If you’ve always wanted to know what types of exercises I prescribe to my pelvic floor dysfunction clients for homework and why, today you’re in for a treat.

 

I’ll be featuring 3 clients that I’ve worked with over the last 12 months, all who have had success at different times, but mostly pretty quickly, simply because I set them the right things to do at exactly the right time.

 

Have a read, and if you want any clarification of any of the exercises – just ask!

 

CLIENT 1

Client one is a pregnant client presenting with stress incontinence at 20 weeks who’s been coming to my pregnancy Pilates classes since 14 weeks.

 

She noticed an increase in the incidence of “sneeze wee” now she’s getting a little further along, so enlisted my help one-on-one.

 

MAIN FOCUS:

After assessment, my main focus for this client was glute activation and glute strengthening.

 

She appeared to have not a lot of connection to her butt (read that as: her glutes have been on holiday for a few decades!) so we set to work doing some squats, released out her dominant quads and hip flexor stretching.

 

Her foot mechanics were already pretty good because she’d been practising that from my pregnancy Pilates classes.

 

RESULT:

She saw a decrease in her symptoms after 3 weeks of seeing me one-on-one by doing just 5 exercises as homework.

 

Next up is to focus on labour prep as she enters her third trimester.  Yay!

 

CLIENT 2

A 16-week postnatal client (third baby) with diastasis recti and stress incontinence with no previous exercise history with me.

 

MAIN FOCUS:

Her pelvic floor.  In fact, she’s one of the few clients that crossed my path recently who were more concerned about the aesthetics of her “mummy tummy” than the fact she’ll probably continue wetting herself every time she runs after her toddler, unless she makes some changes.

 

When a client presents with abdominal separation AND pelvic floor dysfunction, I always prioritise the pelvic floor because that’s the quality of life stuff right there.

 

 

On assessment, I noticed this client had a tendency to stand with her weight thrusted forwards, her feet were quite turned out, and she had one tight and weak ar*e!

 

So, for homework, I prescribed her standing posture, posterior chain mobilising and lengthening, lateral hip strength work (specifically monster walk), education on foot mechanics, and a discount code for Vivobarefoot shoes.

 

RESULT:

This client emailed me 4 days later to say she saw an improvement in her stress incontinence symptoms “by doing her exercises religiously” (I have some diligent clients, eh?).

 

Oh, and she returned to her next appointment wearing a shiny new pair of Vivos!

 

CLIENT 3

Next up is a 16-month postnatal client (second baby) with stress incontinence and no prior exercise history with me.

 

MAIN FOCUS:

On assessment, this client had eye wateringly tight hamstrings, a posterior tilted pelvis (no surprises there!), and her job meant she was on her feet for 80% of her shift and 20% was seated at a computer.

 

So, I set her calf and hamstring stretching to do as homework, taught her how to sit and stand better, and educated her about the connection between tightness in the foot and tightness in the pelvic floor.

 

RESULT:

This amazing lady can now finally do things like run to the car to avoid a rain shower (and not leak!) after working with me for just 4 months.

 

I’d say that’s a pretty cool example of someone embracing the full-body approach and not even realising this stuff was working until her system was really put to the test.

 

She told me she rain to the car with her husband, and it wasn’t until she sat down that she said to him: “Oh, well, whatever Claire has me doing is clearly working, because normally I would’ve leaked then!”.

Your Pelvic Matters

 

How cool is that?!

 

Have you checked out my Your Pelvic Matters online Teacher Training program?

 

YPM focuses a lot on foot mechanics, upper body and plenty of releasing of the pelvic muscles (just like the clients I’ve showcased above).

 

If these areas are gaps in your training, add your name to the Your Pelvic Matters waiting list below, where you too can find out how I address pelvic floor dysfunction the full-body, biomechanics way!

Ever wondered why some clients get results with Kegels, and others don’t?

 

Do you have a particular client on your books at the moment, and no matter what exercise or approach you try with them – NOTHING is working?

 

In this video, I talk you through several reasons why Kegels aren’t suitable for clients with pelvic floor dysfunction. 

 

 

No one exercise alone will “fix” stress/urge incontinence, pelvic organ prolapse or pudendal nerve issues.

 

A lot of what I do with clients that’s unique to the pelvic floor dysfunction world is that I assess ALL of the muscles that feed in and out of the pelvis for function.

 

And, when you learn what’s tight, weak and not firing well, chances are, you’ll make a difference to your clients pelvic floor function too!

Your Pelvic Matters

 

Check out my Your Pelvic Matters online pelvic floor Teacher Training program where you can find out how I address pelvic floor dysfunction the full-body, biomechanics way!

 

Want to know WHY the gluteals are such an integral part of pelvic floor rehab?

 

Do you have some clients who’ve been doing Kegels religiously, but they’re not seeing ANY change in their symptoms?

 

Well, perhaps a different approach is required!

 

I’m here to share the reasons why I believe strengthening the gluteals should form part of every pelvic floor rehab program.

 

 

Do you want to prescribe less Kegels to clients with pelvic floor dysfunction?Your Pelvic Matters

 

Do you want to update your skills to a more full-body, biomechanics approach?

 

Click here to find out more about Your Pelvic Matters online pelvic floor exercise Teacher Training program, where you too can help rehabilitate clients both male and female top to toe!

Are you focussing on foot mobilisation, or even addressing foot mechanics with clients with pelvic floor dysfunction?

 

If not, you may be missing a huge piece of the puzzle in your quest to rehabilitate clients with stress/urge incontinence, pelvic organ prolapse and pudendal nerve issues.

 

Here, in this short video, I spell out the reasons why teaching clients basic foot mechanics AND why advising them on the wrong types of footwear can really hinder their pelvic floor’s performance.

 

Would you like to learn more about how tightness in the foot affects pelvic floor function?Your Pelvic Matters

 

Want to update your skills to a more full-body, biomechanics approach?

 

Click here to find out more about Your Pelvic Matters online pelvic floor exercise Teacher Training program, where you too can help rehabilitate clients both male and female top to toe!

In pelvic circles in recent years, there’s a phrase that’s been banded about that I personally don’t agree with and it’s “Squats are the new Kegel”.

 

Nothing will replace the Kegel as an exercise in its own right and you can hear more about my thoughts on this matter here in this video:

 

 

Whether squats replace the Kegel as an effective exercise for rehabilitating clients with pelvic floor dysfunction is very much debatable too.

 

No one exercise will “fix” stress incontinence, just like no one movement will mobilise the spine, lengthen the hamstrings or train the core better.

 

Oftentimes, clients sadly want a “quick fix” nowadays, and it’s sort of unfortunate that Kegels are sometimes the only option given to some men and women when it comes to PFD.

 

One thing’s for sure though: the squat in isolation isn’t going to solve the mystery, just like any other exercise when performed in isolation is.

 

A lot of what I do with clients that’s unique to the PFD world is that I get my patients to make lifestyle and habit changes to the way they move, lift, carry, walk, stand, sit – so you can see it’s less about “exercise” and doing sets of squats, and more about making conscious decisions to improve the function of not just their pelvic floor, but their whole entire body as they go about their day-to-day lives.

 

And, when they learn to squat better, chances are, there are a tonne of those performed in various ways from dusk to dawn – which in turn fires up that pelvic floor musculature!

Your Pelvic Matters

 

Check out my Your Pelvic Matters online pelvic floor Teacher Training program where you can find out how I address pelvic floor dysfunction the full-body, biomechanics way!

 

claire-44-2-copy-copyHi!  I’m Claire Mockridge, a Pre/Postnatal Fitness Expert who’s worked with over 1,000 pre/postnatal women.

 

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 the 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 big pile of firm cushions to sit on on the floor instead.

 

She’s generally confused.  But compliant.pelvisfloorside

 

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:

  1. taken off her shoes, and
  2. 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).5_women_laughing

 

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 has 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 now you want to ask:

 

“Claire, why do you ask your clients to remove their shoes and sit on the floor?”

 

And:

 

“Claire, seriously now – how can you honestly have made such an assessment in so little time?”

 

Keep reading…

 

FOOTWEARvibrams

I’m like a ninja (but without the ninja shoes, although these Vibrams fivefingers are pretty close, eh?).

 

I’ve already covertly glanced at her shoes (and written down ‘footwear education’ in my notes).

 

Why?  Well, I check to see if said shoes have a heel; how narrow fitting they are; and/or if they’re a shoe like a flip flop or ugg boot that makes the foot a) do far too much work to keep the damn contraption on the foot in the first place, and b) doesn’t allow the foot to move through its natural range of motion.

 

Tension and tightness in the foot (through incorrect footwear) in a lot of cases, shows up as tightness and tension in the pelvic floor.

 

So, if her foot is immobile and the nerves that feed each little wiggly toe have been shut off for decades, well, that will affect how her ankles, knees and pelvis (and pelvic floor) operate too.

 

 

And, all of the muscles that attach to dem bones, dem bones, dem, dry bones too (hear the word of the lord!).

 

Any heel, and I mean any heel on any shoe pitches your bodyweight forwards over the forefront of the foot.

 

So, now your centre of mass is NOT back in the ankle where it should be, but it’s applying unnecessary load to – you guessed it – your already immobile forefoot and toes.

 

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.

 

feet-showing-natural-turn-out

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.

 

PELVIC MECHANICS

When she takes her shoes off, I’ve assessed her hamstring 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 ‘natural’ 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.

claire-42

Sorry, I realised I haven’t finished.  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 to the pelvic floor are well – pretty darn close to one another there when the pelvis is in this position.

 

Pretty cool, eh? (Not the tightness bit of the pelvic floor there obviously – a tight muscle is a weak muscle and that’s not good!)

 

How’s your approach to pelvic floor rehab?

 

If you’re doing none of these things when you’re assessing clients – I’m sorry to say, but they’re the ones missing out, eh?

 

This is the full-body approach, guys.spine_side

 

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 that we need to be looking at.

 

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 in as little as 4 days 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!

 

Not only will you you address dysfunction in your clients – you’ll learn a tonne about your own body too.

 

My approach is very much a program of discovery for fitness, exercise, Yoga, Pilates and Personal Trainers who are already serving pre/postnatal clients…

 

…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!

 

CLICK HERE TO FIND OUT MORE

 

Claire Mockridge

Ante/Postnatal Fitness Expert

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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 and it all starts with the foot.

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 Yoga bolster or big pile of firm cushions to sit on on the floor instead.

She’s generally confused.  But compliant.

Read More

So, I was having a chat to 2 postnatal clients after Mummies and Buggies this week, and quite honestly, their postnatal recoveries could not be different from one another.

One client had a pretty straightforward delivery, is feeling fabulous and asked me:

“When am I no longer postnatal, Claire, because I went to a class the other day at my gym and wasn’t sure whether I should say something to the instructor or not…”.

The second client had every intervention possible to get her baby out of her naturally, she has pelvic floor dysfunction, she is desperate to lose her baby weight.

Knowing that she has stress incontinence on impact, I asked what other exercise classes she’s doing and she said:

“Well, I’ve signed up for this other postnatal class, and Claire…I think some of the moves are a bit too hard for me really…so, after week 2, I had to mention it to the instructor that I can’t do burpees…and I can’t run or do sprints and stuff…”.

…and, obviously I’m trying NOT to make that emoji with the big bulging surprised eyes, but I just couldn’t.

Both clients are getting close to the 6-month after birth mark, but seriously – their postnatal recovery experiences are poles apart.

Every pregnancy is different, and therefore I view every postnatal person’s recovery as very individual too.

This is how you should see clients also, in my professional opinion.

Read More

I checked a client’s abdominals for abdominal separation before my Mummies and Buggies postnatal indoor buggy class there last week, and it occurred to me that sit ups aren’t a great thing for mums with a tummy distension to be doing.

And, I appreciate this probably isn’t groundbreaking news to you, but just hear me out, alrighty?

This particular client has a toddler, and her new baby isn’t just one, it’s twins, so she’s got her work cut out for her here, hasn’t she?

ab sep rec check cropped photoI detected a bit of a separation (just over 2 finger widths, but I must point out my fingers are quite narrow), and I was relatively pleased with the tension in her linea alba when I tested it.

You know sometimes you dig your fingers around for DR (diastasis recti) and you get that squishy, non-grabbing sensation at the separation site itself?

Yeah, that’s not such good news, and when it comes to closing the gap – I’m little less interested in the gap itself, and much more focussed on the tensile strength of things going on here.

The client and I continued to chat, and when we were done, how did my client instinctively get up off the floor from supine/bent knees?

That’s right – she just automatically sat up to carry on talking to me.

Is it best to avoid a forward flexion with a separation present?

Well, keep reading to find out more:

Read More

Following on from my earlier blog – Can You Lessen The Chances Of Your PREGNANT Clients Getting Abdominal Separation Part 1?

Well, here are the final 2 ways pregnant women can deform their linea alba.

You’ll obviously want to educate them about all of these:

4) CROUCHING TIGER, TWISTED PELVIS
Maybe your client has been relatively active, but they have a pelvis that’s slightly twisted to the right, and a ribcage that’s slightly shifted to the left?

This means their umbilicus s no longer exactly in the centre.

If you think about the fabric t-shirts are made from – sometimes, you can pull and stretch it in certain ways much better than others, and it bounces back evenly.

It enjoys being pulled one way, but when you try and stretch it from another angle, it doesn’t pull so easily, does it?

There’s only so much tugging the linea alba is going to tolerate too, so getting the pelvis and ribcage better aligned is your job as their prenatal instructor/bodyworker.

Read More


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