Q: Hey Julie! I find that now when I don’t think about engaging my pelvic floor with exertions at the gym, but still concentrate on good form that I experience very few pelvic organ prolapse symptoms. But when I overly focus on my breath/alignment/pelvic floor then I am more likely to feel symptoms. What gives?

A: Hi there! The goal of all of that initial practice and strategy-building work to retrain and create new habits is to build automaticity! Integrating it into function and fitness help the brain embed it as your new baseline, automatic and subconscious strategy, then you don’t have to spend so much conscious thought or effort on it. The strategy, coordinated action, systems and musculature have been trained. It sounds like you and your brain are there for your current level of training!  To contextualized this to a muscle folks are more familiar with… we wouldn’t keep using the same effort to perform a 10 lbs. bicep curl over time. Eventually, your bicep capacity will improve and you don’t need as much effort to lift 10lbs. We need to apply this same understanding to training the pelvic floor with it’s teammates.

Continued focus may actually become over recruitment and recreate symptoms. Your conscious efforts need to always match the demand, and as you strengthen you need less effort to meet the same demand. So this may speak to your return of prolapse symptoms. You may need to concentrate on the strategy again when you increase your weight/challenge or are trying a new skill or an old skill again for the first time.

One last thought, good form under load is generally the form that is best for recruiting your pelvic floor. Good form optimizes the availability of the pelvic floor to participate in the challenge. Couple that with the work you put in to rebuild the brain’s strategy for integrating the pelvic floor into your function and fitness…and it is ready and available when you need it! And as with any activity, monitor and modify for symptoms as you progress.

Hope that helps!

Julie

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