How do I teach men about the pelvic floor?
October 17, 2009 by Leslie Braverman · 2 Comments
I need some guidance…..
It is regarding the pelvic floor and the issue of whether men and women have the same anatomy and then therefore does the contraction of the pelvic floor different between men and women and does it essentially feel different.
I guess my take/my understanding that was realistically men have pelvic floor muscles and women have pelvic floor muscles…they are relatively in the same area for men and women and ultimately function the same way but how we describe it to men might be different than how we describe it to women…I know that men have a the cremaster muscles (which women do not have, right?) but other than that, is there really that much difference……
I recently heard that men and women cannot be told to “kegel” engage their pelvic floors the same way and this just seems a bit silly to me……but maybe I am missing the mark on something…
Any clarification on this and HOW we should be explaining this to our training students would be greatly appreciated. It is a question that often comes up in training courses especially if there are men in the group….
Thanks!
Kelly Dormady
SweatShop Health Club, St Paul, MN LTC
Response from Melanie Byford-Young:
Hi Kelly!
Good question. Indeed men and women have essentially the same muscles (except for the cremaster) and those muscles do both stabilization of the pelvis and sacrum, movement of the sacrum, and closure of the orifices with the sphincter muscles. They work the same. For guys, the feeling is often said to be the same feeling as pulling up their genitals like when walking into cold water. Often the cue I use is indeed very vague ‘your abs and pelvic floor will gently draw in/lift like walking into cold water’. Make sure of course that it is gentle and hardly done with any force at all. The other visuals like ‘an elevator shaft’ can work. One thing I like is to really get to the heart of what we are doing and why; we are trying to stabilize using all of our muscles together, drawing them in towards our center, which sits just in front of the S2. So if you can get the idea that the center of gravity of the body sits just in front of the sacrum, protecting the spine is done by engaging each of the stabilizers together or having them draw in towards that center of gravity.
There are some clients who I just do not talk about the pelvic floor muscles initially because it would be too awkward and detrimental to the session. This can especially be the case if there is an older gentleman working with a younger instructor. If a client has back pain, SIJ pain, asymmetrical pain, has had prostate radiation, grips a ton in the QL or erector spinae, or has some specific pathologies, you need to determine if the pelvic floor is working effectively or not.
Let me know if this works well enough.
All the best
Melanie
Depressed Scapula!
September 11, 2009 by Leslie Braverman · Leave a Comment
| Hi All
I have a question for your website blog….
What exercises are good to help correct depressed scapula?
I attended ISP training with Melanie in 2007 and I remember she helped another instructor attending the training bring her depressed scapula more into neutral – however, I don’t recall exactly what she did.
Thanks and I love your website – lots of great information!
Connie Bruce
Rochester, MN
Response from Leslie Braverman:
Hi Connie:
Sorry it has taken me a while to get back to you; I hope you are well. I would recommend that you do exercises that help to quiet down the muscles that depress and downwardly rotate the scapula (particularly dominant rhomboids will downwardly rotate the scapula). You also want to watch that the client is not over-working their lats (which will drive the glenohumeral joint downward). So, start to wake-up the trapezius muscles and serratus anterior. Do this by giving exercises that encourage upward rotation and elevation of the scapula and minimize the over-use of rhomboids and lats. Then, re-educate the clients movements in order to achieve good balance of all the scapular muscles in a neutral position, making sure mid and lower trapezius are working to place the scapula centered rather than in downward rotation or depression. In addition, you want to encourage the client to set their glenohumeral joint by using their rotator cuff muscles rather than over-empasizing the connection with lats. Exercises that may help: Side-lying overhead push-thru: Lay the client on his side with his hand on the push-thru bar. Then have him push the bar overhead, watch that he is creating upward rotation and elevation with the scapula. He or she may feel a big stretch on the lats. Help he or she guide the movement of the scapula. Superman: Lay prone on a box facing the footbar on the reformer. The bar will be down one rung from the top with 1 spring. Have the student push the bar away using his scapula to create the movement. Watch that he is getting pure elevation and upward rotation rather than protraction and the thoracic and lumbar spine stay stable. Make sure the glenohumeral joint stays centered and doesn’t drop forward during the movement. Salute on Reformer and/or with Cadillac Springs: This is a great way to work on getting upward rotation of scapula.
Mermaid: Work on the patterning of bringing the arm overhead and watch that he or she is not depressing or downwardly rotating the scapula to initiate the movement- again, you may need to guide that movement for the student- encourage upward rotation of the scapula during the movement. If he or she has been over-working rhomboids or lats there may be a lot of resistance on the scapula. Rotation prone on chair: Side arm preps on reformer: Push-up on the wall: Remember, always watch that the head is staying centered over the spine and not going into forward head posture during all the exercises listed above. I hope this helps! There are hundreds of others that you could do, but I hope these give you a good foundation to be more creative with the other exercises you know. Also, Melanie will be doing a 3 day upper extremity workshop on September 17-19, 2010 (we haven’t even announced it yet) that you may be interested in participating in. This may be a great hands on workshop for you to learn how to work better with shoulder, scapula and cervical spine. Take Care, Leslie Response from Connie:
Leslie
Thank you so much for the response! It is a HUGE help.
I have only been teaching pilates for 2 years and am still grasping the depth of the exercises.
I would love to take Melanie’s workshop – unfortunately, I am in Rochester, MN
 and can’t make it.My significant other’s brother lives in Portland and I am pushing to go visit him and his family – so I can visit your studio for some mat/reformer classes.
 Again, thank you, thank you, thank you for taking the time to respond to my email and provide me with such detailed information.
Hopefully I will get to meet you someday.
Connie
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