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Tonight I was sending an email to the owner of my gym to draw him (and his great Goodlife Gym at Graceville) into the Pelvic Floor Safe exercising web and was trawling through all my blogs to link him in to one that succinctly summarized all the key points….and I realized there wasn’t one!?! How could that be? I mean I have mentioned it repeatedly as a concept in lots of blogs but there wasn’t a designated blog on this very important topic. And that is about to change.
Of course there is a fabulous book Inside Out by Michelle Kenway, one of my guest bloggers, and I can’t recommend this book highly enough. Michelle coined this term pelvic floor safe exercising and it is such an important concept to embrace when exercising following childbirth and especially when you have had any gynae repair surgery or even following a hysterectomy. The term means that when exercising you must protect your pelvic floor by avoiding sit-ups, curl-ups, crunches, double leg lifts and lifting excessively heavy weights. And of course by bracing or engaging your low tummy, vagina and anus prior to doing any exercises in the gym.
So whilst Pilates and Yoga have excellent elements to them it is critical to modify them to incorporate pelvic floor safe concepts. Similarly, going to the gym, where you can increase muscle mass and undertake exercises to maintain bone density and improve cardio-vascular fitness, can also cause havoc if you are doing activities which cause unnecessary increases in intra-abdominal pressure which can funnel down the vagina which we have already identified as a hernia portal. This is when pelvic organs such as the bladder, uterus and bowel can prolapse and descend to even OUT of the vagina. I assure it isn’t a good look – having washboard abs but a significant prolapse ‘down below’. These wrong sort of exercises especially boot camps have helped feed my family over the years……
female-six-pack-abs         Anterior wall prolapse copy
So what can we do? Firstly if you’ve had a baby or gynae repair surgery, give your pelvic floor (and abdominal muscles if you’ve had a baby) a chance to recover post delivery or post-op. Take your time – it’s not a race to get fit – if you do it in a careful, measured, ‘paced and graded’ way then you won’t introduce ridiculous downward forces which will cause lax fascia (such as the walls of the vagina) to descend.
Start your pelvic floor muscle training early post-natally but wait till your surgeon gives you the word post-operatively. Start with gentle walking, for short distances and increase as you feel stronger making sure you assess downward drag the next day before you increase the length of the walk and the intensity of the pace.
There are ‘pelvic floor safe’ exercises in the back of both of my books which you can gradually add to your rehab programme – because that’s what it should be – a rehab programme. If you ‘did’ your knee at netball or skiing then you wouldn’t jump back on the netball court or skis and perform at the highest level at 6 weeks post knee reconstruction. You would have a careful programme mapped out for you by your surgeon, physio and PT and similarly that’s what should happen in those crucial early days after a baby or an operation.
But if you have not just had a baby or an operation, you still have to be very careful – walking on a treadmill, cycling, airwalkers or cross-trainers, light weights, narrow-base lunges, swiss ball work and there are lots more you can safely do – just remember that prolapse is affected by gravity and ultimately if you keep pushing and bearing down hard with the wrong sort of exercise it will come out.

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