Rethink Pelvic Health: Beyond Traditional Floor Exercises


Last month I did a webinar on pelvic health over at the fascia; at the fascia hub, they have an amazing membership platform, where every month, there’s a webinar where they get specialists in the field of fascia movement such as Manual Therapy to come in and talk about specific subjects in their specific area.

Women’s Pelvic Health Physio

So last month, I was on talking with women’s health physiotherapist Anna Crowel, who has, as you may already know, the most amazing research papers on the Biotensegrity approach to treating pelvic organ prolapse and other pelvic floor dysfunctions. So we were talking a lot about the process that we go through. So how she treats why we treat and work with women the way we do. And it was great to meet a lot of people who were thinking along the same track as we are, so it felt very reassuring and supportive to know that we’re not alone.

Women with Prolapse

Very often, in the work of working with women with prolapse, it feels like we’re swimming against the tide because so often, the standard approach to treating prolapse is to strengthen and do isolated contracting exercises, which are proven to provide a maximum of 9% improvement for women who work in it that way. Whereas the way that Anna and I work, they’re getting upwards of 50% improvement by working in a biotensegrity way which is a whole body approach, which is why I teach whole body pelvic health. 

Swimming against the tide of Pelvic Health

We had brilliant feedback and everybody was rallying and excited about the whole body approach to treating prolapse; then today, I got reminded that we are still swimming against the tide. When an amazing friend and colleague sent me a link of somebody recommending out there globally to 1000s of women recommending their top 3 strengthening exercises for your pelvic floor.  The frustration for me is that strengthening is not the only thing that needs to happen. 

One size doesn’t fit all

We’re putting this one size fits all answer to a range of problems, imbalances, and different dysfunctions. We’re putting this one size fits all on top of that. And, in many cases, there’s too much tension in the wrong way, which exacerbates the symptoms that women are experiencing, like pain, incontinence, all sorts of imbalances that they’re feeling, even just the pressure downwards of a pelvic organ.

Having an organ displaced into the vagina is enough to warrant some consideration of different ways of treating it. So this one size fits all. Just do strengthening exercises, no matter what it is, even if it’s to do with the pelvic floor, just go ahead and strengthen it because we’re going to hold up everything held up from below when that’s just not the way that our biological system works.

And we cannot ignore the science and the research and the foundation that is there now about biotensegrity. I appreciate not everybody knows what Anna and I know, and other people that were at our fascia hub webinar last month are already informed not everybody knows. So when I got this message through today from my friend and colleague who was sharing a link that somebody’s out there teaching these strengthening pull-in and zip-up exercises for the pelvic floor instead of me getting frustrated (okay, I’m lying. I did get a little bit frustrated for a moment) – I then flipped it, I flipped it because that just emphasises how much more education is needed.

A ripple effect

So if you’re reading this now, if you go and talk to somebody else and ask.. “did you hear about this idea of a biotensegrity approach to pelvic floor dysfunction, a whole body approach to teaching Pilates for pelvic health?” Or share what I teach in any way.  Anything that we can do to create a Ripple Effect out there? It’s going to make a difference because it’s changing the angle of the conversation on how we exercise and treat pelvic organ prolapse and other pelvic floor dysfunctions.

So instead of me being frustrated that this person has a voice and is reaching 1000s of women and is being supported and hailed by other organisations, what I need to do and what we can all do, even if it’s not about pelvic health, maybe if you’re a teacher or a parent rearing teenagers, your message is something else.

What we can do is we can be the voice for pelvic health. We can educate those who don’t know; it’s not their fault. They don’t know whatever it is; people don’t know what they don’t know.  If we can educate with grace so that those people who have an impact that are out there, with a voice, learn what they don’t know. 

Get me on Lorraine

You know, one of my goals is to get on Lorraine and talk to Lorraine and Lorraine’s audience and the people who are watching and listening to what she has to say. Divina, the Loose Women all of these people who have a platform and a voice they don’t know that while they’re sitting there saying,” Oh, yes, I’m doing my pelvic floor exercises right now.” They’re reinforcing the way that is least effective. For women to solve their pelvic floor dysfunction. They just don’t know because everybody around is saying the same thing.

So, instead of us being frustrated, when it’s out there in the media when it’s being called a floor when it’s a diaphragm, when people are saying yeah, I’m doing my Kegels, or I’m doing my Squeezie app, or I’m doing my zip and hold when I’m waiting at the traffic lights, or I do it while I’m brushing my teeth. Instead of being annoyed. Let’s just graciously educate.

We know what we know and have an opportunity to educate, so please, can we graciously educate and use our voices as women and teachers wherever we can with whom we can? Because it’s not. There’s nothing to gain from being annoyed. There’s only something to gain from educating the people who have a platform who have access who don’t know and just report just keep saying it. Keep rippling out there to your clients, your friends, family members, and everybody that doing your traditional pelvic floor exercises is the least effective way to restore your pelvic health.  What you can say:

  • It needs to be the whole body because everything is connected. 
  • The tension is what’s holding things in place. 
  • We are a body-wide balancing act that is isolating all of the time. 
  • If we’re not balancing if we’re not flexible and dynamic, that’s where the problems in our pelvic health occur. 

We can pivot our frustration and educate with grace. So please be on that with me, educate with grace, whoever that might be free. 

Claire x