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Using Pilates-Based Physical Therapy for PFD (Pelvic Floor Dysfunction)

By: Stephanie Ruopp

Do you “leak” every time you sneeze, cough or laugh too hard?

It could be the result of PFD (pelvic floor dysfunction) and it’s no laughing matter. It occurs when the pelvic floor becomes stretched, weakened or overly tight. 

Beyond urinary incontinence, other common symptoms of PFD can include bowel incontinence, sexual dysfunction, lower back pain, and/or pelvic pain.

Fortunately, symptoms can improve with Pilates-based physical therapy for PFD.

PFD Is Not Just a Woman’s Issue

Women tend to be more vocal about how they “pee a little” during the situations listed above. Thus, they are more likely to be diagnosed with PFD. Pregnancy, osteoporosis, endometriosis or surgery in the pelvic region are blamed as the main culprits.

But PFD affects men too. 

Men with chronic prostatitis are also prone to “leakage” and since these cases are rarely bacterial, the origin could easily be a result of musculoskeletal issues relating to the pelvic floor.

Some people believe that PFD is just a normal part of aging. This belief, combined with a general lack of awareness of pelvic floor dysfunction amongst health professionals, leads people to believe they must resign to simply living with the symptoms. 

But that’s not the case. 

What Exactly Is the Pelvic Floor?

The pelvic floor plays a pretty serious role in your anatomy.

Formed by both deep and superficial muscles that work together to create a sort of hammock to support the pelvic organs, the pelvic floor acts in harmony with the other abdominal and back muscles to create intra-abdominal pressure. 

All of this serves to stabilize and support the spine.

The Magic of Pilates for the Pelvic Floor

As a result of the pelvic floor’s relationship with the spine, many forms of exercise are counter indicated for those with pelvic floor dysfunction – for fear of their exacerbating the condition. 

But not Pilates. 

Given the attention to posture and the deep stabilizers of the core, Pilates is unique among guided exercises. In addition, the wide range of props, availability of resistance settings, and ability of qualified Pilates instructors to tailor sessions to the client’s needs makes it a very specialized and fine-tuned form of exercise.  

In other words, Pilates teaches acute awareness of the role of the pelvic floor in movement, so it actually has the potential to benefit those struggling with symptoms of PFD. 

But as with all things, precautions must be taken. 

And when tailoring a Pilates program for a client with PFD, a responsible Pilates instructor might recommend the client also consult with a Pilates-based physical therapist. 

Pilates-Based Physical Therapy for PFD

The reality is, a lot of people are performing pelvic floor exercises incorrectly. Even with the greatest verbal instruction from a teacher, there is still a huge percentage of people who are unable to contract the pelvic floor correctly. 

What’s worse, they may even be doing things that will promote incontinence in the future.

So a Pilates-based physical therapist first checks to ensure that a client is contracting the pelvic floor correctly, thus establishing a solid foundation for safe movement. They then work with the client on a combination of exercises to both strengthen and relax the pelvic floor muscles, bringing them back into balance. They avoid exercises that:

  • are higher impact 
  • excessively load the pelvic floor 
  • require a wide or open stance 

As the client begins to build pelvic floor strength, the physical therapist modifies stronger Pilates-based exercises to reduce pelvic floor load to safe levels. 

They also regularly assess the clients’ posture and assist them in becoming more aware of the postural changes toward which they’re working. The focus becomes maintaining a healthy lumbar curve and neutral pelvic position. 

Breathing is also an important way to improve pelvic floor health. Simply focusing on moving the diaphragm up and down during respiration can improve pelvic floor function.

So a physical therapist cues proper breathing to ensure that clients are not holding their breaths and bearing down on their rectus abdominis – as this increases pressure intra-abdominal pressure. 

Finally, educating clients on the proper way to engage the core, inner thighs, back muscles, and pelvic floor is important. So a Pilates-based physical therapist does just this; encouraging the client to take this awareness into their daily activities.

Do You Struggle with PFD?

There is absolutely no reason to feel shame or embarrassment about this common condition.

But neither do you have to accept it as your fate. 

By strengthening your pelvic floor with Pilates-based physical therapy for PFD, you could vastly reduce the impact of this condition on your life.

So if you’re ready to break free from the shackles of PFD, contact us. Our knowledgable and helpful staff will help you feel confident again. 

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