Enhancing Pelvic Floor Health with Pilates: A Physical Therapist's Perspective


Pelvic Floor and Pilates

Written by Dr. Katie Fincher, Limitless Pelvic Health

As a board-certified pelvic health physical therapist, I truly believe that movement is medicine. There are so many ways people can choose to move their bodies to optimize their overall health, and I have witnessed the way Pilates can have a transformative effect on pelvic floor & core function, mobility and strength. Pilates, a system of exercises developed by Joseph Pilates, focuses on core strength, flexibility, and overall body awareness. In this blog post, I will delve into the numerous benefits that Pilates offers for pelvic floor health and function, providing insights and recommendations based on my clinical experience.

Understanding the Pelvic Floor

Before we can understand how Pilates impacts the pelvic floor, we must know what it is! The pelvic floor is a group of muscles located at the base of the pelvis, responsible for supporting the pelvic organs, maintaining continence, and facilitating sexual function. These muscles do not function in isolation – they respond to pressures within a system that is made up of four main muscles and muscle groups: the diaphragm, the transverse abdominus, the multifidi, and the pelvic floor. Dysfunction in the pelvic floor muscles can lead to a variety of impairments, including urinary incontinence, pelvic organ prolapse, constipation, painful sexual activity, low back and hip pain to name a few!

Pilates can be so beneficial for our pelvic floor and body awareness when exercises are performed intentionally and with the right technique. I’d like to highlight 5 ways that Pilates can positively impact our pelvic health and wellness below.

1.      Core Strengthening

Everyone wants a strong core! Pilates exercises target the deep stabilizing muscles of the core, including those surrounding the pelvis – the deep core canister mentioned above. By strengthening these muscles, Pilates helps to support the pelvic organs and improve overall pelvic floor function.

2.      Improved Posture

I am a firm believer in the phrase “Your best posture is your next one!” This being said, certain postures held for prolonged positions can contribute to pelvic floor dysfunction by placing increased pressure on the pelvic floor muscles. Pilates emphasizes proper body and postural awareness, helping individuals to maintain optimal pelvic positioning that can reduce strain on the pelvic floor.

3.      Flexibility and Mobility

Tightness in the muscles surrounding the pelvis can negatively impact pelvic floor function. A tight muscle is usually a weak one that is over-gripping to help stabilize a joint or it's surrounding attachment sites. Pilates incorporates stretching and mobility exercises that promote flexibility in the hips, pelvis, and lower back, reducing tension and promoting better pelvic floor mobility.

4.      Mind-Body Connection

Pilates emphasizes mindful movement and body awareness, encouraging individuals to connect with their breath and engage their deep core muscles. Mind to muscle connection is extremely important in pelvic floor rehab, and this heightened awareness can help individuals to better control and coordinate pelvic floor muscles, leading to improved bladder, bowel and sexual function.

5.      Functional Movement Patterns

Many Pilates exercises mimic everyday movements, such as bending, twisting, and lifting. We don’t live on our backs! By practicing these functional movement patterns, individuals can improve their ability to perform activities of daily living while maintaining optimal pelvic floor function.

Incorporating Pilates into Pelvic Floor Rehabilitation

Everyone’s body is different, and so are people’s exercise preferences. I genuinely believe that there are no unsafe exercises for your pelvic floor. This being said, HOW you perform an exercise can matter for individuals experiencing pelvic floor dysfunction. Pilates can be a valuable adjunct to traditional physical therapy interventions when performed appropriately and with the right instruction. When incorporating Pilates into pelvic floor rehabilitation programs, it is important to:

1. Seek guidance from a qualified physical therapist or Pilates instructor with experience in pelvic floor health.

2. Start with gentle, low-impact exercises that focus on mind to muscle connection and gradually progress as strength and flexibility improve.

3. Focus on proper technique and position to ensure effective muscle engagement and minimize the risk of injury.

4. Listen to your body and modify exercises as needed to accommodate any pelvic floor symptoms or limitations. 

Pilates offers a multitude of benefits for pelvic floor health and function. By incorporating Pilates into pelvic floor rehabilitation programs, individuals can experience the benefits of movement as medicine. As a board-certified clinical specialist in women’s health physical therapy, I highly recommend Pilates as a valuable tool for optimizing pelvic floor health and promoting a healthy, active lifestyle!  


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