Pilates Effect on Pelvic Muscles and Urinary Incontinence

Pilates is a system of exercises that uses special apparatus that is designed to enhance flexibility, posture, physical strength and improve mental perception. Among women, the prevalence of urinary incontinence varies widely but approximately is 5-70%.  Urinary Incontinence in many cases goes undiagnosed just because many women feel hesitation and believe that it’s a normal part of womenhood. Urinary Incontinence is correlated with depression, lower quality of life, and very high annual medical care costs and it has a socioeconomic burden worldwide.

Risk factors for Pilates:

• Pregnancy and childbirth
• Diabetes
• Constipation
• Higher body mass index
• Urinary tract infection
• Caffeine and smoking

Mechanism of pelvic floor injury:

Studies showed a strong association between pelvic floor disorder and vaginal childbirth. This childbirth and pregnancy may lead to pelvic floor injury because of stretching, compression, or tearing of muscle, nerve, and connective tissues. The pelvic floor muscle mostly consists of coccygeus muscles, and the levator of ani. And stimulated from the lumbosacral plexus. Its main function is to control over bowel, bladder, pregnancy in women, sexual function, and provide support to the pelvic organ.

Management Plan of Urinary Incontinence:

Lifestyle Modifications:

• Reduce carbonated drinks, caffeine, and fluids.
• Treating constipation
• Reduced body mass index
• Timed and regular urination
• Kegel muscles training

Stress urinary Incontinence:

• Fascial slings
• Burch colpo-suspension
• Injectable bulking agents
• Mid-urethral synthetic slings

Pilates and pelvic floor muscles training:

It’s essential to know that the function of pelvic floor muscles is synergy with abdominal muscles, diaphragm, and chest wall and not in isolation. Throughout every day the trunk muscles and intra-abdominal pressure activity are regulated regularly. To prevent prolapse of pelvic floor organs and incontinence, pelvic floor muscles have to respond rapidly to all these changes. The concept of pilates is based on control and center (core). When referring to the core the Pilates method focuses on following muscles.

• Pelvic floor muscles
• Diaphragm
• Oblique muscles and transverse abdominis
• Multifidus

That’s why, when pelvic floor muscles are rehabilitating, it is beneficial to do so in conjunction with other groups of muscles mentioned above.

Pilates Exercise program versus pelvic floor muscles exercise program:

Although pilates exercise and conventional pelvic floor muscle exercise seem to be equitably effective in boosting the recovery time of urinary Incontinence as well as improving quality of life. However, individuals diagnosed with urinary Incontinence are fully recovered at a higher rate by following Pilates exercise programs. Current studies indicates that individuals who are noticed with urinary Incontinence can get welfare by doing  as compact as one session per whole week, for eight to fifty two weeks.

Clinicians frequently apply some activity limitations among those women who are suffering from pelvic floor disorder. It is due to the association of pelvic floor loading with increased intra-abdominal pressure. A study absolute in 2015 states no statistically significant difference in between the intra-abdominal pressure in sit-to-stand and underlying pilates exercises and that’s why recommend pilates exercises to those women desiring low intra-abdominal pressure exercise routine. In addition to standard physiotherapy care, modified Pilates seems to be even more beneficial.

Pilates Exercise practice:

As an exercise movement pilates yields numerous benefits as it increases circulation, and lung capacity, improves bone density, and joint health, and strengthens kegel muscles and recovery from urinary Incontinence. It is necessary to be sure that every movement should be made unhurriedly and involve following basic postulates.

Concentration: Pay attention to the starting position and perform slow and smooth movements as well as each part of the body. Stay concentrated and do not let yourself distracted.

Breathing: Inhalation of oxygen refreshes your brain and mind. Deep breaths clear the lungs and bring relaxation to the mind. Correlate breathing with movement to acknowledge bodywork.

Control: Pilates exercises need to be done with complete focus and full control of muscle work.

Centering: All muscles start from centering immersing core muscles including lumber, pelvic floor muscles, and oblique abdominis. This step helps to improve posture and balance which in other words is a powerhouse of the body. The primary benefit of pilates exercise is to strengthen the core stabilization or powerhouse.

Precision: This step is to focus on the step of exercise to get benefits from this.

Movement:  Every movement of pilates exercise should start from a strong center and then flow slowly and gently.

Role of Pilates exercise in physical therapy:

Pilates exercise has numerous roles it’s not beneficial only for kegel muscles and urinary Incontinence but also possesses several other roles in physical therapy. Pilates exercise incorporates breathing patterns. Active breathing patterns when inhalation occurs through specific movement or exercise from one phase to another increase your muscle’s strength and performance.

 People suffering from multiple scissors very often experience mobility and balance impairments and reduced trunk stability. Pilates based core stability coaching as a physical therapy which is aimed at refining and magnify control of body stabilizing muscles is a approved exercise to overcome. Multiple scissors symptoms like sensation, fatigue, and reduced physical performance are improved by Pilates exercise as physical therapy.

Pilates exercise sessions of a few weeks are effective in reducing lower back pain. It’s a therapy that provides improvement in pain, disability, and physical and psychological perception of Women’s health with few sessions of exercise. Pilates also shows effectiveness in reducing obesity and flexibility in obese women. Its major benefits include strengthening pelvic floor muscles and recovery from urinary Incontinence.

Key takaways:

• Pilates can be a great plus point to standard physiotherapy care by adapting exercises to ensure the contraction of pelvic floor muscles.

• Adding Pilates exercise to standard Physiotherapy care has been found to lower the economic burden on the healthcare system.

• Pilates exercises can be used as an alternative for individuals who dislike conventional pelvic floor muscle exercises.

• Every patient is different from other patients that’s why it is essential to individualize every session to the individuals specific abilities and needs.