What is the pelvic floor?
It is the base of a group of muscles referred to as the core. The pelvic floor muscles run from the pubic bone to the tail bone. These muscles play an important role in bladder and bowel control, as well as sexual sensation and function in males.
1 in 3 women are affected by pelvic floor issues, even though it can be an embarrassing topic to bring up, please do speak up and discuss with your trainers. It’s important we prescribe the best exercises to help you. 60% of people with a bladder or bowel control issue do not seek help, I stress that you need to speak up as there are ways to significantly improve your issues. Why suffer in silence?
Core muscles are made up of four groups
-Pelvic floor – supports pelvic organs from underneath
-Multifidus (deep back) – helps take pressure of vertebrae so our weight can be distributed along spine
-Traverse abdominus/TA (deep abdominal) – stabilises trunk and pelvis, acts like a corset
-Diaphragm (below your lungs) – main muscle in respiration
How can you tell if you have a pelvic floor problem?
Common signs include
Light bladder leakage
Needing to go to the toilet in a hurry and not always making it
Constantly needing the toilet
Difficulty emptying your bladder/bowel
A prolapse – bulging, pressure or discomfort in pelvic area
Pain in pelvic area
Who is at risk of pelvic floor problems?
Women who have had a baby
Women going through menopause
Women who have had gynaecological surgery (hysterectomy)
Men who have had prostate cancer
Elite athletes – gymnasts and runners
You are more at risk if you have a history of back pain, have previously injured your pelvic region, have chronic coughing/sneezing issues, are overweight or have a BMI of over 25 and if you lift heavy loads frequently.
How do we engage our pelvic floor?
Just squeeze your pelvic region as hard as you can and pull a funny face right? Well no not at all it turns out.
It’s actually a subtle exercise. Squeeze your back passage about 30% and then pull through to your pelvic bone. Put your hands on your hips and make sure you don’t feel any other movement. It’s quite a small movement. For men imagine the feeling of walking into very cold water and trying to pull your balls up.
Go for 3 sets of 10 contractions daily, hold for 1-5 seconds. Rest for 5 seconds between reps. You can lay on your back with bent knees.
Core training will not help strengthen your pelvic floor muscles.
So you have pelvic floor issues but you want to get back in the gym, what exercises are safe?
As a rule avoid high intensity/impact exercises that place downward pressure on your pelvic floor. Also be aware of your pelvic floor, stop and change exercises if your pelvic floor feels like it’s dropping or pushing down.
Safe cardio exercises
Walking, swimming, seated cycling, cross trainer with low resistance, low impact group fitness classes and aqua jogging/aerobics.
Safe resistance exercises
Seated exercises or exercises where you lay down on a bench, seated swiss ball exercises, shallow forward lunges, shallow and narrow squats, floor bridge, standing balance work and wall/bar push ups. Also watch how much weight you are lifting.
If you really want to do boot camps or group fitness classes, arrive a bit earlier and grab the trainer and discuss your exercise regressions. Honestly they don’t mind, try not to be influenced by what others are doing around you. Concentrate on what you can do with good form, you know your body best, stop if something doesn’t feel right, speak up and ask for regressions.
Your trainer should also consider reps, sets, weights, technique, position and monitor your fatigue levels. Your heavier compound exercises should be done at the beginning of your programme.
A good standing posture to maintain during exercise is to stand tall, shoulders relaxed, chest open, arms by the side, neutral spine and breathe into your abdomen.
Notes on Rectus Diastasis – separation of fascia (connective tissue, mostly collagen) connecting abdominal muscles, this occurs in pregnancy and in overweight men and women. Fascia can either be torn or stretched.
If you have rectus diastasis please please tell your trainer. Things to remember early post partum, if its severe you can wear an abdominal brace, focus activating deep core and pelvic floor muscles, avoid abdominal twisting and roll to the side to sit up.
If you notice no progress within 2 months then ask your trainer to refer you to a pelvic floor physiotherapist.
If your symptoms persist or worsen its a good idea to seek out a pelvic floor physiotherapist.
For more information on pelvic floor on continence issues. Free help line – 0800 650 659 09 238 3172 firstname.lastname@example.org
Information obtained during pelvic floor workshop with Continence NZ in association with Exercise Ass of NZ and REPs.