No one would argue that problems surrounding incontinence and leaking are embarrassing to talk about. Even Polestar® instructors have reported leaking during classes and chuckle it away as best they can. Why does this occur? How can Pilates professionals remedy these leaks? Brent D. Anderson and Christi Idavoy sat down for Pilates Hour to discuss their research on movement for incontinence.
In this context, we are referring to stress incontinence; when you leak as a result of pressure on your bladder from exercise, sex or other strains. This intra-abdominal pressure is regulated by the pelvic floor. You can train it with more than just Kegel exercises. By identifying certain patterns, the pelvic floor can be conditioned to protect against untimely leaking. Unfortunately, many are confused on how the pelvic floor ought to contract. There are 3 main types of contractions:
Volitional Contraction – deliberate contracting of the pelvic floor and surrounding tissue.
Mechanical Contraction (Elasticity) – Contractions resulting from the pressure of regular breath.
Spontaneous Contraction – the pelvic floor’s natural elevation when standing.
Pressure measured on Pilates routines
In one study, researchers found that out of 45 women observed in the resting supine position, 45% (20) of participants pushed the pelvic floor down rather than up. By skillfully using an intra-vaginal pressure transducer they were able to measure the pressure being applied to the pelvic floor.
Brent and Polestar graduate Hadar Shwartz also found about 45% of participants applied the same pressure to the pelvic floor when they observed over 250 women in the supine position. When asked what to do about relieving tight pressure in the area, Christi said to relax. She recounted that she had too much tone in the pelvic floor, and as a result, was not able to have a vaginal birth. Her colleague Pamela Downey, adjunct professor of Physical Therapy at the University of Miami, recommended her a particular squat exercise. First, assume a deep squat with the support of a pole or door frame. Slide down into the squat while holding your support. Next, allow your pelvic floor to relax as best it can without forcing it. All the while you visualize slow release of that tension.
Brent stresses that our patterns of behavior can routinely fool us into applying pressure or support in places where there ought not to be. For example, how the pelvic floor may be hypertonic from a lack of support on the anterior abdominal wall. To simulate that missing pressure he suggests using Kinesio Tape to pinch and crease the wall to simulate that missing pressure. You can do the opposite by performing diaphragmatic breathing, relieving and dispersing the pressure.
You may not admit it, but we can learn much about movement when we address the less sanctified functions of our bodies. Above all, remember it is perfectly natural. How often do your clients report incontinence issues? Have you had success cuing clients on pelvic floor movement? What do you recommend for stress incontinence? Let us know on social media with #IamPolestar and #PelvicFloor.
Many therapists and instructors are compelled to apply their knowledge of movement in different ways to benefit society.
Hagit Berdishevsky is one such person, whose passion for health has lead her to cooperate with FOCOS (Foundation of Orthopedics and Complex Spine) foundation in Africa. World-renown orthopedic surgeon Dr. Baochie-Adjei founded FOCOS with one goal in mind – provide life-changing, spinal surgeries to children in his home country of Ghana, and in other developing nations in Africa. Hagit applies her extensive knowledge in working with scoliosis to aide in the recovery of these children.
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Dr. Boachie-Adjei is known globally for his extensive knowledge of spine deformity and special expertise in the treatment of scoliosis, kyphosis, and spine reconstruction in adult and pediatric patients. Originally a group a 250 volunteers, FOCOS set to work on administering hundreds of free spinal surgeries to patients in the region. In 2008, Dr. Boachie-Adjei and his team moved from their humble clinic, Watson House, to the FOCOS Orthapedic Hospital. It was constructed with over $20 million in donations, boasts state-of-the-art medical equipment, and treats patients from all over the globe. They are committed to sustainability, education and research on spinal injuries in these developing nations.
Some of the rarest, riskiest surgeries are performed by FOCOS – surgeries many other surgeons wouldn’t dare touch. Almost 50,000 patients have been treated worldwide, with conditions ranging from complex spinal deformities to knee prostheses. If you are curious about the different surgical interventions, videos of Dr. Boachie-Adjei performing these surgeries are on YouTube.
Hagit’s background as a physical therapist makes her perfect for her role in the patients’ recovery. Over fourteen years ago, she graduated a Physical Education and Sports Science program with a focus on Postural Defects Cultivation in Israel. In 2010, she earned her certification as a Schroth Method Therapist by the Asklepios Katherina–Schroth Clinic in Germany and uses this method with the recovering children. Hagit is one of 5 Schroth Method professionals in the United States. She is incredibly passionate about her work.
Hagit and Polestar Educator Lise Stolze have combined their knowledge of how best to treat patients with Scoliosis in the course: Pilates Adaptations for People with Scoliosis. This is a course for conservative care of idiopathic Scoliosis (IS). In this course they incorporate breath techniques and modify Pilates mat exercises for Scoliosis.
You can learn Pilates adaptations for Scoliosis patients, based on the Schroth Method, from Hagit and Lise. Join them in our upcoming courses in Allen, TX. You can make an impact on world health by learning new skills like these. In fact, any way you choose to make an impact makes a difference.
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Brent and Polestar graduate Hadar Shwartz also found about 45% of participants applied the same pressure to the pelvic floor when they observed over 250 women in the supine position. When asked what to do about relieving tight pressure in the area, Christi said to relax. She recounted that she had too much tone in the pelvic floor, and as a result, was not able to have a vaginal birth. Her colleague Pamela Downey, adjunct professor of Physical Therapy at the University of Miami, recommended her a particular squat exercise. First, assume a deep squat with the support of a pole or door frame. Slide down into the squat while holding your support. Next, allow your pelvic floor to relax as best it can without forcing it. All the while you visualize slow release of that tension.
Brent stresses that our patterns of behavior can routinely fool us into applying pressure or support in places where there ought not to be. For example, how the pelvic floor may be hypertonic from a lack of support on the anterior abdominal wall. To simulate that missing pressure he suggests using Kinesio Tape to pinch and crease the wall to simulate that missing pressure. You can do the opposite by performing diaphragmatic breathing, relieving and dispersing the pressure.
You may not admit it, but we can learn much about movement when we address the less sanctified functions of our bodies. Above all, remember it is perfectly natural. How often do your clients report incontinence issues? Have you had success cuing clients on pelvic floor movement? What do you recommend for stress incontinence? Let us know on social media with #IamPolestar and #PelvicFloor.