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The Fitness Zone

Pelvic Floor Rehabilitation
May 28, 2013 | by Christine McCormack

Millions of Australians are suffering in silence with issues surrounding incontinence says Christine McCormack, Australian Institute of Fitness WA Fitness and Massage Coach, and fitness professionals are perfectly placed to assist some of these sufferers with pelvic floor rehabilitation.

Given the high statistics on the number of sufferers (4.8 million, with 3.8 million of them women), it is important for Personal Trainers to gain an understanding of correct pelvic floor activation techniques and both safe and high-risk exercises for at risk clients.

Type of Client

Clients at risk of pelvic floor dysfunction range from pregnant women, women who have given birth, menopausal or post-menopausal women, both men and women who have undergone pelvic surgery, and elite athletes. Others at risk are people with chronic back pain, overweight and obese clients, people with a chronic cough or condition and anyone having suffered a pelvic injury.

Symptoms

Symptoms from pelvic floor dysfunction range from urinary and faecal incontinence, urgency to urinate and inability to control flatulence.

Pelvic Floor Muscles

The muscles of the pelvic floor are no different to any other muscle in the body. They require correct activation to function as they should and if damaged or stressed require the correct rehabilitation program. The pelvic floor forms the base of the core, spanning from the coccyx to the pubic bone and ischial tuberosity to ischial tuberosity. Their role is to support the pelvic organs, assist in the control of urination, defecation and flatulence; they are important in sexual function and assist with spinal support and the maintenance of Intra-abdominal pressure.

Exercise Program

As with any rehabilitation program the first step is for the client to identify the sensation of the correct muscle activation. Clients having trouble with identifying correct activation of pelvic floor muscles should be referred onto a continence advisor. Once the client has identified the pelvic floor muscles, a strengthening program must follow.

A gentle contraction drawing the pelvic floor muscles upwards into the pelvis should be followed by relaxing the muscles allowing them to recover for the next contraction. With the client placing the index fingers about 2cm inwards from the Anterior Superior Iliac Spine (ASIS) a gentle firming and drawing in of the underlying muscles can be felt with the contraction. A secondary firming can be felt with the activation of the lower abdominals, which is ok. Tightening of the upper abdominals and buttocks is not desirable.

Over time the contraction will become easier and the duration of the contraction can be held for longer, up to 10 seconds before releasing. As with all fitness programs the number of repetitions and duration of hold will depend on the client's ability to perform the exercise correctly and advance only when the client is ready.

With clients experiencing issues with weak pelvic floor muscles it is vital to prescribe appropriate exercises in the gym. High impact exercises, heavy lifting and exercises increasing intra-abdominal pressure should be avoided.

If you enjoy helping people with injury or illness, check out the Exercise Therapist program (Diploma of Fitness) with the Australian Institute of Fitness.

About Christine McCormack

Christine is a Massage and Fitness Coach at the Australian Institute of Fitness in WA. She also practices as a Remedial Therapist, Personal Trainer, Movement Therapist, and Institute of Motion Trainer, with a focus on functional movement and rehabilitation.

This content is not intended to be used as individual health or fitness advice divorced from that imparted by medical, health or fitness professionals. Medical clearance should always be sought before commencing an exercise regime. The Institute and the authors do no take any responsibility for accident or injury caused as a result of this information.

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