The pelvic floor is probably the least discussed aspect of Pilates and yet is probably one of the most important in terms of medical rehabilitation. For most of us it is a taboo subject, something that we are embarrassed to talk about, and yet current medical research shows us that up to 70% of women and around 40% of men suffer from stress incontinence at some point in their lives.
Pilates teaches you how to co-contract the core muscles, that is, the pelvic floor, the transverse abdominis ("TA") and the multifidus. Every exercise that Pilates Lifestyle teaches targets both the muscles of the pelvic floor and the TA.
Often I get asked the question – is it the whole sling of muscles or just the front or just the back that we should be squeezing. To further this discussion let's take a moment here to examine the structure of the pelvic floor.
The structure of the pelvic floor is, put simply, the floor of the pelvis. It comprises a whole sling of muscles attached to the walls of the pelvis from the pubic bone at the front to the coccyx at the back. The anal sphincter is the strongest whilst the weakness most often occurs in the muscles around the vaginal and urethral openings. It makes sense therefore to focus on the front sling of muscles especially as these are the muscles weakened dramatically by childbirth.
The pelvic floor consists of two types of muscles, fast twitch and slow twitch fibres. The slow twitch fibres provide support for the body over long periods of time and are slow to fatigue whilst the fast twitch fibres can be recruited reflexively or on demand for example when coughing or sneezing. These fast twitch muscle fibres can produce a quick strong contraction but they are quick to fatigue. Because there are two types of muscle fibres in the pelvic floor it makes sense that some exercises should be slow and some fast.
From over a decade of instructing and teaching Pilates, I have found that one of the most successful ways to train the pelvic floor muscles is through the use of the small ball. This is why in June 2011 I produced an iPhone App and DVDs using the small ball. Just like any other muscle in the body, the pelvic floor muscle too requires training.
When new clients come into the studio and participate in one of my Beginner Workshops, I always introduce them to the Small Ball and teach them that in order to find and recruit the muscle groups that we target in Pilates they have to focus their minds completely on their bodies. The wonderful truth about Pilates is that not only is it a method of rehabilitation that produces results quickly, you will also discover a whole new range of muscles you never knew you had!
Now try out these two exercises to find and strengthen your pelvic floor.
Resources; The complete guide to postnatal fitness, Judy diFiore, A & C Black, London, 1998