GRAPHS: PELVIC FLOOR MUSCLE STRENGTH AND ENDURANCE
Pelvic floor fitness and core control
Pelvic floor muscles, when assessed by a pelvic health physio, can be
graded for strength, endurance, hold times, reps and coordination.
Some women are unable to counteract the forces generated within
the abdominal cavity with particular core exercises.
The top graphs represent examples of the strength and endurance
capacity in the pelvic floor.
To provide the right level of core training for a female client, we
must match their functional level of pelvic floor control with the force
generated during the training.
For example, a client with a 3-second pelvic floor hold, with
a weak contraction, needs controlled positions for training, as
illustrated below:
The 30-second article
• Female clients, particularly those that have recently, or ever, had
babies, often need specific training to strengthen the core and
pelvic floor
• Clients may have a lengthened abdominal wall, abdominal muscle
separation (diastasis), a weakened pelvic floor resulting in urinary
incontinence or pelvic organ prolapse
• PTs need to help clients develop an awareness of their current level
of pelvic floor fitness and its response to different loads/exercises
• PTs should be aware of clients’ pelvic floor strength and endurance in
order to prescribe training that will safely and effectively build both
• Clients with more serious symptoms should be referred to a doctor
or a continence professional.
4 point kneeling
Core with clam
Checkpoints to assess with a client
P The quality of movement and maintenance of form with repetitions
P Onset of fatigue, and when it occurs during training
P The ability to maintain breathing smoothly, as appropriate to the
level of exercise
P Evenness side to side, e.g. no drop of hip with single leg bridge
P Nil pressure downwards felt in pelvic floor
P Maintaining neutral spine position vs sagging or loss of alignment
P No abdominal wall bulging or bulging of linea alba
TAKE NOTE! Clients should not feel any descent, heaviness, pressure
or feeling like they are going to leak urine during any training.
Modified side plank
Before progressing to the next steps in core training, clients need
to rebuild their level of core control, including:
• pelvic floor fitness and awareness
• breathing and coordination of control during movement
• building endurance hold capacity during training
• matching level of core control with building load and increasing
level of resistance.
NETWORK SUMMER 2017 | 65