Can you imagine asking your female clients, “Do you pee your pants when you exercise?”
It can be both awkward and embarrassing for you both. The thing is, we need to talk about it. Did you know that up to 45% of women will suffer from urinary incontinence during their lifetime? So while I am writing this post aimed at my female audience, I would love to invite male trainers to read this too. Understanding the pelvic floor is a complicated and sensitive subject that many trainers either don’t understand properly or tend to avoid. If we approach the subject in the right way, we can bring the subject to forefront and educate both clients and trainers likewise in ways we can resolve the issue.
Urinary Incontinence is very common, BUT it is not normal! We need to be very clear about that. And although we associate the condition primarily with the elderly, you will find that many women suffer from leakage at postpartum, during menopause when estrogen is in a deficit and it also happens to men. It can happen when they exercise, laugh, cough, So seriously, read this post as I know you will know somebody who needs this information.
I have broken this blog into 4 areas, each one of these areas needs to be addressed in order to get your body working in sync, so that your pelvic floor can activate correctly. We will look at alignment, breathing, your inner core and then some at home exercises you can do, utilizing the DVRT Ultimate Sandbag for corrective and strengthening exercises.
Good posture is key to preventing injuries, having a pelvic floor that doesn’t leak, maintaining a strong, stable core, and being able to exercise safely. Before thinking of building strength, we need to understand how to optimally position the body to prevent injury down the road. If we don’t have a good posture this will often present itself in a number of ways.
- Posterior pelvic tilt, where bottoms are tucked under.
- Ribcages flared out or shifted backwards which means the core has a hard time developing any stability.
- Lower backs may be flattened, with glutes that are not engaged again preventing the body from attaining enough tone and strength throughout the core.
- During exercise anterior pelvic tilt sometimes occurs, where we see the bottom sticking out and the lower back hyperextending.
Mastering good alignment is the first step you should take before addressing other areas. So how do you do this? By thinking of your trunk as a bell! Have A Quiet Bell Think of your trunk as a bell. If the bell is sitting still, with the rib cage over the hips and the fly zipped up, the bell is silent. However, if the bell is rung up or down, you’ll have a noisy bell. Think of this noise as symptoms: soreness of the neck, low back or hips, or pelvic floor issues. (thanks to Jessie Mundell for this analogy)
- Bell rung up = ribcage flaring up.
- Bell rung down = ribcage rounded down.
This breathing exercise will help to relax the muscles of your pelvic floor where you hold tension. This is about allowing rather than doing.
Supine Breathing – (or Sitting on a Stability Ball)
The breath should follow a pattern of inhale through the nose for 4 secs, hold for 4 secs, then exhale for 8 secs through the mouth.
If sitting on the ball feel a tripod between the sitz bones and perineum. In both positions, one hand sits on the belly and one hand is placedon the side of the ribcage.
Cues to remember:
- Inhale to expand, and soften the pelvic floor.
- Exhale to contract the pelvic floor with non-aggressive contractions: contraction should be about 30% of our max. Visualise picking up a blueberry or a flaxseed.
Activation Of Your Inner Core
- pelvic floor
- an abdominal muscle (transversus abdominis)
- a low back muscle (multifidus)
The main players in the correct functioning of the pelvic floor are the above 4 muscles. If one of these muscles isn’t activating correctly, your pelvic floor may become dysfunctional. By paying attention to unifying these 4 muscles together by using breathing techniques and exercises to strengthen the core, we can help to retrain your inner core muscles to provide optimal support.
Pelvic Floor Strengthening Exercises
USB Bucket Hold Squat
The squat should be considered a basic human movement rather than an exercise. One of the first movements we do as babies is to squat, and if you think about it, it’s the most natural way for us to give birth or even go to the toilet. It might be some time since you have squatted, but that doesn’t mean you can’t or shouldn’t try. We are not talking about weighted squats here, or using the quads to power through an exercise, rather you should look to try to relax into in a sitting squat to try to add some length to the pelvic floor.
Hold the Ultimate Sandbag underneath with interlaced fingers, and slowly try to sit in a relaxed ‘potty squat’ for as long as is comfortable. If practiced regularly, over time this position will become easier as the squat helps the muscles and involved joints change their tension patterns. Play around with foot position too. If you find that you are limited in your movement towards the ground, try to angle your feet out to 45 degrees or widening your stance.
Holding the bag in this position will help to keep your back straight and supported, you will also get feedback from the bag which will add some extra weight to your pelvic floor as it is lengthening.
USB Dead Bug with Overhead Reach
A very safe and effective way to engage the CORE 4 muscle group, especially when working to correct an anterior tilt towards attaining a neutral spine. The best way to effectively perform this exercise is to slow the movement down – it will allow you to have greater muscle recruitment and really understand how your body creates stability and strength through the movements.
USB Bridge with hold
This exercise will strengthen the pelvic floor in conjunction with other muscles, and allow you to activate your CORE 4. Make sure to not hyperextend through the lower back, stop the exercise at the top of the movement when you feel the glutes engage. You will try to hold the bridge at the top of the exercise for the count of 5 secs, during this time try to engage the pelvic floor by ‘picking up your flaxseed’.
USB Side Plank with Iso Hold
Possibly the king of the plank exercises and one of the best ways to safely exercise the core and help support your spine. Holding the Ultimate Sandbag to create tension in the upper serratas and lats, while focusing on keeping the lower body active.
Over at The Fit Foodie Mama today, Annamarie is sharing her story about how she coped with Urinary Incontinence while training for her marathons. Go head over to her blog today and check it out.