Pelvic Floor

 

Information in this section has been provided by Moira Clark, an experienced, specialist prenatal/pregnancy and postnatal Pilates and exercise instructor.

What is my Pelvic Floor?

This is a sling of muscles and connective tissue forming a support structure for the organs in your pelvis that are the bladder, uterus and bowel. This structure helps to maintain continence until the body is ready to empty the bladder and/or the bowel. It also has a role in maintaining good posture and the breathing mechanism.

Men have a Pelvic Floor too.

What happens if this structure weakens?

Pelvic Floor weakness happens for a variety of reasons including inherited factors, excess body weight, poor posture, trauma, ageing and child-bearing. All women are vulnerable. There may be a link with back and/or pelvic pain

Any structural weakness can lead to:

  • Stress incontinence - involuntary urine leakage on physical exertion
  • Urge incontinence - a sudden and uncontrollable desire to empty the bladder
  • Anal incontinence inability to control the bowel
  • Prolapse a descent of one or more pelvic organs

What happens in pregnancy?

In pregnancy the bodys support structure is weaker; posture changes and weight increases. The body is therefore more vulnerable to Pelvic Floor weakness and poor function. It is now thought that many problems may be set up during pregnancy and not caused by the birth process alone. It is a myth that birth by Caesarean section may keep the Pelvic Floor structure strong.

Why is exercise important for the Pelvic Floor structure?

For a structure to stay strong it needs to be used correctly. Improving posture, keeping weight within normal range, improving diet and maintaining healthy hydration levels will all help. Activity/exercise choice should be such that good posture and technique can be maintained at all times; this will help the Pelvic Floor contribute correctly to good physical function.

Exercise involving impact such as running or jumping, rapid and uncontrolled twisting, or sit up type exercises are unlikely to be helpful. It is not safe to assume that disciplines such as Pilates or Yoga will be helpful for all Pelvic Floor problems.

The majority of urine leakage problems can be improved or managed with regular, specific Pelvic Floor exercises.

Other Pelvic Floor problems should be discussed with a GP or Physiotherapist in Womens Health.

What specific exercises will keep my Pelvic Floor healthy?

In good posture, sitting or standing, try to stop yourself passing urine and wind at the same time. Now lift higher up inside. This is the feeling you are aiming for. Your ribcage, tummy and bottom muscles should remain relaxed and you should still be able to breathe.

Practice this lift, as firmly and strongly as you can, in one swift lifting movement. Relax down slowly. This is a fast hold. Do this up to 8 times.

Now lift up inside and aim to hold as strongly as you can for a few seconds. Remember to keep breathing. See how long you can hold - up to 10 seconds. Most women will manage a shorter hold, so dont worry if you cant hold for a full 10 seconds. This is a slow hold.Do this up to 8 times.

Aim to do 1 set of 8 fast holds plus 1 set of 8 slow holds every day. It will help if you do this at the same time every day to establish a habit.

Aim for quality of hold, maintaining the strength of the contraction, rather than quantity of repetition. There must always be a contraction remaining when you release.

The best place to do these is standing up or seated in good posture. Sitting in the car is not effective.

Add 2 more sets every day, making a total of 3 sets, as you establish the routine.

You will need to continue these exercises for the rest of your life to reduce the risk of problems later in life.

After the birth of your baby you may find that, because of reduced feeling in the Pelvic Floor area, the fast hold exercise is more useful for the first few weeks. As feeing returns add the slow holds. If you find that you have problems with loss of urine, bowel incontinence or a heavy feeling in your pelvis after a few weeks post birth, ask your GP for a referral to a specialist physiotherapist in womens health.