The “Bulletproof” Your Pelvic Floor Routine for Weights

Stress Urinary Incontinence affects many women throughout the world. Up to 50% of women who exercise experience some sort of bladder leakage. You don't have to have had a baby to get incontinence...and despite the name, it isn't mental stress that is the main cause of problems - it is increased intraabdominal pressure on the pelvic organs that cause problems. The usual practice is for people to "do their pelvic floor exercises" or "their Kegals"...but if it were as simple as that, we would solve the problem of incontinence...unfortunately it is more dynamic and variable than that. Part of the problem is that no matter how well you do your pelvic floor contraction, if you are generating pressure against the pelvic floor, you can still create incontinence problems. Part of what I have developed is a system of doing a breathing-coordinated core contraction and teaching the patient to spread the load around the body (#spreadtheload). In doing so, we can actually decrease the bearing down pressure we put on the pelvic floor (the subject of future research). Also, matching the #tensiontotask helps as well. But the biggest differences I think are being able to know how hard you should squeeze (most people including physios squeeze too hard)...and TESTING...if you don't test the contraction in a functional movement and compare it to what you normally do, how do you know you have really helped? So while this is a somewhat generic routine, by changing a few variables, we can individualise it... Read More

Is The Stork Test For The SIJ Useful Or Relevant?

Please this article, I will give away yet another clinical "secret" that has contributed to my successful treatment of SIJ conditions...this post is mainly for therapists today but patients can get a lot out of it as well. Ah, the stork test. It goes by a few names - the Gillet test and one leg standing test are some of them. This test has been used by therapists for many years and I have been personally using it for 15 years. in this blogpost, I will explain what the Stork test is, how I use it and still stay true to the intent of the original test and the interpretation from neuroscience.

How to Activate Your Pelvic Floor With Breath Holding For Lifting / CrossFit / Everyday Life!

This blog post is for EVERYONE - Men and Women!!! It will improve your performance and improve your symptoms. Everyone knows you should activate your pelvic floor...but why? You do your Kegels but you still leak urine...why? You saw a Pelvic Floor Physiotherapist...but you still want to keep squatting 220lbs (100kg)...did they teach you how? In this post, I will be using Maria Hogan as an example. Maria is one of the "old guard" of CrossFit in Australia. She is an ex-rower who competed at a high level. She had a 150kg (330lbs) deadlift, 112kg (246.5lbs) back squat, 83kg (182.5lbs) power clean and 64kg (141lbs) 3 months post partum! She is married to 3-time CrossFit Games athlete Chris Hogan and runs CrossFit 121 with Chris in Melbourne, Australia. All of these are fair questions. I hope to briefly explain how to combine the good work that Pelvic Floor therapists have done over the years and combine it with the knowledge I have gained in the Musculoskeletal and Sports Physiotherapy field I have worked in. For more information on the Pelvic Floor, I have written this one for CrossFitters and as a general explanation.

Back Injury – A Physio’s Experience

As a Physio, I know what to do when I get an injury...theoretically... You see, we are taught how to listen and assess and work out what is wrong. We tell the patient what we have found, what we think is wrong and what needs to be done to make things better. We do our "manual magic", we give appropriate advice and whatever things the patient needs to do at home. What they don't necessarily teach you is what it is like to be a patient. Even if I saw someone daily, it is still only 30-60mins in 24 hrs...I think too many physios and other health professionals need to think about that more. I realised this quite a while ago when I had injuries. I have always been quite active so with that comes increased risk of injuries and I have had my fair share. What I want to write for you today is what happened when I strained my back quite badly and how I dealt with the issue. I will discuss what I was thinking and throw some commentary into why I chose what I did and how I made my decisions. This is post is all about ME, NOT YOU. This is NOT what you should do. You should get assessed for any problems you have. This is about informing you what I was thinking and how I think as a patient and a physio.

Ep 2 of The Physio Detective Podcast – Lori Forner (Continence and Womens Health Physio) and Antony Lo discuss the pelvic floor

Last weekend, I had the opportunity to present the "Bulletproof" Your Girls seminar to athletes and coaches at CrossFit Cuties. Many thanks to Sim Irvine, the owner of CrossFit Cuties for hosting us. During the presentation, I introduced the holistic philosophy that Lori and I both utilize, Lori then presented on the pelvic floor, its functions, stress urinary incontinence, pelvic organ prolapse and pelvic pain from an overactive pelvic floor. During the presentation, there was about 30mins of questions, which was fantastic...Lori is very professional, approachable and made things easy to understand. After her presentation, I presented the practical side of things - how the core works together, how to do "core" contractions properly and then how to transfer those things to skipping, box jumps, running, and lifting. We even had one lady do a PB (personal best) on her power clean using our techniques! Of course, things have to end and we could have easily spent another 2 hours going over exercises so we may make it a 6hr seminar next time! In this podcast, Lori shares her experiences having treated CrossFit athletes in the past as well as hearing my presentation.

Are your pelvic floor exercises making you weaker?

Purpose - to challenge your thinking and beliefs...and those of your therapist! Method - questions and answers, haven't had a chance to look at the research Summary - my beliefs were challenged...I hope yours are! ***i will add pictures and formatting to this post when I get home 🙂 *** Do your kegals! Switch on your core by using your pelvic floor! Do more pelvic floor to increase your core stability! A strong pelvic floor will help your back pain! We have heard it all before...but do you (and your therapist) understand what the implications are? These are my musings about the hysteria about pelvic floor exercises and how it affects your back pain and performance. I have not read about this mentioned anywhere in the past so if you find resources, please let me know. The closest I have found is Taryn Hallam from WHTA in Sydney...brilliant woman.

Open email to Women’s health PTs about Crossfit and peeing

This blog post is an open email to all physiotherapists interested in helping women who leak during exercise, especially skipping and box jumps. I wrote this email to some women's health PTs but all patients and health professionals are free to respond. Please comment below if you have suggestions or want to be included in the discussions as it will give me your email address privately. Please share this to those you know who help those who have stress incontinence. Thank you! Ok, I had some interesting patients in LA which led to some interesting findings. Some background first. From the survey I did on CrossFit and peeing (which has issues: acknowledged) 73% of those who answered as leakers cited skipping as an issue. About 50% cited box jumps then running I think in 33% (from memory - it is nearly 5am here). Dead lifts was the worst weight lifting one and came in at 13% and anecdotally, it is when they go close to 1RM ie HEAVY. In the 'other' column, they reported some pull-ups, rings dips, trampoline and star jumps/jumping jacks as non listed exercises. Not many had signs of prolapse. So my thinking is: 1. Crossfitters who leak are probably ok in normal ADLs and don't prolapse - have to check the stats. This is obviously a subgroup of the incontinence population 2. Vertical Visceral Load (VVL) - have I just made up a new term? - seems to be the major contributing factor by far. Heavy... Read More

CrossFit, Your Pelvic Floor and Peeing During Workouts

This post is inspired by the video that CrossFit HQ put out, presumably with good intentions, due to an “event” during the deadlift-box jump event at the Central East Regionals [see video below]. Pelvic floor dysfunction is real and I would never make anyone feel bad if it happens...but it is not “OK” or normal to pee during workouts – it is a sign of Pelvic Floor Dysfunction. This article hopes to cover the following: What is Pelvic Floor Dysfunction What is “normal” and what is not Things that do NOT help Things that you can do that will help