As women we’ve all heard of the pelvic floor, in fact in comparison to other muscles, most women know quite a bit about the pelvic floor – roughly where it is, what we need it for and how it can be damaged. And yet for many of us it is still quite allusive.
We all know where our abdominals are, or our biceps, mainly because of the fanfare around their aesthetics. These muscles have nicknames and are visually associated with fitness and health, so they become aspirational. With the pelvic floor there is no fanfare, it’s not sexy, no one is going to win a contest for having the strongest or the most toned pelvic floor, and to top it off it doesn’t even create a movement in the body which we can associate it with. It’s dull. For most of us, the first time we give the pelvic floor any thought is when it goes wrong, Not the best introduction and certainly not the best way to inspire us to devote time to its wellbeing and nurture it’s strength – no matter how much it might benefit us.
The problem with this mysterious persona is that when it goes wrong or stops functioning effectively we are stumped as to how to kick start it again – we can’t see it, it’s hard to feel and no one can watch us to tell if we are doing it correctly or not. It’s also a pretty intimate area and even though us women go through a lot with our bodies but we are still not great at sharing when things aren’t right!
Usually people discover they have a weak pelvic floor when they go to cough or sneeze and suffer from a small leakage of urine. This is known as stress incontinence and is usually most common during or after pregnancy or as you age and approach menopause. Fun.
I’m not sure whether its comforting or not but issues with a weekend pelvic floor are incredibly common, it’s estimated that 70% of women have experienced bladder leakage at some point and in many cases the weakness has developed to cause other issues such as lower back pain, pelvic instability and even organ prolapse. There is help available so please don’t suffer in silence, none of these issues are irreversible. In the best case try the below suggestions but if you’re still not sure seek help from a women’s health physio who will be able to test the strength and activation of your pelvic floor to ensure you are working correctly.
As I said, it is a tricky muscle to find and because there is no associated movement we can’t always be sure we are activating it correctly. I have detailed some methods for strengthening the pelvic floor below and I find best results are achieved when the below techniques are practiced in a variety of positions (sitting, standing, lying), at various times of day and with differing intensities, so mix it up, don’t only practice this in bed or whilst driving, set an alarm on your phone or sign up to an app so that you really commit to practicing at random times and in various positions. (The NHS have an app called “Squeezy”, its FAB!)
To start practicing imagine that you are in the middle of passing urine (I’d advise not to actually practice this when on the loo as it can cause infections and even issues with emptying the bladder). As you imagine this feeling, try to think how it would feel to lift the urine back into your bodyup to your belly button, try not to squeeze your belly or buttocks (a feeling of engagement in your back passage is normal). Begin by trying to hold this lift for a couple of breaths. If you are new to this, stick with these short holds for a few days, over time you can build the intensity and length of time you hold for or even practice little pulses, fast and slow releases and staggered lifts.
Progression from this would be to incorporate these exercises into other movement patterns, for example, while your walking or exercising, to practice the activation when you need it and when you are distracted.
I incorporate pelvic floor awareness and engagement into all of my programmes as a matter of course because I understand that it is such a huge issue and usually a secretive one! I’m normally only told about the problem when we have come out the other side and symptoms have improved. I’m happy to say that with consistency, a happy outcome is very common! x