Teach pelvic floor exercises in school

[thatdinothing]

Interesting.

Teach pelvic floor lessons in school, say guidelines www.bbc.co.uk/news/health-57640558

[vivariumvivariumsvivaria]

I think it's a good idea to introduce the concept as part of sex ed. Kids need to know what normal is, if they learned that their anatomy does x, y and z that would probably do.

They also need to be able to count and read. The more time we spend on "add ons" the less time there is for core education.

[SempreSuiGeneris]

Agree with lots of pps that this needs to be much more about a holistic approach. Most people would benefit from learning and understanding Pilates breathing before doing any other sort of PE training. The technique is equally applicable to lots of music training. Even string players improve with better posture although the application is more obvious in singing and wind / brass. Also lots of scope to introduce within the science curriculum rather than just teaching disjointed physiology.

[Soontobe60]

Bloody hell, what absolute nonsense! I can just imagine target setting for measuring successful pelvic floor strength, having to be inclusive to any trans or non binary students who either are male and want to identify as female or female and want to identify as not, having to demonstrate the exercises whilst simultaneously being observed by an Ofsted inspector, having to make cross curricular links (perhaps demonstrating forces in a physics lesson) and timetabling intervention sessions for those who need additional support as they haven’t quite got the hang of exercising their pelvic floors!

[FemaleAndLearning]

I was told that you shouldn't stop your pee often when on the loo as the backflow can cause infection. If you don't know where your pelvic floor muscles are you can stop your pee mid flow once or twice. The other way is to stick your finger in your vagina and when breathing out engage the muscles. But the squat exercise sound much better overall do thanks for mentioning it I'm off to read up on it.
I've had a double bowel prolapse repaired, I still have a womb prolapse and have a urinary tape. Three vaginal births, biggest baby was 10lb 6 oz but I think it was the first one that did all the damage lots of pushing when I didn't have the urge to push! Female physiology hey!
I had my ops at a fairly young age, 37, you need to be sure you don't want any more babies as it can undo all the operations.
I agree with other posters school PE really does need an overhaul.

[user1745]

I feel like girls in school wouldn't take it seriously. There's only so much time on the school timetable, so it'll be an hour long session here or there, which they'll giggle all the way through and it will all be forgotten by the time they get pregnant (potentially 20 or more years in the future). Far better to teach it during pregnancy in my opinion.

[NotAlwaysWrong]

Fuck I’m 54 and my pelvic floor has deteriorated badly in the past 18 months. I used to be able to hold in a wee for quite a while and then go to the loo. I still think I can and then find myself getting up to go to the loo and losing a knicker wetting amount before I get to the loo. So it’s a race to the loo as I strain to hold back the floodgates. Coughing and sneezing results in the need for some theatrical leg crossing and/or a knicker change.

I’ve been having telephone consultations with a nurse via my Dr who has told me no caffeine, don’t drink late at night, double void. I also need to lose about 4 stone. I got some pessaries that release low dose localised oestrogen and was on them for about a month but I haven’t had anymore. Because of lockdown I’ve not actually seen the Nurse but I’ve had leaflets and instructions for pelvic floor exercises - I just can’t keep doing them - I hate them - I tense up and then want to kill someone - I haven’t improved but I haven’t done them 3 times a day - pathetic I know. But by the looks of this thread it would appear that they’re not what I should be doing anyway?! Is that right? What about all the gadgets you can get?

I read a report about this in the Daily Mail and was horrified at the reaction. It was as if they’d suggested demo-ing vibrators in school. Pelvic health as part of overall fitness is not about sex (alone) - PE needs an overhaul - our kids should be doing exercises that concentrate on maintaining flexibility throughout life. Kids who don’t do competitive gymnastics or dance are stiff as boards by senior school and that’s shocking. Pilates and stretching every week instead of standing around bored with a game of rounders would be a much better idea (OK with some aerobic exercise thrown in too)

Oh and I have never had a vaginal birth ( 2 x CS) and my pelvic floor is shagged so it’s not only childbirth that does for it!

[OvaHere]

I think it's a good idea to teach core strength in schools but I feel it would be more beneficial as a PE module and available to both sexes.

Pilates isn't just good for gyne issues it can be transforming for back problems and mobility issues too.

DH had so many back problems in his 20s and 30s (maybe hereditary because his mum has similar problems) which were exacerbated by a career that meant long hours at a desk.

He had quite a bit of time off work because of it back then. He discovered Pilates in his 40s and within a couple of years all his issues were mostly resolved in a way that drugs or physio never achieved. He's in his 50s now and it means he is still able to participate in other sports he enjoys and have a good quality of life.

Most kids won't take a lot of notice of what they learn in school at the time but it would be useful to introduce the knowledge so it's there for if they do need to return to it in later life.

[trancepants]

I'm not sure about this because the way that pelvic floor exercises are taught tend to be kind of bollocks and strengthen parts of your core/pelvic floor while neglecting others. Ultimately leading to over-engagement of the stronger muscles and atrophy of some of the others, leading to further problems. I have a very strong core, which the pelvic floor is part of and encountered this when I took up trampolining. By trying to engage my pelvic floor, I was actually making myself more likely to pee on bigger jumps.

The actual key to not peeing myself was breathing correctly. Once I breathed fully into my belly my pelvic floor engaged itself properly, up not in and clenched, and I jump for a couple of hours, downing a couple of litres of (electrolyte) water in that time and could do repeated mid-air split jumps and finish up with pee-free underpants. Learning to engage the pelvic floor partially can do more harm than good.

[lazylinguist]

OMG OP - you've sent me down a rabbit hole now . I followed that link, ended up buying Katy Bowman's 'Move Your DNA' book on my Kindle and spent most of the evening reading it. It's fascinating. I'm a total sucker for health improvement advice, in spite of my doubts about teenagers in schools taking any interest!

[TeaandHobnobs]

@thatdinothing I also wish Pilates was taught more widely to teens.
Having done Pilates as an adult (post first child), I now understand so much more about what it was my ballet teacher was trying to get me to do when I was a teen! And I might have been better at some things had I known how to use my core properly.

[Gibbonsgibbonsgibbons]

Haha I started doing Katy Bowman squats as soon as I read the first post! (Always good to have a reminder! I always squat as I brush my teeth too) Delighted others have referenced her fantastic work.

[EmbarrassingAdmissions]

the advice thirty years ago was wrong.

I wouldn't be too surprised if a fair amount of knowledge and advice has changed in 30 years although it's quite hard to get accurate coverage in mainstream media and to persuade HCPs to update their knowledge.

NICE has a number of evidence reviews on different aspects of pelvic floor dysfunction as well as a consultation document on which they're inviting comments.

[LibertyMole]

Okay, totally confused now. I was told, and read, on numerous occasions that pelvic floor exercises were about pretending you were gripping a coin in your vagina. I didn’t know it was about stopping your flow of urine.

I am glad I haven’t bothered doing them, as the advice thirty years ago was wrong.

[EndoplasmicReticulum]

Just imagining year 9 on a Friday afternoon "you want us to do what miss?"

[thatdinothing]

That is interesting Lucy. Glad it helped.

Bowman is an advocate for the whole body, weight baring movement and a lot of her stuff is very much about alignment and better movement (and sitting in many different ways) so the body doesn't end up with the weakened/ strained muscles and ligaments that lead to longer term issues.

She's very into hiking due to the way it exercises so many different pelvic, foot and leg muscles. ( barefoot!) have to say my lower back improved loads when we spent a half term doing lots of walks with a kid in a sling on my back.

It's just hard to wade through her stuff as she writes a huuuuge amount.

I'd agree with you 0noneO and purple.

As a teacher, I can definitely also see the issues with yet more things to cover in the curriculum. can think of a number that could go though

[0None0]

None of this is up to date or relevant. Knowledge of the structure. Function and care if the pelvic floor has moved on since the idea of ‘pelvic floor exercises’. I suggest we wait until modern science developed some basic understanding of what the pelvic floor even is before start deluging children with misinformation.

Of course, being an aspect of female anatomy rather than male, it’s a long way down the priority list for research.

I’ve heard it described as the only organ left in the human body that isn’t known, apart from the brain, and we are investigating the brain

[LucysSkyDiamonds]

Katy Bowman advocates for squatting exercises with a lot of research to back it up.

That's very interesting. I have pelvic damage as a result of 2 c sections and the physiotherapist I saw give me lots of info on kegels. It was only when I started with a personal trainer doing body weight training and then weight lifting that my pelvic floor actual improved.

[PurpleWh1teGreen]

I'd like it to be taught. Along with consent & contraception it's such an important issue for women's health.

But the biggest biggie for me is prevention of UTIs. They are not just a routine part of being a woman - they are mostly preventable. Thousands of sick days must be lost every year, women suffer pain and discomfort and long-term health issues if they are allowed to become recurrent. They also cost the NHS a fortune.

Wipe your bum from front to back. Teach your daughters to wipe their bums from front to back. Drink enough clear fluids & have a wee after sex.

[WarOnWoman]

@lazylinguist

Not everything can be taught in schools! I don't mean conceptually, I mean practically. Every single campaign from menopause to sexual abuse the cry goes up 'teach children about this in schools'. It's madness. What is it - about 10% of kids leave school functionally innumerate or illiterate?

Exactly. Schools don't have the time, the qualified staff or the resources to teach effectively all the things they are already supposed to teach.

Yes. This. I also don't think many teens would engage with this as lazylinguist has already pointed out previously.

[thatdinothing]

@PaleGreenGhost

Agree that PE would be a great place to incorporate it - pilates or Mutu style exercises are basically normal strengthening exercises where you are taught to focus on the pelvic floor at the same time. I believe school PE needs to broaden its outlook away from just competitive team sports anyway.

Absolutely; apparently that kegels are only a part of helping the pelvic area and lower back avoid problems.

Katy Bowman advocates for squatting exercises with a lot of research to back it up.

I don't hate the Kegel at all, but what people need to know is there is a poorly understood, much larger whole-body issue going on in those with PFD that the Kegel doesn't even touch.  If this larger whole-body issue were addressed, you would never need to kegel to keep your junk in place.

The pelvic floor is not supposed to be a muscle you "train". It is a muscle meant to be working continuously based on the correct use of the lower limbs and muscles in the trunk:  diaphragm, psoas, TVA and TVT, lumbar extensors, multifidus, intercostals, latissimus, gluteus maximus, TFL, etc.  Because of years of mal-alignment and incorrect lower leg muscle development, your larger muscles are not bestowing the PF with the space and support it needs to maintain a healthy tension. That tension is necessary to its ability to generate force. A Kegel is a good way to "fake it", but the PF is too small to make up for the work not being done by the larger, slacking muscle groups.

www.nutritiousmovement.com/kegel-queen/

MUTU was great, I didn't do it all but I still dip in occasionally. I think the author worked with Katy Bowman as well as being a women's health phyiso.

Interestingly a lot was similar to some martial arts stuff I used to do. Another thing I feel should be on the curriculum.

[GrandmasNightgown]

I think schools are the place, and it would be part of teaching either in a general strength and conditioning session, or as an add-on to warm up/cool down stretching

It's good for both boys and girls, and an important exercise.

[Chwaraeteg]

Girls should be taught about pelvic health but I don't like the way this has been approached. The articles I"ve read on this are suggesting this is taught as part of sex and relationship education, which is a bit fucked up 😐 It should be taught as part of PE surely? In a 'this is how to keep your body healthy' way rather than 'you need to stay tight for the boys'/handmaids tale way.

Also, I fear there is a lot of victim blaming from health professionals around the subject of pelvic floor health. Some seem to give the impression that all pelvic injuries/prolapses etc can be avoided by doing your excercises. This just is NOT true. And why don't they focus on helping women who do have pelvic floor dysfunction?

[lazylinguist]

Not everything can be taught in schools! I don't mean conceptually, I mean practically. Every single campaign from menopause to sexual abuse the cry goes up 'teach children about this in schools'. It's madness. What is it - about 10% of kids leave school functionally innumerate or illiterate?

Exactly. Schools don't have the time, the qualified staff or the resources to teach effectively all the things they are already supposed to teach.

[PacificState]

Not everything can be taught in schools! I don't mean conceptually, I mean practically. Every single campaign from menopause to sexual abuse the cry goes up 'teach children about this in schools'. It's madness. What is it - about 10% of kids leave school functionally innumerate or illiterate?

Women need to learn how to do kegels effectively, healthcare practitioners need to talk about it more, we need more women's health physios, GPs need to refer more women to specialists, maternity services need to stop bullying women into vaginal births when there are significant risk factors. Like most things it's complex and there isn't an easy answer. Giving year 9 one half-hour lesson about pelvic floor exercises is largely pointless.

[PaleGreenGhost]

Agree that PE would be a great place to incorporate it - pilates or Mutu style exercises are basically normal strengthening exercises where you are taught to focus on the pelvic floor at the same time. I believe school PE needs to broaden its outlook away from just competitive team sports anyway.