Many women face a problem that they don’t always want to talk about –trouble with their bladder. They experience incontinence, sometimes extreme, sometimes just a little leaking when they laugh or exercise, or they have pain with movement. Too often, they accept it as a natural part of having babies or getting older. But it’s not. It’s related to having weak pelvic floor muscles, and that is something women can improve.
This epidemic is a fitness issue and there are exercises, programs and education that can help improve it in many cases. Board certified Urogynecologist and pelvic floor expert, Bruce Crawford, MD, has designed a unique exercise program called Pfilates (pronounced Fil-la-tees) that helps women strengthen their pelvic floor muscled using natural movements. We’re excited at Ella Health to be working with Dr. Crawford to offer an educational program for health care providers and exercise professionals who want to become certified Pfilates instructors and change the future of pelvic health. With this certification, they will be qualified to offer this effective program to their patients and clients. Dawn-Marie Ickes, Ella Health Director of Integrative Wellness and Physical Therapy was first introduced to the program in 2010 and was astonished by how a few simple exercises with the correct cueing had a profound impact in stress urinary incontinence, not to mention improving a variety of other pelvic health issues. We talked recently with Dr. Crawford about how the program was developed and how it works.
How is Pfilates different than Pilates and other exercise programs? It uses some of the same movements as Pilates and other programs, but it is specially designed to strengthen the pelvic floor muscles. Common problems such as urinary incontinence, vaginal prolapse and poor sexual satisfaction are all associated with weak pelvic floor muscles. This helps avoid medications and surgery.
What is the pelvic floor? It’s the internal muscles around the vagina, rectum and bladder. The muscles of the pelvic floor naturally contract when we move around and we don’t even have to think about it. But when they become weak, we lose control.
How did you develop Pfilates? I started working on it in 2008 as an alternative to Kegels. Although they can be effective if done right, I found that many of my patients weren’t doing them at all. What women really need is something that is more closely aligned with their every day movements. The pelvic floor is designed to work while we’re moving. You need to train a muscle by challenging its natural purpose, and the natural purpose of the pelvic floor is movement.
How did you find the exercise that you use? We tested more than 100 exercises using our VESy system, a video imaging system that measures the effectiveness of exercies. From this, we identified ten that engaged the pelvic floor muscles and were easy to do. Seven of the movements are from Pilates, three are from regular exercise training programs and one is from Yoga.
How have you tested the program? After we saw results from our patients, we set up a clinical study to measure the effectiveness of the program. That was presented just last year to the Society of Gynecologic Surgeons. We are also continuing to update our clinical data. What we’ve found is that patients are actually building muscle. By focusing on the Pfilates movements, you are able to increase the number of cells firing by 75 percent.
Does this work for women at any age or stage of life? It really does. We’ve seen great results in women who have just recently given birth and in those who are in their 80s and have struggled for years with incontinence. It works as prevention and as treatment. It’s good for women who want to prepare for childbirth as well as those who want to regain strength after.
How long does it take to see improvement? Some women see improvement almost right away. For most, it takes a few weeks of sticking with a simple exercise routine. This can be done through a class or at home for just a few minutes twice a day. The key is learning the right movements and integrating them into daily activities such as sitting down and walking up stairs.
Do you have to keep doing the exercises? Like any muscle, you need to keep working the pelvic floor to maintain strength. But the movements we use can easily be integrated into an ongoing fitness routine.
How can women find out more? We offer DVDs through our website and we have programs to certify instructors. It’s ideal if women can work directly with an instructor who can help tailor the program to their needs. Some of our instructors set up classes that focus just on the Pfilates exercises and others incorporate the movements into their existing classes.
How do you integrate VESy? The system is available to work with women one-on-one on their specific concerns. It’s an imaging system that allows women to see instantly how well the various exercises are engaging their pelvic floor muscles. This way, we can identify the ones that work best for that particular woman. This is used to develop an exercise routine for her and to follow her progress. Ella Health and Dr. Crawford are providing training programs for health care and exercise professionals to become certified Pfilates instructors. San Francisco: June 6-7; 2211 Bush Street, Suite 100 To register, call (415) 440-4151 San Antonio: June 13-14; 999 East Basse Road, Suite 1078 To register, call (210) 290-9760 
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