Pelvic Health & the Gym

It’s more than just kegels, folks.

By Sarah Moore, PT | Pelvic Health Specialist, CORA Physical Therapy Edgebrook Pelvic Health

Pelvic health is often a taboo topic. But when one-quarter of women and more than 33 million people have some type of pelvic health disorder, it bears mention. Not only can those affected continue to exercise, they can utilize fitness activity to actually improve pelvic floor function. Improving pelvic health does not have to be complicated, and with a little insight, you can confidently and safely take pelvic health to the gym.

OOPS! AND OUCH!

Both men and women have a pelvic floor — the muscles, ligaments, connective tissue, and nerves that support the bladder, rectum, and other pelvic organs. With proper coordination and strength, everything opens and closes as it should. When pelvic floor muscles become weak or uncoordinated, however, leakage can occur. Whether it is urine, feces, or gas, we call this incontinence. Urge incontinence — sometimes known as an overactive bladder — presents as a strong urge to urinate despite the bladder not being full. Stress incontinence, on the other hand, is leakage that occurs when physical strain is placed on the pelvic floor. Simple activities like coughing, laughing, or lifting trigger stress incontinence, and more strenuous tasks of running or jumping can cause leakage as well. Neither type of incontinence should be considered normal, and a healthy pelvic floor minimizes leakage. In addition to incontinence, weak or poorly coordinated pelvic floor muscles can just as easily cause pain in surrounding areas. When a pelvic floor is weak, excessive pressure is placed on the low back, hips, or even the pelvic floor itself. This pressure causes pain, muscle spasms, or prolapse. Other times, compensation causes pelvic floor muscles to work too hard and results in weakness or unwanted muscle tension. When you restore proper muscle strength and coordination, however, these symptoms typically improve.

INSIDE THE GYM

KEEP BREATHING | Since holding your breath places excessive pressure on the pelvic floor, low back, and abdomen, coordinating breathing with the movement of exercise reduces strain and improves muscle function. Be sure to exhale on the “effort” part of the exercise. Using a squat, for example, you should inhale when the hips lower toward the floor and exhale upon standing.

MORE THAN KEGELS | While kegels are often the go-to exercise for pelvic floor dysfunction, exercises that engage the pelvic floor while the body moves are better. Wellfunctioning pelvic floor muscles need to contract and relax during movement. Strengthening and lengthening muscles with dynamic movement trains the pelvic floor muscles to respond at the speed at which you bend, reach, squat, and move. Start slow and work on coordinating breathing with various movements. Progress to faster or more challenging positions as control improves.

STRONG HELPERS | Strengthening your abs, low back, and hips can assist with pelvic floor function as well. Because these muscle groups coordinate movement with the pelvic floor muscles, improved strength leads to better pelvic floor performance with exercise and various fitness programs. Squats, lunges, bridges, and most core exercises target these muscle groups, and recruiting the pelvic floor muscles with these movements is even better.

PRACTICE RELAXATION | Pelvic floor muscles need to relax as much as they need to tighten. To relax the pelvic floor, assume a deep squat or child’s pose and relax the pelvic floor with breathing. Aim for deep breaths, a 360-degree expansion of the ribcage (think of an umbrella opening), and a downward expansion of the pelvic floor. Practice this type of breathing in static postures of sitting, lying, or standing, and progress to dynamic movement when control improves.=

OUTSIDE THE GYM

NUTRITION MATTERS | Spicy foods, chocolate, alcohol, and carbonated beverages — basically all of the fun stuff — can contribute to bladder irritation. If a person experiences incontinence, limiting “irritant” intake will help with overall fitness goals and promote bladder health at the same time.

STAY HYDRATED | While many with incontinence limit water intake to avoid extra urges to go, dehydration concentrates urine, makes it more acidic, and causes increased bladder irritation. Increasing water intake can actually decrease the urgency to use the bathroom. To see this benefit, figure half your body weight and drink that many ounces of water per day.

MAINTAIN A HEALTHY BODY WEIGHT | A lower body mass index (BMI) helps to reduce pressure on the pelvic floor and contributes to overall pelvic health as well. Since excessive pressure from adipose tissue strains pelvic floor muscles and leads to weakness over time, a healthy body weight promotes pelvic floor health. If you’re intentional about nutrition and exercise, you’re already on the right track.

PERSONALIZED TRAINING & TREATMENT

The good news is that pain or incontinence can often be controlled, and physical therapy can help. CORA Physical Therapy has physical therapists with special training in pelvic health who can work with you to strengthen pelvic floor muscles for proper function.

We teach patients how to coordinate their contractions, protect the pelvic floor (hint: don’t hold your breath), and incorporate relaxation techniques to promote optimal function with exercise and other activities of daily life. In fact, pelvic health muscle-training has proven to help cure or improve function for more than 80 percent of those suffering from pelvic health disorders. If you’re ready to get back to living your life free of painful or embarrassing urges, our trained pelvic health specialists can help. All it takes is a quick consultation at our convenient Edgebrook location in Rockford, and we’ll have you on your way. •