Advice & Support
Incontinence Exercise Zone

Pilates and Strengthening the Pelvic Floor

Pilates is often recommended as a way to improve the tone of your pelvic floor muscle, which can help reduce incontinence problems. But what is that, and how does it help?
Published by Jane Granger
Pilates and Strengthening the Pelvic Floor

What is the pelvic floor, and why its strength necessary for continence?

The pelvic floor is a sling of muscle in the base of the pelvis that runs from the pubic bone in the front to the coccyx, or tailbone, at the back in both men and women. In addition to supporting the pelvic organs, it’s also the muscle that you clench and draw up when you’re trying to prevent passing wind, ‘holding on’ when you need to urinate or pass a bowel motion.

Over time and without due attention, the muscle can become weak and inefficient. There are also factors that can put additional strain on the muscle and reduce its tone, which can cause incontinence. These include:

  • pregnancy
  • childbirth
  • being overweight or obese
  • having a persistent cough, usually from smoking
  • straining from on-going constipation
  • repeatedly lifting heavy weights, either in the gum, at work or of small children
  • high impact sports, like running, tennis or netball
  • pelvic injury or surgery

Incontinence describes the involuntary loss of urine or faecal matter. There can be many causes, but regardless, a strong pelvic muscle will almost always improve control.

What is Pilates?

Pilates is a type of exercise and body conditioning developed by Joseph Pilates (hence why it’s always spelt with an uppercase P) in the early-to-mid 20th century.

Born in Germany, Pilates dedicated his young adult years to the study and trial of all kinds of exercise, including Roman, Greek, bodybuilding and gymnastics, as well as the Eastern disciplines of yoga, tai chi, martial arts and meditation.

While interned in Britain during World War I, Pilates worked as a nurse and given his keen interest in exercise, experimented with ‘spring resistance’ to allow bed-ridden patients to improve their muscle condition. This was the beginning of an essential piece of Pilates equipment found in many gyms and studios today, the reformer.

Later, Joseph migrated to the United States where he opened a studio favoured by dancers. They found this form of exercise ideal to safely gain condition after an injury.

These days, there are all sorts of Pilates classes to choose from, but the traditional method is low-impact, focusing on flexibility, muscular strength and endurance. There’s also an emphasis on technique precision, posture, core strength, control, flowing movements, and breathing to centre the mind.

Classes can be on a mat or using equipment such as the reformer, and are offered at specialist studios, some gyms and by physiotherapists.

It’s an ideal way to get back into exercise as it’s gentle on the body, but the exactness can be challenging for the mind! Muscles aren’t worked to the point of exhaustion, so you don’t sweat, puff, strain or feel stiff for days afterwards. It’s the type of exercise that can accommodate all fitness levels from very low to very high.

If you do two to three classes a week, you should notice improvements within four to eight weeks.


How it differs from yoga

Yoga stems from an ancient Indian philosophy to harmonise the body, mind and spirit. The exercises centre on obtaining and holding various positions with the physical purpose of improving strength, endurance and flexibility, and the psychological benefits of relaxation and mindfulness. Born from the one philosophy, many different classes are available today, the most popular being Hatha, Bikram (or ‘hot yoga’ because it’s performed in a room heated to 41C), Iyengar and Vinyasa.

Like Pilates, the exercises are low-impact, and the precision of posture and control of movement are key. They also share an emphasis on breathing techniques and engaging the mind as well as the body.

Both yoga and Pilates are suitable for all levels of fitness. Although the media often portray yoga with extreme positions, don’t be put off as there is a full spectrum of levels, with many devotees regularly enjoying gentle, achievable positions.

The difference is that yoga doesn’t use any equipment (other than a mat), is based around poses and aims to create a more meditative environment, while Pilates focuses on a series of controlled movements, has a greater emphasis on the core and does use various pieces of equipment.

If you’re unsure which you prefer, try a beginner’s class of both. Many people find they like them equally so chose to do classes of each in their week. However, if your principal objective is to improve the strength of your pelvic floor, you’ll likely get faster results with Pilates.


How Pilates exercises strengthen the pelvic floor muscle

The focus Pilates has on core strength is how it benefits the pelvic floor. Most of the exercises require ‘engaging’ or ‘turning on’ these muscles (meaning to contract them) to improve their condition, as well as getting into the habit of using them (muscle memory) – which may have been lost over the years.

As you can see in this diagram, the ‘core muscles’ include the abdominals, lower back and pelvic floor.

Core strength is critical for balance, stability, and to support your lower back. People who experience pain in this area often find Pilates improves it.

Activities that could otherwise damage the pelvic floor, like lifting heavy weights or high impact exercise, are mitigated with a strong, engaged core.


Check with your healthcare professional

If you have any lower back or other pain, a pre-existing injury, have recently had surgery or a difficult birth, check with your doctor before embarking on any new exercise regimes.

Keep in mind that Pilates classes at physiotherapy studios tend to be much smaller and more closely supervised by experienced health care professionals. They will check that the right muscles are being engaged and that you’re doing the exercises correctly, working with you individually if you’re having any difficulty. While they may be a bit more expensive, if you’re starting out or have other health considerations, participating in a few classes to grasp the principals and get you going on the basics might be a good investment before heading to a larger studio or gym.


Manage incontinence in the meantime

Don’t let a little leak stop you from exercising as there’s no downside; it’s good for your health, weight control, keeping your bowel regular and releases the feel-good hormone, endorphin. Besides, if you’re doing Pilates, it will strengthen your pelvic floor and stop those leaks once and for all.

So while you’re getting your pelvic floor back into shape, you might find the security of a discreet absorbent product helpful – especially in those first few classes when the pressure exerted on your pelvic floor which may cause a few leaks.

For women, one of the TENA Liners or one of the smaller TENA Pads would be suitable. These products are small and discreet under clothing, even activewear. They all contain Super Absorbent Polymers (SAP) which rapidly draws in and locks away any moisture to keep you dry, comfortable and confident. All are made of breathable fabric and have Odour Lock TechnologyTM that prevents the development of any odours.

For men, anatomically designed TENA Shields and TENA Guards that fit snugly into the front of briefs and offer ideal protection for dribbles while exercising and are also extremely discreet, comfortable and have odour control.

To find the right product to suit your needs, use the TENA Product Finder Tool, where you can also order free samples to try.



Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.