A daily activity, and one of the least publicly discussed effects of aging, is the dysfunction of the pelvic floor which results in incontinence. The embarrassed elderly become reluctantly accustomed to enriching pharmaceutical chains with purchases of pads and diapers. Family doctors warn of the risks and probable failure of surgical or drug interventions, so for the aging, incontinence becomes an unwelcome daily inconvenience. God forbid one should ever find oneself out of easy access to a bathroom.
Pilates exercises are not a magical panacea, restoring the quality of bladder control that we enjoyed in our youth, but they can go a long way to improving quality of life so that frequent nocturnal visits to the bathroom are reduced, and activities like errands or longer car trips do not have to be planned around bathroom access.
The specific muscles which need to be strengthened to reduce incontinence are the pelvic floor muscles which are the foundation for the body’s Core muscles. They both help stabilize the pelvis and support lower abdominal muscles in the abdomen such as the bladder and uterus. It is these muscles along with the deep abdominal muscles such as the Transverse Abdominus or deep back muscles such as the Multifidus, which form the muscles referred to in Pilates as the Core or Powerhouse.
Pilates exercises which can help reduce urinary urgency are as follows
Kegels are not specifically a Pilates exercise but they still need to be mentioned here. Most of us are familiar with the fundamentals of Kegel exercises. They involve pulling up and squeezing the set of muscles that we would use to stop urinary flow. These exercises can be done in supine, seated, standing or squatted positions. It is the daily frequency of these exercises ( thirty times is a good number) through which improvement in urinary continence can be achieved.
If you engage pelvic floor muscles during all Core activated exercises by pulling them gently upwards, over time, these muscles will show improvement. One exercise which is specifically helpful in developing pelvic floor muscles is detailed as follows:
From a supine position, lie with an imprinted, neutral spine, hip bones flat and stable and lift and bend one’s knees as in a ball. When the bent legs are in place, put the hands on the hips, and alternate opening each bent leg to the side and back again to center. Be mindful of gently engaging pelvic floor muscles throughout the exercise.
It is important to note that some Pilates exercises are contraindicated for people with exceptionally poor bladder control because they might exacerbate rather than improve the situation. These are exercises that might produce an excess of downward pressure and strain on an already weak pelvic floor, and before the client has learning full control of the Pelvic Floor muscles, which counter-intuitively includes learning how to relax them. Therefore, some Core exercises should be avoided, including The Hundreds, Pushups, Planks, and Rollups.
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