By Dawn-Marie Ickes • Edited by Amanda Altman 

Recently, I had an eye-opening experience after experimenting with a VESy lab and Pilates equipment. At the lab, which uses EMG technology to assess how the pelvic floor reacts to movement, I was able to measure peak engagement of the floor muscles and their co-recruiters during some of my favorite basic Reformer exercises. The result was fascinating and provided an upgrade to much of the programming used in our small group classes. It also completely changed the way I looked at promoting longevity and wellness for my every client.

Previously, we had tried offering mat classes at my studio geared toward the pelvic floor—with all kinds of creative descriptions and shock marketing—but at the end of the day, our clients weren’t having it; they didn’t want to spend the hour on small movements, they wanted to move the whole body. Although I’d already learned back in 2008 from Dr. Bruce Crawford that pelvic floor dysfunction is, in many cases, a preventable issue, after the VESy experiment confirmed that certain movements optimize this connection, and that we can do this statically and dynamically during Pilates exercises, I knew I had to do something to help address the pelvic floor for both men and women in a medium that’s movement-based—and not defined by a diagnosis, injury or dysfunction Pelvic floor dysfunction affects men, teenagers and elite athletes—not just postpartum women or women over 50 (see “Pelvic Floor Problems, By the Numbers,” on page 55). We all need proper pelvic floor use for overall health, prevention and longevity. Problems can begin when the muscles are stretched, weakened or too tight, and without a crystal ball, it’s impossible to determine when this might occur. We can, however, apply simple “upgrades” to tried-and-true exercises we love, and empower our clients by guiding proper awareness, connection and use of the muscles “down under” for optimal movement.

With this approach, teachers have two options: a 30-minute class focused solely on the pelvis, or selecting alternative cueing and “additions” to the exercises (see “Pilates Pearls of Wisdom” tips for teachers throughout). And don’t be afraid of mixed levels or genders in your classes—my male athletes and retirees love the upgrades, too!

The first step is to find and connect to our pelvic floor. (Yes, it is possible without wireless biofeedback or real-time ultrasound!) Next, work on training the muscle group as a dynamic stabilizer by linking it to its anatomical, systemic and functional relationships (transverse abdominis, diaphragm and lumbosacral multifidi) and move.

Lastly, consider the canister effect: The “core” of yesteryear is an archaic concept, and it’s time to evolve our thinking and optimize movement by connecting to and through the whole system—and not in isolated little units. It’s only then that we can uncover the true power of what is within us.

GENERAL GUIDELINES

Props: Box; 4-to 6-inch medium-density ball; medium- to firm-density foam roller; medium to soft ball
Breath: Breathe in a relaxed state and monitor your breathing throughout; often thinking too hard limits the breath capacity.
Tip: Do these exercises 2–3 times per week.


Svelte Below the Belt: Pelvic Floor Primer

Spring Setting: heavy (2 red)
Purpose: brings awareness to alignment, weight bearing and activation of the pelvic floor for meaningful engagement and differential recruitment of fast- and slow-twitch fibers; helps connect to the pelvis

 

 

Seated Slow-Twitch Prep

Setup: Sit tall on the Short Box facing the footbar with your legs sit bone–distance apart on the carriage and the ball between your knees. Reach your arms toward the front of the Box, activating your back muscles. Ground into your sit bones while reaching through the crown of your head with your pelvis in neutral. Press your feet into the carriage, and activate your hamstrings by energetically drawing your heels toward the Box.

1. Draw the bottom of your pelvis between your sit bones and pubic symphysis up, and visualize connecting to the front (anterior) part of your pelvic floor (this will feel like 25 percent), and then engage your whole floor.
2. Hold this sustained connection from your heels to the top of your head while contracting your pelvic floor for 5 seconds, then release for a full 10 seconds. Do 5 reps, breathing naturally throughout.

Seated Fast-Twitch Prep

Setup: Same as Seated Slow-Twitch Prep.

1. Exhale, drawing the bottom of your pelvis between your sit bones and pubic symphysis up, and engage your whole floor in a quick upward pulse with an immediate release. Do 5 reps, working up to 10 quick, coordinated pulses.

Pilates Pearls of Wisdom
• Teach the pelvic floor connection slowly, and build reps of fast additions to any applicable exercise slowly.
• Make sure your client can always feel a relaxation phase of the pelvic floor between reps.
• The torso should not move up and down—this indicates over-activation of the glutes.
Modification: Decrease the pulses.


Ball Sit Differentiation

Spring Setting: heavy (2 red)
Purpose: improves contraction of the pelvic floor; increases awareness of anterior versus posterior floor bias; important for proper neuromucular control and stability
Setup: Sit tall on the Short Box facing the footbar with your legs sit bone–distance apart on the carriage. Perform 1 sustained 5-second contraction, and observe how it feels. Now, place the ball in the center of the triangle created by your pubic bone and sit bones (i.e., ischial tuberosities), making sure you feel equal weight throughout. Reach your arms forward, palms in.

1. Sit on the ball for 30 seconds, working up to 60 seconds.


2. Remove the ball, noticing how you feel (e.g., like you’re sitting in a hole?).
3. Practice 1 slow contraction of your pelvic floor, first contracting the front, the back and then the full floor. Assess how you feel—any differences?
4. Do 5 fast pulse-like contractions coupled with quick exhales. Self-assess to see if you feel any different.

Pilates Pearls of Wisdom
• If your client experiences a significant difference in their connection with the pelvic floor with this exercise, begin with it.
• Breathe naturally throughout, with an exhale on the quick pulses.

Modification: Use a softer or larger ball, and/or lower your hands to the Box to offset some of your weight.

 

 


Prone Imprinting Primer

Purpose: promotes cervical stability and endurance, pelvic proprioception and awareness as well as anterior floor recruitment
Setup: Lie facedown on the Long Box facing the headrest with your mid-chest at the edge, and your neck and thoracic spine (ribs) in line with your torso. Place your arms to the side or in front of the Box (depending on your shoulder muscular balance), palms gently pressing in, and squeeze your legs together.

 

1. Inhale to prepare, noticing the front of your pelvis on the Box.
2. Exhale, engaging your abdominals and scapular depressors (shoulder blades), and gently lift your belly away from the Box while “magnetizing” the front of your pelvis to the Box and lifting your pelvic floor.


3. Inhale, filling your back body and lengthening through the crown of your head.
4. Exhale, practicing a 5-second sustained contraction and/or 5 quick pulses.
5. Repeat the sequence 5 times.

Pilates Pearls of Wisdom
• Monitor scapular elevation and over-activity of the spinal extensors.
• Watch that the client doesn’t “dump” in the sternum, or hyperextend the cervical and/or lumbar spine and hips.
• Avoid excessive internal rotation at the arm bones.
Modification: Stay in neutral, and move from slight flexion to neutral.
Advanced: Repeat steps 1–3, then exhale to lift your upper body into extension. Inhale to reach further through the crown of your head before exhaling to return to the starting position.


Seated Hamstring Curl

Spring Setting: none
Purpose: increases lower-abdominal awareness and pelvic floor connection; combines pelvic stability with controlled mobility
Setup: Sit tall on the carriage facing the footbar with your pelvis neutral. Place your feet on a foam roller in the well underneath the springs, with your hips and knees bent and aligned with the front bones of your pelvis (i.e., ASIS). Curve your arms in front of your chest with your fingertips reaching long.

1. Inhale, extending your legs with control.


2. Exhale, engaging your abdominals, connecting to your pelvic floor and drawing your legs back to the starting position, growing taller as if you’re sitting on a pin cushion without over-activating your glutes.

Pilates Pearls of Wisdom
• Stay in a neutral pelvic alignment throughout while avoiding hyperextension of the knee joint.
• Watch that the shoulders remain over the hips.
Modification: Omit the roller, and perform the movement with your feet flat on the floor.
Advanced: Add rotation, and/or do the exercise with a single leg, seated on a balance disc or with rotating discs or balls under your feet.


Spine Stretch Forward in the Well

Spring Setting: light (1 blue) or medium (1 red)
Purpose: enhances spinal articulation, scapula-thoracic mobility and pelvic proprioception; increases the complexity of the connection by adding movement flow with co-activation
Setup: Sit tall against the roller placed horizontally between your pelvis and the back of the Reformer frame. Extend your legs shoulders-width apart, feet softly pointed, and grab hold of the shoulder rests.

1. Inhale, activating your torso and reaching through the crown of your head.
2. Exhale, drawing your navel toward the roller without going into flexion, gently tuck your chin, and roll down segmentally, maintaining even weight through your sit bones, until your shoulders, ears and elbows are aligned.


3. Inhale, protracting your shoulders, reaching toward the footbar as you lengthen through the crown of your head even more,
4. Exhale, and without moving your spine, retract your shoulders.
5. Inhale, rolling up vertebra by vertebra, drawing up and in with your abdominals.
6. Exhale at the top of the movement, settling into your pelvis. Do 5 reps.
7. Repeat the entire sequence with the roller positioned vertically between your spine and the Reformer frame.

 

Pilates Pearl of Wisdom
Keep the shoulder girdle stable, and the pelvis neutral throughout. You can add protraction/retraction at the top of the movement too.


Chest Expansion Kneeling

Spring Setting: medium (1 red)
Purpose: progresses the Chest Expansion exercise; deepens the pelvic floor connection by adding movement flow with co-activation
Setup: Kneel on the carriage in Chest Expansion start position, with your hips in line with your ankles and knees near the shoulder rests. Hold onto the straps with your hands by your sides, fingertips reaching toward the floor.

1. Inhale to prepare.
2. Exhale, engaging your abdominals and scapular depressors, and lengthen your arms past the midline of your body as you reach out through the crown of your head, maintaining the kneeling starting position.


3. Inhale, slowly lowering your body to the carriage without changing your arm position, drawing your pelvic floor up.
4. Exhale, performing 5 quick pulses at the bottom.
5. Inhale, pause, and then, exhale, lifting your body from the carriage without moving your arms.
6. Inhale, returning your arms to the starting position.

Pilates Pearls of Wisdom
• Don’t allow the carriage to move during the pulses, which would indicate a loss of hamstring, adductor or gluteal connection.
• The wrists and spine should stay neutral—no thoracic hyperextension or sternal “dumping” allowed—and the shoulder girdle stable and trunk still.
Modifications: Place a yoga block or moon box between your thighs/shins to limit knee flexion during the squatting phase; sit on a small ball; or place a ball or yoga block between your ankles for enhanced connection. Skip altogether if you have knee pain.
Advanced: Move farther away from the shoulder rests.


Pelvic Power Lift

Spring Setting: depends on level
Purpose: uniquely beneficial for developing and enhancing pelvic-neuromuscular connectivity and strength, as it uses gravity to assist the shortening phase of both the slow- and fast-pulse contractions
Setup: Lie on the carriage with your feet parallel on the platform, the ball between your knees and your arms pressing into the carriage.

1. Inhale, connecting to the carriage.
2. Exhale, bridging up while performing a 5-second contraction with your pelvic floor.


3. Inhale, pausing with your hips lifted in line with the midline of your torso and shoulders.
4. Exhale, performing 5 quick pelvic floor pulses.
5. Inhale, pause, then exhale, returning to the starting position, either in neutral or with articulation.

Pilates Pearls of Wisdom
• Start slow, with a low number of reps—this doesn’t look hard, but it is very complex.
• Don’t allow the pelvis to move during the pulsing.
•Avoid hip flexion or hyperextension.
Advanced: Place your feet on the footbar, and/or add a single-leg extension with or without a ball or Magic Circle. Add single-leg adduction squeezes of a soft-medium ball or Magic circle with pelvic floor pulses.


Savvy Second-Position Footwork

This is by far the most challenging coordination exercise in the beginning, but it has an amazing impact.

Spring Setting: heavy (3–4 medium)
Purpose: switches up the typical connection to contracting the pelvic floor; increases the complexity of training
Setup: Lie on the carriage with your thighs turned out, feet on the corners of the footbar and palms pressing into the carriage.

1. Inhale, lengthening your legs away from the footbar.
2. Exhale, drawing your pelvic floor up in 5 counts as you return the carriage. Do 8–10 flowing reps.
3. Do 5–10 pulses just 1–2 inches from the stoppers, drawing your pelvic floor up as you get closer to the footbar.

 

Pilates Pearl of Wisdom
Begin slow, making sure your client feels the lifting up as the legs return to the carriage. This is extremely counterintuitive for most people, so it’s important to establish the correct sequence early on.
Advanced: Add 5 pulses while returning the carriage to the starting position (instead of the 5-second sustained contraction). And/or try this pelvic floor work with the entire Footwork series.


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March 10, 2017 at 10:03 am
Category: Articles, Exercises, Teasers
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