Pilates and Incontinence – How Pilates Can Help

Everybody knows what it feels like to urgently need the toilet. Usually you experience that after having had a lot to drink. But some people feel that urge much more frequently with little or no chance to postpone their visit to the toilet. Or it might be hard to prevent leakage when coughing or sneezing.

If you are affected by that, you are not alone.  Almost 13 million Americans have the same problem, of which 85% are women. There is a common misbelief that only the elderly suffer from incontinence, however, this is quite common in younger women as well, especially during and after pregnancy. So how are Pilates and incontinence related to each other?Pilates-and-Incontinence

To understand the issue better, it’s necessary to establish why and how incontinence develops, as it is a symptom rather than a disease. The most common types of incontinence are stress incontinence and urge incontinence. Whilst urge incontinence occurs when the nerve passages from the bladder to the brain are damaged, stress incontinence is a result of damaged or weakened pelvic muscles.

Where the pelvic muscles are affected, pelvic muscle rehabilitation is an appropriate and successful technique of treating the problem. This mainly involves exercising the pelvic muscles to restore and strengthen them, so they are able to fulfill their task again. A great way of achieving that is to do Pilates which mainly targets and strengthens the core muscles, or pelvic floor muscles.

Why incontinence occurs in women

Many women experience a degree of incontinence during and after a natural childbirth, before and during menopause and after a hysterectomy. Most of them don’t seek advice about this issue and just wear pads and diapers believing they have to put up with that. However, the symptoms – and the cause – of stress incontinence can be treated successfully.

During pregnancy, your pelvic floor muscles get challenged a lot. Not only does the weight of the growing baby exert more and more pressure on the pelvic floor, but the hormonal change in that time can also weaken it.

If levels of the hormone estrogen decline, your pelvic floor won’t be as supple and stretchy and weakens. As a result, you have less control over your bladder. This type of hormonal change does not only happen during pregnancy but also during peri-menopause and menopause.

Something similar happens after a hysterectomy if the ovaries are removed as well as the womb. However, even if the ovaries remain, there is a risk of the pelvic floor muscles weakening and sagging as removing the womb also affects the pelvic floor.

Pilates strengthens the pelvic floor muscles

When incontinence is due to a weakness in the deep abdominal muscles impairing pelvic floor control, exercising the pelvic floor muscles to strengthen them is the right way to go. And this comes with another benefit: As weak core muscles are often to blame for lower back pain, by exercising your core muscles, you not only regain pelvic floor control, but you also reduce and prevent any back pain due to a weak core.

Pilates is an excellent exercise regime for stabilizing and strengthening the pelvic floor and the core. In fact, it’s one of its main aims to promote a strong and healthy body from the inside out. Therefore, all exercises focus on building strength, core stability, muscle control as well as on flexibility, posture and breathing.

While other sports and physical activities, such as rowing or weight lifting, can strengthen your core, Pilates is probably the safest and most efficient exercise programs for this purpose. With its low-impact exercises and slow controlled movements, it is suitable for any age group and ability. In addition, it is often used for rehabilitation purposes after injuries and surgeries.

As there are over 500 exercises all devised by Joseph Pilates, it is easy to put together a customized workout for your individual needs. Also, you can easily modify exercises to suit you to make sure you practice safely and effectively. However, if you are not familiar with Pilates, you need to first practice with a qualified instructor to ensure you perform movements correctly.

Best Pilates pelvic floor exercises

A very easy and effective exercise is Knee Folds:Pilates-And-Incontinence-Knee_folds

  • Lie flat on your back in relaxed and neutral spine position with your feet parallel on the floor and your finger tips on your hips.
  • Breathe in and then breathe out while lifting your right leg keeping your knee bent. Make sure your pelvis does not move and stays in neutral position. Also, do not put all your weight on the other foot to stabilize you. The other foot should just gently touch the floor.
  • Breathe in and hold for a few seconds.
  • Breathe out and slowly return the foot to the floor.
  • Repeat at least 5 times on each leg.

Pillow Squeeze is also great for working the pelvic floor, and helps with sciatica, as well:

  • Lie flat on your back just like in the Knee Folds exercise.And-Incontinence-Pillow-squeeze
  • Place a cushion between your knees and double-check that your pelvis is in neutral.
  • Breathe in and then breathe out while squeezing the cushion between your knees and keeping the pelvis still and in neutral.
  • Continue to breathe normally while squeezing the pillow for a count of 10.
  • Release then repeat at least five times.

Shoulder Bridge is a slightly more challenging exercise targeting the back and the pelvic floor:

  • Lie on your back in a relaxed position with your feet parallel and hip-width apart, approx. 20 cm from your buttocks, arms by your sides with the palms down.
  • Breathe in and then breathe out while slowly curling your tailbone off the floor.
  • Breathe in again and breathe out while lowering and lengthening your spine back onto the floor.Pilates-And-Incontinence-Shoulder-bridge
  • Repeat about 5 times lifting the spine a little more off the floor each time until you reach the top.
  • When reaching the top, take your arms above your head and rest them on the floor to get an extra stretch. Only do this if it is comfortable! Your upper back must not be arched whilst doing that.
  • Repeat this sequence 3 more times.

Pilates is a safe way to tackle incontinence

When you are affected by stress incontinence as a result of damaged or weakened pelvic muscles, Pilates is a good and safe way to build up strength in your pelvic floor. There are a variety of exercises that target the core muscles and a number of exercises can be modified to suit your needs.Pilates-and-Incontinence-Healthy-Woman

As the exercises are quite gentle and low impact, performed in a controlled way, there is no risk of injury or making things worse, as long as you make sure you perform them correctly. For this reason, you should always practice them with a qualified instructor or a physiotherapist first before exercising at home.

And the great thing is: Doing these exercises, you will not only improve your pelvic muscles, but also your overall core strength meaning you will have a stronger back and be less likely to suffer from back pain. So, you will not only tackle incontinence, but gain a stronger and healthier body. A real win-win situation!

Click here if you want to find out more about back strengthening exercises

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4 Comments

  1. Tina

    Hi! I never had an issue with incontinence until after having my baby as you stated.
    I do a ton of yoga exercises to strengthen my core but I can always tell when I haven’t done enough pelvic floor exercise because my lower back takes the strain holding a plank. I will have to keep the pillow squeeze in mind for the future. I have chronic sciatic problems and that looks like it’ll help. Thanks for sharing!
    Out of curiosity, I noticed you didn’t mention Kegels. Is that not a Pilates exercise?

    • Hi Tina,
      Thank you for your comment. I think it’s fantastic that you exercise regularly to strengthen your core. It is so important to do some pelvic floor exercises expecially after a pregnancy as most of us experience a certain degree of incontinence after giving birth.
      Kegels exercises are what’s usually recommended by nurses after you’ve had a baby. They involve squeezing the muscles of your pelvic floor like when you are trying to hold back or stop the flow of urine. They are not a Pilates exercise as such although you usually need to engage your core (pelvic floor) muscles to perform a Pilates exercise. The main difference between Kegels and Pilates is that in a Pilates exercise, the pelvic floor muscles are squeezed or engaged to naturally support a movement whilst in Kegels, there are no movements involved, just squeezing. Because of that, a Pilates exercise is more intense than a Kegels exercise and – in my opinion – more effective.
      I hope the pillow squeeze exercise will help to relieve your back pain. If you are interested, you can also have a look at a choice of Pilates back strengthening exercises here.

      All the best,
      Sammy-B

  2. Lane Onson

    First of all, thank you for this article.
    Secondly, I too, thought that incontinence was something that an individual had to put up with. I had no clue that one could go to the doctor for it.
    Thirdly, thank you for the insight on the pelvic muscles. Again, I didn’t know that strengthening your muscles could help prevent it.

    Again, thanks for this info.

    • Hi Lane,
      Thank you for reading my article. I’m glad you liked it.
      Talking about incontinence is still considered a health taboo by some people. Because of that many affected people still feel too embarrassed to get help. But it can be quite easy to tackle this issue when a weak pelvic floor is the cause of the problem. Doing Pilates core strengthening exercises is a very effective way of treating and preventing that type of incontinence. So Pilates is not only good for your spine but can help you with other potential health issues as well. It’s an exercise regime with many benefits.

      All the best,
      Sammy-B

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