Urinary incontinence and pelvic organ prolapse are two types of The most common pelvic floor disorders associated with pregnancy. Both conditions can negatively affect the quality of life of a pregnant woman.
More importantly, these disturbances may prevent them from sticking to a regular workout routine due to fear (that exercise may exacerbate symptoms), shame (of losing bladder control), or a complex combination of both. This, in turn, prevents them from reaping Many physical and mental health benefits It is observed with an active lifestyle during pregnancy – from a reduced risk of gestational diabetes to an improved mood.
So, like a file Certified Personal Trainer or a Certified Prenatal and Postnatal Fitness Specialist, you may be wondering, “What can I do to help?” Well, that is the purpose of this article. Keep reading to learn how to confidently help your pregnant client improve their pelvic floor health while staying within your practice.
What do the pelvic floor muscles do (in people with vaginas)?
The pelvic floor is made up of the muscles and connective tissue (including the fascia) located within the pelvis. The pelvic floor muscles perform Two main functions:
- Provides support to the pelvic organs: The pelvic organs include the vagina, uterus, bladder, urethra, and rectum. You can think of the pelvic floor muscles and connective tissue like the hammock, which is essentially a support structure that helps keep the pelvic organs suspended and “in place” within the body.
- Helps to narrow the urethra, vagina and anal canal: Proper contraction and relaxation of the pelvic floor muscles enables bladder and bowel control (ie controlling urination, defecation, and passing gas) — and can also lead to more pleasurable sex (think: vaginal contractions during orgasm). And perhaps most importantly, the pelvic floor muscles support the baby’s weight gain during pregnancy, as well as vaginal delivery during childbirth.
How does pregnancy affect the pelvic floor muscles?
Pregnancy affects the pelvic floor muscles by:
- hormonal changes: To allow the baby to pass through the birth canal more easily, the body releases increased amounts of “pregnancy hormones,” such as relaxin, to lubricate the muscles and ligaments, especially in the pelvic area. This, in turn, contributes to the “relaxation” of the pelvic floor muscles.
- increasing pressure: As the uterus expands to accommodate the growing baby, pressure increases on the pelvic floor muscles, which are often not strong enough to handle the additional pregnancy.
Unfortunately, hormonal changes from pregnancy and increased stress often translate to pelvic floor dysfunction.
Take urinary incontinence, for example. Search It shows that up to 58% of pregnant women may show signs of urinary incontinence by week 30.
Although accurate estimates of the prevalence of pelvic organ prolapse are difficult to obtain, results of vaginal examinations indicate that the condition affects up to 25% to 65% of individuals with a vagina.
Improving client pelvic health during pregnancy
Luckily, ample evidence Highlights the effectiveness of pelvic floor muscle training during pregnancy in reducing the incidence of urinary incontinence and pelvic organ prolapse after childbirth. But what does “pelvic floor muscle training” mean, exactly? And how do you train the client through it? Find out below.
Step 1: Examination for a pelvic floor defect
The most important things first. Make sure your client is medically qualified to exercise (have them fill in their healthcare provider medical declaration form!)
Furthermore, it is also a good idea to check your client for any pelvic floor dysfunction before developing a new training plan to improve pelvic health during pregnancy.
You can do this by asking them if they:
- Unintentionally leaking urine when exercising, exercising, laughing, coughing or sneezing?
- Do you need to go to the toilet quickly, sometimes not getting to it on time?
- Constantly need to go to the toilet?
- Do you find it difficult to empty your bladder or intestines?
- Do you have a prolapse (eg, bloating, feeling of heaviness, discomfort, pulling, pulling, or falling into the vagina)?
- Do you have pelvic pain during or after sex that involves vaginal penetration?
While it is not within your practice to diagnose and/or treat pelvic dysfunction, you can develop an exercise program that takes into account any pelvic floor concerns. You will learn how to do this in steps two through four.
Step Two: Introduce pelvic floor exercises
Contrary to popular belief, pelvic floor muscles cannot be strengthened solely through “contraction exercises,” such as Kegel exercises. Instead, like other muscles in the body, pelvic floor muscles work best when they are able to Fully released after full contraction.
TThat’s why you’ll need to train your client through a combination of “contracting exercises” and “relaxation exercises”:
- Contract exercises: Examples include Kegels, quick Kegels, heel slides, and toe taps
- relaxation exercises: Examples include the happy baby pose and abdominal breathing
If your client has difficulty “finding” (ie activating) their pelvic floor muscles at first, have them tighten the muscles they are squeezing to stop the flow of urine or prevent gas. Try to get them to isolate the pelvic floor muscles without contracting the abdominal and gluteal muscles.
Step 3: Teach “Same Connection”
Under normal circumstances, an increase in intra-abdominal pressure during lifting is beneficial; It helps increase core stiffness, improving overall stability and strength, allowing the lifter to move larger loads while reducing the risk of injury.
But this does not apply to pregnant women.
More specifically, intra-abdominal pressure can be increased Puts extra stress on already weak pelvic floor musclesA very high risk of urinary incontinence and pelvic organ prolapse, among other pelvic floor abnormalities.
This then begs the question: How can your client best manage their intra-abdominal pressure while still performing exercises safely and effectively (particularly in heavy, compound movements like squats and deadlifts)? Answer: using something called “same contact. ”
By making the pelvic floor muscles and core work together again, continuous breathing helps keep the heart stable without creating excessive pressure within the abdomen.
reference to the same connection
To indicate connection breathing at the bearing client:
- Ensure that your customer is in a comfortable position. If your client is away in pregnancy, have them sit on a bench. If not, they can lie on their back (with a towel supporting their lower back) on the floor, with their knees bent.
- Have your client breathe with their hand on their stomach. As they inhale, have them imagine the diaphragm expanding with the air and pushing down toward the pelvic floor muscles. As a result, your pelvic floor muscles should relax naturally.
- Now, get them to exhale. Have them imagine the diaphragm collapse and the pelvic floor muscles contract “up”. If they are having difficulties with this, one of the signs that may help them is to get them to think about grabbing a pea with their vagina while exhaling.
- With practice, it will likely become the same connection as second nature to your customer. They will unconsciously relax the pelvic floor muscles on inhalation, and then contract when exhaling. You can then have them practice breathing while lifting weights. This can help them maintain core stability without excessive intra-abdominal pressure.
Here is an important disclaimer. There is no one specific way for your client to breathe in and contact the pelvic floor during exercise (eg, inhale during the lengthening phase, then exhale during the contraction phase). This varies from individual to individual and will be affected by each client’s condition, as well as the type of exercise they are doing.
Eventually, you’ll have to convince your client to try different variations – such as exhale during exertion, inhale on exertion, or perhaps exhale slightly before exertion – and ask them what helps them lift and feel better.
Step 4: Make exercise adjustments as necessary
The uniqueness of each pregnant woman’s experience with different pelvic floor imbalances makes it difficult to give “safe” and “unsafe” movement lists. However, some activities are more likely to exacerbate symptoms, including:
- High-impact exercises such as running and jumping
- Heavy weight exercises that encourage “squeezing” (for example, squatting)
- Intense “abdominal” exercises, especially anything related to abdominal exercises
- Weight exercises performed in a wider position
by the way: Click here for tips on incorporating low-impact workouts in training your customer.
What to do if a client reports symptoms
It is important to ask your client to tell you immediately if they feel any symptoms during their training session so that you can immediately adjust the exercise, program or technique. Examples of what you can do include:
- Weight loss: Your customer may be able to operate more efficiently with a lighter load.
- Try different ranges for the group and actors: Reducing the number of sets and/or repetitions the client does may eliminate or at least alleviate their symptoms.
- Try a different breathing strategy: As mentioned earlier, there are many breathing strategies a client can use. Feel free to experiment to find what works best for your client in this exercise.
- Reduce range of motion: Working in a smaller range of motion (for example, a half-squat) may help your client feel more in control.
- Change the position of the payload: Instead of loading through the iron bar, have your customer hold a bell low toward the floor. Or have them hold two smaller bells instead of just one. Again, feel free to experiment to find the configuration that the customer feels most comfortable with.
- Check for increased intra-abdominal pressure: You can do this by asking your client what they feel in their abdominal wall and pelvic floor during movement; They should not feel much pressure in the area. Another way is to see if they can breathe relatively normally and even have a conversation with you. If they can’t, this is a sign that they are creating excessive pressure inside the abdomen while lifting.
Remember the configuration that works best for your customer So you can repeat it in future sessions.
While mild discomfort and symptoms can be relieved by exercise and/or program modifications, some signs and symptoms should be a signal to stop. If your client experiences any of the following symptoms during training, get her to stop exercising and contact a member of her health care team immediately:
- leakage of amniotic fluid
- vaginal bleeding
- painful cramps
- Shortness of breath before exertion
Step Five: Knowing When to Return
Pregnant female clients continue to have symptoms of incontinence and pelvic organ prolapse (eg, pelvic girdle pain, urine leakage during exercise, and “heaviness” in the pelvic area) during training despite your attempts to modify their movements.
What should you do now? Ideally, you should refer her to a pelvic health physical therapist or a gynecologist and urologist.
However, remember that your client has complete independence in his or her own body and decisions. Therefore, do not force an unwilling client to consult a pelvic health expert just because you feel it is the best course of action.
Your role is to educate your client about aquarium health – and allow them to make their own health decisions.
As a coach, it is important to realize that pelvic floor imbalances are common in pregnant women. Fortunately, training can help reduce risk or manage dysfunction. This allows your customers to enjoy their carry with the least amount of worry.
Of course, it’s always a good practice to refer your clients to a pelvic health professional to make sure their concerns are well addressed, especially when it is beyond your scope as a personal trainer.
Are you looking to offer more value to your expectant customers? Don’t be afraid to increase skills to gain more relevant knowledge of prenatal client training through AFPA Certificate of fitness specialist before and after birth.