Pilates teacher and physiotherapy assistant Leslie Hopkins has been a “gym rat” since her early 20s. Years of working a desk job made her realize the importance of moving. When she had her children in her early 30s, she decided to stay at home to do contract work, and that’s when she took up fitness training to get out of the house and earn some extra income.
But it’s when she took her first Pilates class, nearly 16 years ago, that her life changed.
“It spoke to me,” says Leslie. “I loved the attention to detail, the precision of movement – my mathematical mind just got it.”
After that first class, Leslie enrolled in Pilates instructor training and soon had enough employment opportunities that by 2002 she was able to quit her other work and teach Pilates full-time. She also started teaching Pilates at a physiotherapy clinic in Victoria and became a physiotherapy assistant (PTA).
When Leslie was going through menopause in 2012, another big epiphany happened.
“I was on a family vacation when I laughed, leaked and freaked,” she says. “How could this happen to me? I’m a Pilates instructor, and your pelvic floor is the base of your core, which is what Pilates strengthens. This rocked my Pilates world, but because I was working as a PTA, I did some research and found there were exercises I could do to tone my muscles.”
That’s when Leslie discovered PFilates, created by Dr. Bruce Crawford, a uro-gynecologist who did pelvic floor surgery and found there were no exercise protocols for rehabilitation.
“Dr. Crawford found that the muscles work best during movement, together with the muscles that support them – inner thighs, buttocks and deep abdominals – not in isolation like Kegel exercises,” says Leslie. “Dr. Crawford analyzed hundreds of exercises and found 10 that strengthen the pelvic floor best. Using EMG recordings, he was able to analyze where in the movement pattern the pelvic floor muscles were most active and, at that point, you hold to produce a stronger voluntary pelvic floor contraction. The repetition of the exercises builds muscular strength, the hold builds muscle endurance and the pulses build muscle co-ordination,” instructs Leslie.
Many of the exercises are well known, like squats or leg lifts, so it’s easy to incorporate them into a fitness training regime. Interestingly, Leslie learned she had to relax her muscles, as they were hypertonic – especially her abdominals – which causes dysfunction.
“I like to call it the Goldilocks Principle: too hot (tight); too cold (loose); and just right!” she quips.
Leslie also learned that a lot of Pilates exercises are not pelvic-floor friendly and some typical exercises such as sit-ups, planks, and push-ups actually increase intra-abdominal pressure.
“If the core muscles are not optimally functioning,” Leslie advises, “dysfunction occurs, and incontinence of urine and/or feces, prolapsed organs, slipped/herniated discs and hernias can occur.”
Leslie says incontinence can happen to anyone, at any stage in life, although typically it’s more of a female problem as pregnancy and childbirth can cause pelvic floor dysfunction. It can also be caused by postural problems, chronic constipation, chronic coughing, high-impact activities, obesity, surgeries, and even repetitive abdominal training.
Incredibly, 40 per cent of women over the age of 45 have significant prolapse, one-third of women are urine incontinent and 10 per cent fecal incontinent, with 40 per cent of women describing sexual dissatisfaction. Pelvic floor muscles enhance orgasmic potential in women and help maintain an erection in men.
Incontinence is also highly related to the aging population, mainly due to hormonal changes, which affect muscle strength and connective tissue resilience. Men are also affected.
For both genders, says Leslie, loss of bladder and bowel control are the leading reason for admission to long-term care.
Currently, there is an increasing trend for TV ads selling adult pads and diapers, using attractive and relatively young celebrities like Brooke Burke to normalize their products and make them sexier and acceptable.
“Incontinence care products are a Band-aid solution,” says Leslie. “We are hiding our problems, or we think this happens to everybody, and as women, we are used to wearing pads. Incontinence is a common problem, but it is not normal. We need to talk more; there is a solution and, if you look closely at these product websites, they do mention exercise as something that helps.”
Eager to share her knowledge, Leslie started implementing PFilates into her Pilates classes and holding workshops. She found that in workshops people do learn a lot, but “the learning curve is steep, and I feel the forgetting curve is just as steep,” she says.
So, Leslie has developed an online program called Laugh Without Leaking, where she can reach more women and teach them step-by-step, a little bit slower, and in the comfort of their own homes. In the online modules, there are educational videos with anatomy lessons and those that teach about the causes and types of pelvic-floor functions, exercises that are pelvic-floor friendly, and those you must avoid until you regain core strength. Participants can access Leslie via a private Facebook group and monthly webinars.
“They can repeat the exercises and hear my voice coaching them through the work, because repetition is key,” advises Leslie. “I hope the online program will reach more women,” she continues, “to give them the tools they need to solve their problems and provide them with an understanding about their bodies and specific issues that will allow them to seek medical advice and make intelligent, educated choices.”
Leslie’s clients are all female, ages 40-80, and when she gets a referral for a male client, she refers them on to a pelvic floor physiotherapist. She says clients can see an improvement after just four weeks of using PFilates exercises.
Her clients report positive feedback on her workshops and say they appreciate receiving this valuable information in a safe environment, where they feel comfortable talking about their incontinence problems. Leslie believes every woman should have pelvic-floor training like this from a young age, especially as a postpartum treatment.
“It is very empowering to know how to use simple exercises to correct a physiological problem, and reassuring to know that this problem is a common one,” she says. “It gives me hope for a dry future.”
For more information, visit: www.confidentcorefitness.com