Can Pre-Contraction of the Pelvic Floor Muscles Exceed Increases in Intra-Abdominal Pressure During Strength Exercises?

introduction and hypothesisA recent study found that young power and weightlifters reported a high prevalence of pelvic floor disorders (PFDs) with urinary incontinence (UI) 50%, anal incontinence 80% and pelvic organ prolapse 23%. Performing "the knack", a voluntary pre-contraction of the pelvic floor muscles (PFMs), before and during stressful events, can prevent UI during coughing and daily activities. However, the effect of this manoeuvre has not been investigated during strenuous exercises. This study was aimed at investigating the feasibility of using the femfit® to measure intra-abdominal pressure (IAP) and PFM pressure during strength exercises and at discovering if a voluntary pre-contraction of the PFMs can exceed increases in IAP during strength exercises.

methodsThis was a short-term, cross-sectional, experimental study. Eleven participants were tested in squat, deadlift, leg press and curl up, performed in a random order with and without voluntary pre-contraction of the PFMs. Assessment of the ability to contract the PFMs was conducted by suprapubic 2D ultrasound. IAP and PFM pressure were measured with the femfit®. Wilcoxon Signed Rank Test was used to estimate differences in change between IAP and PFM pressure with and without voluntary pre-contraction during the strength exercises.

resultsNo participants reported displacement or discomfort from the femfit® device. Voluntary pre-contraction of the PFMs did not exceed the rise in IAP during squat, deadlift, leg press and curl up.

conclusionsThe PFM pressure was not significantly higher than the IAP during strength exercises. Further longitudinal studies are warranted to investigate if systematic PFM training can improve the strength of the voluntary pre-contraction.