If you have had a baby or have one one the way, no doubt the term pelvic floor has been thrown around a lot. You might be even practising some pelvic floor exercises right now!

In this blog post I want to share some less known facts about this important piece of anatomy, clarify if you need to be doing specific ‘Kegel’ type exercises and signs that might indicate pelvic floor dysfunction.

What is the Pelvic Floor?

The pelvic floor is a group of muscles and connective tissue that sits inside the pelvis, attaching to the coccyx and pubic bone.

Functions of the Pelvic Floor

1. The pelvic floor muscles are responsible for the contraction of the urethra, vagina and anal canal. Good bladder and bowel control depends on the function of this region.
2. The provide support for all the internal organs by literally helping keep internal organs inside the body. Sub-optimal functioning sometimes leads to prolapse of some kind.
3. That are part of the deep stabilising system, which includes the diaphragm, Multifidus and Transverse Abdominus. If fact, the pelvic floor and transverse abdomens are active in practically all activities in everyday life, from lifting your arms, coughing and breathing. The pelvic floor responds to the load placed upon it and never work in isolation. There is an argument that if someone is active, Kegel type exercises are not needed. This is because when we move in different directions, the pelvic floor increases and decreases in contraction depending on the demand for support. In other words, we are exercising the pelvic floor muscles all day, simply by living and more so when we are actively lifting weights.
4. They respond to breathing and changes in intra-abdominal pressure.

Signs of the Pelvic Floor Dysfunction

Muscles get strong and maintain strength through use, so definitely being active in everyday life, maintaining a healthy weight and avoiding prolonged sedentary behaviour will all help heal and strengthen the pelvic floor. But is there benefit from doing isolated pelvic floor exercises?

The short answer is yes! Especially for women who are symptomatic of pelvic floor dysfunction, pregnant or early in their postpartum recovery period. The first step would involve seeing a specialist Pelvic Floor Physiotherapist, such as the amazing team from Inner Health Physiotherapy.  Where you will most likely be given an individualise program that incorporates a mixture of isolated and integrative exercises to perform daily.

Signs of Pelvic Floor Dysfunction

• Increased urgency of urination
• Leaking urine when coughing, sneezing, laughing, exercising or otherwise exerting oneself
• Struggling to make it to the toilet in time
• Pain with intercourse or penetration
• Feeling of heaviness in the perineum
• Feeling of things coming out or falling out of the vagina
• Difficulty inserting a tampon.

Isolated Pelvic Floor Exercises

During pregnancy, it is certainly recommended doing pelvic floor exercises on a daily basis, as a way to reduce the rate of urge incontinence later in pregnancy and and in the period post birth.

A Basic Protocol

Perform three sets of eight repetitions twice per day. Aiming to hold for a maximum contraction and try and hold for at least six seconds.  There are lots of ways to ‘train’ the pelvic floor. It is best trained with a mixture of long and short holds and from a variety of different positions.

Some cueing ideas…

It is important to cue the pelvic floor with connection to breath.

Start on the inhale breath and as you flow into the exhale, ‘pick up’ the pelvic floor to engage. It is also important to understand that learning how to relax these muscles is just as important as learning how to engage them to begin with.

Here are some common cues that might help you to successfully engage your pelvic floor.

• Diamond Shape- “Imagine that you pelvic floor is a diamond shape, with each corner attached to your  pelvic. Now imagine brings these points together”.
• Elevator- “Imagine that you pelvic floor is an elevator. Starting from the ground floor, raise the elevator to up to the top of the building and back down to ground floor and then to the basement”.
• Beverage through a straw- “Imagine that you are sucking a beverage through a straw (with your vagina)”.
• Bladder is bursting- “Imagine that you urgently need to go to the toilet and that you are drawing in your pelvic floor”.
• Passing wind- “imagine that you are having tea with your Boss and you need to hold in gass”.

High Impact Exercise

There are a few scenario where optimal pelvic floor control can not be achieved. Studies tell us that the prevalence of stress urinary incontinence is increase in athletes who take part in high impact sports. It is shown that women can not perform voluntary pre contraction of the pelvic floor when taking part movements that create high intra abdominal pressure. The contraction of the pelvic floor must therefore be automatic and simultaneous. Women are therefore advised to build a firm structural base where contraction occurs naturally and without conscious thought.

If you would like to learn more about your pelvic floor and have a complimentary pelvic floor ultrasounds performed with a specialist physiotherapist, book into our FREE Pelvic Floor Workshop on Friday 1st March. Bookings are essential and space is limited to the first 8 to book. 

Date: 1 st March 

Time: 10:30-11:30am

Location: 23W, 17A Shower Street, Preston. 

Book in via our What’s On Page.