Episode 1871 - To cue or not cue the pelvic floor under load
Dec 16, 2024
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Dr. April Dominick, a faculty member specializing in pelvic floor rehabilitation and strength training, explores the nuances of cueing the pelvic floor during loaded activities. She discusses whether intentional cueing is beneficial and shares the A-frame analogy to illustrate balance in pelvic floor function. April also highlights the importance of recognizing client symptoms and the challenges they face, like leaking. Her insights aim to enhance care for patients and athletes alike, making pelvic health more integrated into strength training.
Maintaining the pelvic floor's optimal position during lifting is crucial for preventing dysfunction and ensuring support during loaded activities.
Intentional cueing should be tailored to individual client needs, gradually shifting from tactile aids to verbal cues to enhance awareness without cognitive overload.
Deep dives
Understanding Pelvic Floor Strategies Under Load
The pelvic floor should ideally maintain a specific position during weightlifting activities to prevent unwanted leakage or discomfort. The concept of the 'A-frame' analogy is introduced, where the pelvic floor's position can be likened to three levels: the basement (relaxed), the first floor (tense), and the attic (squeezed). The desired outcome during lifting is for the pelvic floor to be positioned at either the first floor or the attic, which signals readiness and support. Maintaining this position is crucial in ensuring that pelvic floor dysfunctions do not occur while engaging in loaded movement.
When to Cue the Pelvic Floor
Intentional cueing of the pelvic floor is necessary for individuals who exhibit signs of dysfunction, such as those with poor awareness or coordination during lifting. Rehab professionals should first educate clients about the pelvic floor's role as a supportive muscle group before introducing cues tailored to individual learning styles. While tactile and visual aids may be useful early on, the goal is to transition to verbal cues that promote awareness without overwhelming the client. This approach mitigates the risk of cognitive overload, allowing clients to focus on achieving optimal performance during movements, as less is often more.
Pelvic Floor Exercises to Build Strength and Coordination
Certain exercises can effectively target pelvic floor impairments and enhance coordination, progressively building strength through load. Movements such as deep squats, bird dogs, and step-ups help clients connect with their pelvic floor while also integrating functional strength training. As clients progress, incorporating heavier loads ensures that the pelvic floor can adapt to increased intra-abdominal pressure during activities like deadlifting or overhead presses. Ensuring that clients are encouraged to lift with proper mechanics and awareness is essential for achieving long-term pelvic floor health.
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Cueing the Pelvic Floor Under Load: Strategies and Techniques
In today's episode of the PT on ICE Daily Show, ICE Pelvic faculty member April Dominick discusses how we as rehab providers sift through the noise of cueing and set someone’s pelvic floors up for success when they are loading and lifting? Should we intentionally cue the pelvic floor during loaded activities? If so, which cues are the most effective? OR Do we even NEED to intentionally cue the pelvic floor when someone is lifting and moving weight?
Take a listen to learn how to better serve this population of patients & athletes or check out the full show notes on our blog at www.ptonice.com/blog.