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Pilates e incontinencia urinaria

Actividad física


Pilates suelo pélvico
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Si quieres practicar esta actividad tan completa, pero tienes problemas de suelo pélvico, ¡cuidado! Te damos consejos desde cómo elegir el centro adecuado a cómo practicar los ejercicios, para que ayuden a fortalecer tu musculatura pélvica.


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Pilates es una buena opción para mantener en buen tono toda la musculatura del cuerpo. Si una mujer está sana y en buenas condiciones físicas, esta actividad puede resultar muy beneficiosa para ella, e incluso cuando existen problemas de espalda o articulares puede actuar como técnica rehabilitadora. Sin embargo, cuando hay incontinencia urinaria, prolapsos o riesgo de debilitamiento del suelo pélvico (durante el embarazo, en el postparto o durante la menopausia), hay que vigilar y tener mucho cuidado con los ejercicios que se practiquen. Aunque no se tengan síntomas, esta musculatura puede estar muy distendida y débil. Si estás en situación de riesgo, cuanto más protejas tu suelo pélvico, más estarás conservando tu calidad de vida.

Algunos ejercicios de pilates provocan una excesiva presión en el abdomen y hay que tratar de evitarlos cuando existen problemas de suelo pélvico

Esto no significa que no debas practicar pilates. Las mujeres en riesgo son las que tienen más razones para hacer ejercicio y mejorar el tono muscular general, pero siempre deber hacerlo bajo control y con instructores de formación garantizada. Algunos ejercicios de pilates provocan una excesiva presión en el abdomen y hay que tratar de evitarlos cuando existen problemas de suelo pélvico.

Cómo practicar pilates según la causa de la incontinencia

  • Problemas neuromusculares: Hay mujeres que tienen pérdidas de orina  y su problema no se encuentra en la calidad de los músculos del suelo pélvico, sino en el proceso de control neuromuscular. El sistema nervioso actúa como si se hubiera olvidado de esta estructura y aunque se encuentra en buenas condiciones no lo activa cuando debiera. Esto significa que si se realiza un programa de pilates correcto puede mejorar y corregir las condiciones de su suelo pélvico.
  • Debilitamiento de suelo pélvico: Cuando el problema está relacionado con una alteración en las estructuras musculares o con el tejido de sostén del suelo pélvico, los órganos del interior de la pelvis (vejiga, vagina  y recto) se encontrarán en una situación muy vulnerable cuando se produzcan aumentos de presión dentro del abdomen, por lo que debe haber un estricto control de qué ejercicios deben realizarse.

Algunas recomendaciones:

1. Antes de empezar hay que valorar cómo está tu suelo pélvico:
Si tienes incontinencia urinaria o estás en situación de riesgo, es recomendable que un profesional (médico o fisioterapeuta especializado) valore tu estado antes de iniciar las clases de pilates. Él te indicará qué tipo de ejercicio es más conveniente y en algunos casos te recomendará realizar otras técnicas antes de comenzar a practicarlo. A veces es difícil conocer qué grado de presión abdominal puede ser perjudicial, porque siempre estará en función de las condiciones en las que se encuentre el suelo pélvico, es decir, cuanto mejor se encuentre el suelo pélvico mayor presión abdominal podrá soportar y por tanto podrá practicarse cualquier ejercicio.

2.- Falso pilates y monitores reciclados:
Asegúrate de que lo que vas a practicar es pilates y no mantenimiento. Muchos centros ofrecen gato por liebre, y sus clases de pilates realmente son aquellas clases de gimnasia que existían antes de que el boom de pilates invadiera los gimnasios. Exige que tu monitor se haya especializado en pilates. En la medida de lo posible, elige centros cuya actividad principal sea pilates. Y, puestos a elegir, valora clases con pocos alumnos y las de máquina sobre las de suelo, porque permiten una realización de los ejercicios más controlada, evitando posibles lesiones. 

3.- Informa de tu caso al monitor:
Es normal que los monitores de esta actividad, al menos en  las clases de pilates con un número reducido de alumnos y centros especializados, estén informados y familiarizados con las lesiones o problemas que tengan sus pupilos. Pilates es una técnica que tiene en cuenta la musculatura del suelo pélvico en muchos de sus ejercicios, así que informa a tu monitor de que tu musculatura del suelo pélvico está debilitada para que lo tenga en cuenta y te recomienda qué ejercicios no debes hacer o hacerlos de otro modo para no lesionar el suelo pélvico.

4.- Automatiza la contracción del suelo pélvico:
Independientemente de que el monitor señale la contracción de suelo pélvico en un ejercicio determinado, acostúmbrate a compaginar contracción y respiración. Si siempre que expiras el aire contraes el suelo pélvico, acabarás interiorizándolo y cada vez que sueltes el aire contraerás la musculatura pélvica y contrarrestarás la presión abdominal.

Fuente: Dra. Carolina Walker 

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