Exercises that harm the perineum area and expose you to urinary leakage

Certain movements and positions offend the perineum, the group of muscles that provide support to the pelvic organs. An overview of pitfalls to avoid.

By focusing on drawing a silhouette in the gym, we’re almost forgetting an area of ​​deeper and unexpected strength: the perineum. This group of muscles is located between the pubis and the anus, yet it plays an important role in supporting all of the pelvic organs. Despite this, she remains very neglected during the efforts, as dismayed by Carol Maitre, MD, an ob-gyn at the National Institute for Sport, Experience, and Performance (Insep). “The perineum weakens with pregnancy and then again around the time of menopause, but exercise can also reveal and increase weakness,” she recalls. Among the harmful consequences of this loss of tone, there are two major female panic attacks: urine leakage and organ descent. To prevent this, the doctor and two physiotherapists give us a list of the most common mistakes made during our training sessions.

Abdominal belt pressure

While searching for exercises to tone your belly button and improve your posture, you have surely come across videos of breast lifts (also called “chest lifts”).crunches”), and on its differences. Know that these exercises are not friendly to your perineum. “When we bring the shoulders closer to the pelvis, we inflate the abdomen and increase intra-abdominal pressure. As a result, we put more pressure on the organs, which leads to flattening of the perineum. Then the muscle tissue of the latter swells and leaves more space for the urinary tract,” summarizes gynecologist Carol Maitre.

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If it is desirable to avoid bending too much forward during exertion, the reverse is also not recommended. “Some sports like rowing involve bending back a lot. This will accentuate the arch in the lower back and this pressure will also affect the perineum area,” says the gynecologist.

Following this reasoning, the specialist also advises swimming enthusiasts not to focus primarily on breaststroke movements because this swimming is known to tire the lower back.

Use heavy weights

Lifting dumbbells helps increase the size of the muscles in the arms, shoulders or chest, but sometimes the movement is not always done correctly. “The most common mistake is forgetting to tuck in your belly and forgetting to contract your perineum when pushing. However, if this isn’t done, we find ourselves again in a pattern of excessive pressure,” notes Carol Maitre.

However, in practice, this shrinkage can be difficult to maintain over time. “You can contract your perineum over one or two chains but not more than 20. After a while, he gets tired and can’t make that effort, especially if he’s forced into a load that’s too heavy for our physiology.” Sandrine Galiak Al-Anbari, Physiotherapist in Perineal Rehabilitation, confirms (1).

Focus on ground-impact sports

Handball, basketball, running, cardio training or even Zumba are the so-called “impact” sports that combine, as the name suggests, the impact of the foot on the ground and rapid movements. “When running, the effect of gravity is more felt. By pressing the foot on the ground, the force of the impact in the legs rises to the perineum, which somehow absorbs the shock,” says gynecologist Carol Maitre. Sandrine Galiak Al-Anbari adds, by applying pressure in this way, you are more prone to incontinence problems and this is emphasized a lot by running.

The swallowed mileage is not only responsible for this pressure on the perineum, but also the intensity of movement. “This is the case during a serve in tennis where we will very quickly extend play, followed by a fast forward start,” the gynecologist stated.

trampoline abuse

In recent years, mini trampolines have been used in fitness classes to work the core and lower body muscles. However, this is the pet peeve of the perineum, confirmed by physiotherapist Sandrine Galiak Al-Anbari. Scientific studies consider it the most harmful activity of this area, because intense and regular rebounds will act as a rebound on the internal organs. After a while, the perineum will no longer be able to absorb the shock.”

What do you do in prevention?

None of these sports and movements are contraindicated. It is still possible to walk on asphalt, push a barbell or race on a HIIT circuit, provided a few ground rules are respected. First, we stop forcing ourselves to contact the perineum during exercise. Sabrina Vagau, physiotherapist, osteopath and author of We trust the perineum(2).

Then, in parallel with the exercise, the physiotherapist recommends wrapping sessions, for example on a ball. Fellow Sandrine Galiak Al-Anbari promotes gentle yoga poses, such as tree poses or small bridge poses. “To better rehabilitate him, the perineum must be placed on an unstable plane, assures Sabrina Vagau. Thus, he is taught to act spontaneously in the event of a defect.

Finally, in the event of discomfort or pain in the lower abdomen or urine leakage during activity, specialists seriously recommend consulting a health professional (physiotherapist, midwife, or physician) for a perineal evaluation.

(1) Female perineal rehabilitationby Sandrine Galiak Al-Anbari, published by Danod, 320 pages, €29.
(2) We trust the perineumby Sabrina Vagau, first published, 192 pages, €16.95.

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