When a Client Leaks in Class: A Path for Fitness, Pilates, and PT Instructors

A client leaks during jumping jacks, a run, or a reformer set, and then looks at you. Many instructors have been there. You want to help, and you also do not want to step outside your scope.

Your job is not to diagnose or treat. It is to offer a pelvic floor routine she can feel, and to know when her questions belong with her clinician.

What you can do in the session

Pelvic floor training belongs in fitness, Pilates, and physical therapy sessions when it is taught as exercise. PfilAtes™ is a movement-based method created by board-certified urogynecologist Bruce Crawford, M.D. It uses Pilates-inspired movements, plus a short pulse, so clients can feel the pelvic floor work alongside the glutes, inner thighs, and deep abdominals.

Stay in your lane, and be clear about it. A useful line is: “That’s a great question for your doctor. What I can do is help you train the muscles that support your bladder.”

Pause and refer to a physician or a pelvic health physical therapist if a client reports pain, burning or frequent urinary infections, blood in the urine, a heaviness or bulging feeling, sudden new urgency, or leaking that keeps getting worse.

What the Instructor Course covers

The PfilAtes™ Instructor Course: Self-Paced Online is an 8-hour course for fitness instructors, Pilates instructors, physical therapists, and other health professionals who want to teach this method with a clear scope.

The course includes:

• Pelvic anatomy and neuroscience
• Pregnancy and pelvic floor disorders
• Exercise physiology, including VESy Lab videos that show pelvic floor activity during movement
• The ten PfilAtes™ movements and their variations
• Client materials you can use to assess and train, including a symptom questionnaire, bladder diary, and movement worksheet

It is self-paced and online, so you can work through the lectures and movement lessons on your schedule. Rated 4.50 out of 5 by 35 instructors who completed the course; 35 of 35 said the VESy Lab demonstration was helpful.

A way to start this week

The next time a client mentions leaking in a workout, you do not have to improvise a lecture. Teach one movement you can cue clearly, have her rate how strongly she feels it (0 none to 3 strong), and keep the medical questions with her clinician.

If you want a structured path to teach this in your practice, the Instructor Course is here:

https://www.pfilates.com/for-professionals