Why your pelvic floor matters

Woman whispering to another woman

When you’re busy and constantly juggling work, life and living, the odd leak here and there is often put down to an occasional one-off. Let’s face it, it’s fairly easy to avoid trampolines, and pads are easy to come by if required.

Woman whispering to another woman about pelvic floorHave you chalked it down to the inevitable? That it’s ‘just being a mum’ or ‘just getting old’?

An important conversation…

I talk to lots of women in my role and with other physiotherapists in the women’s health field. It has amazed me just how many have never talked about it, yet just how many DO have symptoms of incontinence or even prolapse.

Looking at the clinical evidence, 1 in 3 women experience continence issues at some point in their lives. And as women rarely disclose this unless they’re directly asked, the true figures may be even greater.

Though it’s embarrassing, this subject is so important to address, as our bladders and bowels are as fundamental to good health and longevity as our brain and lungs.

Even though the body bravely holds up and copes on the ‘odd’ occasion, as we age the integrity of our tissues decreases, and symptoms can suddenly start to appear far more regularly, even when we are not changing our usual habits.

Moving beyond Kegels

Kegel exercises – squeezing the pelvic floor muscles – can help improve symptoms well, especially in the early days after childbirth. However, there are lots of limitations to these – not least that the pelvic floor muscles, which support the bladder and uterus, are quite difficult to access and many ladies really aren’t sure whether they are squeezing the right bits.

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Things are further complicated by the fact that the pelvic floor doesn’t act alone, and weakness elsewhere, such as in our bottoms or abdomen, or scar tissue (caesarean anyone?) can interfere with their activation and tone.

The pelvic floor can even be too strong – causing issues such as constipation, back pain, and even dryness and pain during sex. If you have religiously done Kegels and your symptoms haven’t changed, then it may be time to try something different.

What you can do for your pelvic floor?

This is tricky, as without an elaborate angling of mirrors and knowing what you are really feeling when you feel it, it’s easy to go off on a tangent. But there are some easy things you can do to narrow down your specific problem and start to tackle it.

Take stock

Do you ever leak urine during activities such as lifting, running or simply laughing? This is called stress incontinence and is the most common form of continence dysfunction. Though it’s possible to manage these ‘accidents’ socially, it can quickly reduce ladies’ fitness, bladder control and confidence if left unchecked.

Try making a note of when it happens over a couple of weeks and you will start to build a picture of how big a problem this really is for you.

How often do you have to go to the loo each day? Somewhere between five and seven times is ‘normal’, with one visit to the bathroom at night at most. If you’re going more than this, or if you realise you’ve started to reduce your fluid intake to avoid going so often, then you’re exhibiting patterns of potential ‘urgency incontinence’. This often goes hand in hand with other conditions such as recurrent thrush or urinary infections.

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Woman with Hands Holding her CrotchTake a peek

Though many ladies may balk at this suggestion, one of the most important facets of any physical rehabilitation is to improve your relationship with your body, so you feel more like a ‘team’ rather than fighting yourself through embarrassment or fear.

Some may have not wanted to look ‘down there’ since their last labour, but there is wonderous variety in what we look like, and your own is nothing to be scared of, even if it has changed over time.

On the more internal folds of tissue, you should look slightly moist and be a warm pink colour, similar to the inside of your mouth. If you are particularly pale, dry, or overly red or sore looking, these are signs that you may need some specialist guidance to restore the health of your lady bits.

Try giving a cough while you are looking at yourself in the mirror. Does anything suddenly bulge outwards as the pressure peaks? Do you even leak a little? Or does everything appear to tighten and lift? Leaking or bulging is a sign that the pelvic floor isn’t activating as well as it needs to.

Do a Kegel as you normally would. What do you see happening? Does it look like everything is pushing downwards, or lifting up? Do you notice your bottom squeezing hard, but not much else happening? Does your tummy pull in or outwards as you tense?

Correct Kegels result in a lifting of the undercarriage upwards into the pelvis. Any bulging, or tensing of the bottom or pushing out of your tummy means that your brain and the pelvic floor have a bit more communicating to do before you are nailing those sets and reps safely and correctly.

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Light at the end of the tunnel

The good news is, there really IS something you can do about it. Not just the Kegels, but simpler things – improving posture and strength, even learning how to relax.

You can re-strengthen your pelvic floor at any age, learn to manage leaky moments, ease long-held scar tissue and get back in control of your toilet habits. And there are specialists out there who can identify your individual issues and help make a plan for change.

Simply finding out what information, local specialists, contraptions and solutions there are out there may make you feel more empowered… and even perhaps more happy to talk and share your experiences. You are not alone.

About Kathryn Peden

I specialise in women's health physiotherapy – meaning pelvic, bladder, and pre and post-natal care – and musculo-skeletal physio – necks, shoulders, backs, knees etc. My goal in life is to help people overcome physical problems while developing a new understanding of and positive relationship with their bodies. I find it hugely rewarding, especially working with people who have been told or believe they 'just have to put up with it' – that's so often not the case! It's important to take the whole person, their mind and body, into account when working on pain, injury or dysfunction, as well as their work or home situations. BSc Hons, HCPC, MCSP, MPOGP