Training the Pelvic Core

by Christina Christie, PT on Feb 15, 2017

Core

These exercises help women strengthen and support a key area of function.

"I wish someone had told me this could happen to my body after having a baby!" . . . "Why did my doctor tell me I could return to exercise at my 6‐week checkup?"

I hear these questions every day as a physical therapist specializing in women's health. The topics: pelvic organ prolapse, incontinence and pelvic pain. Every third female has some type of pelvic‐floor dysfunction, which may include one or all of the previously mentioned diagnoses (American Urogynecologic Society 2016). Women with these problems are angry, frustrated and scared. Many have lost confidence in their bodies, and they are likely taking your classes!

If a woman returns to impact‐oriented exercise too soon, she may put her pelvic‐bowl organs and pelvic‐floor muscles at risk for dysfunction. As an instructor, you don't work one‐on‐one with attendees, and it is not within your scope of practice to diagnose or offer medical advice. What you can do, however, is offer an "impact preparation program" by presenting simple core exercises in specially themed classes.

The following exercises, based on the Gray Institute®'s Female Chain Reaction® Live Function training program, use gravity to improve pelvic‐floor activation submaximally, subconsciously and without the load of the pelvic‐bowl organs. As soon as the body returns to upright, the pelvic‐floor muscles need to support the pelvic‐bowl organs. The pubic symphysis joint contributes bony support beneath the bladder, since the female pelvis naturally has a slight anterior tilt.

Bridge With Overhead Reach

Bridge

  • Start in bridge position, feet firmly planted, arms at sides.
  • Place feet in narrow position, and then wide.
  • As you press feet into floor and lift hips into sagittal‐plane bridge, reach arms overhead.
  • Perform bridge with toes turned in and toes turned out.
  • Use small, inflatable ball and band for resistance (optional).
  • Do 2 sets of 10 reps (with variations).

Forearm Downward‐Facing Dog

Forearm

  • Do modified downward‐facing dog (place forearms parallel on floor, lift hips up and back).
  • Place ball and band between legs to provide resistance (optional).
  • Step feet apart and then back together.
  • Progression: Do jumping jacks (feet only), 2 sets of 10 repetitions.
  • Additional progressions: Perform stepping/jumping motions in sagittal, frontal and transverse planes of motion.

Downward‐Facing Dog

Downward

  • From all‐fours position, lift hips up and back to downward‐facing dog.
  • Place ball and band between legs to provide resistance (optional).
  • Step feet apart and then back together.
  • Progression: Do jumping jacks (feet only), 2 sets of 10 repetitions.
  • Additional progressions: Perform stepping/jumping motions in sagittal, frontal and transverse planes of motion.

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References

American Urogynecologic Society. 2016. Pelvic floor dialogues. Accessed Dec. 2016. www.augs.org/index.php?mo=cm&op=ld&fid=432.

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About the Author

Christina Christie, PT

Christina Christie, PT IDEA Author/Presenter

Christina Christie, PT, CCE, FAFS, FMR is the president of Pelvic Solutions, LLC and inventor of the Pelvicore™. She is a senior physical therapist and the Women's Health Manager at Athletico Physical Therapy in Park Ridge, Illinois. She is also faculty for the Gray Institute and the developer of the CEC the Female Chain Reaction. Christina specializes in the evaluation and treatment of women’s health issues, orthopedics and sports-related injuries. She is also a childbirth educator and has lectured extensively on the evaluation and treatment of women’s health for the APTA, IDEA and in other settings.