Tag Archives: Pelvic Floor

Dealing with Symphysis Pubis Dysfunction (Pelvic Girdle Pain)

Symphysis Pubis Dysfunction or Pelvic Girdle Pain as detailed in a past post is the separation of the symphysis pubis.

One of two things will happen if you experience this. You will want to stay in bed for the remainder of your pregnancy, everyday activities seeming too painful or you will want to carry on with some sort of activities least of all your day to day tasks.

First things first though make sure you see your doctor. In severe cases you will need to see a physiotherapist.

Either way management of the pain and knowledge of what will worsen or help the situation is always useful.

Exercises for someone with Symphysis Pubis Dysfunction (PGP).

I wish I could give a straight forward answer but I can’t. I can generally state that movements that would worsen the condition would include movements that mean the hips, legs are separated ie a wide squat, lunges. Or simply putting one foot in front of the other ie walking.

Saying that though this will vary from woman to woman. Ranges of movement and particular exercises will differ across the board.

Prescription needs to be specific to each woman. How do certain moves and ranges feel? If pain is experienced quite simply STOP

I have seen a client who struggles with wide squats but found regular squats with a shortened range fine. Or couldn’t do lateral lunges but reverse lunges and regular lunges are fine.

If you want to continue to train you need to be realistic that something like Crossfit at this point is probably going to be extremely scaled and or stopped altogether for a more gentler approach.

Remember ladies this is fine!

Your symphysis pubis will return to normal after your baby is born.

It is Ok during pregnancy to take the tempo down. It is a small amount of time in the grand scheme of life.

Believe me you won’t have time to slow down when your baby arrives!!

In all cases focus on the core stabilising muscles of the pelvis is vital.

Working on transverse abdominal activation, pelvic floor recruitment will all make this condition far more manageable. And would be prescribed for any degree of PGP.

(Please note -Always seek help and advise from a trained professional)

Approaching day to day tasks you will need to think about how you move.

Here is an everyday example to help get in and out of bed.

Keeping your legs together. Hips and knees square, rolling onto your side and pushing yourself up to seated using your arms. Swing your legs gently, allowing your legs to dangle off bed/sofa, keeping them firmly together throughout the movement.

Remember the golden rule – if it hurts or gives you pain STOP

(A small minority will experience extreme pain, during pregnancy you are not able to use pain relief in the same way as before. Please consult your doctor or midwife for advice on pain relief and ways to deal with it.)

I hope this gives you a good starting point for PGP management. You can reach me through email for further advice on specific areas and questions. -sally@crossfitlondonuk.com

 

Sally Dixey is a Crossfit London Coach at Bethnal Green

Pelvic Floor 101

If I were to ask a room full of people ‘what are kegal exercises?’ I’m sure it would be all the women’s hands that would shoot up.

For those of you who don’t know, kegals are pelvic floor exercises that women are advised to do during their pregnancy to help avoid embarrassing ‘leaks’.

Embarrassing leaks are not confined to women who have had children, cosmetic companies spend a lot of money targeting women in general, which sweeps under the table the fact that men can suffer too. So although this is a pregnancy focussed health and fitness blog the below holistic approach could apply to anyone.

The pelvic floor (or pelvic diaphragm) consists of muscle and tissue that covers the area below your hips, keeping lots of your important bits separate. It also has important functions during childbirth helping the fetus navigate through the pelvic girdle i.e. helping contain the baby until the head is ready to engage.

So what right?

Well when I first had my first few mid-wife appointments I was told I should be doing my kegals if I wanted to say fit “down there”. This never seemed right to me and I never bothered doing them. I felt that I would be much better served by performing squats regularly and working on posture and body awareness.

Whilst pregnant I had no problems with those embarrassing leaks I was warned about and have no issues presently so for me,  I am glad I did not waste time with kegals.

I have since read a great article which further confirms my doubts regarding kegals.

According to recent research published by Rehab Management, pelvic floor incontinence has been linked to postural alignment and weak glutes. Interestingly the act of squeezing and releasing the pelvic floor (the simplest way to explain kegals) adds to the tightness of the muscle and neglects the length. Over time you tighten the muscle and by doing this reduce optimal length-tension relationship. When the pelvic floor is not functioning adequately the result is an inability to control your urge to ‘go’ or the frequency with which you need to do so, and at worse cause infection.

From a training perspective a shortened pelvic floor are key factors in stress incontinence (imagine sneezing or laughing and a bit of wee coming out! That’s stress incontinence) and is a worry when added intra-abdominal pressure is increased. I was starting to put together a picture of someone who cannot control their lower back, bad posture and a weak bottom, frantically doing their kegals without success.

The research continued to highlight a holistic approach to pelvic floor health looking closely at posture and core strength rather than isolating the muscle itself. As a CrossFitter this makes perfect sense as to we get strong by working the whole body as one unit.

Where does this leave me with kegals? In a healthy active pregnant lady I wouldn’t prescribe them.

I would look at the bigger picture, addressing posture and body awareness to the developing changes in her body. I would recommend squats regularly both with weighted resistance and without. My response is simply squats over kegals – they provide a much better and more natural way for the pelvic floor to do its job the way nature intended.

Please be aware that past 37 weeks pregnant deep squats are not advised as they can cause an early rupture of the membranes (early sign of labour).

 

Sally Dixey is a Personal Trainer @ Crossfit London in Bethnal Green