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Episode 20: Pelvic Floor In-Depth with Stephanie Prendergast, MPT

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In this episode, Sarah interviews Pelvic Floor Physical Therapist Stephanie Predergast, co-founder of the Pelvic Health and Rehabilitation Center, about everything and anything pelvic floor related. Stephanie also answers your questions from Instagram! Here’s what we cover:

  • Understanding the mechanics and function of the pelvic floor and how it’s different than other muscles in the body
  • Why strengthening your pelvic floor is not always the goal and how it might make your incontinence symptoms worse
  • The difference between stress incontinence and urge incontinence
  • Why dyspurnia (painful sex) and vulvodynia (vulvar pain) are treatable but might get misdiagnosed as an ‘incurable disease’
  • When pelvic floor muscular dysfunction gets misdiagnosed as a UTI, depending on which kind of practitioner you see
  • The efficacy and safety of hormone therapy for menopause symptoms according to NAMS (North American Menopause Society) 
  • What is GSM (Genitourinary Symptoms of Menopause) and how is it treatable
  • Pelvic floor concerns for people with male genitalia, a chronically underserved population
  • Why people with low back or hip pain very often have an underlying pelvic floor issue
  • What are some signs that a movement teacher can look out for with their clients to indicate they may need to see a pelvic floor specialist (and a screening questionnaire included below)
  • What is the female pelvic triad and how teenage athletes may need help 

 

Reference links:

As the Pelvis Turns Newsletter

NAMS position paper on hormone therapy

Pique Health  for online care for pelvic floor and sexual health 

Poise Impressa for incontinence support

Speax by Thinx for incontinence support

Quick Screen for pelvic floor PT

PHRC YouTube page

Pelvic Health and Rehabilitation Center (they’re hiring PTs!)

Sign up here for the Movement Logic Newsletter for course discounts and sales and receive a free mini Pelvic Floor course!

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Program design in the bulk of personal training an Program design in the bulk of personal training and it’s not something yoga or Pilates teachers have familiarity w (unless they resistance train!)

Interestingly, of the 2 components of resistance training—exercise selection and program design—experienced yoga and Pilates teachers DO tend to have a knack for exercise selection.

They’re in touch with the fact that training with certain exercises will prepare people for certain goals better than others (and they can tell you why.)

This is because experienced yoga and Pilates teachers have logged a ton of hours watching lots of people move in a wide (much wider than strength training!) number of ways. They have a strong, learned intuition for human movement.

So the gap, then, when yoga and Pilates teachers wanna start training their people with weights often comes down to program design and their knowledge gap for how to coach students around how much weight, reps and sets, and workouts/week.

Whereas exercise selection is something you can sit on your couch and accomplish in minutes—like writing a sequence!

Program design is THE MAP for how to overload strength within the exercises selected. It unfolds slowly over weeks and months.

And, importantly, this is literally WHEN and HOW progressive overload is applied.

Program design is something you build WITH the people you’re training long term. It’s responsive. 

Because program design involves a longer time course, this model doesn’t fit a group fitness format—students popping in sometimes, often to a totally different selection of exercises—it’s not only not something yoga and Pilates teachers learn, it doesn’t fit their business model.

But here’s the deal. You don’t need to get a personal trainer cert to learn this. Sharp, embodied learners can pick it up by experiencing it. You can effectively coach people on how to build strength bc you’ve got a bunch of teaching experience already and you’ve gone through this process (using progressive overload) to get strong yourself.

The best way to learn about strength training is to get strong by following a program.

Interested in a way you can do this this year with me? Check the comments!
👋Sarah here! This is my home office, it measure 👋Sarah here! This is my home office, it measures 8 x12 feet, so you can see it’s not a huge space!
 
❌Before I got the portable rack I thought there was no room in my house to have a barbell, but I was wrong.
 
 ✅I’m able to set up my rack and barbell and do my lifts no problem in here.
 
It’s also sturdy enough to hold the bar and plates for my back squats, and I also love that I don’t have to mess around with adjusting the height since it’s set up for me.
 
The rack is portable since it is 2 pieces, which means I can put it in the closet when I’m done with it. The plates also live in my closet, and I lean the bar up against the corner of the room.
 
Here’s what it looks like in here when I’m lifting – so you really don’t need a lot of space for your equipment at home.

✅✅✅Wanna take a live lifting class on Zoom with me and @laurelbeversdorf? 

🔗🔗🔗Sign up at the link in bio for our FREE Strength Class on September 14th at 10am PST / 1pm EST.
The Movement Logic podcast team is prepping to rec The Movement Logic podcast team is prepping to record season 3! Got a topic you’d like us to discuss? Drop it in the comments below👇

Also, a sincere thank you to listeners who’ve left us reviews. It helps us out more than you know! We’re very happy you are benefiting from the conversations. 🙏
Let’s be honest... is your upper body suffering Let’s be honest... is your upper body suffering from biceps-and-triceps disease?

(i.e., you do biceps and triceps, and then call it a day.)

Here’s the thing: biceps curls and triceps extensions can be good accessory exercises for working on certain movements. For example, biceps curls are great as part of your training to do a pull up.

But on their own, they’re not especially functional, because they are one-joint exercises (meaning it’s just your elbow that’s flexing and extending) and they’re not ideal for building bone density.

A better option? Why, our friend the bench press! 
 
The bench press includes that elbow flexion and extension, as well as a horizontal press that strengthens the shoulders and chest and preps you for your planks and push-ups.
And while we’re talking bone density (we’re always talking bone density) one of the common areas of osteoporosis is the wrist, so loading your whole upper body in one go could be both a timesaver and a bone builder, with heavy enough weight.
 
If this sounds like something you could sink your teeth into, then you want to get our new FREE Bone Density Mini Course: Barbell 101.
 
This 4-day mini course dives into form, technique, and the basic principles for building up to your 5RM lift. And in case you’re wondering - what the heck is a 5RM lift?!? - we’ll cover that too.

So sign up at the link in bio for our FREE Bone Density Mini Course: Barbell 101 and get a new set of videos dropped into your inbox daily!
 
Don’t have a barbell? No worries. You’ll still get some knowledge bombs from this mini course. ;-)
Laurel (L) and Sarah (R) are showing 2 ways to str Laurel (L) and Sarah (R) are showing 2 ways to strength train.

Laurel lifts a moderate load (for her) and does 3 sets of 10.

Sarah builds up to lifting a heavy load (for her), beginning with a light load and 10 easy reps to dial in her form. Then she adds plates and does 4 reps at about 75% of her working load. Then she adds plates to get her “working load” (the heavy one!) and does 5 reps.

From there, Sarah would rest, and then proceed to do 2-4 more sets of 5 with that weight.

In the end, Laurel will have done 30 total reps (3x10) with a moderate load.

Sarah will have done 2 warm up sets, and then 3-5 working sets for a total of 15-25 reps (3-5x5) of that heavy load.

For Sarah, every single rep is stimulating.

For Laurel, only the last 5 reps of each set are stimulating.

In total, if Sarah does 3 working sets, she will have gotten the same number of stimulating reps as Laurel, however because she’s lifting heavy she will get benefits Laurel doesn’t.

Here are a few:

💪Improvements to maximum strength
💪Improvement to bone density 
💪Improvement to tendon stiffness (think, stronger tendons more resistant to injury)
💪Load specific balance (think NOT losing your balance when lifting a heavy load like tantruming 5 year old, a big dog, or a big bag of garden dirt.)

Sarah didn’t just start with her working load like Laurel did, though. She did some warm up sets.

Warm up sets are a wake up call to your brain that prep it to send big signals to your muscles.

Warm up sets are not necessary with moderate loads (although you could certainly do them).

Chances are, if you’ve been strength training, you’ve been working more in the 3 sets of 10 range, aka, you’ve been lifting moderate loads.

Wanna learn how to lift the way Sarah demonstrates, as well as how to select the appropriate  weights to build up with?

 If so, check out our FREE Bone Density Mini Course: Barbell 101.

You do NOT need to have barbells OR be an experienced lifter to benefit from this FREE course.

Learn the BASICS around lifting heavy with barbells.

This mini course is only avail through July 9th!

LINK IN BIO 👀
I got a hot PINK barbell and I love it! This “w I got a hot PINK barbell and I love it!

This “women’s” Olympic bar is so much better than my “men’s” bar for deadlifts (for me) because the bar diameter is 25mm wide rather than 28mm.

Did you know that a difference of 3 millimeters in diameter can make a HUGE difference in how strong your grip feels (and the whole exercise feels)?

Women’s hands tend to be smaller than men’s hands, women tend to benefit from a smaller diameter bar especially for exercises that require pulling, like the deadlift. 

However, it really depends on *comfort* which largely probably depends on hand size (women can have bigger hands and men can have smaller ones) and so the term “women’s” or “men’s” is another example of how gendering objects creates obstacles to understanding their use.

Meanwhile, when you go to a gym, they often don’t have 25mm options, only 28mm options. 🙄 

The question of why more women (especially older women) don’t lift barbells is complex. We cannot simply look to individual preference to understand why. We should look at how society communicates to women what they should and shouldn’t be doing with their bodies. Subtle or obvious messaging that women don’t belong in the weight room (and certainly not lifting barbells) is rampant.

Which is why @sarahcourtdpt and I are sending a different signal to cut through this noise.

Lifting heavy improves strength, bone density, AND balance. Women who lift heavy weights are less likely to experience life-shortening and life-ending fractures as a result.

Barbells are the SIMPLEST and BEST piece of equipment to lift heavy and build functional strength FOR LIFE.

If you’re concerned about bone density/muscle atrophy/balance/falling/all of the above
 
Get our new FREE Bone Density Mini Course: Barbell 101
 
This 4-day series of videos will give you everything you need to perform the deadlift, back squat, and chest press with a barbell, and teach you how to figure out how to build up to lifting heavy weight safely. You’ll also get a barbell equipment guide if you want some for your home.
 
LINK IN BIO 👀
Red-faced, eyes bulging, muscles straining, aneury Red-faced, eyes bulging, muscles straining, aneurysm-inducing… is this what you think lifting heavy weights looks like?

The reality couldn’t be farther from the truth.

Lifting heavy weights requires a lot more down time between lifts than you might be used to (upwards of 5 minutes, depending on how heavy you’re lifting), which means time to water your plant, pet your cat, and take a sip of coffee…
 
If your current weight workout is only dumbbells and kettlebells
 
AND
 
You’re concerned about bone density/muscle atrophy/balance/falling/all of the above
 
You want to get our new FREE Bone Density Mini Course: Barbell 101 (link in bio to get it!)
 
This 4-day series of videos will give you everything you need to perform the deadlift, back squat, and chest press with a barbell, and teach you how to figure out the right weight to get to your 5RM (aka Pretty. Heavy. Lifting). 
 
This mini course dives into form, technique, and the basic principles for building up to your 5RM lift, including instruction on how much rest time you need (and why). And in case you’re wondering - what the heck is a 5RM lift?!? - we’ll cover that too.

So sign up at the link in bio for our FREE Bone Density Mini Course: Barbell 101 (https://movementlogictutorials.com/bone-density-mini-course/)
 and get a new set of videos dropped into your inbox daily!
Don’t like false advertising? Me neither. Overw Don’t like false advertising? Me neither.

Overwhelmingly the people practicing yoga are women and osteopeorosis affects 1 in 5 women over 50.

These people should be encouraged to do resistance training to build bone, not yoga.

They certainly shouldn’t be mislead to believe that yoga is all they need for strong bones.

Ahimsa ring a bell? 

Heavy strength training builds bone. The best tool for that is barbells. If you’ve been curious about barbells, then @movementlogictutorials and I have a FREE equipment guide for you via the link in our bio. 👀
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