Many pelvic floor specialists are a little perplexed when I say I get clients with pelvic floor dysfunction results without Kegels.
They’re even MORE dumbfounded when I don’t do any internal work, close to zero physical assessment, and start with the foot, but hey ho, I like to stand out.
I agree that it may appear that restoring pelvic floor function the full-body way may be some sort of spell that I cast over my clients, but honestly, I like a simplified, step-by-step, systematic approach to anything really.
I’m here to share some of my tips with you to get your clients consistent results too (and dare I say save yourself time and heartache in the process..!?):
1 – PAR-Q / HEALTH SCREENING
Contrary to most, I don’t have a lengthy health screening form.
Shoot me down in flames if you wish, but my clients are busy people, with busy lives, and if they’ve finally made the decision to pay me £400 for 5 x 60-minute Zoom sessions, I kind of feel like me insisting they fill in a 8-page questionnaire online might just tip them over the edge.
My pelvic floor PAR-Q has 17 questions in total (10 standard health questions, 7 pelvic floor ones), and realistically, I just need the basics on paper because all of the magic happens when I verbally screen them.
2 – CLIENT-LED VERBAL SCREENING
I may differ to others here because at our first appointment, I sit down with my client (on the floor I might add), grab my pen and paper, and start the conversation with:
“So, if you’d like to just let me know anything that you think is relevant really…about your symptoms…when they started – that sort of thing…and I’ll take some notes as you talk, ok?”.
I think it’s absolutely vital in first appointments that the initial 5-10 minutes be CLIENT-lead.
I scratch down some notes (in their words). I’m probably not making a lot of eye contact if I’m honest, but I’m certainly not interrupting her flow.
Sure, if it gets to 10+ minutes and the client is STILL going (boundaries and all that), I’ll probably step in and get her up and moving and carry on the conversation teaching her standing stance etc, but oftentimes, clients have been through the mill, haven’t they?
3 – BE PERSONABLE AND APPROACHABLE
One prolapse client I worked with had had 7 different people look at her vag.
I mean seriously?! If I could’ve reached through the Skype screen and hugged her, I would’ve done.
Because of my alternative approach, I’m sometimes people’s last hope if you catch my drift?
A lighthouse. A beacon of shining light. Guiding them to comfort and safety.
I am: The vag whisperer
(Actually, no I’m not. Someone else has that title. I checked. The domain’s already taken – LOL!)
Anyway, I digressed a bit there, but there is something special about those of us who are passionate about clients’ privates parts, huh, and I think it’s down to being approachable and being personable?
It’s not something many people in general are happy to talk about, but providing a space for clients to open up and be heard is something we can definitely provide, so if there’s some way you can make your appointments enjoyable and less clinical, I’m all for that.
I have a right laugh with some of my clients – I just can’t help myself, and offering 60 minute consults is the best thing you can do. That’s time well spent for both you and them.
4 – IT ALL STARTS WITH THE FOOT
One of the BEST things about the biomechanics stuff I do is this:
I teach the client an exercise to mobilise her foot.
She sets herself up working the right leg. I layer in some nerdy education about the connection between the foot and the vag.
She switches feet, and the process repeats itself on her left foot.
Second round of the same stretch ensues, and I very succinctly layer in more cues, a teeny bit more knowledge and we’ve switched over to the left foot at her pace.
By the third round *ding ding* – she’s repeated my cues verbally to set up – mastered it – and is actually smiling at herself for doing so well.
Actually, no – there’s more cool stuff which forms the absolute basis of what I do.
5 – MANAGEABLE HOMEWORK THAT’S NOT REALLY HOMEWORK
The cool stuff happens when the client comprehends how simple, easy and manageable the exercises I prescribe actually are.
When a client works out (all by herself) that she can do all of her homework:
• At home
• Whilst brushing her teeth (with zero concentration required by the way)
• Changing her baby
• Stacking and unstacking the dishwasher
• Soothing her baby on the landing at 4am
• At the kitchen sink
• Randomly whilst out for a walk
THIS is the part where angels start singing for me because this is where they’ve not seen what I do as exercises. Here, they’ve made a commitment to CHANGE something, however small it is to their LIFESTYLE.
And, did you notice that I did the grand total of NOTHING that focussed on her vag there?
Maybe this stuff is magic? I don’t know.
If however, you’re prescribing “homework” that requires a tonne of equipment, loads of back-lying exercises (I mean come on – one of my clients’ lived on a boat!?), and/or way too many movements in one session…
…can you make a pact with me now to do these 3 things going forward?
1. Prescribe a max of 7 exercises at each appointment (keep it simple remember?)
2. Focus on mobilising the foot (because tightness in the foot doesn’t allow for posterior push off with the glute max, which is what our ultimate goal is), and
3. For the love of the vag Gods up there, can you lengthen her hamstrings (please)?
Do NOT feel bad if the last pelvic floor client who came to see you got 24 exercises from you, none of which were foot or hamstring-related – how were you to know?
Most trainers prescribe Kegels, Pilates, breath work, spinal mobility, core activation and other standard “pelvic” centred exercises.
Fair enough. Your client is coming to you with PELVIC floor dysfunction – it’s only natural you and HER are expecting to work that area.
If you see ANY knowledge gap with anything I’ve listed above though, how about making this the year of vag change for how you treat clients with pelvic floor dysfunction?
Want to find out other ways that you can stop over-complicating pelvic floor rehab for clients?
Click here to find out more about my Your Pelvic Matters Teacher Training program where you’ll learn my systemised, simplifed approach.