Pilates for Pelvic Floor: Can It Help with Incontinence?

You may have heard about the benefits of Pilates for your pelvic floor when working out or chatting with your friends. You may even be doing Pilates already and, while this trendy workout supports full-body health, it may also have another, lesser-known benefit: bladder control.¹

Stress incontinence, urge incontinence, overflow incontinence, or functional incontinence could be part of your day-to-day.¹ And you may wonder if Pilates could help with managing incontinence.

Let's explore how Pilates could help reduce unexpected leaks and safely strengthen your or your loved one's pelvic floor.

What is Pilates?

The Principles of Pilates

Before we dig deeper, let’s look at what exactly Pilates is.

Pilates is a series of gentle or challenging exercises, depending on what your body needs, improving your muscle strength, endurance and even posture and balance.¹ It uses slow, controlled movements to help you build strength and become more aware of your body.^1,4

Each pilates movement works based on six principles that help to focus your body and mind and help to reap the benefits of this practice. They are:⁵

• Breathing
• Concentration
• Centering
• Control
• Precision
• Flow

Now that we know what Pilates is, we can look at the benefits.

How Pilates Benefits the Core and Pelvic Floor

Your core muscles and pelvic floor are important for support, strength, and stability for your spine and internal organs. A strong core also helps to support organs like your bladder to help control dribbles.⁶

These core muscles include:⁷

• Rectus abdominis (your six-pack)
• Internal and external obliques (muscles along your sides)
• Transversus abdominis (deep lower belly muscle)
• Multifidus and erector spinae (small back muscles that support the spine)

When your core is weak, it can lead to bladder leaks.6 Don't worry though, Pilates can help strengthen your core, improving muscle tone and giving your bladder the support it needs.^1,6

Pilates vs Kegels for Bladder Control

When you do pelvic floor exercises, you gently pull in your deep stomach muscles before each move.¹ This action also activates your pelvic floor.¹ Over time, the repeated movement tones and strengthens those muscles.¹ As your core gets stronger, your pelvic muscles do too, helping you have bladder control and less leaks.⁶

Improving Bladder Control

Mindful breathing is at the center of Pilates.⁸ This deep, focused breathing, called diaphragmatic breathing, helps you:⁸

• Connect with your body
• Stay focused
• Engage your core muscles

When done correctly, it engages your core which balances your spine and pelvis.⁸ Over time, this engagement trains your pelvic floor muscles to tighten and relax at the right times, which may improve bladder control and reduce leaks.^8,9

Curious about other ways to manage incontinence? Learn more about bladder training; another good way to improve your bladder control.

Enhancing Posture and Alignment

Proper posture and alignment are key to a healthy pelvic floor.¹⁰ When your posture is off, the muscles in your belly and core may work harder than needed.¹¹

In stress incontinence, this extra effort can increase pressure in your stomach, putting more stress on the bladder.¹¹ Pilates helps by aligning your spine and pelvis.¹⁰ This change helps remove any extra pressure on your pelvic floor, preventing leaks. ¹¹

Feeling More Confident and In Control

Incontinence has a way of chipping away at your confidence; you don’t have to let it.

Pilates focuses on a principle called centering, which helps you reconnect with your body through movement and breath.⁸ 

This awareness could help you feel more confident in your body and reduce the stress or anxiety you may feel about leaks.

And when you combine Pilates with pelvic floor exercises, that calm feeling, coupled with fewer daily disruptions may be just enough to boost your quality of life.⁴

Types of Pilates Exercises for Incontinence

Pelvic Floor-Focused Movements

Certain Pilates exercises gently target the pelvic floor to help build pelvic floor strength.¹⁰ Here a few beginner-friendly movements that could help you take back control and reduce leaks:

Pelvic Curl

Start by lying on your back with your knees bent.¹⁰ Then slowly lift your hips up and down while breathing deeply.¹⁰ As you move, your pelvic floor muscles engage and release in sync with your breath. ¹⁰

Bridge

Starting from the same position as the pelvic curl, exhale as you lift your hips slowly off the floor.¹⁰ Remember to keep your feet grounded as you move.¹⁰ This movement strengthens both your glutes (butt) and pelvic floor.¹⁰

Heel Tap

Begin by lying on your back with your knees bent to a 90-degree angle, and feet in the air.¹⁰ Keep your spine neutral as you lower one foot to tap the ground, then lift it back up.10 Repeat the same for the other leg as you breathe in and out.¹⁰ This helps strengthen your deep core and pelvic muscles.¹⁰

Core Activation and Breathing Techniques

Working together with Pilates, you can try to do some core activation exercises together with some breathing techniques. Warm-ups like ‘The Hundred’ from Pilates and diaphragmatic breathing may help reduce bladder leaks.^12,13

The Hundred

The Hundred is a classic Pilates exercise that offers several benefits, ¹² such as:

• Aligning your spine and pelvis.¹²
• Strengthening your core muscles.¹²
• Reducing pressure on your stomach and pelvic floor.¹⁴

Diaphragmatic Breathing

Diaphragmatic breathing, also called belly breathing, has many health benefits.¹³ For leaks, outside the uses mentioned in the above section, it also relaxes the pelvic floor muscles when you breathe in.¹³

Gentle Pilates for Beginners

Remember, as with any new exercise or activity, it's important to listen to your body, start small, and build up slowly. You could start with one or two classes a week and gradually work your way up.

You can find a Pilates studio close to you or reach for your favorite video streaming service to find some beginner-friendly moves to try at home.

There's no rush; everyone's needs are different, so take your time. Listen to your body and make adjustments as you go.

The Science Behind Pilates and Incontinence

Research and Studies Supporting Pilates

There are studies that support Pilates as a helpful tool for people managing incontinence. Here’s what the science says:

• Consistency: One 12-week study found that both in-person and at-home Pilates programs helped people stick to a routine.¹⁵ The at-home group even continued the exercises six months longer than the other group.¹⁵
• Bladder control improves: In a 10-week study, Pilates was as effective as traditional pelvic floor training.16 By the end of the study, 59% of participants doing Pilates regained full bladder control, compared to 54% in the pelvic floor training group.¹⁶
• Stronger pelvic muscles: A 12-week study found that modified Pilates exercises helped improve deep core and pelvic floor strength, making them a good option for managing stress incontinence.¹⁷

Considerations Before Starting Pilates for Incontinence

Your Pilates journey is unique, and you may want to consider a few things before getting down on a mat.

Consulting a Healthcare Professional

Before you start, talk to a healthcare professional, especially if you have severe incontinence or other health conditions.

Modifying Exercises for Specific Needs

Pilates is adaptable to your needs. Depending on your incontinence severity and fitness level, your trainer can help create a personalized plan. This guidance can help you avoid issues like:¹⁸

• Pelvic strain from increasing your intensity too quickly.
• Extra pressure on your pelvic floor from exercises that may worsen symptoms.
• Confusion around how to properly engage your core and pelvic floor muscles.

Gradual Progression and Consistency

Start with simple core exercises and build from there.⁹ It might be tempting to jump into more advanced moves, but it's best to wait until your body is ready. The key is consistency; regular practice is what leads to lasting results.

Could Intense Pilates Exercises Make Incontinence Worse?

Some Pilates poses might put extra pressure on your pelvic floor muscles.¹⁸ This extra pressure, when exercise may be intense, might make your leaks more obvious.¹

That’s why it’s best to start gently and check in with your doctor as you go along, especially if you have severe incontinence or other pelvic floor concerns.

Pilates as Part of a Holistic Approach

While Pilates is holistic,¹ it works best when combined with other healthy habits like:

• Staying hydrated.
• Eating bladder-friendly foods.
• Doing pelvic floor exercises.
• Using the right incontinence products.
• Accepting help from your loved one or caregiver.

Incontinence Products

Choosing incontinence products may be daunting but finding the right fit and absorbency level for your needs is key to feeling dry, protected, and confident all day.

Here are some Incontinence products to help you on your journey:

• Men’s Incontinence Pads & Guards: These pads are designed specifically for the male anatomy, fitting discreetly under your clothes.¹⁹ They help you go through your day with confidence without worrying about mild to moderate leaks.¹⁹
• Incontinence Pads for Women: These pads are specially designed for a woman’s anatomy. They come in a range of sizes, from ultra-thin to ultra-heavy, offering tailored protection to meet every need.

Supporting a Loved One Trying Pilates for Incontinence

You might not be an instructor, but you could still support your loved one through Pilates for bladder leaks.

• Help them find a beginner-friendly Pilates class for their pelvic floor.
• Offer to take a class with them or do a home workout session.
• Treat conversations and leaks like any everyday moment or topic.

Keen to start trying Pilates at home? You’ve got all the info you need to get started on your journey to stronger core and pelvic floor muscles.

FAQs

Can Pilates Help with Incontinence?

Pilates poses may be part of a gentle exercise routine for incontinence.⁵ They could help strengthen your core muscles that support bladder control.⁵

Before starting, talk to your doctor, especially if your symptoms are severe.

Everyone's experience is different, so keep going; your consistency might just pay off. It might also help combine it with pelvic floor exercises.⁴

Is Pilates Better than Kegels for Bladder Control?

Neither is necessarily better since they work in different ways. Kegels work directly on your pelvic floor muscles,⁷ while Pilates strengthens them through a mind-body connection.³ Combining both might be worth trying to strengthen your pelvic floor.⁴

How Often Should I Do Pilates for Pelvic Floor Health?

You could try one or two sessions a week and gradually build up as you get comfortable. Having regular sessions in the books may matter more than how hard you went.

Can Pilates Make Incontinence Worse?

Pilates poses are safe exercises for most people with a weak pelvic floor.⁵

But increasing the intensity too quickly might strain your pelvic floor muscles.¹⁷

Start with gentle core exercises and speak to your doctor before increasing the intensity once you feel comfortable.

How Long Does It Take to See Results from Pilates for Incontinence?

You might notice some changes after a few weeks of practice, but it could take longer to see results.¹⁵

Everyone is different, but your consistency matters more than rushing the process.

What Pilates Exercises Are Best for Beginners with Incontinence?

Gentle, low-impact Pilates for leaks like the pelvic curl, bridge, and heel tap may be a good place to start.¹⁰

These moves focus on slow, controlled breathing alongside gentle muscle engagement.⁸ They could help build your core and pelvic floor awareness without much strain.⁸

A beginner core workout class or video series may help you learn proper form.

Can Men Do Pilates for Incontinence?

Yes, men live with incontinence too and Pilates might just help them too.⁵

Pairing Pilates with the right incontinence products, like discreet pads designed for the male anatomy, could add extra confidence while you build strength.

Is It Safe to Do Pilates if I Have Pelvic Organ Prolapse?

You might need to modify or avoid certain Pilates movements.¹⁸ Certain intense core exercises could add extra pressure to your pelvic floor.^1,18

If you’re unsure about which, talk to your doctor or a pelvic floor specialist before starting a routine, especially if you have other pelvic issues.

Do I Need Special Equipment to Do Pilates at Home?

No, many beginner-friendly Pilates movements for pelvic floor health only need a mat and comfortable clothing.

As you progress, you could add simple props like a small ball or resistance ring. These are optional, not necessary to get started.

References

1. Kloubec J. Pilates: how does it work and who needs it? Muscles, Ligaments and Tendons Journal [Internet]. 2011 Dec 29;1(2):61. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3666467/

2. Sandra Gordon. Tips to Manage Incontinence [Internet]. WebMD. 2024. Available from: https://www.webmd.com/urinary-incontinence-oab/everything-managing-incontinence

3. WebMD Editorial Contributor. Urinary Incontinence: Exercises to Improve Bladder Control [Internet]. WebMD. 2024. Available from: https://www.webmd.com/a-to-z-guides/exercises-urinary-incontinence

4. Lausen A, Marsland L, Head S, Jackson J, Lausen B. Modified Pilates as an adjunct to standard physiotherapy care for urinary incontinence: a mixed methods pilot for a randomised controlled trial. BMC Women’s Health. 2018 Jan 12;18(1).

5. Ivanivna VN, Vasylivna PO. THE ESSENCE OF THE PILATES SYSTEM PRINCIPLES. In The II International Scientific and Practical Conference “Discussions for the improvement of science” January 16–18, Berlin, Germany 306 p (p 163). :306 p. (p. 163).

6. Nipa SI, Sriboonreung T, Paungmali A, Phongnarisorn C. The Effects of Pelvic Floor Muscle Exercise Combined with Core Stability Exercise on Women with Stress Urinary Incontinence following the Treatment of Nonspecific Chronic Low Back Pain. Advances in Urology [Internet]. 2022 Sep 5;2022(1):2051374. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467742/

7. Joanne Lewsley. The best core exercises for all fitness levels, at home and at the gym [Internet]. www.medicalnewstoday.com. 2021. Available from: https://www.medicalnewstoday.com/articles/best-core-exercises#muscles-of-the-core

8. Antero L. The Art of Breath Control in Pilates: A Deep Dive into Mindful Respiration [Internet]. Pilates for All Ages. 2024 [cited 2025 Jun 6]. Available from: https://pilatesallages.com/the-art-of-breath-control-in-pilates-a-deep-dive-into-mindful-respiration/

9. Pelvic Floor Pilates: Strengthening and Restoring Through Movement Ironhorse Physical Therapy & Pilates [Internet]. Ironhorsept.com. 2023 [cited 2025 Jun 7]. Available from: https://www.ironhorsept.com/blog/pelvic-floor-pilates-strengthening-and-restoring-through-movement

10. Live Healthy. Is Pilates Effective for Strengthening Pelvic Floor Muscles? [Internet]. Sandgate Physical Health Clinic. 2024 [cited 2025 Jun 6]. Available from: https://sandgatephysio.com.au/is-pilates-effective-for-strengthening-pelvic-floor-muscles/

11. Smith MD, Coppieters MW, Hodges PW. Is balance different in women with and without stress urinary incontinence? Neurourology and Urodynamics. 2007;27(1):71–8.

12. Bunch E. This Classic Pilates Move Works Every Muscle Group In 2 Minutes [Internet]. @onepeloton. Peloton Interactive; 2024. Available from: https://www.onepeloton.com/blog/pilates-hundred?msockid=36f3b67236c463d23509a5d23703622b

13. Hanna Newstadt. Why Diaphragmatic Breathing is One of the Best Exercises Pelvic Health Therapists Can Give Patients - APTA Pelvic Health [Internet]. www.aptapelvichealth.org. 2023. Available from: https://www.aptapelvichealth.org/info/why-diaphragmatic-breathing-is-one-of-the-best-exercises-pelvic-health-therapists-can-give-patients

14. Taylor J. The Hundred [Internet]. Welcome to taylor-made fitness. 2019 [cited 2025 Jun 7]. Available from: https://www.taylormadefitness.biz/2019/10/04/the-hundred-preparation-and-progressions/

15. Ohayon L. Pilates and Pelvic Floor Dysfunction: Is It the Solution You’re Seeking? [Internet]. RYC®. 2025 [cited 2025 Jun 7]. Available from: https://restoreyourcore.com/learn/pelvic-floor/pilates-and-pelvic-floor-dysfunction-is-it-the-solution-youre-seeking/

16. Hein JT, Rieck TM, Dunfee HA, Johnson DP, Ferguson JA, Rhodes DJ. Effect of a 12-Week Pilates Pelvic Floor-Strengthening Program on Short-Term Measures of Stress Urinary Incontinence in Women: A Pilot Study. The Journal of Alternative and Complementary Medicine. 2020 Feb 1;26(2):158–61.

17. Gomes CS, Pedriali FR, Urbano MR, Moreira EH, Averbeck MA, Almeida SHM. The effects of Pilates method on pelvic floor muscle strength in patients with post‐prostatectomy urinary incontinence: A randomized clinical trial. Neurourology and Urodynamics. 2017 May 2;37(1):346–53.

18.Coleman TJ, Nygaard IE, Holder DN, Egger MJ, Hitchcock R. Intra-abdominal pressure during Pilates: Unlikely to cause pelvic floor harm. International Urogynecology Journal. 2015 Feb 12;26(8):1123–30. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4506704/