No one would argue that problems surrounding incontinence and leaking are embarrassing to talk about. Even Polestar® instructors have reported leaking during classes and chuckle it away as best they can. Why does this occur? How can Pilates professionals remedy these leaks? Brent D. Anderson and Christi Idavoy sat down for Pilates Hour to discuss their research on movement for incontinence.
In this context, we are referring to stress incontinence; when you leak as a result of pressure on your bladder from exercise, sex or other strains. This intra-abdominal pressure is regulated by the pelvic floor. You can train it with more than just Kegel exercises. By identifying certain patterns, the pelvic floor can be conditioned to protect against untimely leaking. Unfortunately, many are confused on how the pelvic floor ought to contract. There are 3 main types of contractions:
- Volitional Contraction – deliberate contracting of the pelvic floor and surrounding tissue.
- Mechanical Contraction (Elasticity) – Contractions resulting from the pressure of regular breath.
- Spontaneous Contraction – the pelvic floor’s natural elevation when standing.
Pressure measured on Pilates routines
In one study, researchers found that out of 45 women observed in the resting supine position, 45% (20) of participants pushed the pelvic floor down rather than up. By skillfully using an intra-vaginal pressure transducer they were able to measure the pressure being applied to the pelvic floor.
Brent and Polestar graduate Hadar Shwartz also found about 45% of participants applied the same pressure to the pelvic floor when they observed over 250 women in the supine position. When asked what to do about relieving tight pressure in the area, Christi said to relax. She recounted that she had too much tone in the pelvic floor, and as a result, was not able to have a vaginal birth. Her colleague Pamela Downey, adjunct professor of Physical Therapy at the University of Miami, recommended her a particular squat exercise. First, assume a deep squat with the support of a pole or door frame. Slide down into the squat while holding your support. Next, allow your pelvic floor to relax as best it can without forcing it. All the while you visualize slow release of that tension. Christi also gives a 10 step supine exercise for the pelvic floor on her blog!
Brent stresses that our patterns of behavior can routinely fool us into applying pressure or support in places where there ought not to be. For example, how the pelvic floor may be hypertonic from a lack of support on the anterior abdominal wall. To simulate that missing pressure he suggests using Kinesio Tape to pinch and crease the wall to simulate that missing pressure. You can do the opposite by performing diaphragmatic breathing, relieving and dispersing the pressure.
You may not admit it, but we can learn much about movement when we address the less sanctified functions of our bodies. Above all, remember it is perfectly natural. How often do your clients report incontinence issues? Have you had success cuing clients on pelvic floor movement? What do you recommend for stress incontinence? Let us know on social media with #IamPolestar and #PelvicFloor.