How to get back to exercise and protect your pelvic floor at the same time

 In Womens Health

Pelvic Floor

In my previous blog ‘Is crossfit bad for my pelvic floor?‘, we spoke about things to watch out for when you are exercising and how to know when something is too much. Now that you have this information, it is important for you to know how to get back into things. The important thing to remember is that everything is individual. This is not a step by step guide, the best way to get that is by having a thorough assessment done and a plan put it place by your physiotherapist. This blog will include some tips to keep in mind as you get back to exercise and how to do so safely.

Build into it gradually

When you are getting back into exercise after a baby, or after injury, or just after a break in general, fight the urge to go back to the weights you were doing previously. It can be frustrating because it feels like it takes a long time to build strength, yet it drops so quickly with a break. You are not alone. Focus on starting with low weights, and perfect form. Ensure you feel ok body wise and pelvic floor wise during the exercise, afterwards and the next day. After doing the same weights for a couple of sessions, with no pelvic floor symptoms (leaking, dragging etc) or pains, increase your sets, or reps, or weights. If you do something and notice a heavy sensation in your vagina afterwards, or leaking,or it just doesn’t feel right, have a lay down flat, rest that day, and take the weights down a bit when you next go back. Certain exercises will put more pressure on your pelvic floor such as heavy weighted exercises, or overhead exercises, so you may start these a few weeks after you commence your program.

Focus on starting with low weights, and perfect form. #performbetter @pogophysio Click To Tweet

Breathe, breathe, breathe

How our pelvic floor contracts is influenced by our breath. Our “core” is made up of four muscle groups including the transverse abdominus, pelvic floor (levator ani), multifdis and diaphragm. The diaphragm is what aids the inhale and exhale of air in and out of our lungs. If you hold your breath, it is difficult to maintain a pelvic floor contraction and it increases IAAP, therefore placing a downward pressure on your pelvic floor. Ensure that you inhale and exhale to help spread the load throughout all the muscles of your core.

Contract your pelvic floor whilst you perform the exercise

During exercise, our pelvic floor should naturally contract. However, thinking about it and consciously contracting the muscles helps to increase the contraction and support it is providing. By thinking about “closing your anus, closing your vagina and lifting” this helps to contract the pelvic floor which will then spread the load from intra abdominal pressure. It is a tricky thing to do, much harder than it sounds, and you also have to make sure not too contract to hard and squeeze your buttocks or thighs instead of the deep muscles of your pelvic floor. Do not be hard on yourself if you don’t get this instantly, it takes practice.

Strengthen the lumbopelvic region

Do exercises which strengthen your glute max, glut med, deep hip rotators, core muscles, hamstring, back muscles etc so when you get into heavier lifts, you are using all the muscles to help. Exercises that strengthen your stabilising muscles (glut med, deep core) are good because they help with your form and they ensure the load is spread throughout your body, instead of simply going downwards onto your pelvic floor. If someone is trying to increase their exercise loads, I ensure that I also address their stabilising muscles. This helps to really perfect form and make sure the correct muscles are working when you do exercises.

Listen to your body

If something is too much, drop the weight, If you are too fatigued, stop! There is no badge of honour for going so hard that you cause a prolapse. There is no badge of honour for going back into exercise so quickly that you pee your pants. If you cause damage that is irreversible, it will be something you will deal with for the rest of your days. So just think, is that squat PB worth it, or should you spend a couple more days working at the same weight and feel comfortable with it before you go up.

If something is too much, drop the weight, If you are too fatigued, stop! #performbetter @pogophysio Click To Tweet

Emily Georgopolous (APAM)

 Emily Georgopuolos Physiotherapist

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