Diastasis and Pelvic Floor Therapy: What’s new in the pilates world?!
As a pelvic floor physical therapist with over 13 years of experience, I’ve had the privilege of helping many patients reconnect with their bodies. Around 2013, I completed Polestar Pilates training and became a certified rehabilitative instructor. That experience truly changed how I understand movement and breath—it sharpened my ability to guide patients toward using the right muscles in the right way.
Interestingly, Pilates has officially made its comeback. It had a major moment in the early 2000s (cue the DVDs and studio craze), then quietly stepped aside while high-intensity workouts took the spotlight. But now? Pilates is back—and honestly, it never should have left. As more people shift toward low-impact, intentional movement and longevity-focused fitness, Pilates is once again having its well-deserved moment.
And here’s something people don’t talk about enough: Pilates is sneakily hard. Because it’s slow. Because it’s controlled. Because a lot of it is isometric. You’re working under constant tension without relying on momentum—which is exactly what makes it so effective for tendon and ligament health. This kind of training builds resilience, improves joint stability, and helps prevent injuries. Pair it with heavy lifting, and now you’ve got a body that’s not just strong—but smart and durable too. (We love a well-rounded queen.)
Pilates can beautifully complement pelvic floor physical therapy. I genuinely love it—the way it moves, the way it feels, and the way it builds awareness. But I’ll be honest: I did it wrong for a long time without realizing it. When I finally figured that out, I was… not thrilled. But once I corrected my core engagement, my hip flexor pain disappeared and my posture improved. Worth it.
Here are five key tips from my experience:
1. Rethink “navel to spine.”
This cue has good intentions, but it often turns into people holding their breath, flaring their ribs, and aggressively sucking in. That’s not deep core—that’s just tension. Instead of actually engaging the pelvic floor and transverse abdominis, you’re overworking the obliques. Let’s aim for connection, not clenching.
2. Curl-ups aren’t off-limits with diastasis.
Yes, I said it. The blanket “no crunches ever” rule isn’t entirely accurate. If you’re seeing doming or worsening separation, then absolutely skip them. But if you can maintain tension and control? You’re allowed. You have permission. Use it wisely.
3. Stop holding your breath.
Pilates is literally based on control (it was originally called Contrology), and breath is a huge part of that. Your breath should drive the movement. Exhale during flexion to get those abdominals online, inhale during extension to create space and length. If you’re holding your breath the whole time… we need to talk.
4. Pilates is for every body.
You do not need to be wearing all black, perfectly matching sets, or be a size 2 to do Pilates. It is endlessly adaptable and customizable. If it feels exclusive, you’re in the wrong room.
5. Bend your knees. Seriously.
Not every exercise needs straight legs just because that’s how it’s demonstrated. Movements like the Hundred or coordination can absolutely torch your hip flexors and strain your back when done with legs extended low. Bend your knees, bring them to tabletop, and suddenly—magic—you’re actually using your core the way you’re supposed to. Imagine that.
Have questions or want guidance? Reach out anytime at info@empoweryourselfpt.com—we’re here to help you move better, feel stronger, and maybe stop over-gripping your abs while holding your breath.