Sit ups

A recent study by Curtin University’s School of Physiotherapy and Exercise Science found that sit-ups could be bad for the pelvic floor.

The research, published the International Urogynecology Journal, involved 90 women who participated in regular group exercise, typically engaging in a variety of low and high-impact group exercise classes, such as Pilates, yoga, running, ball sports, aerobic classes and weight training.

The researchers used ultrasound to assess the impact sit-ups had on the women’s bladders and pelvic floors, as well as the women's ability to effectively exercise their pelvic floor muscles.

The study found that sit-ups increased the strain on each participant’s pelvic floor, and that about one quarter of the participants were doing their pelvic floor exercises incorrectly.

Researchers found that pelvic floor strain was worse in women who had had children, with 76 per cent of this group reporting they regularly experienced stress urinary incontinence (compared to 60 per cent of the whole group), most commonly triggered by exercise.

The study’s most significant finding – that all the women involved in the study experienced “bladder-base depression on abdominal curl” - demonstrated that sit-ups were potentially harmful to women who exercised, researchers said.

“In symptomatic women or those at risk of pelvic floor dysfunction (women who had had a baby or gynaecological surgery), it would seem appropriate to recommend that they not participate in abdominal curl activities in order to minimise the risk of further pelvic floor muscle strain and incontinence,” researchers warned.

They also said that women who weren’t currently experiencing incontinence should also proceed with caution. “The repeated pelvic floor muscle strain with abdominal curl exercises could potentially be putting asymptomatic women at risk of developing incontinence, prolapse or other pelvic floor muscle dysfunction.”

60 per cent of the total cohort (those who experienced incontinence while exercising) said they modified their behaviour before exercise to avoid leakage; 65 per cent of this group went to the toilet before exercising, 41 per cent altered or reduced their exercise participation, 31 per cent wore a pad and 22 per cent restricted fluid intake prior to exercise.

Interestingly, these behavioural strategies were also adopted by the women who did not report incontinence, leading researchers to conclude that such avoidance habits “not only indicate that the prevalence of SUI (stress urinary incontinence) may in fact be higher than reported in this group, but also highlights that a proportion of women may unknowingly be participating in inappropriate exercise that is placing strain on their vulnerable pelvic floor”.

To learn more about pelvic floor safe exercises and exercise modifications, go to pelvicfloorfirst.org.au

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