Adventures in Pilates

Some of our PT staff have been working toward their Pilates certification and it’s been a rigorous and rewarding experience for them.  

The training involves self-practice, teaching clients, and going to classes throughout the week in order to experience all types of teaching styles.  Pilates, from what we have learned, engages small muscle groups in the body to help stabilize movement throughout the day. There are different versions of Pilates classes; Mat Pilates is done without specific equipment and then there are classes that involve machines such as the reformer, ladder barrel, trapeze table, spine corrector, and chair.  Multiple types of Pilates trainings are available – Stott, Kane, Polestar, Balanced Body, etc. The specific exercises may vary with each training; however, the core values of Pilates remain throughout. This was all developed by Joseph Pilates.

Some things you might not know about Pilates

  • Joseph Pilates, the originator of Pilates, discussed the concept of Contrology.  You may hear this term if you are doing a lot of this practice. Contrology implies that Pilates is a mind, body, and spiritual practice in which your mind should be in the right mental space in order for your body to fully benefit. 
  • Each Pilates apparatus provides different levels of difficulty for the body. In each apparatus, you can work with gravity to help you, or against gravity to create resistance. The springs can be adjusted along with body position to increase or decrease difficulty of the movement.
  • There is a lot of focus on spinal movement and elongating the spine. The goal is to increase the range of motion in our spines as a means to decrease pressure in areas that could be causing us pain.  For instance, if we increase our lumbar spine range of motion, we can decrease pain and pressure in that area.
  • [The importance of breath] There is a focus on breath with every movement.  This is one of the reasons why I love Pilates. You can really use your breath to facilitate proper movement and use it as an aide to help you complete the movement.  Inhaling can increase spinal extension (arching your back) and using exhaling to increase spinal flexion (rounding your back) can protect the spine and kick in your core and other groups of muscles to help stabilize your body.
  • Pilates is a series of exercises that progresses from beginning to intermediate to advanced. It is best when one can master the exercises in the first stage before proceeding toward advanced movements so your muscle tone and flexibility can build properly.

Pilates and the Pelvic Floor

Pilates can assist clients to have an awareness of their pelvic floor during movement.  How can we use our pelvic floors properly during Pilates exercise? Pilates can be a great complement to pelvic floor rehabilitation and management of symptoms. However, individual care must be taken by pelvic floor physical therapists and their clients to tailor a Pilates program that is appropriate for their condition. If you are trying to perform kegel exercises or contract your pelvic floor, let’s say that is 100% effort.  During a Pilates class, you may only want your pelvic floor to contract around 30% depending on the exercise and your symptoms. Your pelvic floor should contract in conjunction with your abdominal muscles. We want to focus on making sure the pelvic floor muscles can relax to normal between each repetition during a Pilates class.

A recent study in 2016 showed that incorporating Pilates for a patient that suffers from pelvic floor dysfunction helps their strength and coordination.  Again, these are for patients that do not have a hypertonic pelvic floor but rather just a weak pelvic floor. In our pelvic floor space at 5 Point PT, we make sure the muscle tone in our patients is normal before we start to strengthen through Pilates.  Pilates instructors also need to know how to design appropriate programs that ensure they do not overload clients’ pelvic floors or increase chronic tightness, and to monitor clients to ensure they perform exercises safely.

If you notice that your pelvic floor is bothering you during a Pilates class, meaning you have more tailbone pain, pelvic pain, pain with intercourse, or any incontinence, prolapse symptoms, etc., contact a pelvic floor physical therapist to assess your muscles and movement during the exercises.  Pilates practice can help a client develop a greater awareness of their pelvic floor function and how it can vary with position change. It can help a person determine what is safe positioning for them in order to not create an extra heavy load or pressure on the pelvic floor muscles. Pilates has such a broad repertoire that can be adjusted and changed in each and every exercise.  The key is working with the client (and their pelvic floor health professional) to develop the awareness of pelvic-floor safe movement for their own body, and avoiding contraindicated movements beyond the capacity of the individual client.

As always, if you want to start Pilates and have questions about how it will affect your pelvic floor, get in touch with us here at 5 Point PT and we’ll talk you through it!