Humans are not built to cope with constant stress . Chronic stress can lead to hypervigilance in the central nervous system ( CNS ) which has a negative effect on pain
Stress urinary incontinence
Another pelvic floor issue more common in women than in men , is stress urinary incontinence ( SUI ), which is when there is involuntary loss of urine with a cough , sneeze , laugh , lift or exercise . Pregnancy , childbirth and menopause are contributing factors , however studies by Bo and colleagues show that that SUI rates are also high among women who exercise , and young female athletes who have not had children , including 80 % of elite trampolinists .
Men have a pelvic floor too
The pelvic floor muscles have typically been seen as ‘ women ’ s business ’, but men have a pelvic floor too . Morrison regularly sees men with pelvic floor problems in her clinic . “ When a man ’ s pelvic floor is not working properly , it can lead to bladder problems , bowel problems , erectile dysfunction , or pain in the genitals and pelvis . Many of these problems can be improved , and often cured , by seeing a pelvic floor physiotherapist ” she explains .
The most common time for men to experience urinary incontinence is following surgery for prostate cancer . Seeing a physio before and after surgery helps speed up recovery of bladder control .
Similarly to women , a man ’ s pelvic floor muscles can either be weak or tense . “ A weak pelvic floor is often caused by years of heavy lifting , constipation and straining when going to the toilet , having a chronic cough , being overweight or inactive , or ageing ” says Morrison ; “ A tense , or ‘ overactive ’ pelvic floor , is less well known , but something we see very commonly at the practice . A tense pelvic floor can be caused by stress or anxiety , doing too much core exercise , poor core stability , too much sitting or bike riding , or following pain , trauma , or surgery in the pelvic region , such as having a vasectomy .”
How can you help your clients protect their pelvic floor ?
You can assist your clients in a number of ways :
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Pelvic floor protection strategies ( see References at end of article ) can be considered during many aspects of training , with particular care being taken with clients who are at risk of pelvic floor issues .
• Choose ‘ Pelvic floor friendly ’ training options for clients with pelvic floor issues or who are in the ‘ at risk groups ’ of pelvic floor problems . While more prevalent in women , men can also use ‘ pelvic floor friendly ’ training options if they are at risk .
• Cue for good technique during resistance training – poor technique shows up with fatigue , the accumulation of muscle tension or due to muscle weaknesses
• Encourage clients to exhale with effort during resistance training and bring an awareness to their breathing patterns during training
• Program for gradual increases in strength , especially if they have had a break from training , or are feeling tired or fatigued due to sleep disruption
• Monitor and observe changes in form with increased load or onset of fatigue
• Look out for breath holding and excessive tension in the upper abdominals as this can cause pressure to be exerted down onto the pelvic floor and increase the load on these muscles
• Advise your clients that if they feel any pain , pressure or heaviness in the pelvic area during training , these are warning signals . Modify their training by reducing their load or training duration . Direct them to seek further advice if they notice any development or worsening of pain or pelvic floor issues .
• Encourage clients to listen to their bodies and to modify any exercises that make them feel vulnerable or that make them more aware of their symptoms .
The physical effects of challenging emotions
Dr Joan Rosenberg , psychologist , TEDx speaker and author of 90 Seconds to a Life You Love , explains that what we feel emotionally is experienced in the body first as a bodily sensation , for example , embarrassment is felt as a flush in the face . Dr Rosenberg explains that anger as an emotion may be felt as a tightening of the muscles around the jaw .
She identified that there are eight common uncomfortable emotions , and these are normally felt as bodily sensations . Common ways to distract from the experience of these unpleasant emotions can include eating or shopping . Less obvious forms of distraction include holding the breath , tightening of muscles , and swallowing .
Neuroscientists describe how , when these bodily sensations are triggered , a rush of biochemicals is released into the bloodstream , and are then flushed out of the bloodstream within 60 to 90 seconds . Rosenberg and neuroscientists describe this as ‘ a wave ’ and say that in order to ‘ ride the wave ’ an awareness of what the emotions are is required . This needs the ability to stay fully present in order to ‘ ride the wave ’ for an upper point of 90 seconds . There can be more than one ‘ emotional wave ’ in a row to be ridden .
During this pandemic , the emotional ‘ waves ’ which clients have experienced have come as a surge for many . Without the awareness and ability to identify and fully process these emotions , for some clients
26 | NETWORK SUMMER 2020