Your pelvic floor and barbell workouts

Barbell workouts are great for developing muscle strength and endurance and this form of resistance training is effective in maintaining bone mass as well being an enjoyable form of weight training.
This type of workout can be easily modified to cater for people who have pelvic floor issues or are in the risk category.
Top 5 modifications to make when participating in a barbell workout are:

1. Narrow stance for squats and lunges. Avoid wide stance positions for squats, deep squats or lunges. In most classes the instructor will indicate to squat to 90 degrees at the knees. Avoid going down this low and bend the knees less. Also reduce the weight carried on the shoulders as this load will also place pressure on the pelvic floor.
2. Breath holding. This may happen when there is a heavy weight being lifted, or just due to concentration. Try to focus on breathing out when lifting the weight and inhaling in the lowering phase. Another way to think about it, is to exhale on the exertion phase.
3. Plonk the plank. The plank or hover is designed to strength the core and this is great opportunity to focus on Pelvic Floor First. Initiate the exercise by first focusing on lifting the pelvic floor whilst thighs are still in contact with the floor. Do this for a maximum of 10 seconds and then rest. If this can be accomplished with confidence, then progress to lifting onto the knees. The truth is, that if you have pelvic floor issues or are at risk, a full plank on the toes is not recommended.
4. umping lunges and power jumps. These exercises are slowly making their way into a class that traditionally has always been relatively stationary. These are NOT recommended to perform. Low impact alternatives are a must and even explain to the instructor that you will not be doing these exercises during the workout.
5. Over head shoulder presses and tricep extensions. Exercises performed above the head places much more pressure on the pelvic floor and leaking is more likely to occur. Options are to reduce the weight, or perform a forward, lateral or rear shoulder raise with dumbbells. Alternatively for triceps, a bent over or supported (on the step) tricep kick back would be preferable.

The idea of modifying a workout can sometimes be intimidating for most people, as there is a concern with standing out in the crowd. Nothing could be further than the truth. As an instructor, my clients modify the workout for all sorts of reasons and injuries and I would prefer that they took the responsibility for their health rather than relying on me to provide modifications for every injury and issue for every exercise – now that would make someone stand out.  Remember, that this is your body and your workout, so own it and always remember Pelvic Floor First.

How to modify ‘the abdominal curl’ to keep your pelvic floor safe?

Here is a scenario: You are in a group exercise class and the instructor has asked the class to lie on their backs in preparation for the abdominal curl. You know that you have a separation in your abdominal wall or this exercise always makes you feel that need to go to the bathroom. What do you do?

Working at an appropriate level for you supersedes any ambition to keep up with the class or do the same thing – every time. It makes sense that you are exercising for your body, not someone else’s so keep this in mind when you are modifying exercises.  Protecting your pelvic floor is more important than how many abdominal curls you can do and there are no prizes for incontinence which can develop if you don’t put your pelvic floor first.

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Step was first designed by Gin Miller whose primary goal was to develop a low impact, cardiovascular workout that was safe for knees and other injuries. Since the early 1990’s, this class format has changed considerably, including the speed, intensity and impact. Below are 4 guidelines to assist you during a typical step class to ensure that your pelvic floor is not compromised.

1.  Decrease the impact. Step was traditionally a low impact program and there are many that still are, but there are also step workouts where leaping and jumping are a primary way of developing intensity. Power jumps on the step can be simply eliminated by just performing the step action without the jump. Leaping along the length of the step can be negotiated by either standing behind the step and stepping in to the centre of the step and off on an angle or by turning the step around so that you are stepping across the width of the step.
   Any jumping off or onto the step should be avoided. Instead, perform a stepping up and down action as a substitute.
2.  Rhythm changes. This is when the stepping action is a skipping action, or it is a slow and quick stepping action rather than the constant stepping up and down action. These moves can be variable regarding the level of comfort for the pelvic floor, but if there is concern, perform either the same move without the rhythm change or march on the floor to substitute the movement pattern.
3. Arm actions. Adding upper body movements will certainly elevate heart rate but it can also add more load on the pelvic floor. If this is the case, a simple modification is keep the arms below should height or simply remove any excessive upper body actions.
4. Lower step height. Step workouts were designed so that the individual could choose which height was appropriate for their individual fitness levels. Depending on the make of the step, you will have a choice of 3 heights which you can also modify during the workout. If you are unsure on how to change the height – some steps look like Lego pieces, as the instructor as they will be able to show how you can simply shift the blocks to decrease the height. The recommendation is that the lower the step height, the less pressure on the pelvic floor. If you in the high risk category (pre or postnatal, pre or post-menopausal or starting exercise) chose the lowest possible height.

Step workouts are fun and different from most other workouts because you have your own personal space on and around your step and are a great workout. Implement the alternatives above and enjoy a pelvic floor safe workout.

The pelvic floor muscles as part of the ‘core’.  

Muscles play a key role during exercise, but did you know that there are a hidden group of muscles called ‘pelvic floor muscles’ which need special attention?      
Pelvic floor muscles form the base of the group of muscles commonly called the ‘core’. It’s a group of muscles in your pelvis that stretches like a trampoline or hammock – the pelvic floor muscles (PFMs). These are the ‘floor of the core’. Your core muscles are the deep muscle layers close to the spine that provide structural support. The PFMs stretch from the pubic bone (at the front) to the coccyx (tail-bone) at the back, and from side to side These muscles work with the deep abdominal (tummy) and back muscles and the diaphragm (breathing muscle) to support the spine and control the pressure inside the abdomen (diagram 1).  The pelvic floor muscles play an important role in bladder and bowel control, supporting the pelvic organs and sexual function in both men and women.

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How to modify ‘the plank’ to keep your pelvic floor safe?

Here is a scenario: You are in a group exercise class and the instructor as asked the class to move into a plank (on the floor on elbows and toes and lifting up the rest of the body). You know that you are in a high risk group (see attached article) or this exercise always makes you feel that need to go to the bathroom. What do you do?

Often participants in a group exercise setting feel obliged to do all the exercises that the instructor dictates and sometimes to the determent of their own health and wellbeing. A group exercise class is designed to cater mainly for healthy non injured participants. Sometimes there are modifications offered, but quite often the instructor is not fully qualified to provide all the options that would be appropriate for each participant. It is after all, a group session and not a personal training workout.
Often participants will not realise that they are expected to modify exercises to suit their individual needs. Knowing that you are empowered to make good decisions for your body opens up more class options as you are not limited by classes that are specific to your needs.

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The allure of high impact workouts is the energy expenditure and the pure joy of bouncing around – like a teenager, but for some of us, our pelvic floor is not like it was when we were a teenager. For a lot of women, it is a matter of going to the toilet before the class, not hydrating well, racing off to the toilet during the workout or simply resigning to wearing pads.
These workouts can still be enjoyed, but with Pelvic Floor First in mind and while you are working on improving your pelvic floor strength with regular specific exercise for this muscle, the following guidelines will assist you with making the right exercise choices that will not compromise you further.

1. Jumping jacks – jumping your feet out wide, will certainly cause discomfort. The alternative is to do side taps, which can be low and stretched out to either side to maintain intensity. The other option is to have feet together and squat and stretch arms up in a ‘jumping motion’ without actually lifting the feet off the floor. Performed quickly, this will elevate heart rate and also work the thighs leak free.
2. Running or jogging – This is particularly challenging on the spot, whereas moving forward seems to not be as stressful, and going uphill easier. Regardless, marching with high knees to better and power walking more effective at reducing load.
3. The kick – This can be performed to the front, side or back and again, on the spot is very tough on the pelvic floor. The alternative is to lift and kick the leg without the bouncing action. Again, this can be intensified if an alternate arm action is also incorporated.
4. Hopping or wide leg knee lifts – The option with hopping is an alternating low impact leg curl action, where you lift the heel to the buttocks, and the wide leg knee lifts can be modified to narrow leg knee lift. These moves are recommended to be performed without the bouncing action that often is performed at the same time.
5. Low Impact is not low intensity. It is a common myth that low impact, which is when there is no bouncing, is low intensity. This is not true as low impact can use larger muscle groups of the thighs and buttocks more effectively. You simply need to lower the body more towards the floor with each move by bending the knees little more.

High impact exercise is wonderful when you are leak free, but when you are compromised or in risk of weakening the pelvic floor, the outcome can be embarrassing and uncomfortable. Enjoy your workouts by simply applying the suggestions above and have a great workout.

Pelvis proof

A weak pelvic floor is the reason why a third of Kiwi women are incontinent, especially after given birth. Marietta Mehanni’s modified resistance workouts will help whip you into shape if you have a weakness in this area

Why all the fuss about pelvic floor?
When we think about our ‘core’, the first thought that usually springs to mind is the muscles in our torso. What is often unknown or misunderstood, is the major part the pelvic floor plays in effectively controlling the core and
In supporting several important bodily functions.

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Aquacise Your Pelvic Floor

By Dianne Edmonds and Marietta Mehanni

“Lower back pain is also strongly linked with pelvic floor weakness and there is certainly an awareness that aqua aerobics provides a safer choice of fitness program for these individuals.”

Introduction
Many people that want to continue exercise without the implications of impact, joint stress, post exercise muscle soreness and overheating issues will prefer to exercise in water. This cliental group is usually, also the population group that are challenged by pelvic floor issues. It is well known that mature adults and certainly menopausal or post menopausal women would also prefer to exercise in water because of the issues with ‘wetting themselves’ during land based exercise. Pregnant women and obese clients would also prefer to exercise in water for the obvious reduced impact benefit, but also because the pelvic floor is more protected in water. Lower back pain is also strongly linked with pelvic floor weakness and there is certainly an awareness that aqua aerobics provides a safer choice of fitness program for these participants. It is clear, then, that aqua aerobics has not only massive appeal for these population groups for the benefits of exercising in water, but also because of the potential pelvic floor issues that they will face with land based exercise. This provides aqua aerobic instructors with a huge opportunity to provide much needed education, information and instruction on what is the pelvic floor and how to use it during the workout.

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