*Names have been changed to protect the innocent and the guilty.
Today I was horrified by what one of my clients told me. So much so, I haven't been able to think about anything else since, and I am now writing this article madly before school pick up when I should really be tidying the house and prepping for dinner. But the need to get this off my chest trumps domestic duties.
Cassie* was contacted recently by a major women's fitness franchise (you can probably guess which one) because a friend had listed her when they joined up as someone who might be interested in joining. Nothing unusual about that, it is common practice in major gym chains. The sales person (which turned out to be the owner of the gym) asked my client if they had any concerns about commencing exercise at the gym. Also not unusual and a responsible question to ask. The shocking part was to come. Cassie informed them that she had some pelvic floor issues and needed to adjust her exercise accordingly. So here is the bit that freaked me out...the sales person told her to do some skipping to strengthen her pelvic floor. Oh the horror!
So here is why I have got my knickers in a twist:
1. There is no text, course, seminar or Google Search I have done on pelvic floor safe exercise the suggests skipping as a strengthening exercise, EVER. Skipping is a high impact exercise and listed in the "Exercises to Avoid" Section of the Pevlic Floor First website by the Continence Foundation of Australia.
2. This advice was given over the phone without any knowledge of Cassie's medical history or a pelvic floor assessment.
3. This is a major franchise whose target market is women. It is estimated that 1 in 3 women experience pelvic floor weakness so they really should be making pelvic floor safe exercise a priority.
Before I started writing this blog article I posted Cassie's experience on a Facebook Group that is made up of trainers and health professionals that have a specific interest in pelvic floor safe exercise. I wanted to make sure I wasn't crazy and hadn't missed some recent research on skipping and the pelvic floor. The members of this group were also horrified but not entirely surprised. There comments speak for themselves:
"Wow. Just wow. I can feel myself prolapsing just thinking about it."
"Yep, horrified, but I've heard it before."
"That is pretty bad conduct and you have the right to be terrified. There is no excuse to give such advice - and over the phone - in today's information rich world. Especially in a ladies gym...oh dear..."
The saddest thing in my eyes is that it isn't entirely the salesperson's fault. Education on the pelvic floor is not included in the Cert II or Cert IV in Fitness in Australia and from the feedback I received today it is the same in other many other countries (except France, they have really nailed postnatal care). As both men and women have a pelvic floor and both sexes can sustain damage from improper exercise technique, there is no reason why this information should only be limited to women's focused fitness education. Here is what some of my Facebook colleagues had to say about pelvic floor training in the fitness industry:
"I have a degree in Exercise Science, multiple certs and courses. But it wasn't until I went through rehab with The Tummy Team nearly 6 years ago that I started really learning about the deep core. I went home and cried. I screamed in my car. And I hear the same from women around the world when they first figure all this out. It's slowly starting to shift. Slowly."
"The reality is that we aren't given enough knowledge in our fitness courses about safe pelvic floor training methods...unless we are curious enough to do research about the subject...we wouldn't know anything about pelvic floor from the fitness course programs, that's the root of the problem. And that's why we hear these sorts of comments...not enough knowledge."
"This is exactly why I would love to see every women's only gym being represented at the Women's Health and Fitness Summit. They need to be there. They need to be SEEN there."
So there are a few ways we can approach this problem and ensure more women get the help they need, don't live with incontinence unnecessarily or create a prolapse.
If you have a story, opinion or solution related to this topic, we would love to hear it.
What happens when a group of trainers and allied health practitioners get together to discuss women's health? Inspiration, information and a whole lot of fun!
Last weekend I was lucky enough to attend the Women's Health and Fitness Summit in Melbourne. To be honest, this is the second year in a row I have attended and I would sell my left kidney to get there. But fortunately I had enough Flybuys Points to get me there and my sister put me up for two nights so no kidneys had to be sold.
The event opened with some inspiring guest speakers (all of which made me cry like a baby with heartache and happiness for their journeys). A real highlight was hearing Kerryn Harvey share her story of recovery after a minor bike accident in 2013 left her with an aggressive bacterial infection that resulted in the amputation of her arm and shoulder. Since then, she has rebuilt her body to achieve a silver medal in the amputees triathlon world championships. If that doesn't inspire you to overcome your barriers to exercise, I don't know what will.
We then got stuck into the sessions. There were a couple of real highlights for me. The first was a practical session by Kylieanne Farrell from The Movement Room entitled Moving with Prolapse. She talked about the impact that environmental factors such as sleep, nutrition and stress can have on a women's prolapse symptoms on any particular day. I think this is an important point, not only for women with prolapse but for all women. Training within our boundaries and being in touch with our bodies can have a great impact on the effectiveness of our exercise choices.
An eye opening session was conducted by Antony Lo from The Physio Detective entitled Stop Hurting Women with Exercise. Antony likes to challenge popular beliefs about exercise and encouraged us to challenge the status quo and think more broadly about how we train women. For example, he believes that physios and trainers "hurt" women with exercise by:
Over the weekend I also attended a much needed seminar on marketing (I much prefer to move than to market) but it was a great presentation and I promise to add the ideas to my long list of 'to dos'. I also attended a session on diastasis recti from a Melbourne physio. This a topic close to my heart (and stomach) and there was plenty I took away from this session. I also felt great admiration for the presenter as she kept her composure and diplomatically managed questions from accomplished physios in the audience that challenged her points.
Possibly the biggest difference to last year's event is that this time I was not in a room of strangers. Along with the connections I made in 2015, there was also a small contingent of Brisbane practitioners and trainers as well as other contacts I have made via social media in attendance. It was great to put a face to the names and we all enjoying talking at every opportunity we could get. Melbourne of course is never short of a good place to eat and we all braved the fashion police and went to dinner in our #activewear.
If you are a fitness professional that trains women, I strongly encourage you to attend this event. Feel free to drop me a line and I will connect with you there next year.
Mums often ask me "When can I return to running?, How long does it take for abdominal separation to heal?". These are tough questions to answer. Every woman's body, birth and lifestyle is different and will all have an impact on postnatal recovery. For some it will take 6 months, for others, it can take years.
The important thing is to be patient, know your body and how it has changed and to take a progressive planned approach to postnatal recovery. Getting quality, personalised advice from experts such as physiotherapists, exercise physiologists and qualified postnatal trainers will ensure you don't do damage that will delay your recovery and you will be able to lay strong foundations for future health.
There are lots of mummy exercise options out there but unfortunately some of them are downright dangerous. If you are a mum looking to return to exercise (regardless of when you had your baby) here are 5 indicators your exercise class might be doing you more harm than good:
1. No Pre-Activity Questionnaire
If there was no pre-activity questionnaire (PAQ), or the PAQ didn't include questions relating to pelvic floor and abdominal separation then run (or walk) for the hills. Trainers use PAQs to get information on their client's health status and to modify exercises accordingly. If they are only asking you about heart disease and joint pain, then they aren't getting the full picture and it may be an indicator that they aren't equipped to provide postnatal safe exercise.
2. They Get Embarrassed Talking about Vaginas
If your trainer can't discuss pelvic floor issues without whispering and looking at their feet, then they probably haven't been participating in pelvic floor education or hanging out with women's health physios. And if they look at you blankly when you ask them about modifications for prolapse or diastasis recti you are definitely in the wrong place.
3. They Worship Burpees
If your exercise class includes high impact exercises like box jumps, burpees, heavy lifting and running without providing low impact options then it isn't a pelvic floor and abdominal safe environment. A good trainer will be able to advise on techniques to reduce intra-abdominal pressure and get you results without placing you at risk of injury.
4. They think Core Work is all about Sit Ups
If you haven't got the memo yet, crunches (aka sit ups) won't give you a flat tummy. In fact, if you have abdominal separation sit ups could make it worse. Postnatal core training should avoid full planks, crunches or twisting while holding heavy weights and should focus on functional exercises and posture that encourage the transverse abdominals (deep abdominals) to to activate correctly.
5. They Love Competition
They use competition between participants as a motivation strategy. This might seem like harmless fun, but the only way participants can listen to their body and adjust their exercise accordingly is if they feel supported in doing so and wont feel pressured to "keep up". Motherhood is a tough gig and having an environment that supports your mental as well as your physical health will have you feeling good and enjoying your time exercising.
When looking for a postnatal provider, check their qualifications, trial a class and don't be afraid to refrain from doing any exercise that you think is dangerous or counterproductive. As always, we recommend mums get a thorough assessment from a women's health physio before returning to exercise so they have a good understanding of where their body is at and can pass that information onto their trainer.
At Go Mum! Group Fitness we aim to provide you with the knowledge and physical foundations to return to your pre-pregnancy fitness activities sooner and safer. Check out our range of postnatal exercise programs and group fitness classes and if you have any questions about postnatal fitness, join our closed group on Facebook - Go Mum! Community.
About the Author
Christine is a mother of two and the head trainer at Go Mum! Group Fitness. She is passionate about restoring health and balance to the lives of mothers. She is a member of the Continence Foundation of Australia and is registered with Fitness Australia.
You can find her on Facebook or Instagram @GoMumGroupFitness.
Every so often we introduce our loyal readers to a Go Mum client, so you can meet the real mums of Go Mum, understand what motivates them to train and maybe get some hot tips from them on how to juggle husbands, kids, shopping, school runs....the list goes on!
Well this month, it's time to meet Annabel, one of Go Mum's amazing Personal Trainers! Operating out of her Samford home gym, or with you in the comfort of your own home (yes, she will come to you!), Annabel loves to work her clients so they are challenged but not beaten - you will find muscles that perhaps you didn't know about, but you will still be able to function! Best of all, the kids are welcome!
We hope you enjoy meeting Annabel - if you are interested to book a PT class with Annabel, or join us for group sessions at our Arana Hills and/or Enoggera locations please don't hesitate to get in touch via our Facebook page or HERE at the Go Mum website!
GM: Why did you become a PT?
AF: I'm passionate about health and fitness. Not obsessively but see it as an integral part of daily life. I enjoy working with people and helping them to achieve their goals. I get a buzz when my clients walk away from their sessions feeling positive, energised and empowered. We all, deep down, strive for balance in our lives, and health and fitness play a key role in achieving or maintaining this balance.
GM: What is your favourite form of exercise?
AF: I love Pump (weights) and Spin (cycling) classes. I also love the Stairmaster. It's a constant challenge that never leaves you feeling like you've cheated :) ... 30mins and you're done! An efficient workout that is great, both for cardio fitness and leg/glute strength, when you're 'time poor'.
GM: What is your Go-To lunch to keep your energy levels up?
AF: At the moment it's baked beans with baby spinach stirred through it, with a slice of Helgas wholemeal grain bread, toasted!..... Bananas are at hand too!
GM: What are your top 3 tips for mums returning to exercise?
1. Avoid weighing yourself every day. Weighing yourself too frequently could become disheartening and actually distract you from the bigger picture. Once a week is more than enough and that's if you're exercising regularly and are on a meal plan. Taking your measurements every 4-6 weeks is a far better means of assessing how you're going.
2. Make sure your exercise goals are achievable so you taste success. This will keep you on track and motivated.
3. Ease back into exercise gently and listen to your body.
GM: Who inspires you?
AF: My 3 daughters! Every day they make me proud on some level.
GM: What are you reading at the moment?
AF: The 5 Love Languages of Children by Gary Chapman - A very interesting read that makes you further better understand your children.
GM: What is your favourite way to spend a kid-free day?
AF: Not doing much at all!!...... A day lazing on the beach,or having a glass of wine and watching a DVD! or BOTH!! :)
At Go Mum! we are constantly learning and seeking out the best women's health advice and local practitioners. In this blog you will find articles from women's health practitioners that are passionate and experienced in their fields. We hope you enjoy the blog and encourage you to support these local businesses.