Pilates: a fix for incontinence?

Yet another reason for the popularity of Pilates.  Already hailed for the return from injuries the figures of celebs and now this.  Urinary incontinence, the unexpected, uncontrolled passing of urine, can be annoying and embarrassing in equal measure. Stress urinary incontinence (SUI) occurs when sneezing, laughing, coughing, exercising, lifting or doing other similar activities.

These activities pressurise the bladder, causing unexpected leaks. It is estimated that up to one-third of women can suffer from SUI at some point in their lives. Old age, pregnancy and after childbirth are periods when women are more at risk of SUI.

The best technique to follow is one recommended by a continence adviser or physiotherapist. Briefly, it involves tightening and lifting up the muscles around the vagina and back passage, as if trying to not urinate or pass wind, in a set pattern.  Hips, stomach and upper legs should be stable, and a recommended routine involving both fast and slow contractions followed. The movement is an upward and inward contraction, not a bearing-down effort.

For many people, when they think of pelvic floor muscles they think of Pilates. Pilates is an exercise regime practised by millions worldwide, which involves a series of low-impact, flexibility and muscle-toning exercises.

First taught by Joe Pilates in the 1920s in New York as “Contrology”, the practice centres on developing core strength which includes the pelvic floor, but also the upper abdominals, hip flexor origins, and glutei muscles.

So is Pilates an acceptable alternative to pelvic floor muscle exercises? “Pilates which addresses pelvic floor exercises would be as successful as pelvic floor exercises alone. Essentially exercise that aims to strengthen the pelvic floor will reduce the symptoms of genuine stress incontinence.

“Other treatment options include surgery. However, the patient would be advised to continue with pelvic floor exercises to allow muscles to continue to strengthen,”

While there is a growing body of research that points to the standout success of Pilates in treating lower back pain, there is still something of a lacunae when it comes to research on Pilates and SUI.

Pilates is excellent for post-natal recovery. It not only targets pelvic floor tone, but also the abdominals and deep stabilisers in the back and hips, in one movement programme. Pilates works from the inside out, the deeper muscles work to support the bigger more superficial muscles.

It’s important to understand the physical changes in pregnancy, and that previous strength and stability is not present after childbirth, a period of physical recovery is necessary. Pilates training can begin six to eight weeks after pregnancy.