When talking about taboo topics can make us better trainers
Whether we are helping our clients achieve fitness or aesthetic goals, we know that decent mobility and mechanics are essential in the process of building muscle and burning fat while successfully avoiding injury.
The best coaches are trained to identify compensations and teach their clients mechanics that protect the body as it engages in heavy lifting, running or jumping.
As both functional training and mobility become more mainstream in fitness, we trainers are talking about the role of pelvic floor in becoming not just fit, but also functionally strong!
This is amazing (and necessary) because if we think of the body as a house, the pelvic floor is the floor joists and footings which support everything built upon it.
And just like a weak, sagging or poorly maintained infrastructure, a client’s poorly functioning pelvic floor will not be able to support the everything built upon it.
Everything in the body is connected and anything that is connected to the pelvic floor will have to compensate when the muscles of the PF are not functioning well.
As a results, clients begin to experience leakage, stress incontinence, pelvic organ prolapse (things that fall through the floor joists), shoulder injuries, back pain, neck and even elbow and wrist troubles. (JulieWiebe.com)
But we aren’t all given the tools (or courage) required to engage in conversations that help us determine when a client’s body, particularly their pelvic floor, is not responding well to training.
How often is a coach saying to their client:
“We’re working on clean and jerks today, but you need to be honest with me and with yourself if at any point you begin leaking anything (fecal or urine), experience low back pain, tailbone pain, pelvic pressure or the frequent urge to urinate during or after our workouts." ???
I’m not suggesting that every coach and trainer needs to harp on these issues, BUT we are the first line when it comes to detecting health issues that can have TREMENDOUS impact on the body and quality of life.
Therefore these lines of communication need to be open and we can all figure out how to help our clients feel at ease talking about these sensitive topics.
IN FACT I've created a super concise and informative guide for coaches to help them talk with their clients about the pelvic floor. You can grab it by filling out the form to the right!
Ok, so why is all this important?
Because pelvic floor dysfunction is a COMMON issue!
One out of every five Americans (of any age) suffer from some type of pelvic floor dysfunction at some time in their life. Over 25 million Americans suffer from urinary incontinence alone or involuntary loss of urine. And it is not just a "women's" disorder; men and children can have pelvic floor dysfunction as well. (Jundt, Peshcers and Kentenich, 2015)
And what’s even more of an emerging issue that coaches are REALLY not trained to discuss with their clients is diarrhea and constipation or both, referred to as irritable bowel syndrome (or IBS).
IBS impacts one in five people. It is STRONGLY associated with pelvic floor dysfunction, and negatively affects the pelvic floor, aka the structural integrity of the body.
As many as 50 percent of people with chronic constipation have pelvic floor dysfunction (PFD) . (Mayo Clinic) Diarrhea also puts strain on the pelvic floor due to the frequency of elimination that is occurring sometimes 3-5 times in a day!
We see a lot of athletes and folks with fat loss/fitness goals battling with increased gut stress for several reasons.
1. High intensity endurance-based workouts can benefit the gut by increasing microbial diversity, BUT it can also cause problems in some individuals. During intensive stressful physical exertion, blood flow away is diverted away from the gut and sent it to the brain, heart, lungs and muscles.
This is part of the "fight or flight" response and a perfectly acceptable aspect of exercise. BUT if we have an individual that suddenly goes from not exercising to training 5 days a week, then it's very likely that their digestion and gut health will suffer. (Rauf 2017)
2. While protein is beneficial to fat loss, the building of lean muscle mass and the health of the gut microbiome, this is not always the case with protein powder! Many protein powders on the market contain artificial sweetness, thickeners, and allergenic foods that are irritate the gut and can even kill off important organisms in the gut microbiome. (Precision Nutrition, 2016) (MindBodyGreen, 2015).
3. Dramatic changes in diet and lifestyle. We all know that in an effort to get big results in a short amount of time, clients can sometimes adopt extreme diet habits and over-tax their bodies. Chronic, unrelenting stress is for our entire body, but especially the trillions of microbes that make up our gut. (Nature, 2017) A diet rich in nutrition, protein, fiber, and an appropriate amount of good quality fat and high-fiber, watery carbohydrates is ideal for anyone looking to grow lean muscle mass. In this day in age, many people try to take short cuts to physique change by restricting food intake or entirely cutting out certain food groups. For example, low carb diets can starve the gut microbiome of the fiber it requires to function well AND help the host (us) create healthy stools.
All of these issues and more contribute to the increased likelihood that a client will experience digestive distress.
But again, the percentage of folks that are battling IBS and IBD is already so high because most of us have have gut mircrobiomes that have been negatively impacted by pesticides, herbicides, food additives, antibiotics (both in foods and from prescriptions) chronic stress and lack of movement.
So even without the above listed compounding effects, it's very likely that you will encounter clients that struggle with irregular digestion and elimination, i.e. IBS or IBD.
A client’s inflammatory bowel syndrome (or a more sever condition, inflammatory bowel disease, IBD) is causing stomach clenching, bloating due to gas, multiple bouts of diarrhea a day or chronic straining due to constipation, then that chronic pressure and strain is CONSTANTLY pushing down on the muscles of the pelvic floor.
And as mentioned above, these muscles aren’t necessarily in the best of shape to begin with, due to all the sitting and lack of daily natural movement, and now we are effectively kicking them when they are down in the bathroom, NEVER MIND all that high impact work in the gym!
It’s as if a house that was neglected for a while needed some of its footings or joists maintained and bolstered a bit.
But instead of doing that, the contractor drives a gigantic heavy piece of machinery into the house EVERY DAY or maybe multiple times a day, weighing down the already compromised floor of the structure.
If the strain is too much, the floor eventually gives way and the structure crumbles or parts of the house lose strength and abilities, fall through the floor and collapse.
So now I’m not just suggesting that we talk about incontinence and urge to pee, but also diarrhea, constipation and bloating.
But who better than us?
If we educate our clients on the fact that their bathroom habits are in close association with performance and overall strength, then aren’t they going to feel more comfortable sharing with us when they are experiences some not-so positive biofeedback in response to exercise?
And then what do we do?
There are some non-medical suggestions that we can make when it comes to exercise form, breathing, movement habits and gut health, but IDEALLY we have a team of professionals that we can refer our clients to in order to get the help that they need to truly build a body that is fit and a lifestyle that is enjoyable!
We need pelvic floor physiotherapists, functional medicine practitioners or dietitians that specialize in gut health in our network of professionals so that we don’t suddenly lose clients to injury or just no-shows.
How many of us have had folks up and quit with no explanation?
Sure, in the fitness world people get bored or frustrated or lose motivation, but people also get chronic diarrhea, stress incontience, pelvic organ prolapse or chronic injuries that stop them from coming back too.
We will be in a much better of a position to cultivate long lasting relationships and results-production programing when we account for the health of the gut and pelvic floor in our evaluations of a client’s needs and make space for these topics in our communications and discussions with clients!
So stay tuned here (or SHORTLY you can grab my ebook on the topic) to learn more about:
- simple steps clients can begin to take to care for their guts or pursue answers about possible gut-related health conditions
- why our guts are no longer working as efficiently and effectively as they should
- how high endurance sports, some supplements, protein powders and other nutritional practices are negatively impacting the gut and consequently performance
- lots of other things like how dirt makes us strong and how natural movement can prevent pelvic floor dysfunction.
The soil microbiologist and natural movement geek in me is DYING to talk right now about how strong guts populated with ancestral strains of soil-derived microbes and strong butts that support the pelvic floor are the way to bulletproof or heal one’s self from elimination struggles and pelvic floor-related health conditions, but we’ll talk about that next time!
If you are a health professional OR just interested in these topics and want to be notified when my ebook or other blogs are posted on the amazing relationships between the gut, the pelvic floor and athletic performance, fill out the form below.
I would especially appreciate feedback from other fitness professionals in the field. Thank you!