Troy Hurst holds a Doctorate in Physical Therapy from Carroll University. He is a physical therapist specializing in both athletic and vestibular rehabilitation with an emphasis on performance running.
The pelvic floor is a group of muscles that support the bladder, uterus, and rectum. These muscles are vital in urinary and bowel control, sexual function, and overall pelvic stability (1). Pilates exercises can be highly beneficial for strengthening the pelvic floor muscles and improving their function (2).
However, not all Pilates exercises suit those with pelvic floor issues. Those with weak or dysfunctional pelvic floor muscles may worsen their condition by doing specific Pilates exercises.
We are not saying to avoid Pilates altogether, but rather to highlight the importance of understanding which exercises may need modification or avoidance for individual cases.
Here is a breakdown of some of the best and worst Pilates exercises for people with pelvic floor dysfunction (3).
Pelvic floor Pilates for women and men isn’t a specific type but a modified version of traditional Pilates exercises that focuses on strengthening the pelvic floor muscles. It involves slow and controlled movements that target the deep core muscles, including the pelvic floor.
Pilates has long been known for its focus on core strength and stability, making it an ideal form of exercise for promoting pelvic floor health. However, some Pilates exercises put more pressure on the pelvic floor than others, which can be problematic for those with specific pelvic floor issues.
Modifying or avoiding these exercises can help prevent further damage to the pelvic floor muscles and allow for proper healing and strengthening.
Note: you’ll need approval from your doctor or physical therapist before starting any exercise routine, including Pelvic floor pilates exercises, especially if you have pelvic floor issues.
Yes, Pilates can be highly beneficial for strengthening and improving the function of the pelvic floor muscles. Here’s how:
1. Builds Core Strength
Pilates focuses on the deep core muscles, including the pelvic floor (4). By strengthening these muscles, you can improve their ability to support your pelvic organs and maintain bladder and bowel control.
2. Promotes Proper Breathing Technique
Proper breathing is essential for engaging and strengthening the pelvic floor muscles. Pilates emphasizes diaphragmatic breathing, which involves using the diaphragm to draw air into the lungs and engage the deep abdominal muscles (5).
This type of breathing also helps relax tension in the pelvic floor muscles, which can be helpful for those with a hypertonic (overly tense) pelvic floor.
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3. Increases Body Awareness
Many Pilates exercises involve slow, controlled movements that require high body awareness. This awareness can help you better understand and feel how your pelvic floor muscles work and whether they are contracting or relaxing.
This increased body awareness can also translate into improved posture, which is essential for maintaining proper pelvic floor function (6).
4. Enhances Flexibility and Mobility
Research shows that Pilates can improve overall flexibility and mobility, indirectly benefiting the pelvic floor (7).
By encouraging flexibility, the muscles and tissues surrounding the pelvic area are less likely to experience tension or tightness, reducing the risk of strain or injury.
Flexibility is significant for the pelvic floor, as it aids in maintaining normal pelvic alignment and function.
5. Strengthens the Transversus Abdominis
The transversus abdominis is a deep core muscle that works closely with the pelvic floor muscles to support and stabilize the lower abdominal region (5).
Pilates exercises that target the transversus abdominis, such as pelvic tilts and kneeling arm-leg extensions, can enhance pelvic floor function by reinforcing this interconnected muscle group.
Studies indicate that a coordinated effort between these muscles can improve pelvic floor strength and endurance (4).
6. Supports Neuromuscular Control
Pilates emphasizes the connection between the mind and body, which can enhance neuromuscular control. Individuals can develop better neuromuscular coordination by practicing mindful movements and focusing on specific muscle engagement (8).
Research highlights that this improved control can lead to a more effective and timely activation of the pelvic floor muscles during daily activities, thereby preventing issues such as urinary incontinence and improving overall pelvic health.
Read more: Home Pilates Workout Guide: Strengthen Your Core
To cue the pelvic floor in Pilates, follow these steps:
5 Pilates exercises for pelvic floor muscles include:
This exercise involves gently tilting the pelvis forward and backward while lying on your back. It can help strengthen the deep abdominal muscles, including the transversus abdominis, which significantly support the pelvic floor.
To perform this exercise:
You can also perform this exercise by doing wall pilates for pelvic floor:
Bridging involves lifting your hips off the ground while engaging your core and squeezing your glutes. This movement targets both the pelvic floor and gluteal muscles, helping to improve overall strength and stability.
To perform the bridge pose:
This exercise targets the transversus abdominis, gluteal muscles, and pelvic floor by challenging stability and coordination.
To perform this exercise:
Side-lying leg lifts are excellent for targeting the hips and pelvic region muscles, which can indirectly strengthen the pelvic floor. Side-lying leg lifts help stabilize the pelvis and improve alignment by engaging the abductor muscles.
This stabilization is crucial in supporting the pelvic floor muscles and maintaining continence and pelvic organ support.
To perform this exercise:
Kegels are a well-known exercise for strengthening the pelvic floor muscles. These exercises involve repeatedly contracting and relaxing the muscles that control urine flow, known as the pubococcygeus (PC) muscles (10).
To perform Kegels:
Doing pelvic floor exercises with a small ball can effectively cue and engage your pelvic floor muscles.
The ball provides a physical target to squeeze, which helps you focus on contracting the right muscles. Adding resistance from the ball can enhance the effectiveness of the exercises, making it easier to identify and strengthen your pelvic floor muscles (11).
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While Pilates is beneficial for building core strength and flexibility, specific exercises can place undue pressure on the pelvic floor, potentially exacerbating pelvic floor problems. You should avoid exercises involving heavy abdominal engagement, intense core contractions, or prolonged inversions if you have pelvic floor dysfunction.
Examples include exercises like the “Hundred,” “Scissors,” “Dead Bugs,” and “Roll Up,” which demand high intra-abdominal pressure and may place stress on weakened pelvic floor muscles.
Additionally, exercises like “Teaser” or “Double Leg Stretch” can challenge pelvic stability, making them unsuitable for individuals with pelvic floor dysfunction.
We recommend cautiously approaching the “Plank” and other advanced abdominal exercises, as they require sustained core engagement and may cause issues for those with weak or strained pelvic floor muscles.
Fortunately, you or a trainer can adjust many Pilates exercises to reduce pressure on the pelvic floor while still fostering strength and stability.
Consult a certified Pilates instructor or physical therapist to learn modifications and find a program tailored to your needs.
We’ve detailed How To Relax Pelvic Floor Muscles by incorporating breathing exercises, gentle stretching, and mindfulness techniques, which can help reduce tension and improve overall pelvic health.
Strengthening the pelvic floor can vary in time depending on several factors, including the individual’s current muscle strength, consistency of exercise, and overall health. Individuals might start noticing muscle strength and control improvements within 4 to 6 weeks with regular and targeted exercises, such as Kegels or Pilates.
However, significant strengthening and noticeable changes might take about 3 to 6 months of consistent practice. Maintain a regular exercise routine and consult a healthcare professional for personalized advice.
Find out how to Strengthen Pelvic Floor Muscles Without Kegels by exploring alternative techniques that promote core engagement and enhance muscle resilience through mindful movement and posture alignment.
Read more: Can You Lose Weight Doing Pilates Every Day?
Several factors can negatively impact these muscles, leading to dysfunction:
Dysfunction in the pelvic floor muscles can result in symptoms like urinary or fecal incontinence, pelvic pain, and a feeling of heaviness or pressure in the pelvic area. These symptoms can significantly impact daily life and overall well-being.
Yes, squats can help strengthen the pelvic floor muscles when done with proper form. They engage the core and lower body, supporting overall pelvic stability and strength. Walking is an excellent, low-impact exercise for maintaining pelvic floor health. It promotes circulation and can help keep the pelvic floor muscles active without excessive strain. For people without pelvic floor dysfunction, planking can benefit the pelvic floor as it strengthens the core muscles, including those supporting the pelvic region. However, for some individuals with current pelvic floor dysfunction, planks may be an exercise that either needs to be modified or worked up to over time. If you have pelvic floor dysfunction, speak to your physician or pelvic floor physical therapist for individual recommendations. Pelvic alignment issues can be a result of many potential causes. Pilates may benefit those related to hip, core, and pelvic floor strength. For causes that are anatomical or pathophysiological, consult with your doctor.Frequently Asked Questions
Do squats help the pelvic floor?
Is walking OK for the pelvic floor?
Is planking good for the pelvic floor?
Can Pilates realign the pelvis?
Pelvic floor health is crucial for overall well-being, and Pilates offers a low-impact yet effective way to strengthen these muscles. Individuals can improve their pelvic floor strength, coordination, and neuromuscular control by incorporating mindful movements, focused breathing techniques, and targeted exercises.
It is essential to consult with a certified Pilates instructor or healthcare professional for personalized guidance and modifications, especially for those who may have pelvic floor dysfunction or are pregnant.
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