LEAKING? 3 MOVES TO TRAIN YOUR PELVIC FLOOR
Is leaking limiting your lifestyle? Weak pelvic floor muscles may be the culprit.
The pelvic floor is made up of a group of muscles and connective tissue that extends as a sling across the base of the pelvis. It provides support for the bladder, pelvic organs and spine. These muscles contract naturally at a low level with breathing, walking and movements. And they must contract with more force with activities such as a deep squat or lifting heavy objects.
With the demands of pregnancy and childbirth, the muscles and tissues of the pelvic floor become vulnerable. The forces placed on your pelvic floor by your baby, postural changes and weight gain during pregnancy can disrupt the integrity of your muscles and compromise the support these muscles provide to your bladder and pelvic organs.
When the muscles are not strong enough to handle the pressure placed on them, you can experience leaking during high-impact, high-pressure activities such as running, jumping, coughing or sneezing. Studies have shown that women with leaking have a decrease in contractile force of their pelvic floor muscles (PFM).
To restore a functional pelvic floor, patients need to build a combination of strength, endurance and coordination in their muscles. Since 1950, PFM exercises have been recommended to limit pelvic organ prolapse and incontinence.
You can train the PFM just like any other part of your body with specific exercises to contract and relax these deep, small muscles, increasing muscle volume and strength.
PF muscle training has been shown to be effective in improving pelvic floor function in women, including reducing leaking/incontinence.
A 2011 study conducted at the University of Montreal showed that women who did pelvic floor muscle training were 17% more likely to have a decrease in their urinary incontinence.
A 2015 study showed that simply increasing awareness with PFM training helped decrease urinary incontinence in postpartum women.
In a 2020 study of French women, patients significantly improved in just 4 sessions on pelvic floor education.
PFM contractions can be done in isolation or in combination with other physical movements such as Pilates. This benefits overall body strength and fitness which has a positive impact on leaking.
Amy DiRuzzo, a Doctor of Physical Therapy in Denver, demonstrates 3 examples of Pilates exercises to strengthen your pelvic floor muscles:
MARCHING ON YOGA BLOCK - 10 REPS EACH SIDE
Place a block under your sacrum keeping your tailbone heavy. March 1 knee up, initiating the lift from your pelvic floor muscles instead of your thigh.
ASSISTED ROLLBACK WITH YOGA BLOCK SQUEEZE - 10 reps
Sit tall with hands behind your thighs. Inhale wide into your ribs, exhale curl your tailbone under, lifting pelvic floor muscles up and in.
HIP HINGE WITH YOGA BLOCK
With 1 leg out to the side, inhale to sit hips back to your heel. Exhale to lift from the base of your pelvis/pelvic floor muscles to press your hips forward.
Click here to watch videos of these exercises.
Your PFM should be able to initiate a contraction in these exercises and then work together with your TA, Rectus abdominis, and internal obliques.
Your goal is to restore normal, natural function. You don’t want to hold a constant Kegel but instead build a strong PF that responds/contracts when you jump, run or sneeze. By incorporating exercises like these into your regular fitness regime, you’ll be able to maintain continence and improvements in your pelvic floor function.
Pelvic floor function is influenced by your entire kinetic chain, posture and alignment. Factors such as your breathing pattern, hip strength and even foot function can all impact it. A physical therapist should identify all the elements that underlie a patient’s PF weakness and dysfunction to design an individual program for each patient.
REFERENCES:
Blanchard V., Nyangoh Timoh K., (2020) Benefits of pelvic floor education in perineal re-education in women. Prog Urol, 30(4), 190-197.
Dumoulin, C., Glazener, C., & Jenkinson, D. (2011) Determining the optimal pelvic floor muscle training regimen for women with stress urinary incontenence. Neurourology and Urodynamics, 30(5), 746-753.
Marques, A., Stothers L., Macnab A. (2010). The status of pelvic floor muscle training for women. Can Urol Assoc J, 4(6), 419-24.
Ozdemir O., Bakar Y., Ozengin N., & Duran B. (2015) The effect of parity on pelvic floor muscle strength and quality of life in women with urinary incontinence: A cross-sectional study. Journal of Physical Therapy Science. 27(7): 2133-37.
Interested in a personalized Pilates/Physical Therapy session to address your pelvic floor?
Reach out and let’s talk!
Amy DiRuzzo is a Doctor of Physical Therapy and Nationally Certified Pilates Teacher in Denver with more than 15 years of experience in women’s health. She helps mothers build deep, inner core strength the right way. If you have experienced a C-section, Diastasis Recti, back pain, pelvic floor dysfunction or just generalized core weakness, her workouts are perfect to help you safely regain strength and confidence in your body, allowing you to return to the adventures you love.
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