Women were trying hard to improve their physical fitness, placing great trust in their personal trainers and fitness instructors. However, were saddened to hear they were not being properly guided on how to best recruit their pelvic floor muscles for exercise. I became aware of the gap in knowledge regarding the correct recruitment of the “core” of which the pelvic floor muscles are an essential component.
Pelvic Floor First was a brilliant choice to encourage the pelvic floor muscles to be well elevated in the pelvic cavity to counteract the inevitable increase in intra-abdominal pressure in fitness based exercise.
This repetition of intra-abdominal pressure and constant loading of an unrecruited pelvic floor has the negative consequence of pelvic organ prolapse and/or stress urinary incontinence.
Mandy (fictitious name) returned to her local gym 8 months after the birth of her third child. After 3 months of enjoying multi weekly gym visits Mandy presented frustrated that she still looked 6 months pregnant. Mandy experienced mild stress urinary incontinence and abdominal discomfort with exercise.
Mandy’s typical abdominal routine included sit ups which she enjoyed doing. Mandy performed these sit ups with her abdomen swelling outwards and on real time ultrasound observation her bladder descended downwards into her vagina.
Mandy was horrified that she had been working out for the past 3 months potentially developing a prolapse and worsening her stress urinary incontinence. She was upset that the fitness instructors had not corrected her poor technique and wondered why her pelvic floor muscles were not discussed considering she was recovering from the birth of her third child.