For nearly a decade I worked exclusively with women in my private mishfit® Personal Training studio. Before we even contemplated any exercise, each of my clients had an intial consultation that lasted for around an hour and a half. Yes, I assessed their posture, their gait and asked all the usual health related questions. But most importantly, I gave them the space to speak their stories.
You see for the most part, women came to me because I specialised in working with women with pelvic floor dysfunction. Some women with mild incontinence came as part of their post birth recovery. But many came with much more grave conditions. Most of these women had been diagnosed with prolapse.
For a number of years I use to ask the question:
“What bothers you most about your prolapse?”
Although each woman and their story was unique, I started to notice patterns. Repeatable phrases that they used to describe how they were feeling about their prolapse.
These statements were repeated to me many times. By many women. Over many years.
So I modified my intial consultation and asked them to rank the phrases instead.
The phrases were:
- Sometimes I can feel my prolapse rub on my underwear and this is uncomfortable
- My prolapse has affected my sexual relations and / or how I view my body sexually
- I feel like my body has let me down
- My prolapse has affected my self-esteem
- My prolapse stops me from exercising the way in which I would like to
Changing the process this way achieved a couple of things:
- The list gave words to feelings that often the women had not articulated to another person. It was a question that not even the pelvic health phsyiotherapist, whom I made them see (if they had not already), asked them. Mostly their prolapse had been reviewed in technical terms. This is no slight on the physiotherapists – I recommended only those who had a caring bedside manner. But the appointment hardly allowed time for this sort of open ended question.
- It gave space to their feelings. Prolapse is a condition, but for many women it also represents a grief journey. However, because of the extremely personal nature, and perhaps lack of awareness (especially in the fitness industry) many found it was a challenging topic to bring up and talk openly about. Prolapse can represent a sense of loss of their previous self. I am no grief counsellor, but I was able to hold space for them to start to acknowledge the mental healing that needed to happen.
- And finally, these statements confirm that they were not alone. When I explained that these were the words of many other women who had come before them, there was nearly always a change in their physical posture. They relaxed a little more. They would look again at the list and happily point out all the things that did not apply to them.
Pelvic floor dysfunction is varied and complicated and although I had no way to diagnose, I was able to arm them with the right questions to ask the right professional who could.
After our initial consultation the typical number of sessions that each of the women would have with me was between 3 – 5 (of 45 minute duration). I was not particularly interested in training them, week in and week out. Instead I focused on finding out what they needed to know to keep them active, doing the activity that they loved. I imparted on them, a rule book of sorts, that they could use to move forward, confidently in the exercise of their choice.
For the woman who came to my studio, their objective may have been to feel confident to return to their much loved running or weekly bootcamp. Or it may have been to have the confidence to travel and adventure without the anxiety of knowing where the next toilet is. What ever their goal, I quickly learned that it had to start with acknowledging their mental / emotional state, before we could even start the re-education.
If our clients feel their prolapse has impacted on their self confidence, voice concern about how they are going to exercise and disbelief that their body has let them down… then how do you imagine it might feel for female Fitness Professionals who experience prolapse?
Fitness professionals are seen as the leaders for health and well-being. They are on the stage with a mic motivating us. They are the voice pushing us to achieve physical feats that we perhaps did not think possible. Sure, they are just at risk as other mere mortals of injury. (If you have ever run a training program for trainers, it is rare to find one, without an injury!)
Consider if you have ever heard the following:
- a Body Pump Instructor explain that they can’t lift heavy weight because they have pelvic floor issues
- a HIIT Instructor not participating fully in the high impact cardio without an incontinence pad
- a yoga teacher explaining that they can’t do a particular exercise because it will make their abdominal diastasis (DRAM) worse?
Perhaps, it could be possibly concluded that Fit Pro’s are immune from pelvic floor dysfunction?
Research would tell otherwise.
Kari Bø is one researcher, who through many clinical trials, has shown that female athletes are significantly more at risk of urinary stress incontinence. Her research has been around for awhile citing the relationship between female athletes and high impact sports causing pelvic floor dysfunction.
Yet, we rarely read about athletes and their pelvic floor dysfunction.
But there are women who are bravely choosing to speak out.
I would like to share with you three women who are sharing their stories in an effort to bring this issue out into the open.
Lyn from Menofitness shared her story of prolapse to her whole database in a very personal newsletter . She wrote:
“I am a 50 something mother of 4 and had to have surgery to fix my rectocele prolapse lift my pelvic floor lift.
And yes, I am a Fitness Professional!
In my training to become a Fit Pro, I loved learning all about the body, how it worked and fitness in general but there never anything mentioned about the pelvic floor. For years I trained women the way I was taught and I exercised the way I loved… Hard Out! I ran everywhere.
The education and knowledge about the workings of the pelvic floor and how exercise can potentially do a lot of harm to women, came sadly, when the damage was already done.
These days my exercise routine is VERY different but still extremely effective. If only I knew back then what I know now!”
I replied immediately to Lyn’s newsletter and acknowledged her bravey and strength to share her story. And her reply was…
“Being a Fit Pro’s doesn’t give you a special ‘get out of jail free’ injury card. We are only human. But I did have to put my BRAVE on because when my prolapse was diagnosed I felt embarrassed, disgusted, and asked ‘why me?’ I felt that if I told people then they would think I was a scam and say, ‘How can she advise us if she is like that! She is supposed to be a Fit Pro’.
But it is liberating to not hide anymore and I now believe that women find it comforting to hear my story and realise that they are not alone.”
Many people hold the assumption that pelvic floor issues happen only to older and / or overweight women. Kylianne completely blasted that concept out of the water.
Being a fitness professional and an elite athlete, Kylianne felt completely confident to train herself postpartum. The diagnosis of a grade two bladder prolapse eight weeks after the birth of her first daughter, initially destroyed her self confidence. She says of her experience.
“I certainly felt like a failure, very distressed and embarrassed that I had a prolapse. I had let my ego get in the way in my first pregnancy and I thought I knew better. I felt like I shouldn’t be a personal trainer and coaching women, if what I had been doing had resulted in prolapse.”
However, as a testament to Kylianne’s strength of characher, she turned this negative into a positive by vowing to bring this issue to the public. Kylianne shared her story publicly for the first time as a Platform presenter at the 2015 Women’s Health and Fitness Summit. Her story touched the audience profoundly.
Kylianne undertook significant re-education on how women should be trained. And how do to this safely. Women who have experienced prolapse still crave effective training that physically challenges them. Kylianne’s personal experience of prolapse and subsequent re-education, changed everything about how she trains her clients today.
“Once I dealt with the grief and devoted my time to learning more, the more I believe that my prolapse happened for a reason. Pregnancy and birth may have just been the tipping point to my actual prolapse after of a LONG history of pelvic dysfunction. There is so much that can be done to avoid this situation and it will always start with awareness and education.”
Kylianne now runs adventure hikes around the beautiful coastline of Western Australia. She is also a mental health advocate and an Amabassador for the Gidget Foundation. Check out her amazing photos on Facebook and Instagram.
Jenni van den Berg is a Pilates instructor who was diagnosed with both a uterine and rectocele prolapse when she was 9 months post partum after the birth of her second child. Later she was also told that she had a partial levator avulsion. This is a condition where the pelvic floor muscle detaches from the bone. No amount of pelvic floor exercises will re-attach it.
She was just 31 years old.
Jenni says about her experience:
“I hated this condition on every level, it was so hard not to hate my body as well. Explaining to clients about my condition has always been tough – Pilates is meant to be all about the core and mine was literally falling out of me! It takes a lot of bravery to tell clients and instructors because it’s really easy to feel judged and that I’m less of a Pilates instructor.
For a long while I viewed myself as a failure as a Pilates instructor as the advanced movements were now off the cards and how could I possibly teach others how to find their core, when mine was dysfunctional?
“What I have learned is that we are all meant to be training with integrity with our own bodies and as instructors we are in the best position to be role models for our class. It does take bravery to acknowledge an exercise is too strong for my body to clients, but it sends an even more important message that it is all about amazing form, rather than doing the hardest variation.”
The journey of finding my own true core, means I now have a greater understanding of how the core actually works. I have been inspired to believe failure isn’t failure – it’s just a hidden opportunity to find another way.”
Across three employers and her own business, zipRfit, Jenni is an advocate for integration of pelvic floor friendly options into group fitness. Jenni is passionate about assisting instructors to understand more in this area and recently she started a Facebook forum to support instructors on the pelvic floor learning curve. The group has been nominated for a National award and has grown rapidly to over 400 members from across the globe!
If you are a Fit Pro, please know you are not immune from pelvic floor dysfunction!
But you are also not alone.
Click here to learn more about training women’s bodies.
And if you are NOT a Fit Pro… watch this space… I have something very exciting coming for you SOON!
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