Tuesday 13 August 2013

Make Planking Safe for your Pelvic Floor


Forward Plank

The Plank exercise is a very popular core strength exercise performed by men and women in gyms and exercise classes world-wide. The common forward plank, as seen above, is a very effective core strengthening exercise, however if you have a pelvic prolapse or weak pelvic floor muscles, it is necessary to modify this common exercise to be pelvic floor friendly. 

This core strengthening exercise is also commonly known as a hover or bridge, and is prescribed by many physiotherapist, personal trainers, and gym class instructors.

Muscles used in Forward Plank

The Forward Plank exercise involves a range of different muscle groups in the body working to hold the body above the ground. The main muscle groups used during a Plank are the core muscles that surround the trunk; the abdominal muscles and spinal muscles. Secondary muscles are also involved in stabilising or holding the body in position during Forward Plank and these include muscles around the shoulder girdle, chest, middle back, thighs and calf.
Muscles used whilst planking

Is The Plank safe for your Pelvic Floor?

Studies have shown that intense core abdominal exercises force the pelvic floor downwards in women with weak pelvic floor muscles. The Plank performed in the traditional forward position with weight bearing through the toes is an intense core abdominal exercise and can therefore increase pressure on the pelvic floor. This means that the abdominal muscles have to work hard to support and maintain the trunk above the ground during the exercise. The longer the position is held, the longer the pelvic floor muscles need to work to counteract the downwards force that is generated during this exercise.

Safety of Plank exercises for your pelvic floor depends on a number of factors including your:
  • Current pelvic floor strength; your ability to activate and brace your pelvic floor muscles
  • History of pelvic floor surgery
  • Pelvic floor dysfunction (prolapse, incontinence, pelvic floor spasm/Vaginismus)
  • Chosen type of Plank exercise (forward plank on knees, toes or side plank)
  • Overall physical strength 

Ways to Modify Forward Plank Exercise

There are a number of ways to modify this exercise to reduce the pressure on your pelvic floor:

1. Change Plank Position

  • Kneeling Forward Plank – rather than weight bearing through the toes, modify this exercise into weight bearing through your knees (kneeling Plank) so that the abdominal muscles don’t need to work as hard to hold the body above the ground. You can also lower your toes to further reduce the load on your pelvic floor (shown below).
Kneeling Forward Plank
  • Kneeling Side Plank – The kneeling side plank (shown below) reduces the involvement of the outer abdominal six pack muscles, so that the pressure on the pelvic floor is reduced. To perform this exercise correctly; lie on your side so that your hips, shoulders and feet are stacked. From this position, raise yourself up onto your elbow and raise your hips off the ground so that your body is in a straight line body from the shoulders to the hips. Your weight should be distributed between your elbow and outer edge of your knee. 
Kneeling Side Plank

2. Decrease Plank Duration

The longer the body is held above the ground during Forward Plank exercise, the longer the pressure on the pelvic floor is maintained. If you are completing a core and pelvic floor strengthening program you may find that as you become stronger you are able to maintain The Plank for longer without impacting upon your pelvic floor. 

3. Avoid Intense Abdominal Indrawing

Recently, I was assessing another fitness instructor and was shocked to hear the instruction to draw in the abdomen strongly during The Plank. This is not necessary and will increase pressure on the pelvic floor muscles. Your abdominal muscles will be active and strengthen during this exercise – there is no need to draw in the abdomen and as a result over brace your outer abdominal muscles.

4. Breathe Normally

Try to breathe normally throughout The Plank and avoid holding your breath. Holding your breath during static exercises such as The Plank will increase blood pressure as well as the pressure on the pelvic floor muscles. Make a practice of breathing normally during exercises that require maintained positions (static exercises). 

Trainer's Tips for Correct Plank Technique:

  • Commence Plank using the modified kneeling technique described above
  • Tuck your elbows close to your body
  • Keep your shoulder blades back and down, imagine you are trying to un-clip your bra clasp with your shoulder blades
  • Keep your spine straight and your chin slightly tucked to protect your neck
  • Avoid dropping your hips
  • Breath normally throughout

Who Should Avoid Plank Exercises?

As with all exercises, the suitability of the forward plank as a core strengthening exercise is dependent on the individuals ability levels. If you are unsure about the strength of your pelvic floor muscles, then it is recommended that you see a pelvic floor physiotherapist who can assess your pelvic floor muscles and assess your suitability for this and other core exercises.

As a general rule you should avoid the forward Plank exercise if your pelvic floor is at risk with:
  • Weak pelvic floor muscles
  • Pelvic floor symptoms during or after Forward Plank exercise (symptoms such as light bladder leakage)
  • History of prolapse surgery, especially recurrent prolapse surgery
  • Pelvic pain and/or pelvic floor muscle tension
  • Pregnancy and early postpartum
If you are in doubt about your ability, or would like to learn more about pelvic floor safe core exercises seek the advice of a health professional. A health professional with a knowledge of pelvic floor safe exercise practices will be able to assist you with a suitable training program and provide you with alternative pelvic floor safe abdominal core exercises.

Wednesday 7 August 2013

Healthy Dog = Healthy Owner


After being diagnosed with a serious medical condition, I adopted my first beagle puppy, Braxley. 

Braxley has helped me navigate my way through some difficult times. He has supported and loved me when I have been too sick to leave the couch.  Braxley has motivated me to continue moving forward by demanding I take him for his daily walks. 

Braxley (12 weeks)
 There is no question that pets are good for your health, helping to do everything from lower blood pressure, to lessen symptoms of anxiety and depression. My puppy has been the loving encouragement I have needed to get up and moving since being diagnosed with my medical condition. Braxley helps me to get moving and exercising when my motivation levels are below zero.

Initially, little Braxley could not walk longer than 10 minutes without needing a rest, then today something wonderful happened, Braxley and I incorporated Fartlek training into our daily walk.

Incorporate Fartlek training into your daily walk.

Instead of streaching alone, include your bestfriend! 
Fartlek training is a training method that blends continuous (endurance) training with interval training. The variable intensity and continuous nature of this style of exercise places stress on both the aerobic and anaerobic systems. It differs from traditional interval training in that it is unstructured; our walk this morning was certainly unstructured, we ran between letter boxes, sprinted so that he could sniff many different scents, and walked when his little legs were too tired to run any further. Just like an athlete performing Fartlek training, Braxley was modifying our intensity and speed, as he wished. Most Fartlek sessions last a minimum of 45 minutes and can vary from aerobic walking to anaerobic sprinting. Braxley and I were out for over an hour and we were both exhausted when we got home. Fartlek training is generally associated with running, but can include almost any kind of exercise.

After this mornings Fartlek training I began to think about all the different ways people involve their pets into their daily exercise routine, and after a little research I came across some very innovative methods. Here are some of the different exercise methods I came across:

* Doga - Doga combines massage and meditation with gentle stretching for dogs and their owners.
Doga Class 

Stretching out the hip flexors in Doga
*Canicross - This is a snow free version of Skijor, which is a form of cross country skiing and sledding. Canicross is an excellent activity for people who enjoy cross country running and have dogs who love to run. The dog is attached to a lead which is attached to a harness on their owner. Together you navigate your way through a cross country running track. This can also be done with roller-blades, especially if your K9 companion is a speed demon.


Canicross 
Urban Canicross using Roller-blades 
 * Doggy Paddle - In the USA and UK there are providers of swimming/ aqua-aerobics sessions for you and your K9 companion. This low impact exercise offers alternative ways to keep active for people, or dogs who suffer from chronic pain. As we live in a nation with amazing beaches, try taking your dog down to the beach and paddle through the whitewash together.
Doggy Paddle        
* Climbing Stairs - Climbing stairs together will tone your legs and butt, while giving your dog a chance to melt away the Milk-Bones. Braxley and I have mastered the stairs at Kangaroo Point, Brisbane.
Take to the stairs to shake up your daily routine.