I know I read somewhere (thinking in an IDEA Pilates email) about a conference where they tested Pilates teachers on pelvic floor strength using a biofeedback machine. It turned out that alot of teachers missed the mark on contractions while doing a pelvic floor lift. Anyone know what I’m talking about?
This is a fascinating and important part of health and fitness that often gets ignored. I haven’t seen the article you’re referring to, but I’ve watched a great IDEA video from 2014 convention.
It talks about how while you can measure the number of muscle fibers that are firing during a pelvic floor contraction, the number of fibers firing isn’t the only consideration. We don’t need to be able to hold maximum contraction very often, we need to be able to sustain a sub-maximal contraction over periods of time and in a variety of positions. So, what her main thesis is that without over-thinking the pelvic floor, we can do other exercises in abduction and adduction which will co-activate the PCNS, and by doing that, we can improve PCNS function without “overthinking” about it.
My physical therapist (specializing in women’s health) has mixed feelings on the video’s approach. She agrees that the pelvic floor functions more in a sub-maximal state than in maximal, but that a female client should have a good maximal contraction around all three openings as the first step. I’ve had pelvic floor biofeedback and it was surprising. After having read, and attended lectures, and done yoga, I was certain that biofeedback would be a breeze. But getting the muscles around all of the openings to contract and lift is a very mindful exercise! 🙂 Biofeedback helps tremendously in making that connection.
I’m going to take a look through the articles that Jason linked, because I would love to learn more. It would benefit so many of my clients!!!
Wow, thanks so much for this info! I never realized there was such consideration about the efficacy of therapy vs. a Pilates program. I had a baby in 2013, and had a mild prolapse. I sought pelvic floor therapy and am actively engaged in a Pilates program with an amazing teacher.
The dichotomy between both approaches is driving me crazy because I just want to do the right thing to help myself. Basically, I gather that the difference in approach is:
Therapist: lift and squeeze around openings while diaphragm breathing and engaging the TVA
Pilates: lift and don’t squeeze anything while Pilates breathing and engaging the TVA.
Honestly, with both approaches, I barely registered the contraction on the biofeedback machine. I also had 16 sessions of rolfing so far. All of this has definitely helped with structural problems, but I’ve been so down about the machine I put it aside for a while. I was feeling better over the past 6 months, but after a 2 week bought of coughing, I’m experiencing stress incontinence again, which is why I’m back on the case. I’m sharing alot of personal stuff, but I’m really interested in this subject from a professional standpoint as well. So many women have this issue and just assume it’s normal.
I was intrigued by that article I mentioned because it said that many Pilates teachers don’t register either. It’s not a scientific study, just anecdotal. My teacher is confident she’s doing it correctly, but I just wonder how she’d fare on the machine.
Anyway, it sounds like both approaches have not followed women long term to see whether the problem remains, or the PF stays strong.
I would be willing to break off into a group just to discuss this subject!
This is an important topic, and it’s relevant to more clients than the clients and the trainers are willing to admit. I, also, am interested in it from both personal and professional context. If you break off into a group, invite me!
My PT was very big on contracting without engaging the TVA. Her thought was that it takes about a month to get the isolated neuro-muscular education. Then she was good with co-activation using the TVA and other complementary muscle groups.
Before I lost insurance, I had “graduated” to standing biofeedback, biofeedback while going up and down on an 8 inch step, and a few light barefoot jumps. I continue to work on these at home with decent success, but I’m interested in learning more (within my scope of practice) so I can be of more use to my clients.
I just have to share this fun video I made of the pelvic floor up close and in play-doh!