To Fitness Pros — Hold off on the cues to “engage your pelvic floor” (and what we can say instead)

To Fitness Pros — Hold off on the cues to “engage your pelvic floor” (and what we can say instead)

November 12, 2020

Let me start this by saying that I am incredibly grateful for those who have gone into the fitness industry.  WE NEED YOU!

Of all the things I have missed during the 2020 year, I have REALLY missed being able to settle into a group fitness class, let the instructor take over (turn off my PT brain a tiny bit), and get my butt kicked in the best way.

Group fitness is a fantastic way for those of us that are more externally motivated an/or socially inclined to get a great workout in a more directed fashion and be held accountable.  It helps us push ourselves MUCH farther than we would on our own in the quiet of our home or solitude of a personal workout area of a gym.

In the years that I have been a consumer of group fitness or personal training, I have very rarely heard much mention of the pelvic floor muscles.  Discussing this private-yet-crucial area of our core muscle team is increasing these days, but I have only heard the phrase “engage your pelvic floor”.

When I hear this, I am super happy that the instructor had the awareness of this core muscle group AND that they had the GUTS to mention it!  After all, saying “pelvic floor” seems to be holding on strong as a tabou phrase, even in 2020!

What I would recommend if we are really gonna go there, that we REMOVE the ASSUMPTION that everyone has a weak pelvic floor.

There is a LONG HELD belief or idea that ALL pelvic health issues are a result of WEAKNESS. WHAT?!  This isn’t the case?  NOPE.  At times, I could easily say that 70% of my patient population have issues that include the INABILITY TO RELEASE their pelvic floor muscles.  This includes issues with bladder leakage, pelvic organ prolapse, pelvic pain, and more.  Telling women that we should ALL focus on “engaging” or contracting will possibly make many of the clients’ issues WORSE.

INSTEAD, I would recommend that fitness professionals do the following.

  • Bring attention to the fact that pelvic floor muscles exist (for men and women) and we can connect to them with our BREATHE.

  • We can BREATHE into our belly AND our pelvic floor area.  Meaning we can release and expand these areas with our inhale.

  • We can “engage” our pelvic floor AFTER releasing it while we exhale.

  • Help our clients understand that breath holding with exercise can strain or put undue stress on many areas of our body INCLUDING our pelvic floor.

  • Recognize that there will be exercises that clients may not be able to manage their intra-abdominal pressure well and they will get an outward bulge of both their pelvic floor and belly.  THIS IS NOT GOOD.  These people need to scale back the difficulty of their exercises if this happens.  Applying excessive downward forces on the pelvic floor can only work to weaken the ligaments that suspend the pelvic organs and once they fail, they cannot be strengthened like muscle.  LEARN WHAT PELVIC SAFE EXERCISE IS.  

Know that pelvic floor specialist physical therapists cannot fully be sure WHAT the pelvic floor muscles are doing or not doing unless we perform an internal pelvic floor muscle assessment.  That’s right!  Even with all of the evaluating we can do externally with our clients, we STILL can’t fully know if we should be advising our patients to focus on contracting or relaxing their pelvic floor.  


The SAFEST bet when teaching group fitness classes or even one on one training sessions is to learn more about pelvic floor health so that you feel comfortable talking a tiny bit about it.  YOU can help MANY women begin to be body literate and understand that their pelvic floor is a part of their core muscle team and that it is connected to breathe.

Learn what clues may indicate if your client could benefit from seeing a pelvic floor specialist and don’t be afraid to mention this source of help to them.  If you are a trainer or fitness coach and have questions, please reach out!  I would be happy to give some specific guidance in talking about pelvic floor muscles with your clients.

They NEED us ALL to be their advocate on this.  Pelvic floor dysfunction can rob many of their quality of life.  And the numbers of women with dysfunction is HIGH.  Assume that at least 30-50% of your clients have something going on with the function of their pelvic floor muscles, but let’s not assume that everyone is weak.  

So again to all of the fitness pros out there, THANK YOU for helping to motivate and guide us to being the healthier and happier versions of ourselves!

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