Prevent Pelvic Organ Prolapse! Fall into a Healthy Pelvic Floor Routine the Pilates and Pfilates Way!
Pelvic floor exercises (kegels) have been evidenced to increase pelvic floor strength, improve sexual function, improve bladder and bowel function, prevent further pelvic organ prolapse, and even decrease prolapse stage. When lower abdominal muscles are recruited, research has shown that healthy functioning pelvic floors, normally contract just before the lower abdominal muscles do, indicating that strengthening the lower abdominals should be a part of any pelvic floor strengthening program. Research also reveals that the “maximum strength kegel” is produced when the buttocks, inner thighs, and lower abdominals are recruited along with the kegel. Thus, research has just described the perfect exercise routine “recipe” for maintaining healthy pelvic floor function: the Pilates and Pfilates exercise methods.
Pilates, created by Joseph Pilates, is designed to strengthen the core including the abdominals, back, gluteal and inner thigh muscles. Pilates focuses on precise movement patterns to facilitate the core to prevent back injury.
Pfilates (pelvic floor Pilates) was created by Dr. Crawford, a urogynecologist, who researched pelvic floor engagement during 10 specific Pilates moves through use of electromyography. (EMG) Pfilates takes the well-known kegel and applies it to functional positions that augment pelvic floor recruitment, utilizing the gluteals, abdominals, back, and inner thighs.
Correct movement is key to both exercise programs. Thus, ideally, it is recommended to work with a certified trainer of both disciplines. (Since 20-30% of the patients in one study have been discovered to do the kegel incorrectly with just a verbal command, and 10% were actually doing damage by bearing down, you may want to see a women’s health PT or OT first to make sure you are doing it correctly. Some studies have shown a higher percentage of patients performing the kegel incorrectly). Smaller classes are also key to getting corrections and modifications from the instructor as needed.
When Pilates and Pfilates are performed correctly, they are effective in reducing back pain and preventing pelvic organ prolapse. So, this autumn, as we fall back and gain an hour, don’t let your pelvic organs fall, but do let yourself fall into a daily healthy pelvic floor routine!
Braekken IH, et al. Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol 2010; 203: 170.e1-7.
Hagen S, et al. A randomized controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse. Int Urogynecol J 2009; 20: 45-51.
Stupp L, et al. Pelvic floor muscle training for treatment of pelvic organ prolapse: an assessor-blinded randomized controlled trial. Int Urogynecol J Pelvic Floor Dysfunction 2011 (Epub ahead of print)
Piya-Anant M, et al. Integrated health research program for the Thai elderly: Prevalence of genital prolapse and effectiveness of pelvic floor exercise to prevent worsening of genital prolapse in elderly women. J Med Assoc Thai. 2003; 86: 509-515.
Ghroubi S, et al. Effect of conservative treatment in the management of low-degree urogenital prolapse. Ann Readapt Med Phys. 51: 56-102.
Critchley D. Instructing pelvic floor contraction facilitates transverses abdominis thickness increase during low-abdominal hollowing. Physiother Res Int. 2002; 7(2): 65-75. Case control 3b.
Sapsford RR, et al. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2011; 20: 31-42. Case series 4.
Bo K. Pelvic floor muscle training. In: Evidence-based Physical Therapy for the Pelvic Floor. Bo K, Berghmans B, Morkved S, Kampen MV (eds). Philadelphia: Elsevier, 2007.
www.familypracticenews.com. February 15, 2007. Simple questions can help uncover urinary incontinence. Found at http://www.rheumatologynews.com/fileadmin/content_pdf/fpn/archive_pdf/vol37iss4/70230_main.pdf, 10-22-12.