Hi there! I’m sorry I’ve been M.I.A. for the past few weeks! June has been a complete whirlwind for me so far: First, I landed a ghost writing gig, a 200-page book that needs to be completed in six weeks! (My full-time gig is ghost writing/editing books.) And on top of that, my boyfriend’s family came into town and swept us off to Santa Barbara as a special treat for his completing his MBA. Added to all of that excitement was my never-ending job of keeping my temperamental pelvic floor under control, and the end result was me falling terribly behind on many of the important things in my life.
Today I'm playing a bit of catch up, and to help me get back into the swing of things, my good friend from Downunder, Mary O’Dwyer, is weighing in with an informative blog entry. Mary is a physical therapist in Queensland, Australia who has dedicated her life to not only treating pelvic floor dysfunction, but educating other PTs on how to best treat PFD. I asked Mary to write about a topic that I am currently dealing with. One of my self-treatment strategies is regular chocolate intake. Unfortunately three years of self-treating with chocolate has amounted to about 15 extra pounds, most of which seems to have settled in and around my gut. Before hitting the gym, I thought I’d check in with Mary about the best way to get my waistline back. I’m concerned about abdominal exercises because I know how closely related my abs are to my pelvic floor.
Take it away Mary!
Thank you Bonnie! Like Bonnie, most women long for a flat stomach and toned abs. And according to the physical fitness community, all we have to do to obtain that goal is to do repetitions of exercises such as sit-ups, crunches, double leg lifts and so-called “medicine ball rotations.” But, what we’re not told is that each one of these exercises has the potential to harm our pelvic floors. Especially at risk are new mums, women who have undergone pelvic or spinal surgery, women with hypertonic pelvic floor muscles, unfit/uncoordinated, overweight women, and menopausal women.
Let me explain how common ab exercises can harm the pelvic floor:
For one thing, sit-ups, and many other common ab exercises, strongly increase pressure within the abdomen that pushes down on the pelvic floor. One role of the female pelvic floor is to tension and hold up the bladder, vagina and bowel against this downward intra abdominal pressure. If a woman has a weak, uncoordinated or ineffective pelvic floor, sit-ups will force the pelvic floor to bulge down promoting bladder urgency and vaginal prolapse.
Also, regular repetitions of these exercises focus on building strength at the waist in the “Rectus Abdominis” muscles and the “External Obliques,” and can result in an imbalance between outer and inner abdominal muscles. Women who over-exercise these outer abdominal muscles tend to lock their pelvic floor muscles. Holding the waist and pelvic floor muscles constantly tight may eventually cause the pelvic floor to become hypertonic. It’s this excessive tone or tension that can cause a full-blown pelvic floor pain situation.
So, despite popular exercise opinion, abdominals SHOULD NOT be worked in isolation. They are designed to work together in a coordinated pattern when we move along with the pelvic floor. Allow me to explain: With any movement, the pelvic floor, Transversus Abdominis and spinal Multifidus ‘tension’ as an inner cylinder, milliseconds before the outer Rectus Abdominis and Obliques ‘brace’ and hold or move the trunk. Abdominal exercises should encourage this pattern. However, sit ups and other common ab exercises, cause narrowing and hollowing of the waist, instead of bracing and widening with exertion.
For abdominal strength focus on this bracing pattern with
• Lying and seated stretch band exercises • Four-point kneel, opposite arm/leg holds • Balance work on a disc or wobble board • Pilates reformer and mat exercises • Pilates ring slow squeezes • Fitball holds with arm or leg movements
If you’re at the gym or in an exercise class a good rule of thumb is to: NEVER PERFORM AN EXERCISE THAT PUSHES YOUR PELVIC FLOOR DOWNWARDS AND BULGES YOUR TUMMY FORWARDS.