Remember, it’s OK to Walk Before You Run.

Today I just wanted to remind you that its okay – in fact not just okay, but necessary – to walk before you run. To slow things down and master the basics before trying to get to the advanced stuff. To recognize that just because you aren’t achieving your end goal at this moment in time, it doesn’t mean you won’t get there. And most importantly to appreciate that its your habits over time that make the biggest impact on your results.

I once had a goal of doing a pull-up. So, in an effort to achieve my goal I would jump on the pull-up bar and try with all my might to do a pull-up. My legs kicked everywhere, my neck got all tense, and I pretty much just shrugged my shoulders instead of using any sort of useful strategy to lift my body upwards. Oh, and then I would always have to let go of the bar because I didn’t actually have the grip, back or core strength to hold on to it for long.

I was trying to run before I walked.

I was trying to perform my end goal before developing the strength and movement patterns needed to successfully execute this goal. And in my effort I ended up just creating a number of compensations that were harder to break later when I focused instead on learning the fundamentals.

Fast forward to today: I still can’t do a pull-up, but I can hang on the bar with all the right muscles engaged and hold myself there in a solid position. If I have a coach around, with their assistance I can pull-up without those wonky strategies I once used – no flailing legs, sore neck or shoulder shrugs. And I know that this puts me at a much better trajectory towards the end goal of a pull-up than if I had just kept trying to “do a pull-up”.

I think we are all guilty of this sometimes. Of wanting to reach our end goal so badly that we skip steps along the way. But most always the process of learning the skill is so important and doing so properly under the guidance of a coach will help you achieve your goal at a much faster rate AND avoid a lot of frustration along the way.

What This Means in Relation to Our Pelvic Health

When it comes to our pelvic health I find a lot of times women start running before they walk. And to be clear, I don’t mean literal running and walking. I mean trying to do advanced versions of their pelvic floor exercises or advanced exercises (with little to no coaching) that they may not yet be ready for.

The progression of what we work on will differ, of course, depending on the individual, the presence of any pelvic floor dysfunction and the activities they are doing. But to give you a few examples of the most common cases of running before walking I see are as follows:

  • Practicing Pelvic Floor Muscle Contractions (PFMC aka Kegels) when you are not ready to do so (either due to incorrect technique or oversight pelvic floor muscles
  • Holding the contractions longer than you are capable of, leading to compensations
  • Doing other exercises with poor form (holding breath, increasing intra abdominal pressure unnecessarily)
  • Doing exercises your pelvic floor is not yet able to tolerate

Sometimes doing these things can lead to further dysfunction (aka worsening symptoms, which no one wants!), or simply putting forth a substantial effort with little to no results from all the hard work. Either way, it can be incredibly frustrating to work towards something without seeing the results you want.

When this happens, we just need to re-adjust and focus on finding out what it is we need to be doing to see continued progress! And I am here to help you do just that

How Do You Know What is Too Much?

Quite simply, you will know by working with a Pelvic Health Physiotherapist who will assess your body (including your pelvic floor) and determine what is best for you.

You see, during an assessment we look at the whole body (posture, alignment, movement, range of motion, coordination, strength, tissue health) including a detailed assessment of the pelvic floor. When speaking of the pelvic floor we assess your ability to voluntarily contract and relax those muscles (in other words, can you do a Kegel properly? Can you relax those same Kegel muscles?), the strength and endurance of the muscles, the coordination of your pelvic floor (does it contract and relax when it is supposed to? Is the timing right?), and how supportive it is to the organs above/is there a prolapse present.

Based on this assessment we will guide you and coach you on how to train the muscles of your pelvic floor to work on any one or combination of the following: strength, endurance, power, and/or coordination. We will coach you on how to move and exercise effectively to both improve your overall fitness and health, but also to both protect and improve your pelvic health.

When your body starts making compensations, or symptoms start occurring (incontinence, pain) we know that we have to adjust what we are doing. Common compensations related to the pelvic floor include holding your breath (which can sometimes lead to more pressure on the pelvic floor) and recruiting other, bigger, muscles or strategies, such as using the abdominal muscles, glute muscles, squeezing your thighs together and tensing your upper body.

What this Blog is NOT Telling You

I want to be clear: I am here to work with to ensure you experience success when it comes to your pelvic floor muscle training and training in general. I will help guide and coach you on how to progress your pelvic floor muscle training, chat with you about all the lifestyle and behavioural strategies we can use, and work with strength coaches to ensure you are incorporating physical fitness.

When I say you have to walk before you run, what I am NOT telling you is this:

  • You can only walk for fitness
  • Running is bad for you
  • You can’t workout and train
  • You can’t do most exercises
  • You are not doing as well as you should be or you are not good enough
  • Something is “wrong” with you
  • You won’t get better
  • You are alone in this

No. All of these are NOT true.

You can workout. You might be able to run. You can do most exercises, though some may just need to be modified slightly.

You see, it isn’t so much about what exercise you do, but how you do it. And luckily I work with some amazing strength coaches who are highly educated and skilled so they can ensure you can have a great workout doing things you love that will not only not negatively affect your pelvic floor, but that will help!

You are good enough. Nothing is wrong with you. You will get better. You are not alone.

So many people think that whatever they are dealing with – be it incontinence, pelvic pain, prolapse, weakness – is just going to be their new normal. That they just have to get “used to it”. This is absolutely not the case! Regardless of what symptoms or things you are experiencing know this: it is common, but there is SO much we can do and you will see change. Because you are not alone in this. So many other women experience these same symptoms, and they, along with us are here with you. We will guide and coach you and ensure that you can be your best you.

Remember: it’s not only okay, but it is also necessary to walk before you run. Allow yourself to go through the process instead of rushing to the finish line. I promise, it will be worth it in the end.

Wearing High Heels Could Make Your Incontinence Worse

Wearing High Heels Could Make Your Incontinence Worse

Our pelvic health is so incredibly important to our overall health and thankfully this fact is starting to get more and more recognition with more resources and research focusing on improving this aspect of women’s health.

Pelvic floor dysfunctions such as incontinence, pelvic organ prolapse, pelvic pain and low back pain are incredibly common among women (both who have had children and who have not), but they are NOT normal. In other words, there is SO much we can do to prevent and treat these dysfunctions so you can feel and move your best!

And I’m not just talking about doing Kegels. In fact, did you know that there is so many more factors to consider when it comes to our pelvic health than just training the muscles of the pelvic floor?

One of these factors is what I want to talk about today – a particular habit that can affect how your pelvic floor functions: wearing high heels.

A recent study just published earlier this year looked at the effect of certain ankle positions on the resting and maximal contraction of the pelvic floor muscles. In other words, they looked to see if there was a difference in pelvic floor muscle activity when someone was in a neutral ankle position (ie flat foot), in a plantar flexed ankle position (ie in high heels) or in a dorsi flexed ankle position (ankle flexed up).

So, let’s dive in to the study and see what the effects of wearing high heels are on your pelvic floor!

The rationale for the study:

When looking at urinary continence it is important to understand that the pelvic floor muscles form a major component of what’s called the uretrhal support system. They provide this urethral support by maintaining the constant muscle tone necessary to support the bladder neck and keep the urethral closure closed both at rest and during episodes of increased pressure (such as during a sneeze).

The Pelvic Floor muscles maintain a constant muscle tone that is necessary to keep you continent.

Previous studies have shown us that the activity of the pelvic floor muscles will change based on different body positions or postures, such as sitting, standing, or in varying degrees of pelvic tilts.

Other studies have shown that wearing high-heels will significantly change your biomechanics, posture and the way you walk, and armed with this information this study sought to determine if there would be a difference in muscle activity wearing high heels (ie plantar flexed ankle position) vs in a neutral or dorsi flexed ankle.

The Results

Authors of the study determined that there is significantly more muscle activity in the pelvic floor at rest when the ankle is in a neutral or dorsi flexed position as compared to a plantar flexed position.

This means that your pelvic floor muscles have a better ability to work and support your bladder and to keep you continent when in these positions, versus when you are wearing high heels.

Authors also determined that women had a maximal pelvic floor contraction (aka Kegel) that was much stronger when they were in the neutral or dorsi flexed positions vs in the plantar (high heel) flexed position. In other words, they were able to better consciously contract their pelvic floor when they weren’t wearing high heels.

Why this is important

The results of this study show us that women who experience pelvic floor symptoms such as stress incontinence could experience worse symptoms when wearing high heels due to the decreased support of the pelvic floor muscles in the urethral support system.

This means that women who experience leaking throughout the day could potentially improve their symptoms by opting for flatter shoe choices.

Just another reason to limit the amount of time you spend in high heels and to visit a pelvic health physiotherapist who can help you to ensure that your pelvic floor muscles are functioning as optimally as possible!

Wearing high heels leads to less activity of the pelvic floor which could mean more leaking.

Check out the study, here.