RECOVER / STRENGTHEN / PREVENT
TAKE BACK CONTROL
An Introduction to Pfilates (Pelvic Floor Therapy)
Pfilates is a program of neuromuscular conditioning based on extensive EMG recordings taken of the pelvic floor. Pfilates was created by a Urogynecologist Dr. Bruce Crawford to provide a method of pelvic floor fitness training accessible to a broad population. As a surgeon, he realized that pelvic floor disorders are absolutely epidemic:
- Stress Urinary Incontinence
- Postpartum and Postsurgical Pelvic Floor Reconditioning
- Overactive Bladder/Bladder Control
- Female Sexual Dysfunction
- Pelvic Organ Prolapse
- Fecal Incontinence/Bowel Control
These disorders are so commonplace they are often regarded as the inevitable consequences of childbirth and aging. When these conditions are treated they are too often regarded as purely mechanical disorders requiring a surgical solution.
Although trained as a surgeon, Dr. Crawford has come to regard these disorders as neuromuscular disorders deserving of a neuromuscular solution. It is clear that programs of pelvic floor neuromuscular rehabilitation successfully improve pelvic floor symptoms. Such programs typically involve a set schedule of isometric pelvic floor muscle exercises (Kegel exercises) that must be continued long term. It is also clearly established that very few women will continue to perform this type of isometric exercises for an extended period of time.
The Cochran Review, an authoritative body that summarizes the scientific literature on diseases states "The review provides support for the widespread recommendation that PFMT be included in the first-line conservative management programmes for women with stress, urge or mixed urinary incontinence."
The Pfilates Program
In the Pfilates program, we have ventured to provide a plyometric (movement oriented) method of pelvic floor exercise. Our neuromuscular research reveals that movements which engage the external hip rotators, adductors of the thigh, transverses abdominals, and gluteal muscles also facilitate, or induce, a pelvic floor contraction. This information has proven especially useful for women unable to perform an isolated voluntary pelvic floor contraction.
The Pfilates program is a simple program consisting of ten movements. There are three phases. Each of the Pfilates movements includes a series of repetitions, a hold phase and a pulse phase at peak engagement. The three phases develop the essential elements of neuromuscular performance: strength, endurance and coordination. Pfilates is intended to be preventative but also a therapeutic alternative for those who already experience symptoms of pelvic floor dysfunction. For patients that have already had surgery, Pfilates can help protect and reduce the chance for recurrent symptoms.
Dr. Bruce Crawford MD is a board certified Obstetrician Gynecologist and Pelvic Floor Specialist in private practice in Northern Nevada. Dr. Crawford attended medical School at New York University before completing a residency at the University of Arizona, Tucson. Dr. Crawford is a member of the International Organization for Women and Development and has made several surgical trips to Niger, West Africa to repair obstetrical fistula. Dr. Crawford is the creator of Pfilates and the VESy Lab, two cutting edge methods of pelvic floor conditioning. Dr. Crawford has published numerous articles in the areas of obstetric fistula and pelvic floor neuromuscular function. Dr. Crawford is a member of The Society of Gynecologic Surgeons, Society for Urodynamics and Female Urology, The International Continence Society, and the American College of Obstetricians and Gynecologists.