Weakness in the pelvic floor is a common issue in women and especially so if women who have had children. Common diagnoses of a weak pelvic floor range from stress urinary incontinence (SUI) to pelvic organ prolapse to pelvic girdle pain (PGP) to sacro-iliac joint pain (SIJ).
"Are you doing your Kegel exercises?," is a question often posed to women complaining of urinary incontinence issues. A Kegel exercise is a direct contraction of the pelvic floor, as if you were stopping your urine flow. Unfortunately, there are a number of studies which have shown that women often do Kegel exercises improperly - incorrectly bearing down on the pelvic floor vs creating an in and up contraction.
However, there are other studies and specifically two physical therapists (Beate Carriere and Janet Hulme), who speak to the use of the extrinsic muscular synergists of the pelvic floor in order to treat a weak pelvic floor without doing a direct contraction of the pelvic floor.
The extrinsic synergists of the pelvic floor are: the respiratory diaphragm, the hip and the trunk muscles which attach to the pelvis.
Pilates is a great exercise method for strengthening the torso muscles which attach to the pelvis and thereby indirectly improve the strength of the pelvic floor muscles. Furthermore, breath is encouraged throughout all exercises which means the respiratory diaphragm is getting a workout. Importantly, if the individual is breathing than the bearing down on the pelvic floor by doing a valsalva maneuver is diminished.
Breaststroke is and exercise commonly done on a Pilates reformer that will engage a number of extrinsic synergists of the pelvic floor. In the pictures below, I demonstrate Breaststroke being done with the Hooked on Pilates® HANDIBANDS which are adjustable, latex free resistance bands which allow you mimic Pilates reformer exercises anywhere!
Start position: Lie on your stomach with the smaller foot loops at the arches of your feet. Legs are bent, heels are together toes are apart, abdominals drawn in. Arms are bent and hovering an inch or two over the mat.
Movement phase: Inhale, stretch arms to straight in front of you. Exhale, circle your arms out to your sides to the T position, simultaneously lifting your breastbone and squeezing your heels together. Do 10-20 repetitions.
Extrinsic synergists working in this exercise include: Diaphragm, spinal extensors, gluts and hip lateral rotators.
Pilates is a smart way to increase the strength of your entire body from deep inside (pelvic floor) to out. Please consider checking out your local Pilates studio for classes and/or privates. If you prefer to workout at home, please consider my Hooked on Pilates® product line of small pieces of Pilates equipment for the home: the HANDIBANDS, (Pilates bands) and the MINIMAX, (a softer version of a Pilates arc barrel.)
Below is a full body exercise which will indirectly strengthen your pelvic floor done with the MINIMAX flipped over. The other advantage is that as your legs lift and the MINIMAX is rocked forward the effects of gravity on your pelvic floor are diminished.
Start Position: Lie on top of the MINIMAX with legs open, turned out and toes resting on the mat. Arms are straight and torso is lifted.
Movement: Exhale, as MINIMAX is rocked forward and legs lift up to ceiling with turn out. Inhale, return to the start position. Do 10-20 repetitions
Bottom option: Upon rocking forward, Inhale and bend both knees criss crossing your ankles 3 times and then exhale extend both legs to straight and up to ceiling and inhale to rock back to start position. Do 8-15 repetitions.
Extrinsic synergists working in this exercise include: Diaphragm, spinal extensors, gluts and hip lateral rotators and hamstrings.
You can do this exercise with the flat portion of the MINIMAX on the mat, similar to how this exercise is done on a Pilates arc barrel. However, doing the exercise as depicted in the pictures, allows for more support of the spine which is important for individuals spinal surgeries and stenosis of the lumbar spine.
The MINIMAX and the HANDIBANDS are my patented small pieces of Pilates equipment. If you find this information helpful please share and of course support my small business and consider getting your own Pilates props for home, MINIMAX and HANDIBANDS. Thank you!