Urinary incontinence might not be the hottest topic of conversation, but approximately 25 million American adults are suffering from some form of it. The World Health Organization estimates that stress incontinence affects 15 million adult women in the U.S. alone, not to mention the alarming number of sexual-health problems on a global level.
At my Los Angeles studio, I regularly train clients with these issues and was inspired to develop a program that specifically addresses the pelvic floor muscles. I quickly found that my repertoire not only helped to alleviate these issues, but it enhanced my student’s overall Pilates practice.
Learning How to Actively isolate and Contract The Pelvic Floor is The Secret to Strengthening and Enhancing Your Performance on The Mat and İn The Bedroom to Boot Photo Gallery
Think of the muscles of the pelvic diaphragm as a hammock or sling from the pubic bone to the tailbone. (See figure on page 55.) Structurally, the pelvic diaphragm supports vital organs; in women, it supports the passages of the bladder, vagina and rectum. Functionally, it’s the muscle group used to open, close and even lubricate these passageways. In the bedroom, contractions of the pelvic diaphragm and the secondary muscle layers of the pelvic floor are responsible for sexual pleasure.
On the mat, the pelvic diaphragm works in concert with the core muscles to resist external forces and regulate the internal pressure in the abdomen. Additionally, it has a close relationship to the adductor muscles (inner thighs). Each muscle group supports the contraction of another. The network of skeletal muscles that make up the pelvic diaphragm respond to the same training techniques as the body’s other skeletal muscles. That’s why the pelvic diaphragm is a point of interest in just about every exercise in Pilates.
The following routine emphasizes the role of the pelvic diaphragm in abdominal exercises. A medium “squishy” ball is used to help stabilize the movement, promote and strengthen the adductors and help trigger the contraction of the pelvic diaphragm.
Before you begin, to help you gain a better understanding of how to contract the pelvic diaphragm, try these two scenarios:
1.Imagine that you’re stuck in traffic, and you have to go to the bathroom. The muscles you contract to “hold it” are your pelvic floor muscles. Squeeze and hold these muscles, then relax them.
2. Now, imagine that you’re in a crowded elevator and feel the urge to pass gas. Use your pelvic floor muscles to refrain; you should feel a tightening or closing deep within your anus. Hold. Relax. Hold. Relax.
Contracting the entire pelvic diaphragm involves combining these two contractions. Once you get this, you’ll find that you’re able to work deeply and more efficiently. You’ll be able to power through your practice like never before.
CONTRACTING THE PELVIC DIAPHRAGM WITH BALL ADDUCTION
Prop: medium ball
purpose: teaches how to actively isolate and contract the pelvic diaphragm in conjunction with pelvic movement to increase strength and stability while promoting proper function setup: Lie on your back, with your spine neutral, knees bent and feet hip-width apart on the floor, heels about 12 inches from your rear. Place the ball between your knees, and lengthen your arms by your sides, palms down.
1. Inhale deeply, maintaining a neutral spine.
2. Exhale, contracting your pelvic diaphragm as you roll into a pelvic tilt, pressing the ball between your knees for 5 seconds.
3. Inhale, releasing the pressure on the ball as you roll back to neutral spine. Do 5-10 reps.
Tip: Emphasize the exhale to allow for a deep contraction of your abdominals.
Prop: medium ball
Setup: Lie on your back, with your legs straight and flexed feet together. Holding the ball between your palms, bring your arms overhead, a few inches from the floor.
1. Inhale, rolling into a pelvic tilt as you reach the ball toward the ceiling, directly above your shoulders.
2. Exhale, contracting your pelvic diaphragm, and roll up one vertebra at a time, reaching the ball toward or past your toes.
Exhale, contracting your pelvic diaphragm to return to the starting position. Do 5-10 reps.
Tips: Take 2 full breaths on each rep, contracting your pelvic diaphragm on each exhale. Keep your shoulders away from your ears.
Advanced: Place the ball between your ankles. Add a gentle press or squeeze of the ball every time you exhale and contract your pelvic diaphragm. Be mindful not to lock/ hyperextend your knees as you press.
3. Inhale, reversing the movement, rolling down one vertebra at a time, until your shoulders just pass your hips;
PROP: medium ball
Purpose: challenges and strengthens the oblique and pelvic floor muscles; brings awareness to the contraction of the pelvic diaphragm and the role of the surrounding muscles; promotes hip and pelvic stability setup: Lie on your back, with your knees bent and together, feet flat on the floor, arms at your sides and palms down. Roll into a pelvic tilt, and extend your legs straight to 90 degrees, with your feet in Pilates stance. Inhale to prepare.
1. Exhale, contracting your pelvic diaphragm, and lower and circle your legs in one direction; inhale, returning your legs to center.
2. Repeat step 1 toward the opposite direction. Do 6-12 reps.
Tips: Focus on maintaining your pelvic tilt throughout; exhale deeply and tighten and contract your abdominal muscles.
Modifications: Instead of placing your palms flat at your sides, place them just below your sacrum for support. Make smaller circles and/or decrease the reps, paying attention to the number you can do before your pelvic floor muscles fatigue.
ADVANCED: Do the exercise with the ball between your ankles, pressing gently into the ball while exhaling and contracting your pelvic diaphragm.
setup & step 1
Prop: medium ball
PurPose: increases strength in the abdominal and pelvic floor muscles; brings awareness to the contraction of the pelvic diaphragm and the role of the surrounding muscles; enhances hip and pelvic stability
Setup: Lie on your back, with your legs extended at 90 degrees and the ball between your ankles. Place your hands at the base of your head, elbows out to your sides. Lengthen the back of your neck, allowing your head to relax into your hands. Inhale, then exhale, lifting your head, neck and shoulders.
1. Inhale, lowering both legs to about 45 degrees.
2. Exhale, contracting your pelvic diaphragm, pressing on the ball and lifting your straight legs back to 90 degrees. Do 5-10 reps.
TiPS: Maintain your pelvic tilt, and allow your head to rest in your hands. Notice how many reps you can do before your pelvic floor muscles fatigue; add rests or reduce the number of back-to-back reps if necessary.
ModificAtion: Place your arms down at your sides and hands at your
sacrum for support. Lift your legs to tabletop position, and place the ball between your bent knees. Inhale, lowering your legs until your toes touch the mat (if possible); exhale, contract your pelvic diaphragm, press the ball between your knees and return your legs to tabletop. If you’re suffering from very weak or damaged pelvic floor muscles, skip this exercise altogether.
BRIDGE WITH BALL ADDUCTION
Prop: medium ball purpose: strengthens the inner thighs and glutes; increases awareness of the relationship between the abdominal and pelvic floor muscles and hip stability; promotes spinal articulation setup: Same as Contracting the Pelvic Diaphragm with Ball Adduction.
1. Inhale deeply, maintaining a neutral spine.
2. Exhale, contracting your pelvic diaphragm, and roll up one vertebra at a time to Bridge. Inhale.
setup & step 2
3. Exhale, contracting your pelvic diaphragm, and return to the starting position. Do 1-10 reps.
TiPS: Focus on the exhalation, contraction of the pelvic diaphragm and then the rolling. The contraction
will assist in lengthening your spine and stabilizing your hips.
ADVANCED: Pause at the top of the Bridge and squeeze the ball while contracting your pelvic diaphragm for 1-10 reps.
setup & step 1
Purpose: strengthens the abdominal and pelvic floor muscles; increases awareness of the inner thighs and their relationship and support to contracting the pelvic diaphragm setuP: Lie on your back, then prop yourself up on your forearms, with your elbows directly under your shoulders. Keep your neck and shoulders relaxed and chest open. Bend your knees toward your chest, and “glue” your heels together, slightly turning out your thighs into a Frog position. Inhale to prepare.
1. Exhale, contracting your pelvic diaphragm and extending your legs out diagonally, keeping your heels together and gently pointing your toes while you engage the midline of your body, squeezing your inner thighs together.
2. Inhale, returning to the starting position. Do 6-12 reps.
TiP: Don’t allow your chest to drop—keep the weight of your upper body lifted and out of your shoulder joints.
On the mat, the pelvic diaphragm works in concert with the core muscles to resist external forces and regulate the internal pressure in the abdomen.
Purpose: promotes lateral flexion and flexibility; challenges the core muscles; encourages hip stability and better posture
Setup: Sit on your left sit bone with both legs bent to your right side. Extend your arms out to your sides at shoulder height. Inhale to prepare.
1. Exhale, reaching your right arm up to the ceiling and then over to your left side.
2. Inhale, lengthening along the right side of your body, keeping your right hip down.
3. Exhale, contracting your pelvic diaphragm and returning to the starting position. Do 3 reps on each side.
tiPs: Pay attention to the contraction of your pelvic
diaphragm, and allow it to help you anchor your hips.
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Karen armstrong is a health and fitness professional in the Los Angeles area. She holds a BS in exercise science and physiology from the University of Arizona. Armstrong began her Pilates education in the late ’90s under the guidance of Romana Kryzanowska and has since received her certification through Balanced Body and DK Body Balancing. She’s also studied yoga, tai chi, belly dancing, The Franklin Method, The Lotte Burke Method, different styles of Pilates as well as traditional functional training. Armstrong is the author of InControl Pelvic exercises for Women (Cricket Productions, 2012), available at www.amazon.com. A wife and mother of two daughters, she loves to share her passion for fitness, health and nutrition with her family and clients at her private L.A. studio. For more information, visit www.incontrolworkout.com.
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