How to know if an exercise is safe for your pelvic floor

There are few types of pelvic floor problems, men and women can suffer with.

The three most common are:

  • stress incontinence (commonly known as that “sneeze wee” where you laugh, cough, sneeze and you wet/poo yourself, or when you jump/run/lift something, leakage occurs),
  • urge incontinence (that urgency to urinate/defecate without warning), or
  • pelvic organ prolapse (sometimes asymptomatic, but you may experience a heavy dragging feeling in your vagina/rectum later on in the day or after bouts of activity, or movements you haven’t done for a while)

In today’s article, I’m here to help you:

  • understand which exercises are considered safe, and
  • which ones you need modifications for to make them safe/attainable

The problem with the pelvic floor and exercise is, depending on the type of disorder you have, it won’t necessarily tell you immediately that the exercise or movement you’re performing is good or bad.

Sometimes, it will give you instant feedback:

  • on high impact where you jump and you leak, yes
  • when doing something like a sit up, and you feel a bearing down/load/force being applied to the pelvic floor when doing the sit up too, yes

But, some of the patients I help with pelvic floor rehab, actually can run for a few miles without wetting themselves, then into the next mile, their pelvic floor lets them down.

Or, others can do a few sit ups, with good form, then forget to apply the breath strategies I’ve taught them previously, and as they start to fatigue into their set of reps – bingo – they feel it in their pelvic floor!

These are just two examples of instances where the movement or exercise the client is doing is unsafe for them to continue doing, until the pelvic floor has gained more length and strength into it.

I love a plan of attack me, and rather than saying “Don’t do this movement” or “Avoid doing these exercises” , I need you to understand that I don’t really like scaremongering.

And, to be fair, you probably already have enough other medical experts around you right now using words and phrases like those, so, my approach is simply this:

  1. Understand that leaking isn’t normal on movement or exercise – and you needn’t suffer in silence, so reach out to me,
  2. If you go to an exercise class at the local leisure centre/gym, taught by a non-pelvic floor trained specialist, you are likely to be faced with exercises that will put load on your pelvic floor – not all “Pilates” is the same,
  3. Avoiding movements that apply pressure to your pelvic floor needn’t be avoided per se – it’s more about understanding mechanically WHY the pelvic floor is letting you down here and backtracking a bit to find out HOW you can do the movement without leaking/feeling that downward pressure, and
  4. Modifications are key – doing an exercise that’s too intense for your pelvic floor over and over and over will not help strengthen it – you’ve got to start with the low options for a while to get that breathe/core synergy going on first.

The road to recovery when you have pelvic floor weakness is not dissimilar to building a house,.

Give your house a good solid foundation (a strong pelvic floor at the base) and your house can have many stories and floors loaded on it.

But, in construction, the foundations aren’t loaded from zero to a huge heavy weight – they’re applied slowly and surely, brick by brick.

So, applying this analogy to pelvic floor health is the same: start low intensity, learn and master the basics, and then start adding on further loads.

I hope that’s given you enough to understand that exercise most definitely is accessible when it comes to exercising with pelvic floor dysfunction.

Rosie Dhoopun is a Movement Teacher, Pregnancy and Postnatal Exercise Specialist and Pelvic Floor Rehab coach.

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