I may have mentioned the pelvic floor once or twice or a million times on this website and on my Facebook page. But how does that factor into our workouts?
What does it mean for a class to be "pelvic floor-friendly"?
It starts before you even walk in the door. I have all my moms fill out a detailed health questionnaire before coming to their first class so I have a lot of the information I need to make sure the workout is not only appropriately challenging, but also appropriate for whatever stage they may be in of pregnancy or the postpartum period.
These are questions you probably haven't been asked before by a personal trainer or group fitness instructor.
Do you have any bladder or bowel incontinence? Did you have a vaginal birth or a c-section? How old are your children? Are you currently breastfeeding?
There are all REALLY important questions and I write all my class workouts with these answers in mind.
A mom whose youngest child is five years old and who had a vaginal birth and no incontinence issues has different workout needs than a mom of a 5-month-old baby who experiences leaking every time she coughs or sneezes and is exclusively breastfeeding.
Are these personal questions? Yes. And I am so grateful for all the moms that trust me with this information. Because unless I know the honest answers, I'm not going to be able to help you work towards running without leaking, or whatever your goal may be.
What kinds of workouts can you do?
We mostly just sit around and take deep breaths while we stretch our hamstrings.
If you have any pelvic floor problems, whether it's leaking, pelvic organ prolapse, or anything else, you might think one of two things: 1) I can't do ANYTHING and the only kind of exercise I'll ever be able to do is walking, or 2) I already leak/have a prolapse, so it doesn't matter what I do. I'll just wear a pad or plan on surgery later.
There is a middle ground, I promise you.
It's really, really important that your first stop is not to my class, but to a pelvic floor physical therapist. I'm not a doctor or a physical therapist, I don't diagnose or treat anything, and obviously I'm not going to do an internal exam to figure out what, exactly, is going on with YOUR pelvic floor. That the job of your friendly neighborhood pelvic floor physical therapist.
But assuming that's all taken care of, I'm sure you're wondering what, exactly, a pelvic floor-friendly workout looks like.
And the answer is, it looks a lot like strength training. High impact exercise (running, jumping, etc.) is the primary culprit when it comes to bladder incontinence, but strength training takes those jarring movements out of the equation.
If you've never set foot in a weight room, I don't want you to freak out. No previous experience is required to join us at Stroller Strong. I will coach you through everything we do, and I'm not going to start you off with 200-pound deadlifts. Fear not -- this is a kind, supportive environment.
Strength training is SO GOOD for moms. You'll feel like a badass, and because we are also mindful of the pelvic floor while we lift weights, we're actually improving our pelvic floor function at the same time.
But what about cardio?
I can sense your panic. You love to sweat during a workout, and you don't feel like you've accomplished anything if your heart isn't racing when you're done. But if we're not running or jumping, how do we accomplish that in a pelvic floor-friendly framework?
Scroll back to the top of this post and check out that picture for just one answer. You see the sleds those mamas are pushing? If you think that won't get your heart-rate up, have I got a surprise for you!
We can also use battle ropes! There are few things as satisfying as the THWACK of the ropes on the floor, and trust me, you're gonna FEEL it. We can use one arm at a time, both arms, sitting on a box, standing, hang it from a squat rack and use it to pull ourselves up to standing -- for a single piece of equipment, we can do a lot of conditioning exercises with it.
Or if those aren't your cup of tea, how about medicine balls? Try to smash the ceiling (you won't, they're super high for a reason!) or knock your partner over as you use all the power in your body to fling that ball.
There's also an exercise bike. Full disclosure, I personally hate the bike. But if YOU like it that's cool and it's totally fine to use that to do some intervals!
My point is, WE HAVE OPTIONS. Sweating and improving our cardiovascular system is not the sole provenance of running.
Does that mean we're never going to run sprints or anything like that in class? No, it means that I take your personal needs into account, and if you are experiencing leaking when you run, I'm definitely not going to have you do sprints until that improves. Pushing through an exercise even when you're leaking is not going to help and your pelvic floor is not going to magically improve on its own.
Essentially I treat running and plyometric exercises (any kind of jumping movement, even something as basic as a jumping jack) as exercises that need to be earned. Remember how I said I wasn't going to start you off with a 200-lb deadlift?
Running sprints is essentially the same thing as a 200-lb deadlift for your pelvic floor. Just as we strengthen all the muscles that allow us to deadlift and gradually pick up more and more weight, we also gradually add in higher-impact exercises to be sure the pelvic floor can handle it.
Final answer: it depends
What it really comes down to is this: a pelvic floor-friendly workout is a little different for a mom with prolapse, vs. one with no prolapse or leaking but significant diastasis recti, vs. no pelvic floor issues at all. The beauty of strength training and finding alternatives to cardio other than running is that we can tweak a lot of different variables to make it work for YOU.