Talk about Pelvic Floor!

Diagram of Female Pelvic Floor MusclesIf you hear the words pelvic floor (PF), don’t be embarrassed or change the subject. It’s something we all need to be aware of even if you’re a man, even if you haven’t had kids or even if you’ve had a C-section.

Articles on the PF are not just for women who recently gave birth. As we all age and gravity takes its toll, the chance of incontinence issues grows. It’s not what we want to hear, but it’s true.

Even nuns have issues. The Nun Study: a study of 149 nulliparous (no children), postmenopausal nuns found that 50 per cent had urinary incontinence.

But I do do my pelvic floor exercises, I hear you cry. The question is: how do you do them? Where do you do them? And are you really doing them effectively?

If you’re a man, don’t switch off here. Andy Murray has credited Pilates and pelvic floor work as his secret to returning to tennis after back injuries.

Even if sport isn’t your thing, as men age, the prostate naturally grows putting added pressure on the bladder. If you notice a change in bladder habits and frequency, then seek medical advice. As a general rule, if you can’t hold your bladder for up to four hours, PF work can reduce your trips to the loo. Seeing a women’s health physio (ignore the name!), who specialises in the pelvic floor, can help men too.

As a physio that teaches Pilates, after having my first baby I thought getting back to doing my PF exercises would be one of the simpler tasks. After a few weeks of trying to wake these muscles up, I realised I needed a women’s health physio to assess what I was doing. Turns out I wasn’t recruiting the whole right side of my PF when contracting, due to some temporary loss of sensation. Left unchecked, this could have led to me overworking the left side, leaving a gap in the right side for a potential pelvic organ prolapse to form in later years, or after having another child. Fair to say, I found the assessment a humbling experience that took me right back to basics.

Most postnatal women in the UK are encouraged to do some PF exercises by their midwife and health visitor. In my experience though, often the anterior and posterior fibres of the PF are not isolated correctly. They teach the contractions in such a hurry that a fatigue effect occurs too quickly and so endurance is never built up.

The importance of this muscle group is so often neglected. If you built your dream house from scratch, you would learn to be patient as the foundations were laid before even one brick above ground was visible. You know that a long-lasting, durable house needs good strong foundations. It’s the same with general exercise of any kind – you need a good foundation on which to build.

Choose something in your day that prompts you to do your PF exercises. You can do them sitting in a boring meeting (don’t worry, no one will know!), on the tube or at traffic lights; before you go to sleep, breastfeeding or waiting for your computer to warm up in the morning.

No equipment is needed, apart from self discipline. So here is a good programme to give you some new ideas or to get you started:

Strength

Aim for 10 on/off holds as if you are stopping passing water. These are steady, not too fast.
Then 10 on/off holds as if stopping yourself passing wind.

Endurance

Squeeze as if you are stopping passing water and wind at the same time. Hold for 5 seconds, repeat 5 times. Over several weeks build up to holding for 15 seconds, and repeat 10 times. At first, the best position to feel this is lying down, knees bent. Progress to doing it in sitting and later standing.

Tips

Here’s the bit lots of people forget. To build true muscle endurance you need to wait between each long contraction (I suggest 10 seconds) to recover… it takes concentration to stay focussed. Also, don’t hold your breath or tighten your stomach, buttock or thigh muscles at any point.

Once you’re in the habit, keep it up! Remember to keep bracing your pelvic floor during your daily tasks or when playing sport. A strong foundation will pay off in your performance and, as a bonus, give you flatter, more toned abs.

 

Posted in Anatomy and tagged , , .

Lucy Rix

Lucy is an exceptional physiotherapist who enjoys a challenge and seeks to inform, treat and motivate each patient to achieve their goals.
Having graduated from Southampton in 2005 she started her career in the NHS working at a leading teaching hospital -University College Hospital but has been in the private sector since 2009.
She is a keen sportswoman.

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