can pilates strengthen the pelvic floor

Can Pilates strengthen the pelvic floor?

pilates for pelvic floor
Pilates exercises can be tailored to suit mums from the very Early Days postnatal

Yes!

IF you already know how to work your pelvic floor effectively, then YES! Definitely, Pilates can help strengthen the pelvic floor & teach you to use it in a functional way.   Many specialist antentatal & postnatal physiotherapists are also experienced Pilates Instructors. Exercise is a key pillar of our physio training and Pilates has proven to be a style of exercise to really suit mums’ needs. Chosen carefully, some exercises can be started from the early days, even after a caesarean.

I am such a Pilates enthusiast that have made a series of postnatal exercise videos taking you from “birth to 6 weeks”, via abs & gluts focus sequences to getting ready to run. With Pilates for Pelvic Floor Strengthening to really target this most elusive bit! Join me here….

And no….

NOT if your pelvic floor muscles are very weak. Or even completely ‘switched off’. That’s when you do have perfectly good muscles but your brain is not telling them to work. Maybe because of some nerve problems since your delivery. Rather like having windscreen wipers but no button to switch them on in the rain. Or working too hard. Sometimes you are subconciously over-gripping since you had your baby. Perhaps still tense around an episiotomy scar or going into spasm when you sit or walk too long?

tabletop & head lifts are classic Pilates exercises that need to be done with EXCELLENT technique to avoid abdominal doming or pelvic floor strain.

If your inside pelvic floor muscles are not ready (even if your outside seems fine), then unfortunatley, you could do an entire Pilates class with relatively little benefit. Some times things get worse:

  • you might feel more sore in your pelvis after a class than before.
  • it’s easy to accidentally bear down and stretch & weaken them more
  • or not reaslie that you have too much pressure on your bladder or uterus inside, encouraging a prolapse to appear as you exercise more.

Not sure what’s going on inside?

If you have any worries that your pelvic floor is not quite what it should be, or want to return to a high level of sport or fitness, get your technique checked before you do too much more DIY.


Ask your midwife or GP to refer you to a Specialist Physiotherapist. They will examine you and properly advise on your personal situation.

Why see a specialist physio?

There is so much a specialist pelvic floor physiotherapist can teach you to improve internal muscle strength, endurance & co-ordination. They will also check your posture, tummy gap, core strength & scars.

 Through post-graduate training, we have the skill to properly assess and examine the pelvic floor muscles with a vaginal examination.  We do this in a kind and gentle way putting you as much at ease as we can.

We aim to help you understand how your body works.  With a better understanding of your muscles’ strength, weakness or tension problems, your exercises will make sense & be motivating. We can show you how to help them to grow stronger or release & stretch. As well as how to be skilled at using them, to prevent incontinence and improve internal organ support! 

It’s not just up/down squeezes!  

We have lots of different ways of exercising. The standard post-birth exercises are great – but they are not the end of the story. See some new ideas in our Pelvic Floor School. To encourage proper muscle activation we have tricks & tips. We have more advanced and interesting exercises to get you back to higher level sport. Even great gadgets that can show you what you are doing and enhance your muscle work.  

How to get support?

Ask your GP to refer you to the local NHS services (if you are Cambridge-based you can self-refer). Or do come to see me at my practice South Cambridge Physiotherapy or arrange a virtual appointment.  

Not near Cambridge? I believe finding a local physio is best for your longer term support. Women have a long journey from motherhood to menopause. Visit www.themummymot.com for a national directory of physios who specialise in caring for postnatal mums.

Mummy MOT practioner logo

Pilates spine curl vs traditional bridge – what’s the difference?

Spot the difference?

They look the same – bottom in the air – but the difference is how you get there.  If you are not sure about the difference between a classic bridge and a Pilates spine curl then do read on….

How a traditional bridge works

The traditional ‘bridge’ exercise has been around for years, taught as an exercise for the bottom muscles (officially gluteals, or buttOCKS as my Danish colleague  used to say) .  Most people also give a good push on their hands and feet.  If you tune in you will  feel it is a good  task for a bottom work out.   The usual cheat or incorrect technique for a bridge is to misfire and activate hamstrings, getting back of thigh cramp and missing the gluts workout altogether.

Try one now and notice how your spine behaves during a bridge?  Usually as quite an inflexible rod?  It just goes up and down in either one big piece or two sizeable chunks…bend at the waist – up.  This is because all the down pressure on the hands and feet makes you activate your back muscles, the erector spinae.  These little muscles overlap each other from one spine segment to the next.  This creates the effect of ‘stiffening’ the spine to make it solid and lets it behave as one rod-like piece.

How a Pilates spine curl is different

A Pilates spine curl uses a completely different technique to raise the body up.  You drive the movement by  drawing up through the pelvic floor and abdominal muscles (on the front of your body), allowing the spine muscles (on the back) to relax, letting the spine become fully flexible  (33 bones connected by elastic).  The spine should roll through its length.  The first movements occurring at the coccyx, then tilting back onto the sacrum, pressing through the back of the pelvic bones, then the movement travels past the waist, onto the lower ribs, aiming to come to a stop with your weight resting through your shoulder blade area (not your neck).  Hold the position for a couple of breaths.   Use the same technique in reverse to come back down.  Have a breath in, then as you breathe out, keep your strength and control through your front abdominal wall to allow yourself to pay out your spine slowly……..take as many breaths as you need….. to let the ribs soften onto the floor,then  roll down towards your waist area.  You may have to really focus to ‘land’ the waist and last few bones of the spine before the pelvis.  Try to land both sides of the pelvis together.  Then make sure you finish the movement properly by allowing the sacrum and coccyx to fully sink to their resting positions and then very last of all release the abdominal and pelvic floor muscles.  Breathe.  Repeat.

Physiotherapy advice

I recommend 6 repetitions on the floor beside the bed before you climb in for the night.  Get into bed with all the tensions and asymmetries of the day corrected.  A flexible body will mould to the mattress beautifully and not keep you awake fidgeting.  If you go to bed straight and aligned you have a much better chance of starting the next day in a good place.

 Let me know, in the comments section below, if this technique check was helpful to you and which other exercises you would like help with?

Can I run yet? tabletop with leg extensions mimics running action

3 Tips to control abdominal doming in tabletop position

Take care you are not training a pot belly

Do you have a suspicion that each time you bring that second leg up into tabletop position you get  an abdominal bulge or doming?

As tabletop legs is the starting position and foundation for so many of the advanced pilates and core exercises it is absolutely essential to master the art of getting in and out of the position without doming the abdomen.  Otherwise, if each time you move up into position you bulge or dome – what is it that you are actually training?  It could be a  pot belly.

Done well, tabletop legs will help correct a divarification

This is a really important technique to master if you want to correct a divarification and protect your pelvic floor.

It is a hard challenge to get right –  but so satisfying when you do.  You will know when you have got it  because suddenly the whole action feels weightless and even effortless,  the pelvic floor area feels included and the back feels safe and relaxed. And it makes you want to smile!

Tip 1: put your feet on a step.  Practice during the week at home with your feet on a small step (eg child’s step).  This slightly flattens the neutral spine and means  you ‘start’ 1/3 of the way into the leg lift.  This allows you to experience the ‘correct’ feeling over and over again until your brain is happy with the sensation of not needing to ‘flick’.  Then take it down to a phone-book height and last of all back to floor level.

Tip 2:  go onto tip toe first.  Sneaky little manoevre (but a better cheat than ‘the bulge’).  First leg up, then move onto the tip toe of the second leg before you try to lift it.  Your brain will feel the sense of the weight to come and make some subtle core adjustments to half prepare you so that the full lift will be easier.

Tip 3:  you get what you think about!   I say this over and over again because it is so true!  So here is my, as usual bit out the box, visualisation.

 Boats on a beach

Visualisation to help get legs up into tabletop without a bulge

You are on a pebble beach that slopes down to the water.  Think of the first leg coming up as a light-weight rubber dingy which you have to pull by its rope up the beach.  All it takes is a light tug and up it comes.  Now take the rope of the second boat – a big speed boat – much more unwieldy – if you just tug that rope you are not going anywhere  – you will just get a jolt – so rather take up the slack, lean into the rope, let the tension build and build below the surface, until the boat ‘wants’ to come up the beach, then once you have got that initial momentum started – you’re off!

Are you more of a visual learner?  Here is my first ever video, showing the 3 tips.  Even a Playmobil boat (and dog) to help with the visualisation.

Did this post help you?  Please let me know in the comments below if any of these tips worked for you?  Or do you have a trick yourself that would inspire or help others?  Your comments give me ideas what to write about next.  Thank you.

exercises for back stiffness

More granny than gazelle?

MORNING BACK STIFFNESS?

Do you wake with back stiffness, feeling rather like an old lady; starting the day with contorting stretches just to feel normal? Do you find that you struggle to get comfortable in bed at night?

The natural instinct is to try morning stretches to loosen and get going.  If this is working for you please don’t stop – but if it seems rather laborious and more like patching the problem each day rather than solving it – try for the week ahead doing some Pilates spine curls and streches before you go to bed.

WHY DO EXERCISES BEFORE GOING TO BED?

This has been a successful tactic for lots of my patients in clinic with niggly morning back stiffness. 

My theory is that by the end of a normal day of lifting, carrying, sitting, driving, and walking, the majority of people have lost pelvic alignment and their spines have resorted to stiffening the back muscles to keep us upright.  If you go to bed with a rigid lower back and asymmetrical pelvis then you are going to find a soft mattress uncomfortable as it distorts your shape further.  Furthermore,  you will eventually fall asleep but on a poorly arranged spine.  It won’t hurt when you are sleeping but it will complain as you start to move again next day.    

Mini-experiment:  You can feel this effect right now.  Try leaning your hand on the table or chair beside you so that your palm is flat with your wrist at 90 degrees.  It won’t hurt while you lean on it.  If you were distracted chatting to someone you could lean like this for a couple of minutes and not even think about it.  But when you release the pressure off your hand it will ache across the wrist joint and feel uncomfortable for a good minute or two before it wears off.  A night’s sleep on a stiff or crooked spinal column is a magnified version of this.

VIDEO: 10 minutes stretch and relax.

Use my licence code SUPPORTED-MUMS-WITH-BEAM to access all the videos on BEAM free for a month.

Stretch & Relax is good for partners too!
Stretch & Relax is good for partners too!

Even if you don’t do the video try 6 Pilates spine curls, on the floor (the mattress will be too soft), before you go to bed this week and let me know how you get on?  And if you have any other tips for  waking with the suppleness of a young gazelle please do share below.