Pilates & the Pelvic Floor
Pilates Exercises and Pelvic Floor Health: What You Need to Know
At our clinic, we recognize the importance of strengthening the core, but we also understand the need to protect and support the pelvic floor, especially for women experiencing pelvic floor dysfunction.
Certain Pilates exercises can put additional pressure on the pelvic floor, potentially contributing to overload or increased muscle tension. This may aggravate existing pelvic floor problems or lead to pelvic floor symptoms like incontinence or prolapse.
It’s important to note that many Pilates exercises are safe to perform despite existing pelvic floor problems.
How does Pilates Impact the Pelvic Floor?
Some Pilates exercises can cause pelvic floor overload. This is caused by the amount of downward pressure generated by the upper abdominal muscles during the exertion part of the exercise. The pelvic floor muscle be able to withstand this downward pressure to prevent issues like incontinence (leakage) or prolapse. Pelvic floor muscles often become strained or stretched with continued repetitions.
The other concern is when the core is activated strongly, the pelvic floor muscles do not have sufficient relaxation time. This may occur with intense Pilates exercises in which the muscles sustain a contraction over a long period of time. In some cases, this leads to an overactive pelvic floor or excessive pelvic floor muscle tension.
Who This May Impact
The following lists those who may need to be more mindful when performing Pilates exercises targeting the core.
- Pelvic prolapse
- Post-op
- Hysterectomy
- Prolapse repair
- Bladder surgery
- Pre-existing pelvic floor muscle tension and/or spasm
- Menopausal or post-menopause
- During pregnancy
- Postpartum
Here’s a breakdown of some common Pilates exercises and their impact:
The Hundred
This core strength exercise involves holding both legs in a tabletop position or raising them to 45 degrees, while the head and shoulders are lifted off the ground. The intensity is increased with variations like ‘Oblique Lifts’ or ‘Single/Double Leg Stretches.’ While great for core strength, these movements can lead to pelvic floor overload, particularly with both legs elevated, increasing pelvic floor muscle tension.
Scissors
In this exercise, legs alternate from a tabletop position, lowering towards the floor while maintaining a fixed knee angle. Although excellent for core stability, Scissors can contribute to pelvic floor overload, especially for women with weakened pelvic floors or those experiencing overactive pelvic muscles.
Sit-Ups
A sustained chest lift, or abdominal curl, involves holding the head and shoulders off the ground for several breaths. This can increase intra-abdominal pressure, forcing the pelvic floor downward and potentially leading to overload, particularly if performed repetitively.
Roll-Ups
Roll Ups and Rolling Back exercises, which involve rolling the body from a seated to a lying position and back up again, require strong abdominal contractions. These movements can increase pelvic floor pressure and tension, especially when performed with legs extended or when rolling back with bent knees.
Dead Bug
This exercise engages the core by lowering one arm and the opposite leg while maintaining the tabletop position. While effective for core strength, Dead Bugs can also place strain on the pelvic floor, leading to potential overload or overactivity in the pelvic muscles if relaxation is insufficient.
Push-Ups
Push Ups are mainly a strength exercise and target the upper limbs and upper abdominals. Weight is supported through the hands and balls of the feet. rom this position the body is lowered to and raised from the floor. This exercise involves intense repeated upper abdominal core muscle activation.
Plank
Planks are designed as a core and upper limb strength and stability exercise. Planks are performed laying on your stomach. Your body weight is supported through the forearms or hands and the balls of the feet. It’s important to breath slowly and avoid breath holding. Planks involved sustained contraction of the core.
Here to Help
While these exercises are effective for core strengthening, they can place significant pressure on the pelvic floor. At our clinic, we emphasize personalized assessments to determine which exercises are appropriate for your unique needs and ensure that your pelvic floor health is protected. If you experience pelvic floor discomfort, it’s essential to modify these exercises or avoid them altogether to prevent further strain.
If you’re unsure about which Pilates exercises are safe for you, we’re here to guide you through a tailored, pelvic-floor-friendly exercise plan that supports both your core strength and overall health.
