Pilates through the Ages: Why Pilates for Menopause Works

In my 10 years of experience, there is something I have come to realise, Pilates is adaptive. It evolves WITH a person’s needs and FOR a person’s needs. 

When I started my own practice, I was all about the Control Balance Handstand off the side of the Reformer. And not gone lie, I still love to give these a whirl every now and then. But there was a long while there, that my needs were so far from this and I just physically couldn’t do it, nor did I have any interest.
When was this strange time that you didn’t want to flip off reformers you ask?

Pregnancy and postpartum x 2. 

The hormones that fluctuate to create and sustain life in a human body are immense. Not only is it an emotional, moody, ball-your-eyes-out-at-the-drop-of-a-hat rollercoaster but physically the experience and change to you body, is next level. A woman will produce more estrogen during one pregnancy than throughout her entire life when not pregnant. Progesterone levels also are extraordinarily high during pregnancy. It’s these changes in progesterone, that cause a laxity or loosening of ligaments and joints throughout the body. Loosening ligaments and Advanced Pilates exercises are not always the best of friends. As I found out the painful way. See-ya-Later Control Balance! 

I needed to scale things back, focus on my ever changing body’s needs, a little less upside down work, a little more hip strengthening and low back stretching. Pilates can do this. It can challenge you at your fittest and strongest, it can calm, centre and restore you at times when you need the most support. It’s pretty amazing. 

Pregnancy is a stage where women experience massive amounts of estrogen and progesterone, at the other end of the spectrum, menopause is a stage where there is a rapid decline in these hormones. Just like we scale and modify to meet our changing needs in pregnancy, we need to change and modify to meet our changing needs in menopause.  

Menopause is sometimes called 'the change of life' as it marks the end of a woman's reproductive life. At menopause, ovulation no longer occurs and production of oestrogen and progesterone ceases. The word “menopause” refers to the last or final menstrual period a woman experiences. (menopause.org.au).

Although many women might find relief in saying good bye to periods, tampons, sanitary pads and wearing those hideous period undies, for most women the rapid decrease in hormones, will mean experiencing some or all of the following symptoms: night sweats, vaginal dryness, hot flashes, weight gain,  forgetfulness, insomnia, anxiety, and headaches.

Menopausal women also experience changes such as, loss of muscle strength, loss of flexibility and joint pain.  These impacts can contribute to musculoskeletal disorders such as osteoporosis. 

Pilates can significantly reduce the impact of menopause because it helps to build strength and increase flexibility and mobility which decreases joint pain. Pilates is low-impact, there’s no lifting heavy weights in the gym, so it’s considered a safe option. Pilates works on core control which helps with dynamic postural balance, as we age, balance and proprioception tend to suffer the most. 

Pilates focuses on how we use the breath to get the most out of the movement. when you can use the Pilates breath to it’s full potential during exercises, breath has the ability to calm your nervous system down, this in turn is a powerful tool in helping reduce anxiety. Simultaneously,  with a calm nervous system you can reduce your cortisol levels and thus making it easier to lose weight (Catriona Harvey-Jenner) and improve the quality of sleep. 

I have been teaching women between the ages of 40-70 for many years now. And these women often describe Pilates as gentle on their body but fierce in its benefits. Knee problems? Back problems? Shoulder problems? No worries, Pilates can accomodate, and in most circumstances improve the muscle imbalances causing these problems. 

Here’s what one client, aged 60 had to say about her Pilates practice:

“I started with Kirsti Pilates To You 5 years ago, aged 55.  I was feeling unfit, stiff, lethargic and tired all the time, classic post-menapausal symptoms.  My diet was relatively healthy, but I was putting on weight and too tired to try and get rid of it. I started doing a mat class with Kirsti once a week, and within a few weeks noticed a difference - it was easier to get up off the floor or from kneeling down and my energy was returning.  Whilst I didn't lose any weight, I stopped gaining weight and that was a big plus.  I was feeling happier and more relaxed.  I have noticed when I go away on holidays that it doesn't take long to lose the fitness I work hard to gain, and the feelings of tiredness and lethargy return.  I really look forward to my class each week.  During the lockdown in Melbourne, I started doing two classes a week via Zoom, instead of one and quickly noticed the improvement that brought - particularly to my mental health and motivation.   I wouldn't miss my Pilates classes for anything!  Kirsti's enthusiasm is contagious and makes each class a lot of fun”.

Lastly don’t forget your nutrition has to change with your changing body. You can’t expect to eat like you did in your 30’s when you’re 60 and still see the same results, but what should you eat?! It all comes down to what will fuel you for energy, work with your slowing digestion system and address hormonal imbalances to limit sleeplessness, aches and pains and headaches. Recently, I wrote a blog on moving and eating where my nutritionist friend, Emma Lynas was my guest blogger on this topic. You can check it out here .

If you are reading this thinking, yes, yes, yes this is me. Then Emma and I’s upcoming ‘Embrace the Change’ program is for you.

It’s all about encouraging you to embrace the changes in your body by teaching you how to move & eat for strength & vitality on your menopause journey. 

This program aims to:

-improve your strength & posture 

-move more freely and with less pain 

-help you understand how to manage your weight & energy levels 

-enhance your sleep & energy with nutrition

It commences on February 15th for 5 weeks.

Each week includes:

• 2 live, virtual 45minute Pilates classes (replay available)

• 1 x nutrition lecture with discussion in private FaceBook group

Maybe you’re not 50 and/or don’t think this relates to you, but what about your Mum, what about your Aunty, your friendly neighbour? Check in with them. Sadly, menopause is not a topic that is shared so freely, but a friendly ear to someone who might be struggling with weight gain/sleeplessness/pain, could actually be just what they need. So please mention this program, you don’t know who might be missing out. 

Any questions about this or the ‘Embrace the Change Program’, please get in touch here. 

Even Pilates Teachers Prolapse

My experience with birthing big babies and how Pilates helped my pelvic floor ‘come back’

Ah, the ‘P’ word. Prolapse. More specifically, vaginal prolapse. A word that expectant Mothers fear, and new Mothers don’t want to hear. When the pelvic floor is strong, it supports the pelvic organs to prevent problems such as prolapse. If you’re not familiar with what a prolapse is, emedicinehealth.com define it as ‘a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel or the vagina itself -may begin to prolapse, or fall out of their normal positions’. Yikes. No one wants to imagine their bits hanging between their legs, unless you’re male, in which case, the more hang the better, right?! So, you can imagine my state of disbelief when the Pelvic Floor Women Physio examined me 6 weeks after the birth of my second child and told me I had stage 1 prolapse. Now I knew things were a bit dicey down there, but I didn’t know things were that bad?!

Image courtesy of womenshealthadvice.com

So how does a vaginal prolapse happen?

Damage to the pelvic floor occurs particularly:

1) when there is a long second stage labour (tick- both of my boys), 

2) during instrumental deliveries – vacuum extraction or forceps (tick- both of my boys), and 

3) in the delivery of large infants (tick- second baby 4.1kilos; Womhealth.org.au). 

I guess looking at the history of both births I had a fair chance of a prolapse.

After birth, I distinctly remember having a feeling of detachment - not to my baby, but to my body. It was like my organs and insides were just floating around aimlessly inside my skin, not quite sure what to do, where to be or how to behave, especially my bladder. I was wetting myself for a good week after baby number 2. Highly annoying! Don’t even get me going on having to sneeze or having a laugh at this time. I really had to tune into my bladder, the moment I needed to go to the toilet, there was no waiting,  I had to go right then!

I don’t blame you if you’re thinking, ‘but she’s a Pilates teacher, she must do her pelvic floor exercise ALL the time?’ Well yes, and no. 

When I was pregnant (and subsequently immediately after birth for the next little while), I would specifically carve out some time in my day to activate my pelvic floor. Usually I was doing a routine, mundane task like, waiting for the kettle to boil in the kitchen or having a shower- anything that happened daily and more than once a day where I would get in the habit of doing them while I waited (more on those specific exercises later).

When I’m not pregnant I don’t really think about my pelvic floor all that much. Sure, I do Pilates and part of doing Pilates is having an awareness of how to engage those muscles in order to stabilise them while another body part is mobilised. But this ‘internal stabilsing’ is something that has become second nature. So, when I do my everyday tasks (e.g., bending down to pick up the many things sprawled across the floor- clothing, toys, mess, towels, animals, children) I first stabilise internally through my pelvic floor, and low abdominals before I mobilise my torso in the direction of the ‘thing’ I’m picking up. Pilates in this way has been a savior. When you can use your pelvic floor and deep abdominals, you are less likely to have low back pain, and I know how inconvenient and restricting back pain is when you have small children who want to be hugged and chased and comforted.

Another important aspect of pelvic floor activation is pelvic floor release. Especially for me, as a Pilates teacher, I’m constantly thinking of drawing ‘in and up’. I do it along with my clients, so, when I’m telling them to do it, I’m unconsciously doing it along with them! If the pelvic floor becomes difficult to relax, it’s constantly in a state of being semi-flexed. Imagine flexing your bicep constantly and never fully letting go, after a while this would cause your arm to lose flexibility, strength and the ability to relax. That is similar to what happens to the pelvic floor (goop.com).

After birth, the body naturally starts to restore and repair. After a week of wetting myself, I could start to hold my bladder slightly longer, after a few weeks, sneezing wasn’t so scary. Still, after the confirmation of stage 1 prolapse at 6 weeks postpartum, I knew there was some further work to do.  When I went back to the Pelvic Floor Women Physio at 12 weeks postpartum, I had another internal and was relieved to hear everything was back to ‘normal’. 

So what are the actual exercises I did while pregnant and post pregnancy for strengthening and releasing the pelvic floor? Here are 2 simple things that I did:

1. Sitting down with a pillow or folded up towel between the bottom of your inside thighs, sit yourself towards the edge of the couch or chair (no kickin’ back in a slump!). Feet flat on the ground, lift up tall out of your pelvis up to the top of your head. Take an inhale breath to prepare, then on the exhale breath, gently squeeze the pillow or towel while thinking about stopping a wee mid-stream as well as holding in a fart. This will lift the hammock of muscles at the base of the pelvic floor from your front passage to the back passage in and upwards. Try and hold for 5 seconds (you can build up to 10, 15, 20, 30 secs etc.). Make sure that when you let go, you feel a proper distinction between the contraction and the release. If you feel like you couldn’t distinguish between holding the pelvic floor up and letting it go, try reducing the amount of time you hold on for. I was starting at about 3 sets and worked up to around 8-10.

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2. Standing up, slightly bent over (kitchen bench is usually a good option), with your legs hip width apart (it’s harder to squeeze your glutes together in this position so you have a better chance of isolating the pelvic floor muscles), draw up and in through the pelvic floor when you exhale (remember, this should feel like you are holding a wee and fart). I often put my hand on my low tummy when doing this. You want to feel that your low tummy is pulling away from your hand towards your spine. Repetitions and durations are the same as the sitting variation.  

A couple of pointers to be aware of:

·         Don’t hold your breath. Breathe normally over the contraction of the pelvic floor muscles,

·         Don’t squeeze your bum cheeks together (can be tricky to isolate pelvic floor and the surrounding muscles- if you find it hard to switch off the glutes try the version standing up), and

·         Tune in to your shoulders- make sure they don’t creep up to your ears and start overworking.

Image courtesy of @neetaphotography on location at Authentic Pilates Melbourne, Hampton, Melbourne.

Upon reflection, I think the odds were always going to be against me given my birth scenarios, regardless of my job and pelvic floor abilities!  However, I’d hate to think what state my insides might be in without the exercises I did during and after pregnancy… who knows?!

I credit Pilates as setting the baseline of my fitness and strength before I fell pregnant. Being attune to my body allowed me to work safely through exercise to maintain my strength and flexibility while I was pregnant, making the road back from the birth of my boys not as daunting as I initially expected.

I recently made this little video demonstrating the sitting down pelvic floor exercises. In the video I’m using a Pilates Magic Circle, however, a rolled-up towel or cushion would be fine.

For those of you interested in starting Pilates prior to, during or after your pregnancy in the comfort of your own home check out my website for more information and contact details.

Please note: This is not intended to be specific advice; pelvic floor muscle training is not necessarily one-size fits all. I recommend being evaluated by a pelvic floor specialist if you are experiencing difficulties.

You should also be sure to gain clearance from your Obstetrician/GP after the birth of your baby before you undertake/begin any exercise.