PELVIC FLOOR INTEGRATION FOR THE PILATES INSTRUCTOR
CAMERON ANGUS & RUTH JONES
NOTES
THESE NOTES ARE FOR YOU TO WRITE / DOODLE/ DRAW PELVIC FLOORS OR
PICTURES OF US ON!
YOU WILL BE GIVEN ACCESS TO THE EXERCISES AND MORE ON OUR WEB PAGE
PELVIC HIP SPINE CONNECTIONS
Review of not just the anatomy but how it coordinates in function – listen in!
The pelvic floor is just one component in the effective function of the pelvis. Not only
in stability but in allowing synchronized efficient movement of the hips and spine
along with the important stability and organ function roles.
The pelvic floor is intimately connected to the hips via the deep hip stabilizers and
the connections to the major movers such as the glutes, and the spine via the direct
sacrum connection and tissues such as the psoas and diaphragm and abdominal
muscular wall and organs.
The traditional assessment and training of the pelvic floor has been turned on its
head in recent years. We now know that strength deficit is not the only issue and
often it is “over” activity and “unbalanced” activity of pelvic floor, causing pain and
dysfunction and due to the interlink with so many structures such as hips and spine,
these are affected also or in reverse, they have affected the pelvic floor.
HOW DO I KNOW?
As a movement instructor we will give you some “flags” that say refer on to a pelvic
physiotherapy specialist.
These include:
Pelvic regional pain / symptoms (including numbness / tingling)
Incontinence
Prolapse
Non-responding mild Non Specific LBP
Sexual dysfunction
PELVIC FLOOR INTEGRATION FOR THE PILATES INSTRUCTOR
CAMERON ANGUS & RUTH JONES
NOTES
THESE NOTES ARE FOR YOU TO WRITE / DOODLE/ DRAW PELVIC FLOORS OR
PICTURES OF US ON!
YOU WILL BE GIVEN ACCESS TO THE EXERCISES AND MORE ON OUR WEB PAGE
YOUR ASSESSMENT
Along with your Health Questionnaire( we mentioned the NIH-CPSi questionnaire
for males and females, as a specific pelvic pain) , look at:
1. Breathing – Assess appropriate breathing. Focus on relaxed breathing with
particular reference to client not restricting their breathing with overactivity of abdominals or pelvic floor connection (The guarding reaction).
WE REVIEWED BREATHING PATTERNS AND DISCUSSED THE ISSUE OF
TOO MUCH ABDOMINAL WORK PREVENTING RELAXED “ABDOMINAL
BREATHING” (LOWER LOBES) BY RESTRICTING RIB AND DIAPHRAGM
EXCURSION
WE DISCUSSED THAT IT IS OKAY TO PUT STRETCH ONTO THE PELVIC
FLOOR FROM DESCENDING ORGANS DURING BREATH. THIS IS NORMAL
AND PROMOTES NORMAL ELASTIC RESPONSE OF THE PELVIC FLOOR.
WE PRACTISED ABDOMINAL BREATHING WITH NO EFFORT
IN SQUAT OR FLEXION LATERAL RIB EXCURSION IS OKAY AS ABDOMINAL
CONTENTS ARE “SQUASHED”.
2. Transversus skills – Ability to activate transversus / pelvic floor and then
assess if possible any differences between sides.
WE REVIEWED ABDOMINAL SETTING – BASICALLY IF THE AUTOMATIC
APPROPRIATE REACTION TO STABILSE IS TAKING PLACE THEN NO NEED
TO CUE SPECIFICALLY. (STILL USE MOVEMENT CUES )
SOMETINES A DIFFERENCE EXISTS BETWEEN SIDES ON TRANSVERSUS
WE USED DEEP HIP STABILIZER (DEEP PSOAS FIBRES) CUE (DRAW IN HIP)
TO FACILITATE TRANSVERSUS CONTRACTION ON SIDE NOT WORKING SO
WELL. THIS IS FAIRLY SUBJECTIVE BUT CAN BE PERCEIVED AND FELT.
WE GAVE SOME RECENT RESEARCHED CUES FOR PELVIC FLOOR
ACTIVATION. 1. CONTRACT FROM AROUND THE BACK PASSAGE THEN
FORWARD 2. FOR GUYS – “SHORTEN THE PENIS” (GOOD LUCK WITH THAT)
3. Pelvic Tilt – Assess pelvic mobility and correct movement activation
sequence. Including no excessive abdominal / glute activity into posterior tilt.
Ability to release into anterior tilt is also essential. This should be a pelvic
bowl rock and release and not spine driven.
WE DISCUSSED BEING ABLE TO “ROLL THE PELVIS ON THE FEMORAL
HEADS” AN IMAGE TO HELP PREVENT TOO MUCH ACCESSORY MOVEMENT
/ACTIVATION IN SPINE / GLUTS ETC
PELVIC FLOOR INTEGRATION FOR THE PILATES INSTRUCTOR
CAMERON ANGUS & RUTH JONES
NOTES
THESE NOTES ARE FOR YOU TO WRITE / DOODLE/ DRAW PELVIC FLOORS OR
PICTURES OF US ON!
YOU WILL BE GIVEN ACCESS TO THE EXERCISES AND MORE ON OUR WEB PAGE
WE SHOWED THE NEED TO LET ANTERIOR TILT BE MORE PASSIVE (CUEHEAVY PUBIC BONE OR LET YOUR BALLS DROP”!!!
THIS ALLOWED A PROPER RELEASE
4. Leg Slides – Assess ability to do a controlled smooth leg slide with
appropriate hip/pelvic disassociation. Use of hip stabilizers (psoas, deep
rotators) without over recruiting generally.
WE USED SINGLE LEG SLIDE AS AN EXAMPLE OF GETTING JUST THE
RIGHT AMOUNT OF CONTRACTION IN THE STABILITY GROUP BUT
ALLOWING A FLOWING MOVEMENT. THE SUPPORTED LEG MEANS THE
AMOUNT OF “WORK” TO SUPPORT THE LEG IS LESS SO THIS IS A GOOD
EARLY EXERCISE. THE POINT IS TO ENSURE NO GRIPPING THROUGH THE
PELVIS/HIPS/SPINE
5. Knee drop out (HIP control) – Assess ability to perform a smooth controlled
rotation at the hip with appropriate hip/pelvic disassociation.
AS ABOVE BUT THIS TIME USING HIP ROTATION AND ABDUCTION AS
A STRESS ON THE PELVIC FLOOR STABILITY SYSTEM. WE DISCUSSED THE
ABDUCTORS ATTACHING ONTO PUBIC BONE
6. Oyster – Assess Lateral rotator control and range through concentric and
eccentric range plus ability to disassociate movement.
LATERAL ROTATION AT THE HIP IS ACHIEVED BY EFFICIENT USE ON
LOWER FIBRES OF GLUT MED ESPECIALLY. IF THIS IS NOT WORKING THEN
OTHERS WORK TOO HARD. WE DISCUSSED THE DEEP STABILITY MUSCLES
AND THE ATTACHMENTS TO PELVIC FLOOR. INCREASED DEMAND ON
THESE WILL OVERACTIVATE PELVIC FLOOR. TOO MUCH PELVIC FLOOR
ACTIVITY WILL THUS POTENTIALLY OVERWORK THESE STABILIZERS
PREVENTING SMOOTH HIP MOVEMENT.
7. Hip extension – Assess appropriate patterning and activation to ensure no
excessive demand on the pelvic floor.
HIP EXTENSION PATTERNS AND ESPECIALLY GLUT MAX WORKING
APPROPRIATELY WITH HAMSTRINGS IS IMPORTANT. HAMSTRINGS VIA
ISHIAL TUBEROSITY HAVE DEEP CONNECTION TO PELVIC FLOOR.
EXCESSIVE ACTIVITY WILL “LIGHT UP” THE PELVIC FLOOR.
PELVIC FLOOR INTEGRATION FOR THE PILATES INSTRUCTOR
CAMERON ANGUS & RUTH JONES
NOTES
THESE NOTES ARE FOR YOU TO WRITE / DOODLE/ DRAW PELVIC FLOORS OR
PICTURES OF US ON!
YOU WILL BE GIVEN ACCESS TO THE EXERCISES AND MORE ON OUR WEB PAGE
8. Table Top Rock Backs - Assess spinal hip disassociation and also places
pelvic floor on full length and breadth. Prep for squat.
ROCK BACKS FROM FOUR POINT KNEELING ENSURES HIP
DISASSOCIATION AND ALSO LIKE A SQUAT WILL OPEN THE PELVIC
OPENING AS THE ISHIUMS OPEN UP. THIS ENSURES THE PELVIC FLOOR
GOES THROUGH ITS “NORMAL” FULL RANGE AS IT IS STRETCHED OUT.
PROGRESS TO CHILDS POSE!!
9. SQUAT - Assesses mobility of numerous structures to adopt the position
including – Hips, spine, sacral rotation and nutation. Also tissue length
including pelvic floor, hip and spine structures.
What happens – Hips flex to maximum and rotate laterally. Posterior hip
tissues have to control and lengthen (deep stabilizers, piriformis, glutes).
Spinal flexion along with extensor/multifidus release. Pelvic posterior tilt
with sacral nutation involves pelvic floor spreading as coccyx elevates
posteriorly and ischiums spread apart laterally. Limiting factors would be
overactive lateral hip rotators and/or spinal extensors, plus knee hip ankle
joint range.
AS ABOVE AND EXPLAINED ABOVE
10. ROLL DOWN ROLL UP – Assess smooth integrated pelvic / spinal mobility
with reference particularly to hamstring control, lumbopelvic motion, and
extensor control
PUT IT ALL TOGETHER. THINKING SPINAL MOVEMENT AND RANGE,
PELVIC MOBILITY ON HIP AND TISSUE LENGTH ALONG WITH JUST THE
RIGHT AMOUNT OF CONTROL TO ALLOW A FLOWING MOVEMENT