Pilates and back pain- how Pilates saved my back.

Back Pain. 

Arghhhh.

Most of us will either……… 

Have it.

Had it. 

Will experience it to some degree at some point in your life. 

It’s pretty common. In fact, an article published by Monash University, suggests that low back pain is the leading cause of disability globally – with more than 540 million people affected by activity-limiting low back pain at any one time! The article goes on to state that the burden from low back pain has doubled in the last 25 years. Sheesh. 

I have it too.

Yep, I know, the Pilates teacher who has built a career on making people stronger, longer, more mobile, experience less pain, is a back pain statistic.

I have a back condition called spondylolisthesis (spondy). All those years doing gymnastics as a kid is not great on a developing spine and I now have a minor disc slipage in the lower vertebrae. Never knew about it growing up, never hurt either…  until one year, many moons ago, I thought I’d give running a crack. Like proper runnings, not just my jolly 4km block laps I like to do nowadays. So, I did a couple of 10km fun runs, then I did a half marathon. Fun. Exhilarating. Then I thought it would be a good idea to build up to a full marathon. Bad Idea. That sh$t is mental. Body starting failing me miserably. I’m talking shin splints, bakers cysts, pulled hamstrings and all of a sudden this persistent low back pain that just wouldn’t go away. After an X-ray, I was told I had Spondy and had probably always had it. Great. As I walked out of the Chiro’s office, he bid me a-due with this little nugget… ‘watch out for when you have babies, pregnancy won’t be much fun for you’. Ummmm yeah, thanks. Can’t bloody wait. 

Fast forward a few years, and yep, he was right, pregnancy was not fun (is it ever?! Sorry if you were a glowy cloud of sunshine in your pregnancy but that just seems so far away from my experience…thank goodness that pain ends when the human exits your body!) Especially the second time around. Ouch. I distinctly remember saying to my partner at 15 weeks pregnant the second time, ‘please remind me of these firey pits of hell-pain when I say to you let’s have another baby’. 

Me at about 30 weeks pregnant.

So, yeah, spondy and pregnancy are not a match made in heaven. Which makes sense really, when you have a wide, big load at your front, your lordosis (or excessive inwards curve) through your low bag is exacerbated, and this adds more pressure to the affected spondy area. 

 These days, I feel it most when I spend too long working at the computer, or my shoes are too high, or I’m carrying the kids for too long. These are all common movements that put the pelvis into an anterior tilt, exaggerates the lordosis and flares up the spondy.

 The only thing that makes it feel better is more Pilates. A bit of rest doesn’t go astray either. But when it comes to movement, Pilates literally keeps me together. I usually need to do LESS running and LESS HIIT workouts when it gets really bad (other physical pursuits I enjoy), but never less Pilates. Sure Pilates at the top of its game can have you swinging from straps and bars and all sorts of fancy things, but at its foundation are simple principles that build the skills needed to support your spine. So when I’m suffering, I know I need to scale things right back, go into nurture mode, focus on the Pilates basics, breathe, roll and release (full credit to my Osteo here too!) and I will always come out the other side. 

So whether you have spondylolisthesis or are suffering from other kinds of back pain/discomfort, let me teach you the Pilates basics and foundational movements to nurture your spine back to a place where you feel stronger and more mobile and most importantly, equip you with tools to use to help alleviate those pain points in the future.  Shoot me an email kirsti@kirstipilatestoyou.com.au and we can discuss some times that will work for your next class.

Image by @neetaphotography

In the meantime, check out these 5 exercises to help ease back pain. We regularly do them in my classes. They are a great starting point to work on more mobility in commonly tight and stuck areas of the spine, while also introducing some strength work that’s necessary for a supportive core. 

Wall roll down

Leaning up against a wall, with your feet away from the wall, lengthen your spine up the wall. Reach your arms out in front of you, be mindful to keep your shoulder blades on the wall when you are setting up. Peel yourself off the wall from the head down, so you are left with just your bottom on the wall. Keep the back of your legs wrapped and squeezing together, keep your tummy pulled up into your spine to feel the stretch through all the vertebrae of the spine. Stack back up the wall one vertebrae at a time. Aim for 3-5 repetitions.

Shoulder Bridge/Pelvic Curl

Lying on your back with your knees bent and your feet slightly apart in parallel. Start by tilting your pelvis upwards so you feel your low back imprint into the ground, then continue to peel your spine off the mat, vertebrae by vertebrae until your reach your bra strap (or heart rate monitor) line. In this bridge position you want your knees to be the highest point, followed next by your pubic bone, then your hip bones, then your belly button, then your ribs. This creates a C-curve shape through your spine which lengthens the low back, works the abdominals and hamstrings. Articulate your spine down to the ground in the reverse direction - from your upper back touching the mat first, then middle back, then lower back. Aim for 5-8 repetitions.

Supine spine twist

Lying on your back with your legs at tabletop (if this feels like too much load for your back, this can also be done with feet on the ground), move your legs to the right, so your left hip comes off the ground but your left shoulder does not and you can maintain stacked knees. To return the legs to the centre, think about your torso being like a wet towel, which you need to wring out. This helps connect the movement to the powerhouse and not just a transfer of weight through the pelvis. Repeat to the other side. Aim for 3 each side.

Book openers 

Lying on your side, with your arms reaching out straight in front of you and your knees bent up to 90 degrees in from to you. Lift the top arm up to the ceiling then back behind you, following your fingers with your eye gaze to open the chest up. Try and keep your knees stacked to increase the stretch. Return the arm to the other arm and repeat. Aim for 5-8 each side.

Basic Extension

Lying on your tummy with your hands flat on the mat, near your lower ribs, hug your elbows inwards and keep your shoulders away from your ears. Start to lift your chest and head through your arms, like a string that is attached to your heart is tugging your chest forwards and up. What the legs do is really important in this extension, so make sure they are active. That means, they are reaching out long out of your hips and you’re pulling your tummy button off the floor while your pubic bone is pushing into the floor, this will fire up the back of the legs to support your lower back while your upper back lifts and extends. 

Pilates FAQ's - all your questions answered!

Ever wondered: what even IS Pilates, or whether you should be doing Mat, Reformer, Group, or Clinical Pilates? From how often you should be doing Pilates to whether or not you’ll lose weight, read on for the answers to the questions I get most often from clients.

Question: What IS Pilates? 

image from Streamline Pilates.

Pilates is a physical fitness system that is for the whole body. You want abs? Ok sure, you’re in the right place.

But you can’t have (the real-deal) abs without first addressing the alignment of your spine over your pelvis, your posture, your breathing and balance. But don’t let that frighten you, we’ll address everything one part at a time and rest assured you’ll work your abs every session! That I can promise you. 

Joseph Pilates didn’t refer to his work by his namesake ‘Pilates’, he called it Contrology. The name may give you a hint that the control of one’s body is key to the execution of the Pilates exercises. Only, after Joseph’s death in 1967 did it then get called the Pilates Method.  

Pilates improves flexibility, builds strength and develops control and endurance in the entire body. The Pilates system allows for different exercises to be modified in range of difficulty from beginner to advanced and to the client's specific goals and/or limitations.

Question: I’m a total rookie, what can I expect? 

Great question! Expect to:

• Feel muscles you didn’t know you had

• Use your brain

• Change the way you used to think about what defines a ‘workout’

• To see changes in your body, but not overnight

• To think differently about animals such as the Elephant, Crab, Seal and Swan.

Question: How many times a week should I be doing Pilates? 

Joseph Pilates famously said, “In 10 sessions you will feel better, in 20 you will look better, and in 30 you will have a whole new body.” If you are doing 2-3 classes a week, you should start to see results in 10-12 weeks. If you attend one class a week, you will still see results but it might take longer. Ultimately, it comes down to the your goals, other activities, financial situation, etc. The Pilates Alliance Australasia's website states that 2-3 times a week is recommended, but I also have clients who maintain their fitness goals by attending only once a week.

Question: Will I be sore?

Sometimes yes, sometimes no. The key here is recognising what your measure of a ‘successful workout’ is to you. Speaking from absolute experience here, I used to think that a ‘workout’ meant you had to sweat, big time. If I wasn’t, sweating, panting and puffing, pulling up sore everywhere then why was I bothering. Don’t get me wrong, I still enjoy getting the heart rate up, but I’m not so obsessive about it being the bees knees now.

Like at the beginning of any physical fitness program, you can expect to be sore in various different places of the body. Pilates works the body as a whole, this means those smaller or less dominant groups of muscles that often get left behind (willingly or not) will start to come out to play… hello triceps, adductors, serratus (to name a few). Jospeh Pilates wanted all his clients to walk away from his classes feeling better than when they walked in. That was his measure of success. Legs burning so much that you can not sit down on the toilet was not a goal of his, nor mine these days actually. See ya later 150 lunges at the gym. 

Me ‘squeezing the juice’ out of Over Head Balance Control. Pic by @hudlow.photography

Lesley Logan nailed it with this…”There are a lot of myths about muscle soreness. People believe that without muscle soreness they are not working hard enough. And, while you want to be challenging your muscles and soreness is a sign that the muscles are challenged you also should be able to live your life and move!”

When you can walk out of an exercise class with more freedom of movement, feeling lighter, feeling toned, feeling taller and carry on with everyday life, sometimes even better than ‘everyday standards’ eg, you can pick up the grandkids with ease, you can bend down to do the gardening without back pain or you can work a day at your job without the shoulder aching, then shouldn’t those be a true measure of a successful physical fitness program?

In Pilates the emphasis is on quality over quantity, often you will only have 3-5, sometimes up to 10 opportunities to challenge the whole body in one exercise. Especially when you are on the Mat, this is ample opportunity to throw your body weight around in space to build strength and stamina. Pilates is a challenge at the beginning, Pilates is also a challenge when you have been doing it a while. When you know how to work deeply to the centre, all the juice can be squeezed out of the moment and no muscle is neglected. 

Question: Will I lose weight?

The short answer, no. The long answer, probably yes. Like any wellness plan, a healthy lifestyle will always trump a short, sharp, drastic diet. It might take longer to see results but it will be sustainable. The thing with Pilates, is that if you are truly committed to it, you will easily complete 30 session (see question above about the number of times a week to attend classes), if you do 30 session, you will notice a change in your body. Now that might not necessarily be weight loss straight up, but perhaps you feel taller, more toned, stronger, fitter, more flexible. Simply put, your body will change. And then subsequently it is likely to spark further interest or additional motivators to keep the positive changes going. Pilates will make you feel good and it could evolve into the exploration of other lifestyle choices that continue to make you feel good. Nutrition being one of those, cardiovascular activity, being the other. At an intermediate - advanced level, Pilates can become more of a cardiovascular workout, as you move quicker, can focus the breath to get more out of the exercise and transition between the exercises, (therefore getting less rest time), then cardiovascular levels increase. A note on the breathing in Pilates - when you can use the Pilates breath to it’s full potential during exercises, breath has the ability to calm your nervous system down, with a calm nervous system you can reduce your  cortisol levels and thus making it easier to lose weight (Catriona Harvey-Jenner). So in summary, as you progress in your practice AND take a 360 degree view of health and wellness, weight loss becomes an achievable outcome of Pilates. 

Q-What should I look for in an instructor?

Ah derrrrr…. me! I kid, I kid. But seriously, me.

Ok, ok, all jokes aside for a moment…

I always remember my year 12 Psychology teacher. He was passionate, enthusiastic, and full of new and interesting ways to hold the class’ attention. He was the reason I wanted to study Psychology at University. He knew how to get the best out of me, and he demonstrated that he cared about the quality of my work, so in return he had my commitment and full attention. Ultimately, I loved the subject, my grades were my highest for this subject and I was motivated to learn more and more and more. I think this applies to anyone that is going to teach or instruct another person. When it comes to finding your teacher, a good place to start is Google. Look at websites, read reviews. Then check the industry bodies’ websites.

This is directly from the Pilates Alliance of Australasia’s website:  “An instructor should have their authentic (comprehensive) certificate of qualification. Alternatively you may check the list of instructors on industry body websites, such as the PAA, The Pilates Method Alliance or the Australian Pilates Method Alliance. The latter two are not exclusive, as they only list those instructors who are members. It is guaranteed that any instructor listed under the PAA have completed a certificate level of education through a registered training organisation and are competent in all aspects of theory and practice. Finally, all leading registered teaching organisations also list successful graduates on their individual websites”.

Question: There seems to be a lot of different Pilates out there. Physio, rehab, clinical, group, privates, duets, classical, machines, mat, props etc. How do I know what to choose? 

Answering this is similar to answering the question above. It depends. However, there are a couple of broad categories you may find helpful when trying to narrow down some initial enquiries.

If you are injured or have chronic pain you may be better suited to Clinical Pilates where rehabilitation will be the focus. If this is not you, then Pilates might be your jam. It doesn’t mean you won’t have certain complaints/ailments/niggles/old injuries and concerns that you are looking to improve.  Conversely, you might be a healthy body and looking for new ways to challenge and train your body.

If teachers are comprehensively trained- (see FAQ above) then both Clinical Pilates Instructors and Pilates Instructors can use the machines (for example, reformers, towers, chairs) as well as mats and props. Whether you do privates/groups/semi privates it will come down to a few things like, which studio you choose, if you choose a studio at all, maybe you choose an instructor who travels to your own home (hint, hint, nudge, nudge), your budget, your experience with exercise programs and movement based programs previously, priorities around convenience, personal attention and goals you want to achieve. 

Joseph Pilates started his first studio in America in 1926 sharing the building with the New York Ballet company, where his first clients were largely injured Ballet dancers. Pilates is far more main stream now, it’s diversified and therefore there are more options for both teachers to train in and clients to workout with. There are varying approaches, or styles, within the Pilates Method that are equally valid and relevant to the individual. Be open to trying different approaches to find the one that works for your personal needs and requirements.

And I might be biased, but Mat work is the best work. I mean Joseph Pilates invented the Mat repertoire first, these were exercises that serve as the foundation for his entire method. Yes the apparatus and accompanying exercises have a place in the system… of course! But when it comes down to it, the equipment serves as stepping stones, with the ultimate goal of getting the body ready for the Mat exercises. Romana Kryzanowska (one of Joseph Pilates original students) said in an interview with Washington Post in 2003 “The apparatus are good, but the mat work is everything. If you can do the mat work perfectly, you don't need the apparatus. But people love toys.”

So if you want to experience the ‘real work’, come and try my Mat classes. No experience? No worries. I have beginner classes and all-levels classes. Virtual for now. Hopefully some of these classes will return to face-to-face soon and I’ll be able to travel to your doorstep (if you live in Bayside, Melbourne)… let’s just see how ‘Rona plays out.  

Me teaching pre-Rona. Pic by @neetaphotography

There's a First Time for Everything, Including Pilates.

Me reflecting back to my first class back in 2010. Thanks Neeta @neetaphotography for this shot back in 2017.

I’ll always remember my first Pilates class. Just like my first kiss, it was awkward, weird, I didn’t know what to do with my hands, I held my breath a lot and I couldn’t stop thinking about it afterwards.

I almost didn’t go back after my first class. I mean I loved it yes, but man, the teacher was telling me so much stuff… like, how to squeeze my butt (‘don’t you just clench the living daylight out the top of your legs’!!), pull my stomach in, relax my shoulders (‘it’s not my shoulders that need relaxing lady, it’s my brain that’s fried from all these things I have to think about’), do something with my ribs that I just didn’t quite comprehend how I’m going to move a body part that is made out of bone and then also now she’s trying to tell me how to breathe?! Whoa. 

But, never one to walk away from a challenge, plus the promise of 6 pack abs (the friend from my old work who swore to me that Pilates was the only thing she’d ever done that got her visible abs), I knew I’d be back to conquer this ‘Pilates thing’.

This is most definitely not the first time i did the Stomach Series. But you get the jist of the buuuuurn! Thanks Gemma @hudlow.photography for this shot last year.

The first time I did the Stomach Series, or the Series Of 5, I knew I was on to a good thing. How can five movements bring about so much delightful torture? I remember thinking, what a waste of years and years, trying to do 300 crunches a night on my bedroom floor as a teenager, thinking that that was the answer to some ‘bikini body’. It’s all about precision of movement. Do it right and quality will trump quantity every. single. time.

Thanks to @wellness_by_norah for this. Nailed it.

The first time I farted in class doing the Rolling Like A Ball exercise I wanted the world to swallow me up, I was so embarrassed. Thankfully my gorgeous teacher didn’t notice, or else she was so used to it and just ignored it. I’m sure it was the latter. Now that I’ve been around Pilates for 10 years, I know that if any exercise is going to make you fart, it’s that one. I’ve lost count of the amount of farts from clients in class I’ve had to ignore myself. Joseph Pilates himself talked about his exercises being like a massage of the internal organs. It meant you were truly working from the inside out. And it’s the inside or the deep stabilisers of our centre that we are particularly concerned with working in Pilates. Now I just tell those clients, ‘hey, no stress, you’re doing it right when a fart escapes’ ;-) 

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The first time I really connected to my powerhouse (centre/core whatever you want to call it). It was like an Ah Ha moment. The pennie dropped. ‘Oooohhh so this is what it feels like’. How to describe it… like I was zipped up. Supported. Like someone was inside me hugging my organs and muscles. I especially remember, after babies, how much I appreciated the skill of being able to feel like I could physically put back the pieces of the puzzle that were my insides. Childbirth made my insides feel like they were floating around inside me looking for a place to call their home, not connected to anything, just floating aimlessly inside my skin. So weird. Thank F for Pilates with that ol’ chestnut. Who knows where my intestines might have ended up without it. 

The first time I felt the effects of missing a class. I thought Pilates was just a way of keeping fit. When I would miss a week here or miss a couple of classes there, sometimes I would just make up for missing it by going for an extra run or do an extra class at the gym that week. Then I realised, actually, this Pilates thing is keeping me together. When I miss a Pilates class it was making running harder, and I wasn’t recovering from the gym as quick. Hmmmm interesting. 

The first time I realised Pilates was making me a better human. I think this didn’t really occur until after kids. Of course I have known for ages how good exercise makes you feel, the endorphins, the reduction of stress on the brain, mental alertness and all that great stuff. But once you are in the fiery pits of sleep deprivation like you’ve never experienced before, and you would do anything to have 30 minutes of time to yourself without little gritty, grubby hands all over you and 16 cups of coffee is probably bordering on too much, holy hell, do you learn the benefits of moving the body and focusing the mind, it’s all in the mind to muscle baby… centred, purposeful movement is life changing. It reminds you that you can use your mind and body for great things.  (

Love these cheeky monkeys. Pic @hudlow.photography

Image from Vivemasblog

The first time I realised that Pilates never actually gets any easier. About 6 months after starting Pilates, I thought, why does this not feel any easier? Am I doing it wrong? Well firstly, we are our own worst enemy, nothing like a bit of competition with yourself. Secondly, it’s human nature to look for the negatives, once upon a time it would have saved our skins to be on the lookout for the danger/the negative/ the baddies. Hello, Wooly Mammoth, you can’t catch me, I’m outta here. Fast forward to now and we still hold a negativity bias, basically, humans tend to focus on the negatives over the positives. Back to Pilates, my teacher was always really good at highlighting how far I had come. ‘Remember when you couldn’t roll up off the ground?, remember when you could only do this on the yellow springs and now you’re on the purple springs?, remember when you had to rest between every rep?’…..hmmm yeah, ok , good point, thanks. The trick with Pilates is that as you learn more (eg, see paragraph above about connection to powerhouse, hello AHA moment), you learn how to use the right muscles, sometimes these muscles aren’t used to working so hard, they are now working in conjunction with those more dominant muscles and voila you now have more muscles working, more precision and concentration needed to control said muscles and you will most likely feel that effort in spades! I love @carrie_pages_pilates take on this……”I always compare Pilates to dance and music. With dance and music after a certain point in your training, you're no longer learning new movements or notes but you refining your performance of them. You begin to put the movements or notes together in ways that make them more challenging. You may learn to execute more turns or hold notes longer but the fundamentals remain the same, therefore the process doesn’t get easier you just get better. For me, Pilates is like a dance or symphony that flows from one movement to the next and I love to experience how each workout feels different. I try to perform the movements with more precision and control concentrating on how I can move more effortlessly and focused. I never get bored. If anything I find myself falling more in love with Pilates year after year”. Well said Carrie, well said! 

So there you have it, my firsts with Pilates. I know a lot of my clients have had some of these same thoughts/experiences… perhaps you have? Can you relate? Maybe there was a key ‘first’ for you that I’m missing? I’d love for you to share your experience with Pilates firsts. Maybe, you’re keen to get amongst some classes and start some firsts of your own? I’m currently taking on new clients, virtually for now, because of Rona, beauty of this is, it’s harder to hear you fart through Zoom, so what happens in your lounge room, stays in your lounge room! #winning

DM me on the Gram @kirsti_pilates_plus or shoot me an email kirsti@kirstipilatestoyou.com.au.

Pilates Pelvic Floor & Perifit

So I never really thought I would be writing about products or recommending products on my IG feed. However, this one is a doozy. If you have ever had a baby, are thinking about having a baby, are pregnant or have had any sort of pelvic floor weakness/disfunction, then you’ll wanna keep reading. Below is a breakdown of my experience with the Perifit device that reads pelvic floor strength and stamina directly from your lady bits via bluetooth games on your mobile phone! Intrigued? Yep, I was too. 

29 weeks pregnant with my first baby.

It all started with this blog I wrote a while back. It was about my experience of Pilates and pregnancy and birth and the after affects of birth on my pelvic floor and how Pilates helped me recover.

Recently a company, Perifit, contacted me to say they had read my blog and thought I might be interested in their product. Having no idea who Perifit was, I was totally dubious about this so called company wanting to give me free stuff to try. After a Google search and a brief read of the excellent reviews this company was getting, I was more inclined to respond positively to their request for trialling their product. So, what is Perifit? Well this is straight from their website: ‘Perifit is a Kegel exerciser that lets you control video games with your pelvic floor. When you contract your pelvic floor the bird goes up. When you relax it, the bird goes down. These games were designed by doctors to help properly strengthen the pelvic floor. It works so well that more than 1000 doctors already recommend Perifit to combat incontinence and prolapse and other pelvic floor disorders.’ 

Once it arrived, it sat on my bedside table for weeks. Partly because the unknown is a bit terrifying and that’s always a good excuse to procrastinate, party because I thought it might take ages to set up, read the instructions and just generally figure out. But I was wrong. Well, the unknown is always a little terrifying, but it was straightforward to read about and set up. First tick! 

When I decided to give it a go, opening the box and noticing it’s uncanny resemblance for a vibrator, I all of a sudden felt like I needed to excuse myself from the living room couch, ha! ‘It’s for work’, I was telling myself.. and my partner wink, wink. 

Once you have downloaded the Perifit app, turned on the device and activated bluetooth  on your mobile, you’re all set for insertion. It’s only mildly uncomfortable initially, if I had to compare it to a pap-smear, where a pap-smear is an 8 or 9 on the discomfort scale, this is about a 1 or 2. Totally manageable.

You can target your pelvic floor training based on your needs, simply take a short test and it will calculate which training program is best for you eg postpartum, incontinence or intimate wellbeing. Once you have your program, your games will be targeted to getting the best outcome from your program. 

So the game itself… well, think of a rudimentary Mario Cart meets Angry Birds type scenario. Where you (or your pelvic floor to be more specific) are the object that has to fly (by contracting your pelvic floor) to capture the floating items in the sky. And then brought back down (again, with the controlled release of of your pelvic floor) along a specific pathway of floating objects to capture either in a linear angled line or something a bit more adhoc. The point being that you want your pelvic floor to be able to do both, steady increasing contraction with steady decreasing release as well as short sharp contract and release muscular control.  

After the game you receive your results on an intricate biofeedback screen, this helps to break down the difference between your deep vs superficial muscles. It tells you how you rate in terms of Force, Frequency, Stamina, Release and Accuracy. The stats you get are so interesting and really help to target the specific areas of improvement.

There’s a manual mode, which I love! Its designed to record the muscular behaviour of your pelvic floor in its functionality. So, pop it in while your vacuuming or carrying the baby and see how your pelvic floor naturally reacts in these situations. Fascinating! 

Why is this relevant to Pilates and my work?

Some would argue that historically, Joseph Pilates would not have cued pelvic floor engagement. His writings indicate that he believed his exercises would activate the neuromuscular system in its natural “correct” patterns, like those of the "newborn babe" or animal. We also know that he believed in the importance of breath…"Before any real benefit can be derived from physical exercises, one must first learn how to breathe properly." Joseph Pilates. 

Picture from Pinterest courtesy of Dani Menesis at Studio Pilates

These two points give us an insight into what makes Pilates so effective. When we breathe as we should, physiologically, we can distribute our intra-abdominal pressure in a balanced way throughout the thoracic, abdominal, and pelvic cavities. When we can balance intra-abdominal pressure (IAP) distribution, we are creating muscle balance in our “core muscles". Our core muscles include the diaphragm, all the abdominals, the deep intersegmental spinal muscles, and the pelvic floor. To facilitate ideal distribution of IAP, the diaphragm has to be able to move up and down freely, which requires that ALL core muscles, including those in the pelvic floor and abdominal wall, can work in both concentric (shortening) and eccentric (elongated) contraction. When we breathe correctly, we are using these muscles in a balanced way, and our spine can stabilise due to the correct distribution of IAP. 

Picture from Pinterest courtesy of Healthwise, Incorporated

 So this is why I rate this device. Although Pilates works the body as a whole, understanding how and where we need to build stability and that our muscles need to be trained in both eccentric and concentric function (pelvic floor being one of those critical areas), is an essential tool to building overall strength and mobility. 

I would describe childbirth like a semi-trailer has rail-roaded you from the inside out,  so it’s not hard to imagine the imbalances and dysfunctions that women can experience after such an event. We are often told to do our ‘Kegels’ before and after childbirth to prepare and rebuild the pelvic floor muscles, this is often interpreted as just focusing on the concentric contraction in an isolated activity. As already mentioned we don’t just want the shortening of the muscle, we want the eccentric or elongation of the muscle as well. So thank you Perifit for making a device that helps with the both, and therefore setting the groundwork for successful, whole body Pilates conditioning! 

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Me in action! Getting my clients to switch on their core, with the help of the Magic Circle.

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.