Pelvic Floor problems including leakage of urine, loss of bowel control or pelvic prolapse are all too common in women, particularly during and after pregnancy.
- Around 65% of women will experience some sort of bladder leakage during or after this time, even after just one baby
- Women who have had a baby are around 3 times more likely to have incontinence as women who haven’t had a baby
Where is my pelvic floor?
The bladder and its corresponding tube, the urethra
The uterus and vagina below
The bowel finishing at the anus
These all pass through the pelvic floor muscle layers. The layers also include supporting structures such as ligaments and tissue called fascia. The muscles run from front to back and support or hold up the pelvic organs and they more or less wrap around these three openings too, so as to pull them and close them off when the muscles contract.
The pelvic floor therefore plays a very important role in:
- Maintenance of continence from both the bladder and the bowel
- Support of the internal pelvic organs such as the bladder, uterus and bowel
- Increase in sexual response during intercourse
- Working in conjunction with your abdominal and back muscles to help with stability of your spine.
Common problems with the Pelvic Floor
Sometimes the pelvic floor can become weak, or work in an abnormal way which can significantly impact on our day to day activities. Reasons why this might happen can include:
- Pregnancy (most commonly)
- Nerve irritation or damage
- Repetitive stress e.g. high impact sports, excessive coughing, constipation
- Overactivity in other muscles
- Being overweight
- Heavy lifting
The following could indicate various types of conditions such as stress urinary incontinence, urge urinary incontinence, pelvic floor weakness or possibly a prolapse.
It is important for you to know that although these symptoms are common, they are not normal, and something can be done about it!
- A need to hurry to the toilet due to fear of urinary leaking
- Urinary leaking on the way the toilet or whilst waiting for a toilet in a queue
- Sudden desire to pass urine when you know your bladder isn’t full.
- Going to the toilet more than 6 times per day or greater than 1 time at night
- Leaking of urine with a cough, sneeze, jump, laugh or change of position.
- Difficulty passing urine or emptying your bladder
- A feeling of heaviness or a bulge in the vagina
- Difficulty controlling wind or bowel movements.
What can I do? – Get ‘The Knack’!
Pelvic floor muscle training has been shown to be effective in preventing and reducing incontinence if performed effectively and frequently. Ensuring you perform exercises regularly now will help to lessen the risk of having pelvic floor weakness later. All women as a general rule, must perform pelvic floor muscle exercises regularly even if they have no symptoms.
- Lie on your side/back or sit to begin with and imagine where the muscles are
- Think about the muscles around the back side (anus) and tighten them as if to prevent passing wind. Relax.
- Tighten these again but now try to tighten the muscles around the vagina as well- think about them lifting upward toward your bellybutton. Hold for a few seconds. Relax.
- Try to tighten the anus and vagina and now the urethra- imagine that you are trying to stop passing wind and urine flow. Relax.
- A healthy pelvic floor must also be able to relax fully, so make sure that you do this between each exercise.
- Squeeze all of these area again more tightly and feel them lift up and away from your pants – start with a 5 second hold up, relax and rest completely for 10 seconds and repeat 5 times. Do this 3-6x daily.
- As you get better, hold up to 10 seconds, rest for 10 seconds then repeat up to 12 times. When confident, also add in strong quick squeezes at the final few seconds of your lift.
When you cough, sneeze, laugh, blow your nose, or lift baby or anything else, squeeze and lift up inside and also gently activate your low, deep abdominals
What NOT to do
- Stopping and starting your flow of urine every time you go to the toilet
- Tightening your muscles quickly and relaxing and doing 100’s of these per day
- Lying on the floor and lifting your pelvis and hips up and down, while flattening your back against the floor
- Sitting to do the exercises and your body moves up and down
- Squeezing your legs together
- Holding your breath when you tighten your muscles
- Tightening your tummy really hard
Retraining your pelvic floor muscles can be difficult if they are particularly weak or if you have previously learned to do these exercises incorrectly.
If you are experiencing difficulty, are unsure or feel you are not improving please book an appointment with one of our Physiotherapists who can help you further.
Women’s Waterworks – Curing Incontinence – Dr Pauline Chiarelli
Written by – Bianca Elliott (BScApp (HMS- Ex Man), MPhtySt) and Morgan Lake (B.Phty)