concerns, such as pelvic & low back pain, pelvic organ prolapse, urinary incontinence, diastasis recti, c-section scars, painful intercourse, bowel dysfunction, and hormone rebalancing. She promotes an interdisciplinary approach and is a believer in helping women establish their ‘dream team’ of care providers. Her main goal is to support and inspire women using an integrative approach to help them be successful in reaching their personal health and wellness goals.

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