Pelvic Floor Safe Exercising (Re-blogged)
Michelle Kenway coined this term pelvic floor safe exercising back in 2009 and it is an important concept to embrace when exercising following childbirth and especially when you have had any gynae repair surgery or even following a hysterectomy. The term means that when exercising you need to protect your pelvic floor by avoiding certain abdominal exercises (sit-ups, double leg lifts) and lifting excessively heavy weights – when they are beyond the ability of your pelvic floor to support. And of course by bracing or engaging your low tummy, and pelvic floor muscles (vagina and anus for women, base of the scrotum and anus for men) prior to doing any exercises in the gym. More recently I am tending to use the phrase pelvic floor friendly to take the fear element away.
So whilst Pilates and Yoga have excellent elements to them it is critical to modify them to incorporate pelvic floor friendly concepts. Similarly, going to the gym, where you can increase muscle mass and undertake exercises to maintain bone density and improve cardio-vascular fitness, can also cause havoc if you are doing activities which cause unnecessary increases in intra-abdominal pressure (IAP) which can funnel down the vagina which acts like a hernia portal. This is when pelvic organs such as the bladder, uterus and bowel can prolapse and descend to even out of the vagina. I assure it isn’t a good look – having washboard abs but a significant prolapse ‘down below’. And yes men can have prolapse as well from lifting excessively heavy weights at the gym and they can develop over-active pelvic floor muscles like women can and it gives pain in the most personal area (scrotum, testicular and penile pain). These wrong sort of exercises especially boot camps have helped feed my family over the years……
So what can we do? Firstly if you’ve had a baby or gynae repair surgery, give your pelvic floor (and abdominal muscles if you’ve had a baby) a chance to recover post delivery or post-op. Take your time – it’s not a race to get fit – if you do it in a careful, measured, ‘paced and graded’ way then you won’t introduce ridiculous, downward forces which will cause lax fascia (such as the walls of the vagina) to descend.
Start your pelvic floor muscle training early post-natally but wait till your surgeon gives you the word post-operatively (for some it may be up to 6 weeks). Start with gentle walking, for short distances and increase as you feel stronger making sure you assess downward drag the next day before you increase the length of the walk and the intensity of the pace.
We have now commenced a Running Clinic at Sue Croft Physiotherapy to help women return to running if they would like. Jane Cannan and Amanda Lee will be conducting the clinic. Patients will be assessed, a video of them running on a treadmill will be taken and analysed and exercises and advice given to try and enable a return to running. Book an appointment here.