Exercising the Pelvic Floor

When I run workshops for women, fitness trainers and Physiotherapists, one routine test for participants is to feel what happens at their waist with strong coughing, then relate whether their pelvic floor lifts and holds or pushes down. Typically 50% of the participants relate their pelvic floor pushes down, instead of lifting in response to the quick rise of intra abdominal pressure. This uncoordinated muscle action between the floor and abdominal muscles is likely to continue with lifting and exercise, causing pelvic floor muscle (PFM) strain.  Some women display an altered abdominal muscle pattern with waist narrowing as they tighten their PFMs.

It is critical to identify women who have PFM control problems before they begin an exercise program. Traditional abdominal programs, some group classes, weighted machines and high level core exercises overwhelm the ability of a weak, uncoordinated pelvic floor to control intra abdominal pressure rises. These women must first identify and exercise the correct pattern of pelvic floor, core and abdominal muscle tensioning, before exercise progresses.

Carol attended a recent workshop I gave for the fitness industry.  She is an experienced fitness trainer, who recognised immediately her faulty 'waist sucking' pattern during exercise.  After a short session to help her relearn the correct pattern she managed to make fundamental changes by training her pelvic floor and core control without the sucking in waist action.  She realised how important this was for her female clients and later wrote to me saying, 

‘For many gym members, the focus is on exercise classes, personal training sessions and their own strength and cardio exercise.  How important it is to teach awareness of core muscle control throughout the exercise movements rather than just counting repetitions. Women will control and prevent PFM damage when they recognise for themselves, when to rest and re-set, go from high impact to low impact, reduce the weight they’re lifting, drop back from running to walking, and so on to maintain core stability. PFM health will be promoted when women learn their mind-body connection, practice pelvic floor safe exercises and develop core stability before progressing to strengthening exercises. ‘

Carol now realises it is not only the ‘at risk’ group, but all women who will benefit from an awareness of potential problems to the female pelvic floor with exercise training. A new website for fitness professionals www.pelvicfloorfirst.com.au aims to encourage pelvic floor safe exercises, so that people don’t experience unwanted side effects such as bladder and bowel problems. Put your pelvic floor first and stay in control for life.