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antony@physiodetective.com

Pelvic Floor Screening

Introduction

Pelvic Floor Dysfunction and other Women's Health Problems affects up to 1 in 2 women, especially those who exercise and have had children.

Example of Pelvic Floor Dysfunction are:

  • Incontinence - leaking of urine or faeces
    • Stress incontinence - losing control of your bladder or bowel from doing things (lifting, coughing, sneezing, etc)
    • Urge incontinence - the need to go to the toilet **NOW** or not making it to the toilet in time
  • Pelvic Organ Prolapse (POP) - one or more organs bulging into the vagina or rectum (intussusception)
  • Pelvic Pain - pain on the outside of the perineal area or inside the pelvis/vagina/rectum

What do we have to do to have "optimum health"?

The CDC in the USA and the Department of Health in Australia recommend that people get 5 sessions of 30mins (150hrs) of moderate intensity exercise each week and at least 2 of those sessions being weight training.

Yet we know that pelvic floor dysfunction can cause problems with women more likely to NOT exercise because of pelvic floor dysfunction.

Coincidently, we also know that being overweight/obese (high BMI) is one of the leading risk factors for developing or worsening pelvic floor dysfunction.

Screen ALL your patients and clients!

Therefore, I am calling on all health and fitness professionals to screen their clients for pelvic floor dysfunction.

The goal is to identify women who are having trouble or who are at risk of developing pelvic floor dysfunction and begin to take steps to help rectify the situation. I and many health professionals around the world want this message out there!

ChecklistPelvic Floor Screening Questions You Can Ask

I always ask for permission to ask these questions and remind the patient that they don't have to answer these questions if they don't want to.

Answering "yes" to any of the questions below means you should consider altering your workout at the very least but I recommend you see a pelvic floor (women's and men's health) physio for an internal assessment and their opinion.

  • Do you ever leak urine or feces?
  • Do you ever feel the need to go to the toilet quickly or do you not make it to the toilet on time?
  • Do you ever feel a heaviness or dragging feeling in your vagina?
  • Do you have pain in your genital region or during sex or inserting a tampon?

Other questions you can ask can give you more information and help identify who you need to refer for assessment and treatment.

  • Do you have any constipation?
  • Do you have a persistent cough, wheeze or sneeze (asthma, hay fever, etc)?
  • Have you ever hurt your back or pelvis in a fall or had surgery in the area?
  • Are you breastfeeding?
  • Have or are you going through menopause?
  • Is your BMI over 25?
    • Whilst BMI is imperfect in so many ways, it seems to be correlated with an increased risk of pelvic floor dysfunction - it doesn't matter if your BMI is high from fat or muscle

What Can You Do?

  1. See a Women's Health Physio for assessment, treatment and management strategies.
    1. You can find one in your local physiotherapy or physical therapy association
    2. You can always ask me if you can't locate one
    3. Always ask if they will help you achieve what you want to do - not all of them have experience with those who exercise at high intensity like CrossFitters but many are willing and able to help you do so.
  2. You can see me or my team for suitable alterations for your exercise / workouts. I have experience at helping people exercise at high levels of weight and intensity while managing their pelvic floor dysfunction
  3. Skill up!
    1. www.mypteducation.com has my course "Bulletproof" Your Body - Pelvic Floor and Core Course where you can learn more about the different problems people have with pelvic floor dysfunction, how to change your posture and "core activation" and how to change your exercise
    2. Visit websites like the Continence Foundation of Australia and their exercise site www.pelvicfloorfirst.com.au - please note that they have excellent resources including their own screening questions but I do disagree with some of their exercise recommendations - they have to be conservative because of the general nature of the advice.
    3. Find the #pelvicmafia on Twitter and Facebook. They are a bunch of interested health professionals who will be willing to help direct you to more resources.
  4. If you can't find someone to contact, then ask me via the "contact us" box.

Summary

  • Screen EVERYONE for pelvic floor dysfunction
  • Ask the questions on your intake form and ask them of your clients
  • Develop relationships with your local pelvic floor physio
  • Get expert advice about suitable exercise substitutions and technique (that is what me and my team do)
  • Learn more - via courses like mine or at reputable websites like the Continence Foundation of Australia
  • Ask me or someone if you can't find help!