High drama in this season’s ‘Biggest Loser’ reality weight loss show recently when 41 year old Anita, was rushed to hospital with a mystery abdominal injury she sustained doing deep 
wide leg squats thrusting a 5kg weight from ground level up over her head.
My teenage son innocently asked “mum do you think she’s had a prolapse?” I couldn’t help thinking that in view of the exercise Anita had been doing and her pelvic floor risk factors, pelvic prolapse was definitely up there in the range of possibilities.
I had to wonder why, if my teenage son can see the potential for pelvic floor injury, does high risk exercise for pelvic floor injury continue to be inflicted on women during prime time TV? I have deliberated about writing about this issue after years of cringing every time I see unsafe exercises for women, and my son’s question has finally prompted me into action.
I will preface this article by saying one can only applaud the efforts of anyone seeking to lose weight, improve their health and fitness, and that personal trainers are well intentioned in seeking to help their clients achieve their goals, and there are now many personal trainers who are highly committed to providing pelvic floor safe exercises to their clients.
However, isn’t it time that mainstream exercise prescription for women is tailored to their individual needs rather than the one fits all model for men and women we often continue to see? The pelvic floor of a woman is vastly different from that of a male, far more vulnerable to injury with inappropriate exercise.
Who is at Increased Risk of Pelvic Organ Prolapse?
Many risk factors for pelvic prolapse and pelvic floor dysfunction apply to the mature women on this season’s ‘Biggest Loser’:
- Overweight or obese women
- Previous pregnancy and childbirth
- Menopause and beyond
- Regular heavy lifting.
These are all major risk factors for pelvic floor dysfunction including pelvic organ prolapse.
Overweight and Pelvic Floor Problems
This season’s ‘Biggest Loser’ female contestants would have been classified as obese at the outset (i.e. BMI or body mass is greater than 30). Obese women have increased load on their 
pelvic floor whenever they are upright. The weight in and around an overweight woman’s abdominal organs combined with gravity weighs down their pelvic floor. The mature female contestants admit to years of obesity – in other words years of walking around with increased load on their pelvic floor.
Scientific studies confirm that increased body weight is a risk factor for prolapse surgery in women1. Obesity has been identified by the International Continence Society as an independent risk factor for incontinence2. In other words the increased load on the pelvic floor with obesity (and overweight) potentially increases the risk of pelvic floor problems occurring. Obesity combined with exercises that potentially overload the pelvic floor make this issue more problematic for overweight women and can potentially have adverse long-term outcomes for a woman’s pelvic floor health.
Childbirth and Pelvic Floor Problems
Women who have been pregnant and given birth are at increased risk of pelvic floor dysfunction. This season the theme is for a parent and child to lose weight together – so we know the mothers involved have gone through pregnancy and childbirth at least once in their lives. Pregnancy and childbirth are known to impact upon the supportive function of the pelvic floor. Studies implicate vaginal delivery as a risk factor for pelvic organ prolapse3.
Menopause and Pelvic Floor Problems
Menopause and increasing age are associated with increased likelihood of pelvic floor weakness and decreased pelvic floor support. The adult women in this season’s show are mature, some with children in late teens or early twenties, so we can reasonably expect that some are close to or past menopause. With decreased oestrogen the pelvic floor tissues becomes thin, weak and less elastic making the mature woman’s pelvic floor at increased risk of pelvic floor dysfunction.
Exercise, Heavy Lifting and Pelvic Floor Injury
Exercises that increase stress on a woman’s pelvic floor muscle supports increase the risk of pelvic floor dysfunction including incontinence and pelvic organ prolapse. It is known that lifting heavy weights, high-impact exercises and long distance running increase the risk of pelvic organ prolapse3. Intense core abdominal exercises (abdominal curls or sit ups) are known to create pressure causing pelvic floor descent in women with previous vaginal delivery4 – if the pelvic floor is unable to withstand repeated loading of intense core exercise, then pelvic floor dysfunction may result.
So one would expect that in a group of obese and overweight menopausal women (mothers) who have numerous risk factors for pelvic floor injury we would see appropriate pelvic floor safe exercises to promote weight loss and avoid pelvic floor dysfunction. However here’s just a taste of some of the weight loss exercises we have witnessed these women perform to date alongside their male counterparts:
Heavy lifting
- Pulling a semitrailer with an abdominal harness (team)
- Pushing/pulling/lifting a surf boat from end of the beach to the other (team)
- Lifting heavy weights with squats from ground height (shown right)
- Lifting and running to build a tower out of bales of hay (partner).
Intense core abdominal exercises
- Sit up exercises
- Plank extended holds
- Men’s push ups
High Impact Exercise
- Long distance running half marathon (team)
- Sprinting
- Burpees
- Running with load (surf boat, hay bale, semi trailer and harness)
Any Pelvic Floor Safe Exercises?
Participants have also performed low impact exercises including elliptical machines, walking and stationary cycling. It is difficult to comment on whether these exercises were offered as alternative pelvic floor safe exercises to some high impact gym-based exercises.
Implications for Women’s Exercise?
National television coverage of the exercises we have seen keeps us in the dark ages when it comes to promoting appropriate pelvic floor safe exercises for mature overweight women.
There are a number of potential negative implications for women’s pelvic floor safe exercise:
- This type of coverage legitimises these types of high impact heavy loading exercise interventions for overweight women and the notion that the same exercise interventions are appropriate for men, women and teenage children.
- The exercises are prescribed by personal trainers adding to this sense that the exercises are safe and appropriate for obese and overweight women to perform.
The real risk is that large numbers of unsuspecting mature women who are at-risk of pelvic floor injury owing to obesity or being overweight could readily view the types of exercises prescribed as appropriate for them to include in their own exercise regime. If pelvic floor injury is sustained, or any musculoskeletal injury for that matter during exercise it makes it all the more difficult for these individuals to adhere to their weight loss and fitness endeavours and achieve success.
Isn’t it high time that exercise interventions for women cater for a woman’s weakest link ? In many mature women their weakest link is their pelvic floor. Why aren’t the exercises for these at-risk women modified to promote weight loss and pelvic floor protection? This is a simple matter of providing or low impact exercise alternatives, pelvic floor safe lifting practices and avoiding or modifying intense core abdominal exercises.
We want women to be able to exercise safely and effectively, and help them to avoid foreseeable pelvic floor issues they may encounter with inappropriate exercises. If this one fits all model of exercise prescription continues there is only one biggest loser – pelvic floor safe exercise for women.
Will anything change as a result of this article? Probably not, it appears that even the Australian Government funded Pelvic Floor First Initiative that seeks to educate the fitness community and broader community on pelvic floor safe exercises isn’t being heard in some quarters. At least tonight I can rest easy, and maybe, just maybe, some unsuspecting overweight woman undertaking a new exercise program may glance over this article, have a light bulb moment and save herself some considerable pelvic floor grief.
Michelle Kenway is a Pelvic Floor Physiotherapist, author of Inside Out – the Pelvic Floor Safe Exercise Program for Women. Inside Out is a complete pelvic floor safe exercise weekly home workout program.
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1 Mant, Jonathan, Painter, Rosemary, Vessey, Martin (1997) Epidemiology of genital prolapse: observations from the Oxford Family Planning Association study BJOG: An International Journal of Obstetrics & Gynaecology, 104, 579- 585.
2 Chiarelli P (2007) Lifestyle interventions for pelvic floor dysfunction. In evidence-based physical therapy for the pelvic floor Bridging Science and Clinical Practice Editors Bo K. Bary Berghmans, B. Morkved, S Van Kampen M Toronto Elsevier p 148-149.
3 Balmforth J and Robinson D (2007) Pelvic organ prolapse. In evidence-based physical therapy for the pelvic floor Bridging Science and Clinical Practice Editors Bo K. Bary Berghmans, B. Morkved, S Van Kampen M Toronto Elsevier p235-236.
4 Thompson JA, O’Sullivan PB, Briffa NK, Neumann P. (2007) Comparison of transperineal and transabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions and functional manoeuvres in continent and incontinent women. Int Urogynecol J Pelvic Floor Dysfunct. 2007 Jul;18(7):779-86. Epub 2006 Oct 17.
Hi Michelle
Tell you what this is a light bulb article. Every time I watch TBL I cringe and cross my legs thinking there is no way I could do that and now I know why.
I wish you were on the show looking after the mothers in the group, I think you could give those puffed up trainers a run for their money.
Thanks
Pauline
I cringe with you Pauline! Thank you
All through my 20′s I did high impact aerobics. When I had childen in my 30′s my pelvic floor prolapsed and I had a hysterectomy at age 39. I was not told at the time about safe exercises and went back to the high impact aerobics and weights.
Now I’m 56 and my vaginal wall has prolapsed and I suffer with incontinence. I thought pilates and yoga would help strengthen the pelvic floor. But I’ve been doing all the harmful exercises. I ran across your website today and was so surprised that there was so much information. I have ordered your book and DVD. I also plan to share this info with my daughter. Thank you!
Hi Britton
Thanks for your comment! It’s a shame that no one really knew about pelvic floor safe exercises in years gone by – I think that out ability to see what happens to the pelvic floor during exercises using real time ultrasound has been a big leap forward for us in terms of our understanding. It’s good that you are developing an understanding to help you exercise for many years to come.
Hope all goes well for you
Michelle
Thanks for a wonderful article Michelle, lets hope those who read this will realise the importance of safe exercise habits, so important for women but also for men, perhaps your readers could get the menfolk to take a peek at this too. I no longer watch TBL as, like you, I am afraid for the contestants. Keep sharing your expert advice and knowledge it is so appreciated. Cheers Marg.
Thanks Marg, you are spot on this is an issue for men to be aware of as well, especially male trainers
Cheers
Michelle
Love it slash pretty sad that your teenage son could recognise prolapse indicators over the trainers on TBL
Hi Mish
Yes it’s a worry although admittedly my teenage son probably has a little more awareness about prolapse issues in women than most boys his age – I hope that this is a good thing
Michelle
Well done Michelle for putting it in writing. I don’t watch the show, but have done plenty of cringing over the years. So glad you help to lead the way in the next generation of change and awareness! Dianne
Well thankfully we have elite personal trainers like you out there helping women to love exercise and not feel afraid of injury, thank you Dianne!
Thanks Michelle for having the courage to have a really good go at this subject.
Please may I re- post this ,email it and print / laminate it for the waiting room in our practise ? Wouldn’t it be nice to get it through to MORE personal trainers!!
Hi Vanea
Yes of course, I will send you a pdf if you like and thanks for your comment! There are so many great Personal Trainers out there that are individualising exercise programs, it’s such a shame that they are profiled in this manner on TV!
Excellent Michelle! So glad someone addressed this and as well as you have! Just so sad that the women are probably not aware of the pelvic health compromise and reality TV may put even more women at risk! One day more people will hear us!! Keep up the great work!!
Yes I agree Lori, it’s such a shame for these women who are potentially being placed at risk for the sake of ratings and the advertising dollar, the more sensational the exercise (i.e. pulling a semitrailer, running with a tyre) the more people will watch and the more money made) so who’s the biggest loser and who’s the real winner?
Another great article Michelle.
Although… I do think women can lift heavy objects, cart a boat up the beach and lift hay bales. IF… they have the right education…. IF… they lift and contract their pelvic floor muscles as they lift. I think this is getting stronger in two places, internally and externally.
About main stream television, I’m constantly flabbergasted by the billion dollar pad making companies efforts to glamorize incontinence and encourage the population to accept it as a natural part of ageing aren’t you? What do we know? That a pad now is a diaper later and what an un-dignified way to age.
It’s so nice to have an intelligent Ally out there, your such a graceful teacher.
The problem is.. that we are pioneering a new revolution in internal fitness and it’s not that they “the biggest loser fitness instructors” are trying to do harm it’s just that they aren’t yet up to speed with the internal muscles. For so long it’s always been about the external body and it takes time for us to change the psyche of the population. Slowly but surely, faster if we can, we shall get their attention and educate them about how to be fit where it really counts.
I just published my first DVD Pelvic Floor Strength Vol 1 outlining 4 internal moves and I have two more to produce which will expound the 20 internal moves I have developed that are performed in the privacy of the body, with no external movement. Let’s get them breaking out in a sweat without their external body moving an burning calories that way?
Love you book, love your work, look forward to meeting you, I feel we are kindred. Respectfully Lara Eardley. http://www.pelvicfloorstrength.com.au
Well said Lara, best of luck!
Michelle
Well written and yet another question that should be put to the TV trainers.
Of course, not all trainers should be tainted by the unpressional actions of these pseudo celebrity trainers.
Sadly, in TV world a charismatic personality and a chiselled body does not mean your a good trainer with ongoing education credits and an interest in physiological improvements in their clients training. Long sentence, sorry but I feel a major rant erupting. As a trainer myself since 1997 I continuously feel disheartened by what I see on TV. I do remind myself that it is of course no more than entertainment… Unless you’re a participant.
Real world and successful trainers listen to their clients, training objectively towards goals and more than anything ‘do no harm’.
It would be great to see a proper trainer on one of these shows who demonstrate good instruction. :-/
Hi Jamie
So great to hear from you and to put this message across – yes I too see real world trainers listening to their clients, and I am blown away by the support, interest and knowledge of those trainers I have met at the pelvic floor safe exercise courses and forums we have run with the CFA at various gyms and venues throughout QLD.
Yes the show is about entertainment on one level. As a health professional I feel an ethical and moral obligation to speak out when there is a forseeable risk of injury. If no one ever says anything, where will the impetus for change come from?
Keep up yur great work with your clients Jamie!
Hi Michelle,
What great awareness you are sharing with people. I am currently studying to be a Personal Trainer, and am wanting to provide a safe and effective environment for my future clients. Your article has definitely made me think about the effects of high impact exercises and heavy lifting for women. I look forward to sifting through your website! Thank you
Hi Anna
Thanks so much for your comment – maybe visit the Pelvic Floor First website too, they have online training for PT’s and this would be great information for you to know and a wonderful service for you to offer your clients who will love you for it in the future!
Cheers
Michelle
as a Pt I am against group training with various ages in a group of 4 or more.
Everyone is different therefore different exercises need to be prescribed rather than a one exercise fits all training g. These shows are purely for ratings rather than than the long term care of the client.
Hi Kerry
Agreed, group exercise is so challenging, especially when dealing with really diverse groups (men, women & kids). Yes sadly you are right it’s a ratings game for sure, at what expense.
Many thanks
Michelle
Hi Michelle,
This comment is short and sweet – YAHHHH. I was so happy when I read your article, well thought out, informative and accurate. So happy that you did speak out and not be intimidated by the reverence that the fitness industry seems to have in all things media. I was high fiving everyone in my vicinity at your courage and wisdom in writing this.
With gratitude
Marietta
Hi Marietta
In all honesty they should have a trainer like you on the show to advise them on PT and apropriate exercises for women. You are doing amazing work in training PT’s across Australia in pelvic floor safe exercise for women and we all thank you for your commitment, energy and devotion to helping women exercise safely, and to training instructors on behalf of the Continence Foundation of Australia in how to deliver pelvic floor safe exercise programs.
Keep up your great work Marietta
Michelle
Wonderful blog Michelle. Your son doing early training to be a switched on Urogynaecologist!! Everyone else has said all the rest
Sue x
Sue if my son becomes a switched on Urogynae my life’s work is complete!
Thanks Michelle for voicing what so many of us are thinking. It’s so hard to educate patients and keep them motivated with PF Safe exercises when they are being influenced by what they see on national tv, but I truly believe in the “ripple effect”: if we can consistently circulate and celebrate the results of appropriate exercise for women and girls of all ages, we will prevail! Anyone else feel a march coming on?
Cath
I’m there Cath!
Yes agreed it makes it very difficult to educate patients and maintain motivation when they see extreme exercises on TV getting extreme results. Unfortunately we see too many women downstream when things have already gone wrong. Very difficult to get a preventative message out there that appeals to the media.
Hi Michelle,
Well written. I have recently started back at some high intensity boxing fitness group sessions with a lovely PT. Have been longing for a high energy class for my own psychological wellbeing. At least 50% of the group are school Mums as it is held to suit school pick up. I am absolutely loving getting the chance to work hard but I cringe at a few of the exercise prescriptions. I had actually mentioned to the girl at my first class that although I don’t have any pelvic floor issues I have had 3 vaginal births so wanted to be respectful of that history. At my 3rd class a different instructor prescribed planks with legs extended 30cm above the ground holds and then performing double leg raising and lowering. I was the only one doing my own modifications and had to use all my strength not to say something as I saw all of the Mums in the group bulging their abdominals and arching their backs, holding their breath. It concerns me that the exercises weren’t modified when there was very obvious poor technique and that some of the exercises were prescribed at all with the class participants background. I didn’t really want to rock the boat when I had just started there and I was loving the majority of the class. I hope to gradually add in some suggestions as I get to know the team but for now allow myself to take off my physio hat for 45min just for me. I have posted a link on my fb page so hopefully will get a lot of my ladies reading your wise words. Thanks. Briony http://www.beinblossom.com.au
Thanks Briony, I hear you on the group exercise and taking your physio hat off… During holidays I go to a gym with other female family members,and I always feel a little self conscious modifying the intense abs. and wide leg deep squat pump exercises. The classes are filled with mature women and while everyone does eye watering core abs, I feel as though I need to try to somehow remain inconspicuous in modifying these exercises. I think your comments highlight the expectations we often feel in group exercise to fit in regardless – as physios we know and see the consequences of inappropriate exercises prevention is at the forefront of our thinking so where does this leave women generally who perhaps notice pelvic floor symptoms – still compelled to perform regardless or just avoid altogether? I think that one solution is to offer women various exercise alternatives or levels of exercise intensity, and encourage everyone to exercise at their own level of comfort.
Thanks again for your comments Briony and best of luck on your quest
Bravo Michelle great blog.
Love this article. Having lifted weights for years along with high impact cardio routines – imagine my surprise when I found myself up for major pelvic floor surgery and 8 weeks off work! I couldn’t believe that I’d been so totally kept in the dark about the heinous damage these activities caused to my pelvic floor. I’ve been terrified to exercise since the operation and have piled on 8 kilos. I’m only now addressing the weight problem but am proceeding with extreme caution. I also watch TBL and fear for those mothers’ pelvic floors! They’re all in my age group and I can’t help but think what a lost opportunity to promote pelvic floor health via a program like TBL. They should get you on there Michelle – I think ratings would boom. Every woman in the land would be glued as it applies to all of us. One of the most powerful things I read (and it may have been on Michelle’s site) – was that the majority of women end up in nursing homes, not because of dementia – but because of incontinence. I also find it positively scary that incontinence is being ‘normalised’ as other women on this site have noticed. No doubt this will keep the profits rolling in for the manufacturers but at a high price for the average woman.
Hi Barbara
Yes isn’t it just a lost opportunity to promote safe approriate exercise for women! Yes incontinence is the biggest reason for admission to nursing homes in Australians, isn’t that a wake up call. Thanks so much for sharing your personal experience with this issue Barbara, makes your words and insights very meaningful to all of us.
Best wishes
Michelle
Well done Michelle.
It is always great to have excellent resources to refer these women to, especially since you give them great alternatives for advanced, challenging exercises in a safe way.
Love your work!
Allison
Thanks Allison – the feeling is mutual!
Thank you for this!
Two years ago I subscribed to Jillian Michaels’ online exercise program. My weight was in a normal range, yet I wanted to improve strength. I was, at that time, 54 years old, post menopause and hysterectomy. I never had heard about pelvic floor issues at the time. The online program was full of what I later learned were inappropriate abdominal exercises, as well as similar exercises as you described above. One day, during the exercise program, I felt severe pain in my pelvic region, and later followed up with my gynecologist and a urologist who promotes pelvic floor safe exercises. I quit the Jillian Michaels program and have modified my own exercise program accordingly, looking to your website often for advice. I am fine, and have never experienced that pain since. For me, it was an excellent learning experience, yet I worry about other women who may not be so lucky.
I followed up with the Jillian Michaels’ program, explaining why I quit the program, and asking them to consider safe pelvic floor exercises as part of their program. I never heard back from them.
Hi Diane
What a shame you had to go through this awful learning experience when you were well intentioned just trying to strengthen and stay well, it is so easy to see why some women just give up. Diane I’m not familiar with the Jillian Michaels exercise program, where is it based do you know? Is it marketed at women? Is there any pelvic floor screening before commencing?
Thanks so much for sharing your story, it will undoubtedly help other women.
Best wishes
Michelle
Michelle,
Thank you for your reply. Jillian Michaels is one of the trainers on the Biggest Loser. She has a big following in the US. What was most disappointing in my situation was the lack of response from her team when I explained why I quit the program. I realize there are probably thousands of subscribers to her online program, but if I remember correctly, there were lots of “we want to hear from you” type messages when I was paying for my subscription.
Diane
Also, no pelvic screening before commencing the program which is why I specifically communicated with them asking them to consider pelvic floor safe exercises.
Hi Diane
So let me get this straight – you have The Biggest Loser TV show in the US too? You have the same type of high impact, heavy lifting, intense core strength exercises being given to overweight women that I mention in this article? And you have the Jillian Michaels program as a spin off?
We too have the Michelle Bridges spin off (she’s one of the personal trainers on the show). I’d love to know what her ’12 week challenge’ involves that you can sign up for and whether there’s any pelvic floor safe exercise screening before participating.
Thanks so much for filling us in on what’s happening there. Maybe you can tell us what we have to look forward to in terms of pelvic floor safe exercise next season!
From what I understand, the US Biggest Loser was the original, and it looks like Michelle Bridges is the Jillian Michaels counterpart. I’d bet Michelle Bridges’ online program is very much like Jillian Michaels’.
Unfortunately, these are not the only TV programs in the US that promote unsafe exercises, for women and men. We have a couple of daytime shows, “Dr. OZ”, and “The Doctors”, which have physicians hosting the shows, and invariably will have a guest trainer demonstrating “kick your butt” type high impact and intense core exercises, etc to “encourage” viewers to get in shape, with no warning of pelvic floor safety. They seem more interested in the “Biggest Loser” sort of hype, than using their programs as an opportunity to really educate people on such issues.
Thank you for your voice! You are reaching many women.
Having had 2 prolapses I also cringe when watching Biggest Loser and wonder what damage is being done. This also applies to classes run at gyms which I blame for my second proplapse. It’s disappointing gym instructors and personal trainers aren’t more educated with pelvic floor problems.
Hi Kathy
Yes, gyms and fitness centres too. I really think that pelvic floor safe exercise should be a core component of instructor training. Yes there are attempts to train instructors who are interested in professional development in this area, and I do know of some absolutely fantastic PT’s and fitness leaders who have undertaken the additional training and are committed to pelvic floor safe exercise. However the enormity of this problem warrants mandatory training in pelvic floor safe exercise and including it as a core subject with theory and practical during instrucotor training, not some elective course that’s conducted on the side (which is at least a start).
Thanks Kathy
Michelle
Thanks for all the great work you’re doing Michelle to educate people about pelvic floor issues and to help women get back in touch with their bodies.
TBL would be such a great opportunity to educate women.
And I wish gym instructors had more knowledge in this area too!
I thought I was very aware of my body. I exercised regularly and had just completed my second 10km city to surf when I decided to join the Michelle Bridges weight loss program to shed a few kilos. I thought my pelvic floor was safe now that my daughter was 2. But about 6 weeks into the programme, with all the intense aerobic workouts I was doing, my pelvic floor gave way and I now have vaginal and rectal prolapse.
I wish I had known then, what I know now!
Hi Sophie
Thanks so much for your comment, isn’t it such a shame that we often learn this information after the event. I’m not familiar with the Michelle Bridges weight loss program but I imagine there are plenty of at-risk women who are overweight doing her aerobic workouts. Did the prescreening for the program re your general health include any qns that might suggest your risk of pelvic floor injury e.g. recent childbirth, weak pelvic floor muscles etc? This really needs to be included to identify women at risk so that exercise can be appropriate and matched to the woman’s needs. I really appreciate your input Sophie, thank you.
Michelle
Hi Michelle,
I certainly don’t remember anything in the pre-screening that alerted me to being at risk to pelvic floor injury.
They offer various programs including a ‘pregnancy’ program and some kind of ‘low impact’ options, which seemed to really be aimed towards injured people.
I admit I didn’t get a clearance from my doctor, but as I said, I was fit, already running fairly regularly, no injuries – I’m sure my Doctor would have said ‘Go for it!’
I’m a single mum most of the time, as partner works away, so I chose to get her DVD to completer the program so I could do it at home when daughter was asleep. Lots of skipping, jumping, crunches, weights. And I imagine many Mums choose this option as they are stuck at home with kids. Work outs are daily and intense.
The Michelle Bridges Program has gained a lot of momentum lately, especially when TBL is on. And the exercise programs are based a great deal on the same style of training they do in TBL – heaps of cardio, heaps of crunches, skipping, running – all those thing I can’t do now!!
I really miss my running
They do offer some alternative exercises in the program once you have a good search, but as I said, it always felt like these were aimed at people with existing injuries. Not me!
Sophie
Hi Sophie
Thanks so much for this information about Michelle Bridge’s 12 week challenge – helps me and other readers too I am sure. It’s a shame that the alternatives seem to be pitched at the injured individuals. If individuals don’t realise they are at risk, then we know what can happen when it comes to the pelvic floor. Yes I can see how this type of program would appeal to women at home looking after kids like you.
I have receieved some interesting info from the US – see Diane’s comments from the US about the spin off PT program over there.
What about a stationary bik for Xmas? Have you tried the high low intensity Lifesprints workouts – fantastic for time saving, fitness and fat burning. Just a thought …
Best wishes
Michelle
Hi Michelle. I read this article with great interest as I’m currently studying to specialize in prenatal strength training – however I can see a future specializing in many aspects of women’s health strength and conditioning, including women with pelvic floor issues. Like you and many others, when I watch the Biggest Loser I’m in pain for these people. All I can think is “injury, injury, injury!!!” (actually I don’t watch it anymore because its too frustrating). The reason I’ve decided to specialize in prenatal is from my own experience working out while pregnant (currently in my third pregnancy) and seeing there is a huge disconnect between the strength training and physical therapy world. Some of the stories here – I can totally relate to seeing women training or BEING trained in the gym inappropriately and having to bite my tongue!
Concerning my own body, I’m continually finding “current” information that is conflicting. I’ve recently read a blog (biomechanist Katy Bowman of Aligned and Well) explaining why squats are THE exercise to be doing for a stronger pelvic floor. Not just any squat, but a deep squat (to target the glutes). Bowman actually has a course titled “No More Kegels” as she says too many kegels will damage your pelvic floor! But I’ve since come across many women’s health physiotherapists criticizing this. From this article I would ask you (for myself and future clients!) 1 – is it okay to be squatting deep and lifting heavy if the pregnant woman is a healthy weight with no pelvic floor dysfunction symptoms? And 2 – (as Lara Eadley commented) if I proceed with heavy lifts (which I get greatest satisfaction from), should I “kegel” when contracting (straining!)? Some really great comments here and more awesome resources for me – Lara Eadley and Brioney O’Conner – thank you as well.
Thank you!
Jennifer of http://www.mamalionstrong.com
Hi Jen
Yes I have had other ladies write to me about no more Kegels. I have not read Katy’s work so I cannot comment on that. Rather I will say that the notion of doing squats to strengthen the pelvic floor goes entirely against what is known to be true in terms of specificity of muscle training – that is that to strengthen a muscle you need to exercise that muscle. What we know from recent scientific research is that Kegel exercises or pelvic floor exercises (not squats) improve pelvic floor function in women pelvic floor disorders including stress urinary incontinence and prolapse. I have not read any research to suggest that squatting has this effect. There is no evidence to suggest that when women perform Kegels correctly that they are in any way dangerous. The risk would be when women don’t use the correct action, if they fail to relax their pelvic floor or if they do Kegels when they already have overactive pelvic floor muscles.
Lifting a load from ground level increases intra abdominal pressure and subsequent pelvic floor loading when compared with lifting from standing height (Weir et al 2006). It seems that unloaded squat and lift from ground level generates more intra abdominal pressure that lifting a heavy load in standing.
So women who have or at risk of pelvic floor injury (including pregnant women with or without current pelvic floor problems) would be well advised to avoid deep squats with heavy lifting. During pregnancy the pelvic floor is under increasing load, causing stretch, strain and weakness so during pregnancy a woman’s pelvic floor is far more vulnerable to injury.
On squats – fantastic exercise for strengthening the quads and gluteals, because these are the muscles directly contracting. Do squats help women who have well functioning pelvic floor muscles to strengthen their pelvic floor? It may well be that because the pelvic floor muscles are required to contract to counteract associated downward load on the pelvic floor that they do strengthen in women without pelvic floor dysfunction. I don’t know but it’s possible however I would strongly suggest against at risk women performing deep wide heavily loaded squats (which also happen to compromise the knees but that’s another story).
Thanks for your contribution Jen
Michelle