In Conversation With Ayelet Gottesman
Personal trainer and women's health coach, on building real strength on a pelvic floor that can actually hold it.
What this conversation covers.
Everything below is Ayelet describing her own work, in her own words. Personal training is not a service Wellsprings Health provides.
At six weeks postpartum with her second she was checked, told she was good to go, run or jump rope if she liked, and she went back to kickboxing. She describes what followed as opening up her diastasis recti, along with pain during sex and discomfort using the bathroom.
The point of strength training, she says, is to build the body. But if the pelvic floor is dealing with dysfunction and you train straight past it, you are building on a shaky foundation and can end up worse off than when you started.
Every new client fills in a pelvic floor intake that screens for what she should not be handling. Some things are out of her scope, and some she will not touch until a therapist gives a green light, because they only show up on an internal assessment, which she does not do.
She treats this as a real concern, not a silly one, because she had it herself. Dr. Leslie's reply: muscle is compact, and given typical testosterone levels in women, getting bulky tends to be somebody's full time occupation. Ayelet is more interested in bone density heading into menopause.
For someone starting out she suggests at least three sessions a week, split upper body, lower body and full body, with a shorter fourth once they progress. Her pregnancy and postpartum sessions run differently: about thirty minutes of breathing and core work, then thirty minutes of strength and corrective exercise.
Who Ayelet is, and where to find her.
Ayelet Gottesman is a certified personal trainer and women's health coach, and a mother of three boys. Her work sits with pre and postnatal fitness, perimenopause and menopause, PCOS, corrective exercise and strength training. She came to it because she could not find the help she needed after her own second baby. Dr. Leslie refers to her, and Ayelet refers back.
Ayelet did not give a business address on camera, so we are not going to invent one. Dr. Leslie includes her links in the video description. This is a referral, not a promise about any result. Watch the full conversation on the clinic's YouTube channel. What we do at Wellsprings:
Three things worth taking from it.
Cleared is not the same as ready
Ayelet's own six week checkup is the whole argument. Being told you are good to go is a statement about healing, not a plan for loading. If you are heading back into training after a baby, get the pelvic floor looked at first. Florida is a direct access state.
Three sessions a week is the starting line
Her recommendation for a beginner is three resistance sessions a week, split upper body, lower body and full body, with the time it takes less interesting to her than the effort. That is smaller than most people picture.
Treat the small symptom as the opening
The reframe she keeps coming back to: a small leak is not a verdict, it is a reason to look at everything else while you are here. Glutes, back, the whole posterior chain, bone density, balance. The symptom got you in the door.
We were taught biology, but we weren't taught about our bodies.
What we actually treat here.
Urinary Urgency
The small leak on a jump or a sneeze, and the sudden signal that will not wait. Trainable, not permanent.
Coccydynia
Tailbone pain that rules out the floor, the bench and the car seat.
TMJ and TMD
Jaw pain and clenching that shows up under load and at night. Jaw and pelvic floor brace together.