Changes in a woman’s Pelvic Floor function often accompany menopause; weakening of the pelvic support structures can progress to a pelvic organ prolapse. Pelvic organ prolapse is defined as bladder, uterus, urethra, vagina, bowel or anus falling or dropping out of place. The main culprit for women in their menopause is the reduction in oestrogen and this causes the muscle and ligaments within the Pelvic Floor to thin out and weaken.
Exercises to Avoid – Remember this is ONLY if you have a bad pelvic floor!
- High-intensity abdominal exercises – Sit-ups, crunches, double leg lifts
- Plank position on hands and feet (drop to elbows and stay on knees)
- Medicine ball rotations and any abdominal crunch the medicine balls
- Men’s push-ups
- High bench step-ups/step-down
- Side or deep lunges
- Wide-legged deep squats, jump squats
- Jumping, running, star jumps, skipping, box jumps etc
- Lifting or pressing heavy weights e.g. leg press machine (just make it lighter if needed)
- Lat pulldowns with heavyweights
- Deadlifts with heavyweights
- High step-up equipment e.g. box step
- Chin-ups and tricep dips; where the bodyweight (feet) is off the ground
Any sports or workouts that involve stop start running and rapid direction change (e.g. sprints, tennis, netball, basketball, hockey, touch football or squash).
Pelvic floor Safe Resistance Exercises
- Seated exercises (e.g. shoulder press, military press, dumbell rows, pec deck, bicep curls, knee extensions, dumbell lateral raise, upright dumbell raise, tricep kick backs
- Dumbbell triceps extensions (e.g. lying or one arm and leg propped on a bench)
- Dumbbell exercises on a Swiss ball
- Shallow and narrow leg squats
- Shallow Swiss ball wall squats
- Prone leg curl
- Hover/plank on knees/side plank on knees
- Shallow forward lunges, walking lunges, reverse lunges
- Calf raises
- Low box step ups
- Supine bench/flat dumbell press/Swiss ball press
- Wall push ups and modified men’s push ups on knees
Cardio / Aerobic / Group Classes*
Cardio, aerobic and group exercise classes are a great fun way for you to stay fit and can be very safe for you providing the correct way and classes are chosen. This is very important as there is nothing more embarrassing than wetting your pants during a class.
Modification is necessary and this is all dependent on the severity of the condition, conditioning level of pelvic floor and core muscles and the overall strength of the pelvic floor muscles. Therefore, establishing a solid base in terms of strength is important before any form of cardio commences. It is important to talk to a professional to establish what they can and cannot do.
The following cardio activities are to be used as a loose guideline, as the importance of weight loss/maintenance is vital in conditioning the pelvic floor muscles. These include:
- Swimming/Aqua Fitness Classes- is an excellent activity as it works the muscle stabilisers including the transverse abdominus (TA) . These muscles are important for pelvic recovery. Swimming is a fantastic toner and calories burner as it uses all of the major muscle groups. It supports your body weight and absorbs shock, thereby reducing the impact and load on the pelvic floor and joints. NO lifting legs to chest or leg cycling movements while on your back in the water.
- Biking/ Spin Classes- leaning forward to reach for your handle bars rolls the body forward. The right/left sitting bones and pubic bones are in contact with the seat, this body position is perfect for reducing contact with the tail bone which in turn engages the TA muscle. Biking is an excellent cardio full body work out allowing you to work at a high intensity with minimal compromise to their pelvic floor. It will also increase leg strength. Just remember, NO out-of-the seat workouts and activate deep abdominal muscles gently when leaning forward on the bike. Biking is also great for bad knees.
- Yoga- Yoga classes involve a series of exercises or postures that have potential physical benefits for your strength, flexibilty, posture and breathing awareness.
- Circuit Training- These aim to enhance muscle strength, endurance and aerobic fitness which is great providing exercises are modified to lesson pressure on pelvic floor and stick to exercises and equipment that are on the “can-do” list.
- Dance Classes- Are all forms of low impact including Latin American and even Belly Dancing and are aerobic in nature, enhancing flexibility and balance.
- Tai Chi- slow-flowing low impact movements that is a stress relief and also very beneficial for balance, coordination, flexibility, cardio respiratory function and bone density.
- Exercise Ball/Swiss Ball Classes- These classes are great for pelvic floor dysfunction as they have potential benefits for their posture, muscle strength (with dumbbells), deep abdominal control, balance and flexibility.
- Pilates- These are low impact classes designed to improve flexibility, posture and muscle strength not to mention a high focus on improving abdominal muscle control and breathing. Not all classes are good for women with pelvic floor dysfunction as some Pilates exercises place pressure on the pelvic floor. Make sure you always tell your teacher if you have PF issues.
- Interval Training- Perfect for fat loss however once again modify exercises to suit e.g. use stationary bike. Avoid jumping, sprints or any high impact exercises that will compromise the pelvic floor.
We all know the enormous benefits of weight training for women as they age. It is a great way for you to burn fat, defy gravity, keep your independence, prevent injury and disease. Many women fear leakage or further pelvic floor damage so you must you must proceed with caution.
Resistance Training is a must for women 40+ . As we age we increase the risk of osteoporosis – strength training prevents this and can also reverse it! We keep our muscle mass which is rapidly declining and we also burn fat!
At the end of the day, you also need to do exercises and activities that you ENJOY, but you can always modify. For example – instead of squat jumps – just do squats instead and take out the jump. Instead of high box jumps or step ups, just do low box step ups.
And last but not least…. Remember your pelvic floor exercises ladies! We don’t want to be wetting our pants every time we sneeze!