When it comes to training the pelvic floor muscles during pregnancy and after birth, I’m here to tell you, things in the ‘downstairs’ department in recent years have most definitely changed.
I use a full-body approach to rehabilitating pelvic floor dysfunction.
You can find out more about what techniques I use here
When I see a new client with front or back bottom issues, the first thing I ask them to do as they enter my treatment room is take off their shoes.
The next thing I invariably say is:
“No, no, DON’T sit on the chair! I’ll explain why in a moment. For now, let’s pop you down here instead…”…
…and I proffer her a a Yoga bolster or big pile of firm cushions to sit on on the floor instead.
She’s generally confused. But compliant.
I then let her lead the next 5-10 minutes of conversation, where I gather information and note down any relevant history of her pelvic floor symptoms.
I listen. I write. I observe.
By the time the verbal health screening segment is over…
…I’ve already done a pretty thorough physical client assessment (with just my eyes).
And, remember, all she’s done is
a) take off her shoes, and
b) sat on the floor.
Unbeknownst to my client…
….I’ve been busy observing my clients’ foot, leg, pelvic, breathing, upper body and neck mechanics.
She’s starting to become relaxed in my company now.
I’ve cracked a few jokes (winner winner chicken dinner).
I’ve built some rapport. I’ve instilled some trust.
She’s almost enjoying herself. (Ok, that might be stretching the truth a little.)
Depending on how long her symptoms have been evident, I’m realising I may be the first person who’s taken her seriously about her lady bits for a while.
Like the client who had her second baby 10 months ago, but had been suffering since her first baby was born…
…six years ago…(!).
You know that emoji with the bulgy horrified surprised eyes and elevated eyebrows?
I withheld that expression, and instead went for poker face instead.
So, it’s around about this point where you’re asking:
“Claire, why do you ask your clients to remove their shoes and sit on the floor?”
“Claire, seriously now – how can you honestly have made such an assessment in so little time?”
1. FOOT POSITIONING / GAIT
Gait = I clocked that as she walked in. Tick.
Foot positioning = how her feet operate ‘normally’ in gait has a direct impact on her pelvic floor function further up the chain.
If her feet are turned out (hopefully not as severe as Charlie Chaplin’s), I’d hazard a guess that when I align her feet correctly (I’ll have her stand up in a moment), her femurs will show up as internally rotated.
Her body’s ability to move and hold her femurs into external rotation (or more specifically ‘neutral’) actually stems from the deep obturator internus in the pelvic floor.
Are you with me yet? If these muscles are tight, those femurs are going nowhere but inwards.
2. PELVIC MECHANICS
When (or more specifically ‘how’) she takes her shoes off, I’ve assessed her hamstring and glute flexibility, hip mobility and watched how her pelvis behaves in this seemingly simple, every day task.
Whilst she’s sitting on the floor (on my carefully plumped up cushions), my eagle eyes are surveying how her pelvis ‘naturally’ sits.
(Normal and natural and neutral are 3 very different things, just to clarify)
How she approaches the floor indicates a tonne of way-off ‘neutral’ mechanical imbalances, and it tells me what her ‘normal’ patterning is.
And, if I can add one more thing, how she chooses to sit tells me a lot about the health of her hips, knees, ankles and foot joints too.
Sorry, can I add one more thing…?
How she chooses to sit could potentially tell me how tight her pelvic floor is too.
If she chooses to sit on the back of her pelvis (on my perfectly arranged throne), you, with an ounce of pelvic floor anatomy knowledge will realise that the muscle attachments, front and back (pubic bone and sacrum) to the pelvic floor are well – pretty darn close to one another there.
So, how’s your approach to pelvic floor rehab?
If you’re doing none of these things when you’re assessing clients – they’re the ones missing out, eh?
This is the full body approach.
My message here is simple: stop ‘spot-reducing’ your pelvic floor clients by only giving them pelvic floor exercises and/or pelvic-based movements to practise at home.
I haven’t quite had time to talk about breathing, upper body and neck mechanics, but I think you get the idea that it’s all connected!
It’s the body as a whole, functioning and/or dys-functioning unit we need to be looking at.
This is what my online Your Pelvic Matters Teacher Training is all about.
It’s a very different approach, for a very different result.
It’s non-traditional sure, but I’ve had clients lessen the symptoms of their pelvic floor by simply aligning their skeleton better, releasing muscles that feed in and out of the pelvis and strengthen the very muscles that should be holding us upright (hint: it’s not your quads).
If you’ve been prescribing ‘squeeze and release’ and ‘draw up and hold’ exercises to clients and seeing very slow progress…
…maybe it’s time you changed your approach too.
If you’re ready for this change, click here
The Your Pelvic Matters Teacher Training online program is a online CPD certification for exercise, fitness, movement, Yoga, Pilates, Personal Trainers, Physiotherapists, Chiropractors and Osteopaths already serving pregnant and postnatal women.
Not only will it address dysfunction in your clients – you’ll learn a tonne about your own body as you work through the content too.
Your Pelvic Matters is very much a program of discovery which will in turn improve your bedside manner dealing with clients with problems ‘down there’ because…
…you’ve been there and done all of the exercises yourself in the lead up to certification.
I look forward to taking you along this amazing journey so you too can have clients lessen their symptoms of pelvic floor dysfunction in as little as 4 days.
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