Recently, along with Adrienne Sim (Pelvic Floor Physiotherapist) from Full Circle Physiotherapy, I launched a program targeting Mom's who experience incontinence with skipping.
My thought behind this collaboration was to provide a holistic approach to tackling one very specific, common problem.
Adrienne is able to assess each participant with a pelvic health exam, provide insight as to why leakage may be occurring and then together we'd be able to assess movement patterns during skipping and other high impact activities.
I would write the program structure with inputs from Adrienne and keep each person accountable to 5-10minutes of homework (5 x per week) on TrueCoach.
Look - we are 3 weeks in to our first cohort of this program, and I'm not really sure what I expected so I thought I'd share my personal experience as a coach on the blog at each 3-week check in we have with the participants.
Reading that, I think it sounds naive to say 'I'm not really sure what I expected'. Adrienne and I have both helped many clients and patients independently to tackle this problem – but taking in a whole group with the same problem and committing to a 12 week program dedicated specifically to targeting one activity with related symptoms was new to both of us.
At one point, I even asked Adrienne – “Do you think people will benefit from this at all?”
And maybe rightly so - you see, every single person presented with the same symptoms - leaking with skipping. Not one single person had a similar (or even close) reason to WHY that may have been happening.
As Adrienne gently pointed out - because everyone presents so differently, that's very likely why the research is having a hard time finding answers (yet) with regard to treatment for high impact sport and pelvic health. Since you can’t standardize one program for everyone.
Again - maybe I sound naive? I offer personalized programming as one of my services so why should this be any different? I know VERY well, that people can have the same 'issues' and need an entirely different set of coaching cues or feedback to elicit great results.
Let me list some of the observations from the initial assessments for you and you can start to understand why this is so mind blowing and fascinating to me:
We had participants with great pelvic floor function and strength still experiencing symptoms.
Participants with pelvic floor dysfunction including the impairment of pelvic floor levator muscles resulting in an imbalance with weakness and atrophy.
Incredible core, abdominal and pelvic floor tension.
Anterior or posterior pelvic tilt affecting posture, breathing and daily functions.
Tight hamstrings resulting in altered skipping technique.
Decreased thoracic mobility resulting in difficulties with abdominal recruitment patterning or altered skipping technique.
And the list continues - this is a snapshot to show you how diverse the potential causes could be for someone experiencing incontinence with skipping.
Here are some ground rules I set for myself when building programming blocks for each participant:
No more than 5-10minutes a day. Like anyone, it's easy to get stuck in a 'more work = more results' mentality so it could be easy to program 45minutes of work to try and get more done. This is not beneficial, nor does it provide any accountability.
Programming needs to be as diverse as each participant. Not everyone needs to work on their skipping to improve incontinence with skipping... I loosely arranged 'buckets' of programming into strength, stretch, mobilize, breathe and jump with alternating components so if you do miss one day, it would be easy to pair it up and catch up on the next day.
Functional work - one participant was really happy to see that it wasn't just 'kegels' every day and instead they had opportunities to practice work in a variety of different ways.
Accessibility - I figured, as long as someone had access to a skipping rope, they could do the programming - this one has proven more challenging than I realized as I've incorporated boxes, pullup bars and bands into many of the programs.
I could ramble on all day - you just want to know if people are seeing results. Here are my biggest wins and take aways after 3 weeks thus far:
Awareness - every single participant reported a new level of awareness with their body - from the pelvic floor all the way to tippy toes and fingers. With new awareness brings opportunity to elicit change.
Strategies - there is no right or wrong way to do something, when I asked a couple of participants to try skipping with staggered feet or sing a song it was amusing (to me and them) at how difficult seemingly easy things could be. Here's a quote we all know well 'If you do the same thing over and over again, you can expect to get the same results'. So don't be afraid to change it up and play.
Ability to be vulnerable - for some, this is an emotional and frustrating problem. It can bring out years of pain, tension and feelings of disappointment.
After 3-weeks, not many are leak free, but I feel confident that all have made incredible progress towards sustainable life long change and I'm excited to see how the next 9-weeks unfold.
Here's another interesting observation I had which may be particularly interesting to coaches and CrossFit athletes.
Double unders (skipping whereby the rope passes under your feet twice) are a real 'try-hard' exercise. The risk when you fail is small - you trip, you get rope burn, maybe you leak? I realized very quickly that there are no good scaling options or progressions for this exercise (or jumping in general) in typical gyms. In comparison - we don't just load up a 200# barbell and 'try hard' to squat. No - we work on mobility, strength, coordination, power etc in multiple different ways until we get there.
These are words and opinions written by me - Coach Lisa
I'd love to hear your thoughts - are you interested in following along over the next 9 weeks?