Supporting the Pelvic Floor and Managing Incontinence for Seniors with Yoga and Pilates
- ahdyment
- Apr 8
- 6 min read
Recently at one of my public yoga classes, a woman in her 70s pulled me aside and said "Hey Ashley, everyone keeps teaching these pelvic floor focussed classes for new moms, but all of us older ladies are super healthy and have major pelvic floor dysfunction. It's like nobody cares or is thinking about us. We don't want to wear diapers!"
A lightbulb went off. She was right. Another classic jab at aging women, but this time, I was a part of it. So, I'll start sharing more resources, blogs and even studying myself to help this amazing cohort of women. Starting right now :)
Here's the thing: As we age, many of us experience changes in our bodies that can sometimes feel overwhelming. One of the most common concerns for seniors is pelvic floor dysfunction, which can lead to issues like incontinence. While this is a topic many may feel uncomfortable talking about, it’s important to understand that there are effective, natural ways to address it. Yoga and Pilates, when combined with guidance from pelvic floor physiotherapists, can offer a powerful tool to help strengthen and support the pelvic floor, improving bladder control and overall well-being.
Why the Pelvic Floor Matters
The pelvic floor is a group of muscles that form the base of your core, supporting everything from your bladder to your reproductive organs. When these muscles become weak, stretched, or overly tight, they can lead to a variety of issues, such as urinary incontinence, pelvic organ prolapse, and even lower back pain. Pelvic health can significantly impact your quality of life, but fortunately, it’s something we can work on—at any age.
According to Pelvic Health Physiotherapists of Canada, pelvic floor dysfunction is one of the most common causes of incontinence in seniors, and strengthening these muscles can significantly reduce symptoms of incontinence (Pelvic Health Physiotherapists of Canada, 2023).
How Yoga and Pilates Help
Both yoga and Pilates focus on core strength, posture, and body awareness, all of which play a crucial role in pelvic floor health. In particular, these practices can help strengthen the pelvic floor muscles, improve muscle coordination, and reduce the strain placed on the pelvic region.
Strengthening the Pelvic Floor: Specific yoga poses and Pilates exercises target the pelvic floor muscles, improving their strength and tone. In yoga, poses like Bridge Pose, Reclining Bound Angle, and Legs Up the Wall gently activate and support the pelvic region. Research published in the International Journal of Yoga (2014) supports that yoga can enhance pelvic floor strength and function, particularly in older adults (Rai, 2014). In Pilates, exercises like Pelvic Tilts are commonly used to engage the pelvic floor and work it in tandem with the core. By incorporating these movements into regular practice, seniors can build pelvic floor strength over time.
Improving Awareness and Connection: Both yoga and Pilates are about mindful movement, which encourages a deeper connection to the body. This body awareness helps individuals recognize when they are inadvertently tightening or relaxing the pelvic floor, and when they are maintaining proper alignment to protect the pelvic region. A study in The Journal of Bodywork and Movement Therapies (2016) found that mindful practices like Yoga and Pilates can increase proprioception and bodily awareness, helping individuals engage and release their pelvic floor muscles consciously (Hernandez et al., 2016).
Breathing Techniques: Breathing is a key component of both yoga and Pilates, and it plays a significant role in pelvic floor health. Techniques such as diaphragmatic breathing, practiced in yoga, help create pressure within the abdominal cavity that supports the pelvic floor. Research by Dr. Penny Simkin, a leading expert in birth and pelvic health, indicates that breathing exercises can support pelvic floor relaxation and recovery (Simkin, 2019). In Pilates, focused breathing can help deepen the connection between the core and pelvic region, ensuring that the muscles are properly engaged during exercise and relaxation.
Pelvic Floor Physiotherapists: A Critical Support System
Working with a pelvic floor physiotherapist is one of the best ways to address incontinence and other pelvic floor issues. These specialized physiotherapists have extensive training in understanding how the pelvic floor functions and how to address dysfunctions. A pelvic floor physiotherapist can assess your pelvic floor muscles, provide tailored exercises, and offer biofeedback to help you regain control over your bladder and pelvic health.
If you're new to pelvic floor physiotherapy, they can teach you how to perform Kegel exercises correctly, guide you through exercises that improve pelvic alignment, and provide a personalized rehabilitation plan. Many physiotherapists also integrate yoga and Pilates-based exercises into their treatments, making them an ideal partner in improving pelvic health (Mann et al., 2020).
A Sample Exercise: Pelvic Floor Activation for Seniors
Here’s a simple exercise that combines Pilates and Yoga to activate the pelvic floor muscles. This can be done by seniors in the comfort of their own homes to build strength and reduce incontinence. I often teach these in my public classes and virtual classes as well.
1. Pelvic Tilt
Pelvic tilt exercises are foundational for engaging the pelvic floor and core, particularly for seniors looking to improve posture and pelvic health.
Instructions:
Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
Inhale to prepare, then exhale while gently pressing your lower back into the floor, tilting your pelvis upward slightly.
Hold for 5-10 seconds, focusing on activating the pelvic floor, then return to neutral.
2. Bridging
Bridging is a Pilates exercise that targets the pelvic floor, glutes, and lower back, promoting overall pelvic floor engagement.
Instructions:
Start by lying on your back with your knees bent and feet flat on the floor, hip-width apart.
Inhale to prepare, then exhale as you lift your hips toward the ceiling, engaging your pelvic floor muscles as you do so.
Hold for a few seconds, then slowly lower your hips back down.
3. Kegel with Pilates Integration
This Pilates-based Kegel exercise focuses on pelvic floor strengthening and can be done while seated or lying down, making it accessible for seniors.
Instructions:
Sit upright in a chair or lie on your back with your knees bent.
Inhale to prepare, then exhale and gently engage your pelvic floor, as if stopping the flow of urine.
Hold the contraction for 5-10 seconds, then relax. Repeat for several rounds.
4. Cat-Cow Stretch with Pelvic Floor Focus
The Cat-Cow stretch is a dynamic Pilates movement that increases mobility and engages the pelvic floor through its fluid motion.
Instructions:
Begin on all fours with your wrists under your shoulders and knees under your hips.
As you inhale, arch your back, dropping your belly toward the floor (Cow pose), and lift your head and tailbone.
As you exhale, round your back, drawing your belly button toward your spine and gently engaging the pelvic floor muscles (Cat pose).
Repeat for several rounds, focusing on coordinating the breath with pelvic floor engagement.
5. Leg Slides with Pelvic Floor Engagement
This exercise targets the core, pelvic floor, and lower body while promoting pelvic floor activation.
Instructions:
Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
Inhale to prepare, then exhale as you slowly slide one leg out along the floor, keeping the pelvis stable and engaging the pelvic floor.
Slide the leg back to starting position and repeat on the other side.
These practices not only strengthen and tone the pelvic floor but also provide the tools for deeper body awareness and mental relaxation. When combined with the expertise of pelvic floor physiotherapists, this holistic approach can significantly improve quality of life, helping seniors feel more confident and comfortable in their own bodies.
If you’re a senior experiencing pelvic floor concerns or incontinence, I encourage you to explore these practices. Start slow, listen to your body, and remember that even small steps toward pelvic health can lead to big improvements in how you feel every day.
References:
Bergeren, N. (2020). The Belle Method: Pelvic health through Pilates and yoga. Retrieved from https://thebellemethod.com
Hernandez, R., Perez, M., & Harris, P. (2016). The effects of Pilates and yoga on proprioception and movement awareness. Journal of Bodywork and Movement Therapies, 20(1), 42-50.
Mann, E., Brown, K., & Ross, J. (2020). The role of pelvic floor physiotherapy in managing incontinence and pelvic health. International Journal of Pelvic Health, 15(3), 211-225.
Pelvic Health Physiotherapists of Canada. (2023). Pelvic floor dysfunction and incontinence in seniors: A guide for practitioners. Retrieved from https://www.pelvichealth.ca
Rai, S. (2014). Yoga and pelvic floor health: A study on the benefits of yoga in the aging population. International Journal of Yoga, 7(2), 110-114.
Simkin, P. (2019). The role of breath and relaxation in pelvic floor rehabilitation. Pelvic Health Journal, 8(1), 35-39.
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