50 Shades of Coaching.

I was giving a talk last week to a group of personal trainers chatting about pre/postnatal exercise. Specifically, at one (…many) point in the conversation, I was talking about the pelvic floor and how I get my ladies to start thinking about the area between and within their hip bones.

I was going over the cues I use to help generate more awareness to using the pelvic muscles correctly and they are quite vivid, to say the least 😉 One of the trainers on the call said that this was like “50 Shades of Coaching”. Hilarious!

Here’s the thing, talking about the pelvic floor can seem weird at first. It did for me too. It wasn’t always old hat to talk about vaginas, bladders, and rectums all day long. But, it got normal really fast.

On the call, another trainer asked, “How do you make the conversations about the pelvic floor more comfortable?”. I love this question, for a few reasons, but mostly because the conversation is getting started more and more. The increase in quality of life that this brings to women (and their partners) is massive.  Here’s a few ways I go about breaking the ice with “the talk”:

1). Fake it ’til you make it.

You really just have to start somewhere and start speaking with confidence. Start the conversation with your client and meet them where they’re at – I’ve listed some questions I often ask at the end of this article, so stay tuned. Gauge their comfort level. Are they super resistant or do they talk openly about any issues they might be experiencing?

If it’s a client you’ve worked with for a while now you might have a close, trusting relationship and it could be easier to work through these words. If it’s a client who you’re just beginning to work with, it’s most likely that there will be a breaking of the ice process to gain trust and that is OK, too.

I like to put questions directly on my consultation form, and just flow right into that section like it’s no biggie (because, it’s not). I think getting the conversation started from Day 1 and testing the waters is really the best bet. Don’t put it off until you’re 6 weeks into training and try to work backwards. Simply explain that it is really important for you to know before your exercise programming begins as you don’t want to cause any further issues.

This is like anything and the more you talk about it, the more normal it will get. To give you some examples, this week I’ve chatted with clients about why having more orgasms can help their pelvic floor health, how to prevent haemorrhoids, and why their C-section scar could be causing clitoral pain.

And, these are  just normal conversations in my world.

2). Use anatomically correct words.

For the love of everything good, use anatomically correct words. Say vagina, bladder, uterus, rectum, anus. Personally, I don’t like to use slang – just say it as it is.

I think using proper language simply demonstrates your level of professionalism and the client will respect that. You are a health professional. Of course, once you’ve been having these conversations with your clients for many months and know their personality, slang might be fine, but in the beginning stick to the real deal.

I always tell my clients that talking about issues going on with their vagina is like talking about issues going on with your shoulder. It’s just a body part. In all honesty, there is NO difference for me. There is no TMI. Promise.

Keep reminding your client that they’re just body parts.

3). Show empathy, even if you don’t have the same body parts.

Knowing they’re not alone in stuff like this can be really cathartic for many ladies. Normalizing the discussion of leaking when you lift, run, jump, or sneeze is a great place to start by giving examples of your own experiences, other clients’ experiences, or even just things you’ve heard or read. Explain to them that this is all really common and so many other women have been through these things too.

Your ladies might not talk about issues that they’re having for a variety of reasons:

• They don’t think they are having “real” issues. They think it’s normal stuff that happens after baby and that’s just how things are going to be. Why mention it?

• They are worried and trying to down-play the severity of it. They convince themselves that it’ll just go away in time.

• They are embarrassed or are dealing with some sense of shame about their body (could just be regarding their appearance). They have never talked about this kind of stuff before and it can be really tough to start.

The fact remains that we’re often deeply disconnected from our bodies. We don’t actually know what’s happening with our pelvic floors or what that word even means. A lot of women might not know the anatomy of their body/floor, or what those parts should look or feel like.

Many women will not even talk about their pelvic floor struggles with their partners, so do keep in mind that these can be difficult things to open up about initially. Show support however you can by referring them to a pelvic floor physiotherapist, giving them a lot of confidence in their ability to heal, passing on the email address of another client who has been there/done that, etc.

Check in weekly and simply ask, “How’s the bladder working this week?”. After a set of squats you can say, “Was there any uncomfortable pressure in the pelvic floor?”.

4). Ask them to write things out for you.

I do this regularly. Especially with clients that might have a tougher time talking about these things, or, most often, with distance coaching clients for check-ins.

I ask my clients to write out what they’re feeling. The more detail the better, really, as this does affect exercise programming immensely. Especially important if they have not been to a pelvic floor physio/can’t find someone they trust in their area. Here are some typical questions I’ll ask my ladies:

• What are you feeling in your pelvis?

• Does it feel like anything’s going on with your pelvic floor muscles or have they left the building? Does it feel like you’re constantly guarding with your pelvic floor muscles and can’t let them chill out?

• What does it feels like inside the vagina? Is intercourse painful/pain-free?

• Does it feel like your uterus, bladder, and rectum are supported or more droopy than they once were?

Sometimes, I think it can be easier to internalize everything that’s going on in the body, for some people, by putting it down in writing. Encourage them to put it on paper, let it all hang out (…but, don’t) and just keep writing until all the things they’re feeling and experiencing are out (er…).

They don’t even need to show you or anyone else this stuff if they don’t want to, but at least it gets them thinking about the stuff that’s happening in their body. Perhaps they can do this monthly to give themselves a mental check-in of where things are at. And, I bet, they’ll get more comfortable with talking to you or their pelvic floor physiotherapist as they get more in tune with how their body truly feels.

I really hope that helps.

JMG